Full Course Description

The Fit for Purpose Model of Pain and the Bioplasticity of Recovery

View one of the world’s most influential pain neuroscientists, Lorimer Moseley as he shares advances in managing one of the greatest challenges in healthcare - pain. Neuroplasticity is the wonderful ability of our brain and nervous system to adapt, however it is not just the brain changing by itself! The whole body is capable of change in which “bioplasticity” may be a more accurate term. Principals of bioplasticity and pain science education will be incorporated to develop a recovery plan. Lastly, the ‘Fit for Purpose Model’ of pain care will be introduced to enable, empower and optimize patient recovery.

Expect current viewpoints and age-old philosophies to be challenged as this session examines a new frontier of managing persistent pain. You will be provided with theoretical and reasoning models to guide modern science application in clinical practice. This clinical framework will assist in effective planning of patient recovery.

Program Information

Objectives

Investigate contemporary models of learning and how they relate to the development of, and recovery from, persisting pain.
Inspect the Fit for Purpose Model of pain care.
Evaluate the role of education about how pain works as part of an integrated recovery plan.
Investigate how contemporary principles of bioplasticity guide an integrated recovery plan.
Appraise the role of enablement and empowerment in optimizing recovery.

Outline

Learning and pain
- What is long term potentiation and what influences it
- Associative learning and the Imprecision Hypothesis of Chronic Pain
- Predictive processing for clinicians
The Fit for Purpose Model
- Understanding one is safe to move and load
- Feeling one is safe to move and load
- Experiencing one is safe to move and load
- Enablement, empowerment and resilience as mediators of recovery

Target Audience

Chiropractors
Physical Therapists
Physical Therapy Assistants
Occupational Therapists
Occupational Therapy Assistants
Other Rehab Health Professionals

Copyright : 03/03/2022

Unlock Healing Pathways: The Polyvagal Theory’s Role in Chronic Pain Rehabilitation

Dive into the transformative world of the Polyvagal Theory, a groundbreaking exploration of the intricate relationship between the vagus nerve, our physiological state, and resultant behaviors.

Understanding the autonomic nervous system’s role is paramount in tailoring treatments for those in chronic pain.

Unravel the concept of ‘neuroception’, our body’s subconscious radar for environmental safety or threat, guiding our physiological and behavioral responses
Delve deeper into the ‘Social Engagement System’, a cornerstone of the Polyvagal Theory, and discover how cues like voice tone or facial expressions can either foster or hinder therapeutic rapport and patient outcomes
Unpack the “Freeze Response’, a primal survival mechanism, and learn to discern its manifestations in patients
Equip yourself with knowledge on therapeutic models designed to harness cranial nerve feedback for relaxation and threat mitigation
Recognize and leverage cues of safety, a pivotal skill in enhancing patient well-being and recovery

You’ll gain insights into the nexus between chronic pain and autonomic regulation, empowering you to discern when pain transcends its initial cause and becomes a neural imprint. Join us in this enlightening journey, bridging the chasm between theory and clinical practice, and revolutionize your therapeutic approach.

Program Information

Objectives

List and define the key components of the Polyvagal Theory, including neuroception, the social engagement system, and the freeze response.
Describe the relationship between chronic pain and autonomic regulation, explain how pain can become chronic when wired into the nervous system and how cues of safety can alleviate such symptoms.
Implement therapeutic models, such as Alexander and Feldenkrais, to promote relaxation, reduce threat responses, and enhance the patient’s ability to recognize and respond to cues of safety.

