Project Report: An integrated teaching, therapy and research project for the treatment of patients with chronic pain in the region of the spinal column

Abstract

This report presents a project combining university level teaching, the examination and treatment of patients with chronic back pain and an accompanying research programme. Patients were examined with the assistance of a comprehensive, structured anamnesis instrument according to specified criteria. In the course of the teaching programme, which included bio-psycho-social aspects of pain and painful diseases as well as structured interviews, students were given the opportunity to observe initial interviews, review impressions gathered in case discussions, and, with greater experience, to conduct interviews themselves. After initial interviews, patients indicating appropriate motivation were offered the opportunity to take part in an extended single or group therapy. Individual therapies were largely conducted by experienced students working under supervision. Group therapy sessions were conducted by the first author. The project was simultaneously subject to research by doctoral and diploma students. To date, the pilot phase has exhibited a surprisingly high motivation on the part of patients to avail themselves of extended therapy. First data (for which however no statistical base can yet be offered) suggest that the patients profit from initial interviews on. Consequently, the possibility that initial interviews themselves can be viewed as short therapeutic interventions is now under examination. Additionally, successive short therapy sessions appear to offer measurable symptomatic relief, and to be effective in terms of psychosocial variables of health and in the approach and attitude to pain. A short protocol covering 10 individual interviews illustrates the opportunities for student to be of assistance.

Keywords:
Chronic pain, medical training, bio-psychosocial paradigm, psychotherapy.