Chronic Pain and Trauma: ACT, MI and More to Enhance Client Outcomes

Credits

Speaker

Benjamin Keizer, PhD Related seminars and products

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Benjamin M. Keizer, PhD, is a board-certified Clinical Health Psychologist with extensive post-doctoral training in clinical health psychology at the San Antonio Uniformed Services Health Education Consortium. He formerly served as an Active-Duty Army officer in a variety of positions for eight years and currently serves as an Army Reserve Clinical Psychologist. In his civilian capacity, he serves as a Clinical Health Psychologist and Program Director for the Functional Restoration Program at the Center for the Intrepid (CFI), Brooke Army Medical Center, San Antonio, Texas, where he provides care for military service members who have sustained serious injuries (e.g., amputation, limb-salvage, multi-trauma, major surgery). He has been awarded an Army Systems of Health Innovation Grant as a result of excellence in creating novel interdisciplinary programs in a military setting, and his leadership resulted in a 2018 Best of the Best Specialty Care Clinic award from the Military and Army Health Systems.

 

Speaker Disclosures:
Financial: Benjamin Keizer has an employment relationship with the Center for the Intrepid and receives a speaking honorarium from Electromedical Products International. He receives a speaking honorarium and recording royalties from PESI, Inc. All relevant financial relationships with ineligible organizations have been mitigated.
Non-financial: Benjamin Keizer has no relevant non-financial relationships.

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Objectives

1. Describe the relationship between trauma and chronic pain for the purposes of providing psychoeducation to clients.
2. Assess pain and related comorbid mental health symptoms to inform treatment interventions.
3. Apply at least two interventions to decrease risk of suicide in clients with chronic pain and trauma.
4. Practice at least one values clarification intervention with clients with chronic pain and trauma.
5. Utilize intentional questions and appointment framing to assist clients with goal-setting.
6. Determine when and how to coordinate and collaborate with family members and medical providers.

Outline

Trauma and Chronic Pain: The Nervous System as Common Denominator

• Pain as a threat system and why it matters
• The trajectory of acute and chronic pain
• Relationship between ACEs, PTSD, and chronic pain symptoms
• Mutual maintenance and shared vulnerability models
• Principles of pain: nociceptive, neuropathic, and nociplastic
• Pain intensity versus pain distress
• The hidden benefits of pain

Getting Started and Foundations: Assessment, Case Conceptualization, and Safety Planning

• The effect of pain on clients’ sense of self
• How to help clients identify and challenge pain-related myths
• Assessment of pain and related comorbidities
• Essential health and well-being assessments
• Case conceptualization when your traumatized client has chronic pain
• When pain itself is a reminder of the traumatic event
• Identify and shift vicious cycles of maladaptive coping strategies
• Risk management and safety planning
• Help clients get the rest they need – sleep, trauma, and chronic pain
• Case study: 25yo Black female with chronic pain after ACEs

Chronic Pain Treatment Toolbox: Emerging Strategies and Complimentary Approaches

• Why psychotherapy for pain?
• Help clients rethink how they view pain: Pain neuroscience education
• Values, present moment awareness, and other ACT strategies
• Solution-Focused Brief Therapy (SFBT) to construct solutions versus focus on problems
• How to pose the “miracle” question for pain and other targeted techniques to enhance coping
• Motivational Interviewing techniques to optimize engagement and outcomes
• Pleasant activity scheduling to improve mood and pacing behaviors
• Mindfulness and yoga for pain reduction
• Hack the glymphatic system - treat chronic, low-grade headaches with behavioral & nutritional interventions
• Quiet the nervous system with relaxation strategies and breathing techniques
• Harness the power of green space
• Case study: 37yo White male with PTSD and chronic pain

Clinical Considerations

• Integrating strategies for chronic pain into trauma processing
• Cultural factors and integration of cultural humility into practice
• Special populations: children, elderly, military/veterans/first responders
• Effective collaboration with medical providers
• Involvement of family members in treatment
• Rapport and alliance when the client has chronic pain and the therapist does not
• Pain-related health disparities and social determinants of health
• Limitations of the research and potential risks

Target Audience

• Social Workers
• Psychologists
• Marriage and Family Therapists
• Counselors
• Addiction Counselors
• Case Managers
• Psychiatrists
• Physicians
• Physician Assistants
• Nurses
• Nurse Practitioners
• Occupational Therapists
• Occupational Therapy Assistants
• Physical Therapists
• Physical Therapist Assistants