Outline

Introduction to the Polyvagal Theory

Overview of the vagus nerve’s influence on physiological state and behaviors
Importance of the autonomic nervous system in shaping human reactions

Neuroception: The Body’s Safety Radar

Definition and significance of neuroception
How the nervous system subconsciously detects environmental safety or threats
Physiological and behavioral responses stemming from neuroception

The Social Engagement System

Introduction to this cornerstone of the Polyvagal Theory
Role of voice tone, facial expressions, and body language in conveying safety or threat signals
Physiological and behavioral responses stemming from neuroception

The Freeze Response: A Survival Mechanism

Understanding the freeze response and its manifestations
The body’s immobilization strategy during perceived threats
Differentiate between freeze response in humans and animals

Physical Responses to Perceived Threats

Recognizing the body’s physical reactions, such as increased muscle tone or skin coloration changes
Insights into an individual’s state of defense or threat

Therapeutic Approaches for Relaxation and Threat Mitigation

Introduction to therapeutic models like Alexander and Feldenkrais
Harnessing cranial nerve feedback for relaxation
Strategies to reduce threat responses in patients

Neural Stimulation Models

Overview of commercial devices aiming to change the autonomic state
Potential of vagal nerve stimulators and their effects on cranial nerves

Chronic Pain and Autonomic Regulation

Exploring the relationship between chronic pain and autonomic regulation
Understanding how pain can become a neural imprint, separate from its initial cause
The role of safety cues in alleviating chronic pain symptoms

Target Audience

Physical Therapists
Physical Therapist Assistants
Occupational Therapists
Occupational Therapist Assistants
Licensed Massage Therapists
Chiropractors
Athletic Trainers
Nurses
Nurse Practitioners

Copyright : 04/25/2024

Knowing Pain Is Not Treating Pain

You won’t want to miss this opportunity to view one of the great contributors to pain neuroscience, Dr. Adriaan Louw, PT, PhD. We are in a pain revolution! It’s not uncommon for healthcare providers to now talk about central sensitization, neuroplasticity, ion channel expression, inhibition, facilitation and more. But what does this mean for the patient? Knowing more about pain does not mean it reaches the consumer – the patient. This session will showcase how pain neuroscience education has evolved as a powerful intervention for treating people experiencing pain. Additionally, this session will examine how pain neuroscience has found its way into various clinical settings, diagnoses, and reached different healthcare providers. However, unless pain science reaches the end-user, the patient, it’s worthless! Viewers will be introduced to current evidence-based practices in addition to clinical application and significance.

Program Information

Objectives

Analyze the evidence supporting pain neuroscience education for people in pain.
Integrate the latest pain neuroscience into clinical reasoning in people with persistent pain reports.
Develop an understanding of the need to drive implementation of pain neuroscience education in clinical settings among healthcare providers and multiple diagnoses.
Apply the presented concepts, treatments, and examples into immediate clinical application.

Outline

The Human Pain Experience
- The mature organism model
- Input-dominant mechanisms
- Processing-dominant mechanisms
- Output-dominant mechanisms
Pain Neuroscience Education
- Evolution of pain education
- Evidence for pain neuroscience education
- Evolution and emergence of the PNE+ approach
Delivering Pain Neuroscience Education
- Evaluation, screening and setting the scene
- Pain metaphors
- Deep learning
- Adding into PNE+
Reaching patients
- Chronic pain
- Acute pain
- Healthcare providers
- Clinical settings

Target Audience

Chiropractors
Physical Therapists
Physical Therapy Assistants
Occupational Therapists
Occupational Therapy Assistants
Other Rehab Health Professionals

Copyright : 03/03/2022

Empowered Relief™: A Brief and Scalable Solution for Chronic Pain Management

Watch Stanford pain scientist, clinical psychologist, author and international speaker, Beth Darnall, PhD as she introduces Empowered ReliefTM. Empowered ReliefTM is a NIH-funded single-session 2-hour intervention that rapidly equips participants with effective pain relief skills. Remarkably, this method provides advances in scalable behavioral medicine for pain management that may be delivered by ALL healthcare providers! You won’t want to miss this opportunity to discover a method that can make behavioral pain care broadly accessible to your patients, thereby avoiding a singular focus on interventional and procedural approaches to chronic pain management only. Backed by four separate randomized controlled clinical trials conducted at Stanford University, Empowered ReliefTM complements traditional treatment strategies for meaningful ‘whole-person’ pain management.

Program Information

Objectives

Compose two outcomes for Empowered ReliefTM in chronic pain scientific studies.
Investigate how scalable and digital behavioral medicine is being applied within various healthcare systems internationally.
Assess how Empowered ReliefTM is supporting chronic pain management and surgical recovery.
Investigate evidence-based strategies for increased client engagement, treatment adherence and increase the likelihood of overall treatment success.

