• Reference Number: HEY-1408-2023
• Departments: Pain Medicine
• Last Updated: 30 November 2023

Introduction

This leaflet has been produced to give you general information about a therapy group provided by the Pain Management Team. This leaflet should answer most of your questions and may act as a starting point for discussion. It is not intended to replace the discussion between you and your doctor. If after reading it you have any concerns or require further explanation please discuss this with a member of your health care team.

The aim of the Group Pain Management Programme

Many people often describe themselves as struggling alone in a fight to remove persistent pain. Whilst it is normal to try to avoid pain, the evidence now suggests that this battle with pain may be creating further problems by moving us away from the things that are important to us.

Pain Management Programmes (PMPs) are well-established in the world of chronic/persistent pain and are designed to help each individual to manage their pain more effectively. The aim of the PMP is to help people to better understand their pain condition. Developing skills for managing with pain can break the pain cycle that many people find themselves stuck in.

The gPMP at Hull University Teaching Hospitals (HUTH) is a therapeutic group designed to reduce pain related distress and improve quality of life. The group was created to support patients where other pain management treatment options have been of limited benefit. It is primarily led by a team of clinical psychologists who are trained to deliver specialist psychological interventions with support from the pain multi-disciplinary team (MDT). The group aims to bring together people with shared experiences of living with pain to consider alternative approaches to managing pain.

The gPMP has been designed to complement the existing emotional and practical support provided by the Pain Management Team at HUTH. Other support options include an individual PMP led by nurses and physiotherapists which focusses on goal setting and self-management of pain. In some cases psychological therapy with a clinical psychologist may be suggested.

Who, When, Where?

The group programme will consist of a series of eight, weekly sessions, each lasting for two hours with a tea break. The sessions are predominately run by the clinical psychology team but with support from other professionals within the MDT including nurses and physiotherapists. These group sessions will be attended in person at Castle Hill Hospital in Cottingham.

What happens on the programme?

The gPMP combines the benefits that can be gained from individual support with pain management and a shared group environment with other people who understand what it is like to be living with persistent pain. The programme will focus on skills practice and group reflection to provide alternative ways to manage with pain.

The gPMP integrates a number of psychological principles but draws mostly from two main psychological models: Acceptance and Commitment Therapy (ACT) and Compassion Focused Therapy (CFT). ACT helps people to develop psychological flexibility and live a more meaningful life. This is achieved by helping individuals to manage their thoughts and feelings in order to focus on the things which are important to them. CFT focuses on enhancing compassion both towards oneself and others as a way to counteract the impact of self-criticism and other difficult emotions such as shame.

Topics covered

• Week 1: Sharing Experiences and Explain Pain
• Week 2: The Three Emotion Systems and Pain
• Week 3: Managing the ‘Mind Bully’
• Week 4: Training the Brain – Attention
• Week 5: Reducing the Struggle with Pain
• Week 6: Dealing with Difficult Thoughts and Feelings
• Week 7: Identifying What is Most Important
• Week 8: Review and Planning for the future

Objectives

• To increase knowledge and understanding of pain
• To increase self-confidence in managing pain
• To develop skills in willingness and focused action
• To increase compassion for self and others
• To improve quality of life
• To promote a supported, self-help approach to managing pain
• To reduce pain-related distress

What happens when I am referred?

The gPMP accept referrals from the Pain Management Team in HUTH and can be accessed by anyone who is receiving care from the team which involves pain consultants, nurses and physiotherapy.

After you have spoken to a healthcare professional involved in your care and they have provided you with this booklet to read more about the gPMP, you should be provided with time to answer any questions that have been raised by this leaflet. If you are satisfied that you have received enough information and would still like to proceed you will be referred to the group facilitators in the Department of Psychological Services. At times there may be a waiting list but the group facilitators will contact you to talk through the options available.

You will also then be invited to an initial screening appointment which will take place over the telephone with one of the clinical psychologists in the team. This appointment will provide a space to discuss your current difficulties and hopes for the group. In addition, there will be a second opportunity to ask any questions to make sure that you are happy with the group and able to commit to all eight weeks of the weekly programme. You will also be asked to complete a number of questionnaires which are designed to help in identifying the current impact of pain on your life and planning goals during the programme.

Following this initial screening appointment, you will be booked onto the next available group programme or signposted to further support which might be more appropriate. You will receive an information pack which provides more information about the course and some of the resources that will be covered during the programme.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the Department of Psychological Services on Tel No: 01482461060 or 01482461061.

Please note that this service cannot provide urgent mental health support. If you require crisis support, we urge you to contact the 24/7 Mental Health Crisis Team which can be found by searching for your postcode on the following website link: https://www.nhs.uk/service-search/mental-health/find-an-urgent-mental-health-helpline. In Hull, the contact telephone number is: 0800 138 0990. If you are in imminent danger, phone 999.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.