MSK CPAMS - Christine Bonathan
Speaker key
CBChristine Bonathan
I am Christine Bonathan and I am a Clinical Psychologist in the Camden Community Pain Assessment and Management Service. When patients come into our Service they will all receive an initial assessment with either a Medical Consultant, a Pain Specialist or an ESP. In that appointment they will have any test results or scans reviewed. They might discuss medication, perhaps be linked into Secondary Care if injections or other medical procedures are required. Diagnosis and prognosis is discussed and really importantly, I think, an explanation will be given to the patient about why the pain has persisted and I think that’s a really essential platform for patients to go in and learn to self manage; they need to understand their pain.
The next point in the pathway for the majority of patients, about 75%, is a Clinical Psychology assessment. The first thing that we do in that is dispel any myths that this is about the patient being mad or we’re thinking it’s all in their head. What we’re there for is to identify really what the barriers are to them self managing their pain condition. So if they have catastrophic beliefs that, if they use their body, that something’s going rip or tear or if they’re actually believing that perhaps there’s a cure out there that’s being withheld, they’re not going to do the hard work of self management. So we try and identify all of that. We look at the impact of pain and the quality of life, particularly their emotional wellbeing or their mental health. And if we pick up problems—mental health difficulties—that would be a barrier to self management of pain we will then link them into Mental Health Services but otherwise we will then bring them into the treatment part of our pathway.
So the options there are first of all, a Pain Management Programme which follows the BPS—British Pain Society—guidelines. It’s eight weeks. We facilitate that with a Psychologist and a Pain Management Physiotherapist and we cover all sorts of things from pacing, activity, managing your mood but of course, not everybody wants a group, so sometimes people will come in to either one-to-one Clinical Psychology or one-to-one Pain Management Physio, which is a bit different from Primary Care Physio, much more looking at the bigger picture, the long term of how to manage their pain. And there are also nurse appointments available as well, to review medication.
That treatment part of the pathway, we all work very closely together. We’ve a joint formulation of the patient’s pain and we give a clear, consistent message. If you have any questions get in touch with us using the Camden GP website under the MSK section and we can either answer question directly or we could come out to your practice to speak to you further.