Outline

Introduction
- What is the clinical relevance of pain?
- Financial Implications
- Pain driven procedural/interventions approach to ‘fixing pain’
- Opioid crisis
The Problem
- Brief review of current models and limitations
- Pain driven treatment
- Lack of behavioral/psychological involvement for self-management
- Accessibility to proper care is limited on many fronts
A Solution
- 2-hour pain management intervention – Empowered ReliefTM
- Pain neuroscience, self-regulatory skills to address pain and stress
- Rooted in CBT theory
- Evidence-based skills, includes mindfulness principals, relaxation strategies
- Didactic delivery vs. therapy – allows large class size
The Science
- Four randomized controlled trials conducted at Stanford University
- Efficacy at 3- and 6-months post class
- NIH-funded randomized controlled trial supports non-inferior 2-hour Empowered ReliefTM as compared to 8-sessions (16 hours) of cognitive behavioral therapy
- Multidimensional outcomes: reduced pain intensity, interference catastrophizing, sleep disturbance, depression, anxiety, pain bothersome and fatigue
- Enduring effects for Empowered ReliefTM at 6-months posttreatment comparable to 16 hours of CBT
Adoption
- 300 clinicians certified across varied health disciplines
- Delivered in 12 countries in 6 language translations
- Cleveland Clinic Spine Surgery requirement
Conclusion
- Precipice of change in pain management approach and delivery
- Accessible evidence-based, integrated pain treatment
- Alter how healthcare is received for reduced health and pain care disparities to our most vulnerable patients
- Inspired visions – reduce suffering by meeting patients where they are

Target Audience

Chiropractors
Physical Therapists
Physical Therapy Assistants
Occupational Therapists
Occupational Therapy Assistants
Other Rehab Health Professionals

Copyright : 03/03/2022

A Rehab Science™ Approach to Overcome Pain: Empowering Patients with Practical Strategies for Self-Management and Recovery

Pain is a multi-dimensional experience that can manifest differently from person to person. So, what’s the optimal approach to treat pain?

It starts with concise education, systematic movements/exercise, and appropriate mindset. Learn how you can turn these simple strategies into a transformational tool for your patients.

Join Dr. Tom Walters, Author and Founder of Rehab Science™ and an accomplished Physical Therapist with over a decade of experience treating musculoskeletal pain and movement disorders.

Dr. Walters will challenge outdates and misconstrued principles of pain management with evidence-based, optimized protocols for healing and recovery.

Learn how to progressively load the musculoskeletal system with appropriate levels of input to gradually desensitize pain thresholds
Discover graded exposure techniques to reframe pain-avoidance behaviors and overcome fear with movement patterns
Adopt a Rehab Science approach to empower your patients with self-management interventions to take control of their pain
Unpack the debate of RICE vs. Movement – What’s the optimal approach following injury?
Delve into whole-body exercise protocols patients can easily follow to reframe their pain experience

You’ll develop a multi-system clinical framework that champions self-guided pain management through clear education, fine-tuned movement, and graded exercise.

Program Information

Objectives

Demonstrate graded exposure as a therapeutic intervention to influence pain tolerance and gradually encourage functional movement patterns the patient avoids.
Analyze the effect of stress on the musculoskeletal system and evaluate the clinical effectiveness of gradual progressive load on the musculoskeletal system to desensitize stress and increase pain threshold.
Communicate strategies that empower patients to manage their pain with evidence-based, self-guided, treatment protocols and exercise interventions.

