The role of mental health professionals in multidisciplinary pain rehabilitation programs

Abstract

The traditional roles of psychologists and mental health therapists are challenged by the comprehensive treatment necessary for patients being treated in multidisciplinary pain rehabilitation programs (MPRPs). Mental health professionals within MPRPs provide direct clinical care but also guide the biopsychosocial model of pain management and cognitive-behavioral interventions for multiple disciplines. Illustrated by a case example of a patient who has complex chronic pain, this article discusses the biopsychosocial approach to pain treatment, structure of multidisciplinary care, major roles of mental health professionals in MPRPs, complexities of treating patients who have pain, and challenges in collaborating with multiple disciplines.

Bariatric Surgery Patients’ Response to a Chronic Pain Rehabilitation Program

“…Among daily opioid users, the mean morphine equivalent dose at PRC admission was 127.3 mg in bariatric CP patients, which was 44 % higher than that of non-bariatric CP patients and approximately twice that of CP patients in previous cohorts [7,[14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. Although the primary pain sites reported by bariatric patients were back, fibromyalgia, and headache pain, the higher morphine equivalent dose in the bariatric CP patients appeared to be largely driven by the subset who had undergone open procedures or revisions as compared to laparoscopic procedures.…”

“…Four of 12 subscales were used: pain severity, life interference due to pain, perceived life control, and affective distress [2,16,17]. Lower scores on the pain severity, life interference due to pain, and affective distress subscales signify less impairment, whereas the opposite is true for the perceived life control subscale.…”

“…Five of eight subscales were used: general health, physical functioning, role physical, role emotional, and social functioning [2,16,17]. For all subscales, higher scores indicate better health status.…”

“…Tapering off of opioids is an established goal of the program [2,[17][18][19]. Thus, information on opioid use (yes/no) and morphine equivalent dose was collected for all patients at admission and discharge and determined by a combination of patient self-report and review of pharmacy records [18].…”

Multidisciplinary approaches to the treatment of chronic pain: current situation and outlook

“…En effet, les patients arrivant dans les structures douleur ont le plus souvent connu un long parcours de soins somatiques où consultations et analyses invasives se sont succédé sans résultat [16], avec des conséquences en termes de coût de santé publique [16,33]. Cette errance en médecine somatique s'explique en grande partie par le fonctionnement de ces patients dans la pensée concrète et opératoire, qui les rend peu disposés à envisager spontanément la dimension psychique de leur douleur [1,15].…”