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Transcending Stigma Through a Biopsychosocial Approach to Chronic Pain Management

PAINWeek 2019 Scholarship Winning Essay

A sad litany of phrases has become commonplace when listening to those who have chronic pain: “No one believes me,” “They told me it was all in my head,” “They will just act like all I want is meds.” As an occupational therapy practitioner who works at a multidisciplinary pain management center, I hear these words often from the patients I work with; many times the patient is discussing treatment encountered at other facilities from healthcare workers. Other times these statements are about family or friends. But one thing is clear, these folks face a daily struggle with the stigma of a medical condition, one that they did not ask for: the stigma of chronic pain.

The Pain Management Best Practices Inter-agency Task Force Report identifies stigma as a critical topic that must be addressed in order to provide better care for those with pain. Stigma can act as a barrier to access of care, increases risk for behavioral health issues, and affects relationships in the patient’s life. In the complex world of pain treatment, how do healthcare practitioners work to reduce stigma? The research literature and number of case studies are growing at an astounding rate as the practice area of treating pain is ever-changing and grows more and more complex. Despite the demands of keeping up with these changes, it is essential for us, as healthcare practitioners, to ensure that we are addressing stigma at many levels including system and personal.

In East Tennessee, the challenges of stigma shine clearly. The clinic where I work offers a biopsychosocial approach through multidisciplinary modalities in a geographic area where both chronic pain and opioid abuse have touched almost everyone in some way through self, family, or friends. As an occupational therapy assistant, I work closely with each patient I treat at our clinic providing occupational therapy services with the goal of ultimately increasing participation in daily life to improve satisfaction and enjoyment despite having pain. One of the best tools that I have to help the clients I serve is active listening. I find that these patients are desperate to talk to someone who sees them as an individual and not a chronic pain patient. I use these valuable facts and information that patients gift me with to begin to provide individualized training for how to self-manage their chronic condition through better understanding of pain, coping strategies, positioning, body mechanics, and a good dose of cognitive behavioral therapy thrown in throughout. You can bet I hear a lot about the stigma that these patients have faced. I work to help them cope with that stigma and become more assertive. The patients I work with have inspired me to also combat stigma associated with healthcare providers. I present, along with an occupational therapist on our team, to other OT practitioners educating to the appropriate assessment and treatment approaches for those who have chronic pain as well as making them aware of the challenges that these patients face, including stigma. These presentations are targeted at OT practitioners who are not specializing in pain, but who, due to the large percentage of those with pain, are encountering patients in the OT practitioner’s own practice area. I also work to include this information in the curriculum I teach to OTA students at a local community college to lay a strong foundation of evidence-based treatment for pain as well as a strong connection to empathy and care for those with pain. I believe that working to provide a new perspective for these practitioners helps to reduce stigma that may even be unintentional against those with chronic pain.

In the last 4 years of practicing in this specialty area, my eyes have been opened to utilizing a biopsychosocial approach to help make an impact through assisting those who have pain to live life to the fullest. Putting together presentations, pouring through research, and working closely with other members on our multidisciplinary team has been one of the most thrilling and fulfilling acts of my professional life. But, I’m not satisfied as there is much to do and ways to grow to not only provide the best evidence-based, compassionate care to the patients I serve, but to help other OT practitioners increase their awareness on how to do the same no matter what their practice area. I feel that acting on these things is a way to reduce stigma. PAINWeek provides a unique opportunity as a stepping stone on my path to achieve these goals. While at the conference, many opportunities will assist in guiding me forward and farther. Participating in the sessions will allow me to gain new perspective on the latest research and efforts of those in the top of the field in pain. I can interact with presenters and other participants to clarify the ideas that I hear or to ask for those valuable first-hand lessons that these practitioners have already learned. These concepts I can directly apply to provide the most up-to-date care. I plan to continue to help other OT practitioners to increase their knowledge and understanding of treating pain so that their impact can be wider.

As a restorative therapy practitioner, I need to better understand the language that is more uniform and clear. I was fortunate enough to attend a PAINWeekend event, but as most of who participated were physicians, nurse practitioners, physicians’ assistants, and pharmacists I found difficulty in conveying my knowledge, ideas, and sometimes even questions in terms that were familiar to these practitioners. PAINWeek would provide me with almost a full week to soak up interactions and learn the language. Being able to convey my thoughts and ideas in a relevant way is important to accomplishing my goal of better advocacy for having occupational therapy as a member of teams treating chronic pain. How can I convey OT’s distinct value of being client-centered, focusing on function, just to name a few, if I am unable to covey that information in terms that these practitioners can easily understand and targeted at areas of need that the healthcare practitioners are trying to fill?

Pursuing continuing education for both OT and pain is very important to me. I seek out opportunities at state and national conferences as much as I can. The cost of travel along with the conference fees, and food add up quickly. The PAINWeek scholarship would ease the burden so that I can work towards my goals with less impact on my family. PAINweek will be unlike anything I have ever experienced toward gaining a better understanding of pain, providing the best care that I can, and to contribute to as much as I can as a member of the multidisciplinary team.

Niccole Rowe, BA, COTA/L
Pain Consultants of East Tennessee
Knoxville, TN

Submit Your Essay to WIN a Scholarship to PAINWeek 2020!

PAINWeek remains the largest US pain conference and the favorite destination for frontline practitioners to enhance their competence in pain management. You can be one of 10 participants to attend PAINWeek for FREE! Just compose a compelling essay explaining why PAINWeek would be beneficial for your professional area of focus.

Convening at The Cosmopolitan of Las Vegas on September 8-12, more than 2,000 physicians, physician assistants, nurse practitioners, nurses, pharmacists, hospitalists, psychologists, and social workers are expected to attend. There will be 120+ hours of continuing medical education across multiple therapeutic areas, taught by over 70 pain management thought leaders.

We will award 10 scholarships that cover the cost of registration, and one grand prize winner will receive 5 nights of hotel accommodations at The Cosmopolitan and complimentary conference registration.

Submission Deadline
All essays must be received by midnight EST on Sunday, May 31, 2020.

Scholarship winners will be notified via email and/or phone no later than June 19, 2020. Winners must respond by July 31, 2020.

Please click here to submit your essay.