Outline

How Did We Get Here: Conceptualize Modern Pain Science

The Cartesian Model as a starting point
A fundamental shift in thinking – pain as an output of the brain neuromatrix
Analyzing pain as a survival mechanism
Actual or potential damage – can it be both?
Sensory and emotional components – How they affect the pain experience
Exploring your environment and culture in the context of pain expression

Sensing Through the Pain Loop

Review of afferent and efferent pathways in process of sensory input
Classification of Pain
- Mechanical (nociceptive)
- Neuropathic (nerve)
- Persistent (chronic)
Identifying the point of overlap between pain types
Why pain state is not always an accurate representation of physical function
Sensor sensitivity and pain expression – how are they related

Building a Greater Pain Threshold

Rewiring the neurosignature through neuroplastic interventions
Perception vs. tolerance – how does pain catastrophizing inhibit recovery?
Introducing the concept of graded exposure
Progressive load/resistance as a catalyst for desensitization to stress
Clinical language shapes patient perception
- There are no “bad” movements
- Focusing on Implementation of exercise/movement

Challenging Outdated Models and False Beliefs

Balancing rest & movement – What’s the optimal approach
Analyzing RICE model vs. PEACE and Love
Exercise prescription – how much, and how soon?
Looking beyond the Placebo effect – the Nocebo effect

Empowering Patients with Self-Management Strategies

Harness a concise step-by-step blueprint to systematically address injury/pain
- Reduce pain – address impairments – build capacity
Establishing a multi-modal plan of care
- Soft tissue mobilizations
- Aerobic activity
- Mobility & flexibility
- Resistance Training
Strategies for patient adherence with therapeutic protocols
The impact of clear and consistent communication

Target Audience

Physical Therapists
Physical Therapist Assistants
Occupational Therapists
Occupational Therapist Assistants
Licensed Massage Therapists
Chiropractors
Athletic Trainers
Nurses
Nurse Practitioners

Copyright : 04/25/2024

Bi-Directional Associations of Chronic Pain: Exploring How Trauma May Impact Rehab and Functional Outcomes

PTSD and chronic pain are both often misrepresented as lifelong sentences. But now you can get the support and skills you need to confidently work with clients who are experiencing these conditions. In this course, you will receive a blueprint for effective treatment with this complex population. This course will cover functional and targeted assessments along with culturally-informed conceptualization skills. Additionally, the course will also explain strategies to fundamentally alter the ways clients’ brains and bodies interpret and respond to perceived threats and pain. Finally, the course will end with powerful behavioral treatments and adjunctive approaches for managing, reducing, or even alleviating pain.

Program Information

Objectives

Assess pain and related comorbid mental health symptoms to inform treatment interventions.
Utilize intentional questions and appointment framing to assist client with goal-setting.
Demonstrate a values clarification intervention with clients with chronic pain and trauma.
Analyze and differentiate between the presentations of trauma, PTSD, and pain.
Formulate treatment plan integrating emerging treatments and complimentary approaches.

Outline

All Roads Lead to the Nervous System

Pain as a threat system – What does that mean?
The trajectory of acute and chronic pain
Principles of pain: nociceptive, neuropathic, and nociplastic
Pain intensity versus pain distress
How pain can have hidden benefits

Pain is Bi-Directional: A Reciprocal Relationship Between Physician and Mental Health

The effect of pain on clients’ sense of self
Helping patients identify and challenge pain-related myths
Assessment of pain and related comorbidities
When pain itself is a reminder of the traumatic event/injury
Recognize pain catastrophizing behaviors
The role of central sensitization and its impact on therapeutic outcomes
Identify and shift vicious cycles and maladaptive coping strategies
Implementing behavior changes that carryover to healthy daily activities/routines

The Chronic Pain Toolkit: Behavioral Treatments and Adjunctive Approaches

Pain neuroscience education
Targeted pain management strategies
Motivational Interviewing and Solution Focused Brief Therapy techniques to optimize client engagement and outcomes
Mindfulness and yoga for pain reduction
Effective collaboration with medical providers
Establish therapeutic alliance when the client has chronic pain, and the therapist does not
Calm the nervous system with relaxation strategies and breathing techniques

Target Audience

Physical Therapists
Physical Therapist Assistants
Occupational Therapists
Occupational Therapist Assistants
Licensed Massage Therapists
Chiropractors
Athletic Trainers
Nurses
Nurse Practitioners

Copyright : 04/25/2024

Harnessing the Nervous System as a Therapeutic Intervention: Restoring Care That Can be Transformational, not Transactional

