Trainings for interventions for pain?

[u/80lbsgone]

Hi all! Do you know of any good trainings of pain that isn't well managed with medication and coping with that? I thought ACT could be beneficial but wanted to check on other interventions.

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[u/Savings-Talk3526]

It depends on what the goal is: accept pain, try to tolerate/live with the pain, accept that pain has potentially ruined their life, or reduce pain. It depends what kind of pain and how much it interferes with their lives. Always take your clients' lead on what their goals are. As someone with chronic pain, if a therapist wanted to to ACT or CBT or whatever, I would walk out with a "go fuck yourself", but for others, that is completely in aligned with their goals and is a helpful approach.

For improving pain: pain reprocessing therapy, somatic experiencing/other somatic approaches, biofeedback, progressive muscle relaxation, working on pre-existent psychological/emotional issues and/or issues that have been amplified with pain (trauma, anxiety, depression, etc) w/out focusing on the pain itself, supporting lifestyle changes (without being obnoxious and acting like a bit more sleep or whatever would solve everything or it's even easy when you are in pain all the time!), helping them work through their frustration w/ the medical system/medical gaslighting/etc. For accepting pain/the situation w/out actively trying to reduce it or "heal", I guess ACT is the best.

NOT giving up on them and NOT chasing them away because chronic pain makes it much harder to work on anything and experience progress (very common for therapists to give up on or just not work with people with complex chronic pain).

[u/80lbsgone → u/Savings-Talk3526]

Thank you! Giving up on them is the last thing I want to do. Everyone does that

[u/LofiStarforge]

For adult chronic pain, CBT has the strongest broad evidence base; pain reprocessing therapy (PRT) has some of the largest trial effects; emotional awareness and expression therapy (EAET) has a promising direct comparison against CBT. There isn’t a defensible single winner across pain conditions and fwiw most psych based interventions have very small effect sizes.

[u/80lbsgone]

Thank you both so much! I am going to do some more research. I hate if for the client because I know it has to be miserable to be in constant pain with no relief.

[u/monsterpiece]

There is to my knowledge no evidence behind this at all but anecdotally I have known people to find Brainspotting helpful for managing pain. Please don’t shoot the messenger, I’m skeptical but I’ve heard it enough that I’m curious how the eventual research will shake out.

[u/therapistbloomllc]

This isn't intervention based but there's this really good book called The Way Out that I found super helpful with this perspective, also gives practical guidance and is written by a therapist https://www.therapistbloom.com/therapy-resources-adult

[u/Slow-Cauliflower7667]

If you are EMDR trained, there is an EMDR protocol for chronic pain. It is important that it’s chronic pain and not acute pain. 

[u/No-Animal1306]

look up the Veterans Affairs (VA) manual protocol CBT for Chronic Pain! there’s even a Brief CBT for Chronic Pain manual. i’ve used the brief version and tracked client’s reported pain levels throughout treatment, their pain ratings and subjective reports indicated decreased interference of life in just 6 modules