Nickie Coby (puppybraille) wrote,
Nickie Coby

Deconstructing Chronic Pain: Informal Article Review

This post is a modification of an emailed aszsignment where I read an article about a field of social work that interested me. Since I’m going back and forth on whether to go into the field of chronic pain or blindness, I decided to research chronic pain. Here is an informal article review. It doesn’t quote, and it’s not perfect by any stretch of the imagination, but it did receive a 10/10 from the instructor in a slightly different form, so I feel comfortable sharing it here. This stuff fascinates me!

One last word of caution, don’t take any of this as medical advice! I’m fortunate to benefit from great care from several doctors, and I hope you have a similar medical team if you suffer from chronic pain. If you don’t, I encourage you to find a good physician and start finding the relief and coping skills you need.

One of the major reasons I wanted to become a social worker is that I have a strong desire to help and support people. I have been on the receiving end of services, and I feel I could bring this perspective to social work. I see so many areas where my experiences could be useful, instead of ignored. I also used to want to be a nurse, however, my health cannot support the strains of that job. Maybe with social work, I can help someone put things back together, help communities provide better services and, in general, provide a safe ear to help people figure things out.

My current goals for my professional life are to either become a medical social worker and help people who suffer from chronic pain or help people affected by any form of disability. I feel this would be the best use of my skills and experiences.

Since I wanted to learn more about current thought on social work and chronic pain, I searched for information on that topic. Most of the information I discovered was paid content or geared at a completely uninformed consumer. I did find an article from Health and Social Will, written by Judy McDonald.

Ms. McDonald's purpose is to deconstruct the current "contingency management" model of treating chronic pain and replace it with a new model that empowers chronic pain suffers. I will briefly summarize the contingency model, the contradictions in the model and how social workers fit into the new model.

The Contingency model is behavioral in nature. Ms. McDonald explains that the idea of this model is to assume that the environment is causing or reenforcing pain behaviors. This is usually a last resort after all possible treatments have been tried. While at first, the medical profession works to solve the problem causing the pain, none can be found, or, the pain seems out of proportion to the cause. This is what the medical profession refers to as idiopathic pain.

Doctors believe that the reenforcement may come in the form of attention, extra assistance, time off of work or medications. A program that addresses these environmental cues and reinforcers is administered, and the patient's pain behaviors are ignored. This isolates the person in pain even more. The second concept is that pain can be physiological in nature. But, of course, doctors don't find one for "idiopathic" pain, so the first concept of psychological becomes their primary focus. These contradictions make it challenging for a chronic pain patient to receive help. Speaking personally, it is not impossible for several doctors to miss the cause of the pain. I had this happen with my RSD and, if you looked only for conditions that can be seen on a film or with a computer, you won't see the condition I have. Doctors and professionals who dismissed my condition made it harder for me to accept the condition and ask for the help and care I needed.

Ms. McDonald then describes a holistic model, in which the patient's voice is respected and the patient uses self-determination the course of treatment. She further explains that the social work value of self-determination fits perfectly in this model. Social workers, she explains, can facilitate pain management by helping deal with the consequences of pain, teaching relaxation skills, helping find needed resources and facilitating support groups.

This model of pain management seems more likely to succeed, more respectful of clients' needs and more empowering for the client. In this model, I feel I could work well as a social worker.

I referred to the article "A Deconstruction of Chronic Pain Treatment", by Judy McDonald, from Health and Social Work. For this email and post.
Tags: chronic pain, socialwork

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