During the seminar, we’ll explore the role of cognitive, behavioral and integrative strategies in managing chronic pain, leading to an improvement in coping and daily functioning. We will delve into the complexities of chronic pain, with a focus on helping you to understand how dysregulation of the nervous system and neuroinflammation contributes to heightened pain perception. You’ll learn pain relief therapies that help the client gain interoceptive awareness and explore cognitive and behavioral strategies to enhance your client’s ability to cope. You’ll be given tools for mindfulness, meditation and tapping that promote relaxation and acceptance of physical sensations. You’ll explore interoceptive exercises such as body scanning, progressive muscle relaxation as well as anti-inflammatory nutrition that will improve your client’s muscle tension, stress and quality of life. You’ll be equipped with various techniques and strategies that will allow you to manage chronic pain more effectively. With tools that are meant to complement traditional pain management, you’ll have a holistic approach to chronic pain management.

Program Information

Objectives

Analyze signs and symptoms of nervous systems dysregulation and how it contributes to pain, as well as how to harness neural regulation as a therapeutic intervention for pain relief.
Integrate interoceptive awareness, cognitive, behavioral and integrative strategies for pain relief when working with clients.
Determine clinical efficacy and utilize integrative treatments such as mindfulness, tapping, breathwork, body scanning and progressive muscle relaxation in the management of chronic pain.

Outline

Exploring the Biopsychosocial Model of Pain
Understanding Neuroscience of Hyperalgesia
Models of Neuroplasticity for Pain Relief
Interoceptive Awareness as Foundation of Mind-Body Healing
Cognitive Strategies to Enhance Coping: Minimizing Catastrophizing and the Anticipatory Response
Nutritional Strategies to Address Inflammation
Integrative Strategies; Mindfulness, Meditation, Guided Imagery for Pain Relief
Empowering Client’s Coping with Tapping, Breathwork and Progressive Muscle Relaxation

Target Audience

Physical Therapists
Physical Therapist Assistants
Occupational Therapists
Occupational Therapist Assistants
Licensed Massage Therapists
Chiropractors
Athletic Trainers
Nurses
Nurse Practitioners

Copyright : 04/26/2024

Red Light Therapy for Pain and Inflammation

Red light therapy is growing in popularity – and it’s no wonder why. With proven applications for pain, inflammation, and healing, you easily can layer this therapy with your existing treatment! The results from this simple and cost-effective treatment are unparalleled. You get all the benefits of light, without the risks of UV light. Learn how red-light therapy has helped thousands of clinicians get better outcomes as you impact tissues at a deeper level than traditional approaches!

Program Information

Objectives

Appraise mechanisms of red light therapy that are specifically designed to treat symptoms and effects of pain and inflammatory conditions.
Practice and refine red light therapy treatment techniques that are specifically tailored to improve common conditions such as local and systemic pain, inflammation, as well as the patient’s perception of pain experience.
Evaluate clinical case situations where red light therapy may benefit a patient experiencing pain and inflammation and justify treatment approaches and parameters based on recent scientific review.

Outline

Yesterday’s Medicine and Today’s Science

Light in Medicine
History and Recorded Uses
Key Terms in Light Therapy
- Electromagnetic Spectrum
- Wavelengths
- Light Pathways - visual and skin
- Natural Light Recommendations

Light Effects on the Human Body

Cellular Mechanisms (How Light Works at the Cellular Level)
- Inflammation
- Cellular Protection
- Proliferation
- Migration
- Protein Synthesis

Molecular Mechanisms (How Light Works at the Molecular Level)

CCO
Collagen
ROS
Cytokines
Keratinocytic Growth Factor
Photoreceptors
Mitochondria

Today’s Science: Red and Near Infrared Light Therapy

LED vs. Laser technology
Defining and understanding:
Terminology in Red Light (LED) Therapy
- Irradiance/Intensity mw/Cm2
- Dosage J/cm2 - Energy
- Treatment Time
- Treatment Area
- Treatment Frequency
- Direct contact vs. non direct contact red light therapy - wraps vs. panels

