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Pain Management - Psychology

We are a team of Clinical and Counselling Psychologists providing a specialist psychology service to those affected by chronic pain. We see people whose psychological health is affecting their emotional wellbeing, making their health worse or affecting their ability to receive medical treatment.

What is a Psychologist?

Clinical and Counselling Psychologists aim to reduce psychological distress and promote psychological and physical well-being. We have specialist doctoral training in the application of scientific knowledge to reduce distress and promote psychological wellbeing. Our extensive training allows us to conduct detailed assessments and develop a plan to help based on an individual understanding of someone's difficulties, rather than on a diagnosis alone.

Why might you be referred to a Psychologist?

Being referred to a Clinical or Counselling Psychologist does not mean that your pain is not real or that it is “in your mind”. However, pain is complex and can affect people in a number of ways, not just physically. Living with chronic pain can affect your mood and this can in turn affect how you are able to manage your pain.

Psychologists work alongside you and other members of the pain management team (such as Doctors, Physiotherapists, Nurses and Occupational Therapists) to help you manage your pain.

What should I expect when I see a Psychologist?

When you first see a Psychologist, time is spent talking to you about what led to your referral to psychology and what you think the difficulties you are facing are. Your appointment would normally last between 45-50 minutes.

The Psychologist will ask some questions about your life at the moment, including what has brought you to the appointment, and what is going well for you. You may be asked some questions about your background to help understand how your difficulties came about, and what life was like before you had these difficulties.

There are a number of assumptions that people often make about psychology, so we would like to put your mind at rest. For example, Psychologists are not mind readers, we do not have a couch that we expect you to lie down on. Our job is to help to understand and treat psychological difficulties related to a physical health problem, and to improve quality of life.

What happens next?

During the assessment appointment we will discuss the pain and your mood and talk with you about what might be the most appropriate form of help for you and the team will ask you whether this is what you want or not. The options available to you after attending the appointment include:

  1. Being placed on the waiting list for a series of individual appointments with one of the Psychologists. This may involve being on a waiting list for some time, however the team try to keep this down to a minimum.
  2. Being placed on the waiting list for group intervention focusing on psychological flexibility and valued engagement in life alongside pain. Our group is based on Acceptance and Commitment Therapy or “ACT” (pronounced as the word “act”, not the letters a-c-t) which is well suited to helping people address the challenges presented by chronic pain.
  3. Talking to you about other services or organisations that may be able to help you. You may be able to refer yourself to these services or they may require a referral from your GP.

What treatments are offered?

The team provide talking therapy using a range of evidence-based psychological approaches including Cognitive Behavioural Therapy (CBT), Eye Movement Desensitisation Reprocessing (EMDR), Acceptance and Commitment Therapy (ACT), Compassion-Focused Therapy, Cognitive Analytic Therapy informed therapy (CAT), solution-focused therapy, mindfulness, hypnosis, and systemic therapy.

The type of approach that is offered to you will depend upon the nature of your difficulties. Where appropriate, we follow guidelines for evidence-based treatment (approaches that have been shown to work) so that we offer you the most suitable option. It is also important that you tell us what you think will be helpful for you, and whether anything in the past has been of benefit.

Psychologist’s work usually aims to help a patient to adjust to and manage pain by;

  • Increasing your knowledge of how pain works
  • Understanding why we feel anxiety and tension

And by helping you to learn skills such as;

  • Relaxation
  • Pacing activities
  • Goal setting
  • Problem solving

The psychologist may also help you to work through the life events and stresses that may be making the pain worse and harder to cope with.

How are people referred to Psychology?

Some people are referred directly by their GP, but most of our referrals come from within the Pain Clinic from Consultants, Nurses, Physiotherapists and Occupational Therapists.

If you are referred by a member of the pain clinic, you will usually be given a leaflet explaining a little more about what psychology offers and helps you think about whether this is the right service for you. If you decide that you would like to be offered an assessment appointment, there is a telephone number to call by the date shown on the front of the leaflet. We will then book an appointment for you in the next available assessment clinic.

If we do not hear from you by the date shown on this leaflet then we will assume that you do not want a psychology appointment and you will not be placed on our waiting list.

If you decide not to attend the psychology appointment your consultant and GP will be informed of this. A re-referral would be needed if you wanted to be seen in the future.

Pain Psychology Resources

We have collected some resources that other patients have found useful, including written, audio and video information. These include resources on understanding more about persistent pain and how and why psychologists work with people who have persistent pain. We have also included some great self- help resources that may give you some ideas to try out whilst you wait for your first psychology appointment.

Understanding Persistent Pain

  • Flippin Pain - The resource section of this website has links to lots of information about understanding and living well with persistent pain. It includes audios, videos, self-help guides, articles, and book recommendations
  • Understanding pain and what to do about it in less than five minutes - This video explains what we know about pain, how it is recognised by the brain, and what we can do to help reduce its effects
  • Tame the Beast - This 5-minute animated video from Lorimer Mosely looks at what pain is, how it works, and what can help
  • Pain is really strange - This graphic book by Steve Haines explains what pain is and how to change your pain experience
  • Live Well With Pain - This website contains tried and tested self-management information and tools to help people live well with persistent pain, including 'ten footsteps' to break this down into manageable chunks to try out. The website also includes resources for people caring for those who live with pain

Understanding Pain Psychology

The Psychologist’s in these videos from Manchester University NHS Foundation Trust explain more about pain psychology, introduce how stress and pain interact. They also introduce two therapies that are often used when working with people with persistent pain; Cognitive Behavioural Therapy (CBT) and Acceptance and Commitment Therapy (ACT).

Self-Help Resources

Both Cognitive Behavioural Therapy (CBT) and Acceptance and Commitment Therapy (ACT) have been found to be helpful for people living with persistent pain and struggling with their mental wellbeing.

Here are some self-help resources using these approaches that you may find helpful. They include support with the difficult thoughts and feelings that can be related to experiencing persistent pain.

  • Chronic Pain Self-help Guide
  • This is a CBT based online self-help guide for living well with chronic pain from NHS Scotland, it includes written material and audio files.

  • Overcoming Chronic Pain: A Self-Help Manual Using Cognitive Behavioural Techniques by Frances Cole.
  • This self-help book explores CBT techniques to managing chronic pain

  • Living Beyond Your Pain: Using Acceptance and Commitment Therapy to Ease Chronic Pain by JoAnne Dahl and Tobias Lundgren.
  • This self-help workbook is a step-by-step guide to using ACT techniques to live well alongside pain.

  • The Happiness Trap: Stop Struggling, Start Living by Dr Russ Harris.
  • This self-help book explores ACT techniques to building a fulfilling life.

  • Tees, Esk & Wear Valleys NHS Foundation Trust - Self Help Guides (ntw.nhs.uk).
  • This website has lots of short self-help guides for managing a variety of difficulties, including anxiety, stress, anger, depression, and sleep problems. They are all available as audio files too. (Please note the leaflets may not open in a Chrome web browser).

Guided Relaxation

Relaxation can help to reduce psychological stress and body tension and is often useful when living with persistent pain. Listening to a guided audio can be a good way to try out different kinds of relaxation exercises, here are some you can try.

  • Progressive Muscle Relaxation
  • This guided audio from Manchester University NHS Foundation guides you through tensing and relaxing different parts of your body.

  • Our relaxation audios
  • We have recorded some different types of guided relaxation that you can listen to including guided imagery and mindful breathing.

  • Calm is an app which has different types of free guided relaxation audios.