Re-Thinking History Intake to Improve Pain-Coping

There is increasing evidence that instead of being exclusively a reaction to outside triggers (for example: posture, inflammation and stress), pain - just like emotion is a prediction made by the central nervous system. Such predictions are based on the data of past experience. Research by neuroscientists like Dr. Lisa Feldman Barrett (Northeastern University) explains and exposes the tight link between pain and emotion, both of which have been found to share the brain's predictive mechanism. Past experiences are shaped by context. Context is built on observation, language and conversation. This means how we healthcare providers communicate with patients about their pain, and how we teach them to communicate about it, has a much greater, evidence-based impact on clinical outcomes than many of us realize. Dr. John Gottman (University of Washington) did the groundbreaking research which led to what is now widely referred to as Emotion Coaching. This is a five step strategy that has been shown to improve coping and resilience with regard to emotions. These five emotion-coaching steps are an important addition to any clinical practice, given the shared neurobiology by both pain and emotion. When appropriately re-tooled for the application to pain-care, these five steps become the Five S's of Better Pain Coping. Instead of simply addressing emotions as a way to modulate pain, the Strategic Patient Conversation approach addresses the pain and pain-coping directly. This course will elucidate how to incorporate this revolutionary yet intuitive five step strategy into each patient encounter. Attendees will be introduced to the use of clinical history-intake as a treatment technique, supported by the current evidence.

By the end of this course, learners will be able to:

• Name and implement the Five S's of Better Pain Coping based on five steps of Gottman's Emotion Coaching.
• Link the components of the OPQRST history-intake infrastructure for clinical information-gathering, with the five Better Pain-Coping steps.
• Explain the three main benefits of structured history-intake, not just for the goals of clinical data-gathering but specifically for the benefit to the patient.
• Cite the supporting neuroscientific concepts.