Contraindications to Light Therapy Treatment

Heat/Thermal
Eyes
Skin Tone
Age: Geriatrics & Pediatrics
Health Conditions: Pregnancy
Medication Interactions
EMF & Flicker

Pain Pathophysiology

Mechanisms of Pain and Inflammation
Typical Patient Presentation
- Local, Systemic, Post-Operative
Historical Treatment Options
Epidemiology and Prevalence Data
Typical Disease Progression

Pain and Inflammation Symptoms:

Pathogenic and neurogenic
Inflammation
Sensation Loss or Hypersensitivity
Pain and Inflammation from Delayed Wound Healing
Pain and Inflammation from Immobilization or Surgery

Treatment Regions and Red Light Therapy Protocols for Pain/Inflammation Conditions:

Pain/Inflammation Conditions of the Upper Body
Pain/Inflammation Conditions of the Lower Body
Pain/Inflammation Conditions of the Spine
Systemic Pain/Inflammation Conditions

For all Pain and Inflammatory Conditions, each section will include content on:

Mechanism of how red light influences the particular problem
Research review on pertinent studies related to the indication
Treatment parameters for each indication

Picking a Red Light Therapy Product for Clinic/Home Use

Review Power measurements
Irradiance
EMF
Flicker
Contact vs. Non Contact

Case Study Review

Target Audience

Nurses
Nurse Practitioners
Clinical Nurse Specialists
Physician Assistants
Physical Therapists
Physical Therapist Assistants
Athletic Trainers
Coaches
Personal Trainers
Strength and Conditioning Specialists
Occupational Therapists
Occupational Therapy Assistants

Copyright : 06/30/2023

Healing Arts: Narrative Medicine and Pain Care

There is no objective measurement for pain. No thermometer, blood test, visual or manual assessment will tell you how much someone hurts. Pain is a lived experience revealed only through the stories of the one living it. Neuroscience shows that pain is highly influenced by stories too: personal experiences, beliefs, and expectations (the stories we tell ourselves) are just as relevant to recovery as diagnosis and prognosis (the stories our doctors tell us). And yet, most clinical education fails to prepare healthcare professionals to interact with stories in a meaningful way. Narrative Medicine, a new field of study emerging from Columbia Medical School, addresses the need for narrative competence with a practice. Through close reading, the signature method of Narrative Medicine, healthcare professionals learn how to listen attentively and generously to patient stories. Reflective writing exercises also help practitioners examine their own narrative in supportive group settings. By bridging healthcare and the humanities, Narrative Medicine hopes to reform healthcare systems that so often miss the story behind the symptom and the human behind the patient.

Program Information

Objectives

To develop our skills as close readers of art so that we become more attentive to the stories of our patients and learn how to listen and reflect with empathy.
To provide a psychosocial complement to biomedical models of healthcare.
To build a safe space for healthcare providers to connect, collaborate, and process our experiences through the lens of art.

Outline

Introduction

What is Narrative Medicine?
- ”A medical approach that uses people’s stories in clinical practice, research, and education as a way to promote healing” ~ NYU School of Law
- ”A response to a commodified health care system that places corporate and bureaucratic concerns over the needs of the patient” ~Rita Charon
- As we practice absorbing, interpreting, and reflecting on the stories told in literature and other artworks, we are simultaneously learning how to absorb, interpret, and reflect on the stories our patients tell us in a clinical setting – and to be as moved by them.
Experiential Learning
- Narrative competence is built experientially rather than didactically
- Didactic learning: explanatory, removed, cognitively fixed, theoretical, individual, focused on the question “what”
- Experiential Learning: exploratory, immersive, cognitively flexible, practical, collaborative, focused on the questions “how” and “why”
- Through the lens of art, we approach our self-stories obliquely with fresh curiosity. By allowing our self-stories to brush up against the stories of others, we shake the dust of our own curated and stagnant personal histories
Pain Science Stories: An Online Collaborative
- Review of our 15-week qualitative research study with pain care providers from around the world
- Student self-assessments pre-and-post study; the impact of Narrative Medicine on practitioner listening skills, empathy, and burnout

