You, the client, are the most important person in the treatment process and it is Helen’s intention to teach and support you in the treatment process.
Identifying your existing skills, building on those, then applying those skills to your life is all in service of you living more consistently with what matters to you in life.
Your learning to self-manage is the best outcome.
Treatment is in the context of assisting you to live a meaningful life, despite persistent pain or chronic health issues. Helen’s approach is holistic.
Treatment always begins and depends on a therapeutic alliance (we can work together) and identifying what it is you want to achieve by attending sessions.
Helen prefers to work with your other treating practitioners where possible (e.g. your doctors, physiotherapists etc.).
She aims to provide a menu of interventions to ensure your functional and emotional needs are discussed and addressed. She emphasises the use of evidence based interventions. Helen’s menu is broad and draws from Psychological, Occupational Therapy and Rehabilitation Counselling bodies of knowledge as well as her significant experience working in the area of persistent pain.
Initial assessment involves a comprehensive interview, often held over 2 sessions. In addition to interview, Helen uses internationally accepted outcome measures (questionnaires) as part of the practice and to inform reports written to GPs and other practitioners of your progress. They are the same measures currently used by major pain clinics throughout Australia http://ahsri.uow.edu.au/eppoc/participatingservices/index.html
The outcome measures are administered at the commencement of therapy and at intervals along therapy (usually at each 6th session).
During assessment Helen is interested in your taking a holistic approach to your situation. That means having a broad repertoire of strategies (from regular appropriate exercise, through knowledge, through practical strategies such as pacing, psychological strategies, to having a team of trusted practitioners you work with).
These are some of Helen’s Favourite Strategies
Developing a good therapeutic alliance is basic to therapy. It is important you feel you are in a safe place to talk. If there is little sense of feeling safe to speak; a sense of trust in our work; you are best to seek out a practitioner you do have that connection with.
Frequently pain gets in the way of living a life that has value and meaning. ACT (Acceptance & Commitment Therapy) uses the metaphor of a compass. If you want to go north in life but pain and illness is taking you in another direction of the compass, then it is helpful to look at what you value and set goals that move you in the direction you want to go. For example, if family is highly valued by you but pain/depression/anxiety is preventing you from being with family, then it is important to find ways that allow you to participate in activities that enable you to do so.
There are a number of useful tools including questionnaires and card sorts to help in exploring values and setting goals that help you to participate in meaningful and valued life activity.
Exploring Vocation/Meaningful Activity
Looking at values and meaningful activity frequently means exploring work and leisure; participating in activities that provide a sense of achievement and satisfaction in life.
Can help you to explore what your options are, given persistent /chronic pain. Finding a good vocational match based on your previous skills, experience and aptitudes and your level of genuine interest becomes even more important with the load of pain in your life. There are a number of vocational assessment tools, websites and referral to specific careers providers who specialise in resume writing, setting up on line media profiles (e.g. Linked in) we can use.
Similarly, if you are unable to work, ensuring you do participate in meaningful activity is important to your sense of self and your good mental health. It actually helps you to manage your pain.
Education. The Neurophysiology of Chronic Pain
In the treatment of persistent or chronic pain, understanding the neurophysiology of chronic pain is extremely useful. It explains what is happening in the brain and the body that keeps the pain so high and so disruptive to life. It also provides a very good rationale for why one would use a range of strategies to manage pain (from physical therapies and exercise to pacing one’s activity to mind body techniques).
Helen uses the wonderful work of Lorimer Mosely and David Butler from “Explain Pain” http://www.noigroup.com/en/Home and the work of Dr Michael Moscowitz & Marla Golden in “Neuroplastic Transformation-Your brain on Pain” http://www.neuroplastix.com/
Helen sees her role as often helping you to navigate systems well. For example, legal and insurer processes can be quite stressful. Helping you to cope as you move through the processes of these systems helps you to move towards participation in valued living.
MCBT (Mindfulness based Cognitive Behavioural Therapies)
Helen has trained in a number of Cognitive Behavoural Therapy (CBT) approaches during her Masters in Counselling training and as part of ongoing professional training. She draws from training in CBT, ACT, MiCBT and MBSR/MBCT.
In the world of psychotherapy, Mindfulness skills have informed and developed existing and well researched Cognitive Behavioural Therapy (CBT) interventions. Mindfulness based Cognitive Behavioural Therapy (MCBT) is central to Helen’s treatment approach, aiming to increase awareness of physical sensations, cognitions, emotions and urge/behaviour, in turn enabling more skilful responses.
With increased awareness, one can learn and apply skills in each of these areas (physical sensations, thoughts etc.) that can make a real and positive difference in life.
MCBT places an emphasis on compassion including self-compassion (a kind attitude to self) to this process and on acceptance of what one cannot change and working on what one can change.
MCBT is about navigating towards what is important, valued, and meaningful in life, despite pain and suffering.
Mind Body Skills
MBCBT (see above) is very much a Mind body approach to wellness.
Relaxation Training to help consciously calm the body and mind, including breathing techniques, muscle relaxation, imagery techniques, meditation and clinical hypnosis techniques.
For example, it can be very helpful to have skills in techniques such as imagery to change pain sensations, change the brain, create a positive future, manage fear; decrease pain intensity and decrease pain unpleasantness.
Helen regularly develops customised relaxation recordings during sessions which can be burned to CD or emailed for use on mobile phone/mp3 player etc. for home practice.
Clinical Hypnosis has a long history of addressing pain via production of the relaxation response and or by altering the perception of pain. Helen regularly develops and records individualised clinical hypnosis sessions for home practice. The sessions are recorded and can be burned to CD or emailed for use on mobile phone/mp3 player etc. Clinical hypnosis can be a very creative process and can be utilised in many ways.