This Psychology Week, we spoke with Griffith Experts about their careers and research in the dynamic and varied field of pain management. Here, they share their research, reflect on their learnings, and look to what the future might hold when it comes to managing – or even curing – pain through psychology.
Adjunct Professor Paul Martin OAM quite literally wrote the book on managing pain from headaches and migraines when he published Psychological Management of Chronic Headaches. Since then, he has continued his research in this field, developing an app for sufferers of headaches and migraines and a trigger avoidance model for headaches used globally by health professionals. He says that this year’s Psychology Week theme – Pain: finding a way forward with psychology – is an interesting one, as it has such broad reach within healthcare delivery.
“In the most recent Global Burden of Disease study (GBD2017), low back pain was ranked first and migraine second as the leading causes of disability worldwide. So pain is a less than trivial problem however you look at it. And we psychologists are so good at treating some forms of pain, such as headache and migraine,” Paul explains.
“The ultimate goal for psychologists is that we want to cure people, therefore my goal when someone comes to me with headaches and migraines is to help them completely overcome the problem. But chronic pain, such as low back pain, is tied to a physiological cause that often cannot be cured, so the role of the psychologist is to teach how to live with it and minimise the impact that pain has on the patient’s quality of life.”
Paul’s research focuses on identifying and managing the trigger of the headache or migraine as a more strategy for curing them.
“There are some pain management strategies you can use regardless of the cause of the pain. For example, we know that pain worsens when you pay attention to it, so we can cause distractions and provide strategies for refocusing that will overcome the pain,” says Paul.
“For other types of pain, we can use what we call cognitive therapy, where we challenge the thought process to provide alternative options that change a behaviour pattern.
“My work is in the triggers people experience that create headaches and migraines. Very logically, medical professionals have always believed that the best way to prevent migraine attacks is to avoid those triggers, but my research turned that around. I believe and have shown through my research that avoiding the trigger entirely is not an effective strategy for dealing with migraines, as it only increases the severity of the reaction when the patient does eventually experience it.
“Stress is one of the main triggers for migraines and headaches. In my scenario, rather than avoiding the thing causing stress, a psychologist works with their patient to understand the factors causing stress, to provide an individualised management plan. If the stress comes from their marriage, that may be marriage counselling. If it’s from a lack of social support, we would work with them to help them increase the size of their social network and help them develop strategies for seeking support from that network.
“Psychologists speak to people on average for an hour at a time, so we get the opportunity to build a strong relationship with our patients. Our role is to be there for them and talk about different alternatives and the impact that might have on their pain and help them determine what they might do next.”
Dr Heather Green is clinical psychologist, health psychologist, and Griffith University Expert. Her research focuses on quality of life and self-management for people who are living with or at risk of chronic illnesses, such as cancer. She says psychologists assist with the multi-faceted experience of pain in a number of ways. In looking to the future, Heather says psychologists will increasingly contribute to research, prevention, and treatment of pain.
“Some of Griffith’s own psychologists and researchers such as Dr Bonnie Clough, Dr Leanne Casey, and Professor Tamara Ownsworth are part of a team working with Queensland Health researcher-clinicians to identify how videoconference psychotherapy might be best used to assist patients with chronic spinal pain,” Heather says.
“In prevention, multiple research teams from Griffith University’s School of Applied Psychology are addressing practical, evidence based ways to reduce incidents that cause physical and psychological injuries from sources such as vehicle crashes, family violence, violence associated with alcohol use, and workplace stress.
“On the treatment side, psychologists work as part of multidisciplinary teams to help people with pain identify and implement strategies that consumers can use to manage and cope with pain. For example, psychologists can help consumers develop plans and goals for following doctors’ and physiotherapists’ treatment prescriptions, help to refine skills for non-pharmacological strategies for coping with pain, and work towards valued life goals that might change when someone is dealing with chronic pain.”
Heather is a member of the Menzies Health Institute Queensland’s Healthcare Practice and Survivorship Program. She says that helping people with pain has brought some of the most challenging and rewarding experiences as a clinical and health psychologist.
“I hope that the next generation of psychologists that we are training will continue to find new and better ways to help with pain, which affects so many people.”
One of the researchers Heather mentioned, Dr Bonnie Clough, is doing exactly that on her current project with the Royal Brisbane and Women’s Hospital Spinal Pain Unit. The project is targeted at bringing psychological therapies for pain management to people in regional and rural areas.
“We’re looking to combine the Spinal Pain Unit’s physical therapy with psychological therapy via videoconferencing technologies,” Bonnie explains.
“Traditionally these services are often only available in metropolitan areas which makes them hard to access for people living outside of those areas, so we’re trialing new ways of delivering those services via videoconferencing technologies. While that has obvious benefits to people who live outside of metropolitan areas, it can also help those in them as well, particularly those with limited mobility.
“We’re interested in discovering how to make this method of healthcare delivery effective, so we’ll be looking at the therapist and how they deliver the treatment, such as whether they need to use different techniques. We’ll also be looking at the client and considering their relationship with technology and their attitude towards pain management.”
Although set back slightly by COVID-19, the project is set to start taking enrolments in late 2020. Bonnie says that while this research is looking to the future of healthcare provision, like Heather, she is excited to see what the future holds for using psychology to treat pain, and looks to one particular technology she believes will have a big impact.
“I’m excited to see what the future holds when using virtual reality for pain treatment,” she says.
“There’s already some fascinating research in this space for acute pain, such as when someone visits the dentist or has a burn. But the future holds a lot broader scope, and research is beginning to look at how it could be used to treat chronic pain as well.
“Some treatments would use virtual reality as a means of distraction or meditation, but it can also be used to create a more immersive experience to help people become more mobile. This would be great for those who suffer from chronic pain – imagine an experience similar to Pokémon Go, where they would be using the technology to collect things while on a walk or discover the natural environment around them. That could greatly encourage mobility.”
If you’re interested in building a career in psychology or research, Griffith has a range of degree options in psychology. To find out more about Psychology Week, visit the Australian Psychological Society website.