Integrating Motivational Interviewing in Pain Neuroscience Education for People With Chronic Pain: A Practical Guide for Clinicians

Nijs, Jo; Wijma, Amarins J; Willaert, Ward; Huysmans, Eva; Mintken, Paul E.; Smeets, Rob; Goossens, Mariëlle E. J. B.; Wilgen, C.P. van; Bogaert, Wouter Van; Louw, Adriaan; Cleland, Josh; Donaldson, Megan

doi:10.1093/ptj/pzaa021

Cited by 65 publications

(66 citation statements)

References 63 publications

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“…Face-to-face PNE sessions might have been more effective here, as they create the ability to directly respond to (non-)verbal patient cues and enable the opportunity to use certain communication skills (e.g. Socratic-style dialogue) (Nijs et al, 2020). In addition, PNE aims to shift one's conceptualization of pain (Moseley & Butler, 2015) and therefore needs to challenge one's existing knowledge and knowledge structures, which might be more feasible within face-to-face interactive sessions.…”

Section: Discussionmentioning

confidence: 99%

The effect of a pain educational video intervention upon child pain‐related outcomes: A randomized controlled study

Rheel

Ickmans

Wauters

et al. 2021

European Journal of Pain

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Background: Pain neuroscience education (PNE) has received increasing research attention demonstrating beneficial effects on pain-related outcomes in adults.Conversely, studies on the effectiveness of PNE in children are scarce. Methods: This study investigated the effect of a pain educational video intervention on child pain-related outcomes (i.e. experienced pain intensity, pain-related fear and catastrophic worry about pain, pain threshold and pain knowledge) in healthy children undergoing an experimental pain task. Furthermore, the moderating role of children's demographic (i.e. sex and age) and psychological (i.e. baseline pain knowledge and anticipated pain intensity, pain-related fear and catastrophic worry) characteristics was examined. Participants were 89 children (M age = 11.85, SD = 1.78), randomly assigned to either a condition whereby they were instructed to watch a brief pain educational video (i.e. experimental group) or to a control condition whereby they did not watch any video. Results: Study findings revealed that accurate pain knowledge and pain threshold were higher amongst children in the experimental group compared to the control group. In contrast with expectations, no main effects of the video intervention were observed for experienced pain intensity, pain-related fear and catastrophic worry. Moderation analyses indicated that the video intervention contributed, in comparisonwith the control condition, to higher levels of pain knowledge amongst younger children only and to higher pain thresholds amongst boys only. Conclusions: Further investigation is needed to optimize pain educational video interventions and to determine whether more beneficial outcomes can be found in clinical (i.e. non-experimental) situations and in children with persistent or recurring pain problems. Significance: Examining the impact of pain educational interventions within a nonclinical setting is deemed particularly important given that adaptive pain coping strategies likely play an important role in preventing the development and maintenance of future maladaptive pain-related behaviour. Further, study findings provide preliminary evidence of baseline and demographic (i.e. age and sex) characteristics explaining differences in the effect of a pain educational video intervention in pain knowledge and pain-related experiences during experimental pain. | 2095 RHEEL Et aL.

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Section: Discussionmentioning

confidence: 99%

The effect of a pain educational video intervention upon child pain‐related outcomes: A randomized controlled study

Rheel

Ickmans

Wauters

et al. 2021

European Journal of Pain

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“…In the context of pain management, a common thread across these techniques is the importance of patient-centered pain education and motivational interviewing to help guide patients to recognize possibilities for change and future action that are meaningful to them. Recently, there has been recognition that these measures may help optimize patients' motivation and pain-related beliefs to facilitate engagement with adaptive coping strategies for their pain (Nijs et al, 2020). Ultimately, the aim is to shift patients towards improved pain-related self-efficacy, believing that they can successfully (re)engage in valued activities now and in the future.…”

Section: Shaping Salience Valence Mineness and Temporal Horizonmentioning

confidence: 99%

Pain and the field of affordances: an enactive approach to acute and chronic pain

Coninx

Stilwell

2021

Synthese

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In recent years, the societal and personal impacts of pain, and the fact that we still lack an effective method of treatment, has motivated researchers from diverse disciplines to try to think in new ways about pain and its management. In this paper, we aim to develop an enactive approach to pain and the transition to chronicity. Two aspects are central to this project. First, the paper conceptualizes differences between acute and chronic pain, as well as the dynamic process of pain chronification, in terms of changes in the field of affordances. This is, in terms of the possibilities for action perceived by subjects in pain. As such, we aim to do justice to the lived experience of patients as well as the dynamic role of behavioral learning, neural reorganization, and socio-cultural practices in the generation and maintenance of pain. Second, we aim to show in which manners such an enactive approach may contribute to a comprehensive understanding of pain that avoids conceptual and methodological issues of reductionist and fragmented approaches. It proves particularly beneficial as a heuristic in pain therapy addressing the heterogenous yet dynamically intertwined aspects that may contribute to pain and its chronification.

