The CPD/CE credits awarded can be used towards your declaration to any governing regulatory body in your state or country, provided the content is relevant to your discipline.
Pain Management is a key battleground the 21st Century Opioid Epidemic
A history of mental illness and/or substance abuse is an established risk factor for opioid addiction; the clients we see in our practices every day are already susceptible to the trap of opioid dependency. With reports of opioid related addictions and deaths on the rise, doctors and their patients are actively searching for alternative ways to manage pain. Due to our training in the assessment and treatment of mental illnesses and addictions, behavioral health professionals are uniquely poised to battle opioid addiction by helping clients to learn to manage their chronic pain without pills. However, many of us feel that we don’t have enough training or current information to face the very real challenges of treating clients who are experiencing chronic pain.
With over 30 years of practical experience in the treatment of pain, Dr. Robert Umlauf can help you prepare for effective practice with clients who are at risk of or already in the trap of opioid addiction. He will lead you into a deeper expansion of skills you may already possess to assess neurophysiological, cognitive, emotional, and behavioral factors involved in the development of chronic pain syndrome. You will learn to use specific self-regulation and behavioral activation skills that can help any client manage pain better. And you will leave with the ability to immediately apply these skills in your practice. Dr. Umlauf will also present a wealth of information about new medical research, alternative medicines, and the effects of diet and nutrition along with evidence to support treatments that are effective. Dr. Umlauf employs highly interactive, hands-on experiences in teaching multidisciplinary approaches to pain management.
- Describe the common history and physical findings that often predispose someone to a chronic pain syndrome.
- Identify common neurophysiological factors in the experience of pain and pain behaviors.
- Define the 3 major categories of pain and differential diagnoses in pain populations.
- List 5 or 6 specific techniques that help clients reduce pain and suffering.
- Describe 4 non-drug or alternative treatments that have evidence-based support for treating pain.
- Define specific recommendations for Diet & supplement support, as it relates to persons with pain.
Course Content OUTLINE:
CHRONIC PAIN: NEUROPHYSIOLOGICAL FACTORS, EXPERIENCES, and PAIN BEHAVIORS (45 minutes)
• How time from onset, and type of pain play a role
• Pain Egg and nociception (Loeser’s model)
• Psychophysiology of pain as a PERCEPTION
• Smoke Alarm metaphor: acute vs. chronic pain
• Autonomic systems and power of retraining
• Pain vs. Suffering (Fordyce)
• Historical predictors of developing chronic pain syndromes (trauma/abuse, ACES studies, depression, etc.)
PAIN CLINICS AND OPIATE USE IN THE USA (45 minutes)
• Pain Clinic History and shift towards increase in opiate prescribing.
• What influences the drive toward increased prescribing?
• CDC Guidelines on Opioid prescribing
• Opiate overdose deaths and addiction (Surgeon General’s report 2016)
• Screening tools for opiate abuse potential (SOAPP, etc.)
PSYCHOLOGICAL ASSESSMENT IN PAIN POPULATIONS INCLUDING DIFFERENTIAL DIAGNOSES: LIMITS AND CONCERNS (60 minutes)
• Use of tests and their limits.
– Additional tests
• Intake interview components
• Primary Care coordination: Strategy for collaboration with other professionals
• Tools to assess and treat mental processes that exacerbate pain
INTERVENTIONS: TALK THERAPY IS NOT ENOUGH: PAIN PATIENTS NEED SKILLS
• Manage mood & set goals by adapting:
• Educate: “Harm Alarm” retrain perceptions
• Self-regulation: Including mindfulness
• Biofeedback: simple techniques ANYONE can use
• Cognitive Reframes for Pain Management: Including catastrophe assessment & scale
• PACE: Including behavioral monitor and tracking scales for self-regulation
• Motivational Interviewing: Adaptations for chronic pain treatment
• Heal the past: Sarno’s model (Psychodynamic)
– Behavioral tools
– Sleep hygiene
– Sleep restriction,
– Environmental factors
• Apps for Pain Management
INTEGRATIVE OPTIONS (45 min)
• Alternative/Integrative Medicine
• Recent medical advances in pain treatment
• Psychotropics & Antidepressants
– SNRI’s: first line
– Low-dose TCA’s and sleep: be careful!
– Avoid the Benzo’s!
• Nutrition, Diet and Supplements: evidence based suggestions
– Glucosamine/Chondroitin: Brand matters, and most don’t work
– Sugar and Flour: inflammation is key in pain
– Anti-inflammatories: Ginger, Turmeric, Watermelon, etc.
– Healthy fats & ketogenic diets: evidence of relief
– Sleep aids: Lemon Balm, Valerian & Melatonin
• Acupuncture: NIH consensus conference data
– Provider skill is a major factor in outcomes
– MRI data and common pathways for healing
• Hands on Options
– Physical Therapy, Exercise and Rehabilitation
– Chiropractic, Osteopathy and Manipulation therapies
– Massage, Deep Tissue therapies
– Other modalities: Rolfing, Craniosacral, Myofascial Release, Dry needle, etc.
PRACTICE TIME! (45 min)
• Pick a skill and try it out
• Biofeedback lab: see what you can do
• Challenge that catastrophic pain belief: pair up & practice
Who Should Attend:
– Licensed Professional Counselors
– Social Workers
– Marriage and Family Therapists
– Alcoholism and Drug Abuse Counselors
– Psychiatric Nurses
– Primary Care Providers
– Case Managers
– Pastoral Counselors