Inpatient Pain Treatment: Module 2 (Pain Coping Strategies)

Abstract

In the following chapter, we describe the pain coping strategies we use for inpatient pain treatment at the German Paediatric Pain Centre (GPPC). The Vicious Cycle of Pain (Sect. 8.2) may be interrupted at several points. Body awareness can be altered through behavioural distraction, mindfulness strategies and imagery. Cognitive restructuring and acceptance-based approaches aim at minimising Black Thoughts. Muscle tension can be reduced by (imaginative and behavioural) relaxation techniques. Various types of exposure techniques aim at reversing the process of chronification and sensitisation by decreasing fear of pain and resulting pain catastrophising, or by reducing the association between negative emotions and related pain perception. Six to ten therapeutic sessions are required to teach these strategies. In addition, basal social competence training (group sessions) and interventions aimed at restructuring everyday life (e.g. daily schedule) are offered to patients. Transcutaneous Electrical Nerve Stimulation (TENS) and/or biofeedback therapy is undertaken with all children (except in abdominal pain) from the very beginning of inpatient treatment and is performed by specially trained staff of the nursing and educational team (NET). Pain provocation, an interoceptive exposure technique (see Chap. 9.5), is not offered until the end of the stay and not before at least one pain coping strategy has been successfully implemented.