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“…Still, PNE in itself is unlikely to suffice for thoroughly addressing perceived injustice in patients having pain following cancer. Therefore, and in order to obtain the often-required behavioural change towards a more adaptive lifestyle, motivational interviewing is used as the communication process throughout PNE (72). Figure 3 illustrates the key components of strategies that target perceived injustice as a sustaining factor for pain and other post-cancer-related symptoms.…”

Section: Motivational Interviewingmentioning

confidence: 99%

Pain and Opioid Use in Cancer Survivors: A Practical Guide to Account for Perceived Injustice

Nijs¹,

Roose²,

Lahousse³

et al. 2021

Pain Phys

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BACKGROUND: The presence of pain decreases survival rates in cancer. Pain management in clinical settings is often suboptimal and secondary to other cancer-related treatments, leaving many people undertreated. Opioid use is associated with side effects and decreased survival rate in cancer patients. Hence, there is an urgent need for considering factors such as perceived injustice that sustain post-cancer pain and trigger a behavioral pattern associated with opioid use. Injustice beliefs represent a maladaptive pattern of cognitive appraisal that may be a salient target for improving pain-related coping in these patients. Perceived injustice is associated with increased opioid prescription and prospectively predicted opioid use at 1-year follow-up, urging the need for targeted interventions to diminish perceived injustice. OBJECTIVES: Explain the importance of screening for perceived injustice in patients with pain following cancer treatment, its potential relevance for opioid abuse, and its potential impact on the management of pain following cancer. Also, prove clinicians with a clinical guide for an approach comprising of modified pain neuroscience education, motivational interviewing, and acceptance-based interventions to account for perceived injustice in patients having pain following cancer. STUDY DESIGN: A narrative review, perspective and treatment manual SETTING: Several universities, a university of applied science department, a university hospital, and a private clinic (i.e., transdisciplinary pain treatment center). METHODS: Patients were cancer survivors with pain. Intervention included modified pain neuroscience education, motivational interviewing, and acceptance-based interventions. Measurements were taken through the Injustice Experience Questionnaire (IEQ). RESULTS: The IEQ can be used to assess perceived injustice in a valid way. Education about pain, including discussing perceived injustice, should be the first part of the management of pain in cancer survivors. In order to obtain the often-required behavioral change towards a more adaptive lifestyle, motivational interviewing can be used. To thoroughly tackle perceived injustice in patients having pain following cancer, special emphasis should be given to the individual reasons patients identify for experiencing (continued) pain and related symptoms. Pain acceptance should also be thoroughly addressed. LIMITATIONS: Clinical trials exploring the benefits, including cost-effectiveness, of such a multimodal approach in patients with pain following cancer treatment are needed. CONCLUSIONS: In light of its potential relevance for opioid abuse and potential impact on conservative management strategies, clinicians are advised to screen for perceived injustice in patients with pain following cancer treatment. Therapeutic targeting of perceived injustice can be done through an approach comprising of modified pain neuroscience education, motivational interviewing, and acceptance-based interventions. KEY WORDS: Anger, cancer, counselling, education, medication use, motivational interviewing, neuroscience education, opioid, perceived injustice, rehabilitation, survivor

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Integrating Motivational Interviewing in Pain Neuroscience Education for People With Chronic Pain: A Practical Guide for Clinicians

Cited by 65 publications

References 63 publications

The effect of a pain educational video intervention upon child pain‐related outcomes: A randomized controlled study

The effect of a pain educational video intervention upon child pain‐related outcomes: A randomized controlled study

Pain and the field of affordances: an enactive approach to acute and chronic pain

Pain and Opioid Use in Cancer Survivors: A Practical Guide to Account for Perceived Injustice

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