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Home » Health Professionals » Psychological Injury » Comparison of group and individual approaches to pain management

Comparison of group and individual approaches to pain management

 

 

Group Approaches - What Is Involved

 

 

A multidisciplinary approach to pain management involving education about injury, treatments that can work and long term strategies to manage pain and improve quality of life. Typically they have input from psychologists, occupational therapists, physiotherapists and diet therapists. They may have input from pharmacists and doctors about pharmaceutical or medical aspects of injury.

 

The programs typically have:

 

  1. A large educational component

  2. An emphasis on cognitive –behavioural principles and practices aimed at changing “faulty” self defeating belief systems about injury and pain into more constructive ones.

  3. Practical application of program content over the course of the program

  4. Pre and post program evaluation using behavioural measures.

 

 

Advantages:

 

 

  • A standardised approach ensures consistency in quality of information

  • A multi-disciplinary team means that useful information from professions from a range of back grounds is obtained

  • Participants can share experiences and learn from each other

  • Group programs tend be comprehensive in coverage of a range of issues needing to be considered in long term pain management and injury management

  • Group program sessions are generally performed in “blocks” over several days and between 6 and 10 weeks in duration. The intense multidisciplinary input can be helpful in changing entrenched attitudes and behaviours.

 

 

Disadvantages:

 

  • They can seem impersonal to participants
  • Don’t cater for nuances of many individuals
  • Are less effective when a participant has still not accepted the implications that their injury is likely to be chronic
  • May not be suitable or appropriate for individuals with major psychological difficulties – eg major depression, severe posttraumatic stress disorder in addition to a physical injury, personality disorders, aggression, a significant substance abuse problem
  • Problem where English language is limited
  • Problems where disability is complex and individual factors must be taken into consideration
  • Staff may be over zealous in their application of broad principles and not take into consideration individual needs resulting in symptoms being exacerbated, and/or adverse psychological responses of the worker with reluctance to participate further
  • Negative attitudes and beliefs can be passed on about injury and “the system” from other participants
  • Many people with chronic injuries do not feel comfortable in a group situation, particularly in large groups and prefer an individual approach

 

 

 

Individual Approaches - What Is Involved

 

A 1:1 approach to education, counselling and adjustment to injury with input being from psychologists or occupational therapists. Often individual therapy occurs in conjunction with other programs being administered simultaneously, e.g. pain management with a functional restoration program. A range of therapies may be utilised, tailored to the individual’s particular needs and influenced by the therapist’s experiences, skills and experiences. Most psychologists working in this area utilise cognitive –behavioural therapy and principles, however, they are not as rigidly applied as in group programs.

 

 

Advantages:

 

 

  • Strength of one to one relationship

  • Many if not most injured patients prefer an individual rather than group approach when discussing and dealing with the more personal aspects of their injury and change in life circumstances

  • Is better when injury or person’s situation is particularly complex

  • Is better when more serious psychological health difficulties are experienced

  • Is better when individual is likely to be disruptive, withdrawn or a reluctant participants in the group process.

 

 

Disadvantages:

 

 

  • Therapy from a sole professional can result in important information and professional input being left out unless the professional has extensive experiences and skills in pain management / injury adjustment issues, and he or she has additional qualifications and skills

  • The benefit of the experiences of other participants in a group cannot be passed on in 1:1 therapy

  • If a therapist lacks skills or knowledge, the result is potentially more significant than in a group program where information is gathered from other professionals and from the participants themselves.

 

For further information about pain management see our website for:

 

  1. Secondary Psychological problems
  2. Pain Management and Injury Adjustment Interventions

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