Integrative Narrative Medicine Workshop

Close Reading
- The careful, sustained analysis of an artwork that focuses on significant details or patterns in order to develop a deeper understanding of the text’s meaning
- Close Reading Workshop: Picasso’s Weeping Woman
- Take a few minutes to observe this painting in silence. As you observe, I invite you to slow down, be with this painting, enter its space and perspective, and consider the ways it speaks to you
- After a few minutes of observation, you might begin to notice that you can read this painting a lot like you can read a story from a book. Let’s begin our discussion by examining this painting’s setting and plot:
  - What is happening in this painting?
  - Describe the woman’s expression. Does she have more than one?
  - Describe how the color palette and the geometry shifts as you move toward the center of the painting. What does this shift in color and geometry suggest about suffering?
- Students use chat box or “raise hand” to answer the close reading questions above
Reflective Writing
- Timed writing prompts are an experiment in self-discovery. Writing is a way of learning what one knows
- Writing “in the shadow” of the text: an invitation for you to creatively express how this story has impacted and interacted with your own personal story
- Reflective Writing Workshop
- Students free-write for 5 minutes on the following prompt: “Give this painting a voice” OR “Where have you seen this face before?”
Attentive Listening
- Thinking “with” rather than “against”
- An ethic of listening humbly and generously that gives storytellers the benefit of the doubt (even as we ask them questions and make observations that will help then refine their thoughts)
- ”In listening for the other, we listen for ourselves.” ~Craig Irvine
- Attentive Listening Workshop
- We will share our reflective writing with the group, “close reading” each other’s writing with the same generous attention to detail we gave Weeping Woman. We will ground our observations in the details of what is being told, observing the details of plot, time, setting, perspective, and imagery
- Ask for 1-3 volunteers to read their responses aloud to the group. Leader demonstrates active listening/reflecting and asks volunteers from the group to share their reflections too
- If possible, plenary group breaks into small groups via breakout rooms to practice listening and reflecting to each other’s stories
- Sharing is never an obligation. If a student would prefer not to share what they’ve written, I will encourage them to share what it felt like to write something so vulnerable instead
Integration
- Group Discussion (volunteers “raise hand” to answer): After all this reading, creating, and sharing, how do you feel?
- Share a nugget of wisdom you’ve picked up here
- How does this relate to your pain care practice?

Conclusion

Recap: The 3 Movements of Narrative Medicine: These “movements” are cultivated through the practices of close reading, attentive listening, and reflective writing:
- Attention: the “heightened focus” that a listener devotes to a teller
- Representation: a retelling of what is told to us in the effort to better comprehend a story
- Affiliation: the relationship that develops between storyteller and listening as a result of true listening and generous reflection
The Ethics of Caregiving
- ”Spaceship Ethics”: A coping mechanism in which caregivers consider themselves removed from, or above, the plights of the ill and dying. A disembodied perspective that denies both the patient and the caregiver humanity vs
- Narrative Ethics: An ethical practice of positioning oneself on an equal plane with a storyteller, not allowing oneself to be affected, changed, and moved to action by a patient’s story
- ”To decide to listen, to attend to the other’s story, is already to take an ethical stand. To enter the story, the listener must experience its moral complexity in all its ambiguity and challenge to one’s own moral sense” ~ Arthur Frank, The Wounded Storyteller
Contact Info and References
- Limitations of the research and potential risks

Target Audience

Physical Therapists
Physical Therapist Assistants
Occupational Therapists
Occupational Therapist Assistants
Licensed Massage Therapists
Chiropractors
Athletic Trainers
Nurses
Nurse Practitioners

Opioid Use Disorders: The Intersection Between Pain Management and the Opioid Epidemic

A deadly epidemic of serious magnitude. The worst drug crises in U.S. history continues to grab headlines. But you know what lies behind the headlines… people. People left physically and emotionally depleted by highly addictive substances. People who desperately need help… YOUR help!

Yet drug driven brain change, and dependency make opioid disorders incredibly challenging to manage with life threatening implications. Are you equipped to make the difference that can save a life?

This session will provide you with evidence-based tools and techniques you need to screen for opioid use, eliminate barriers to treatment, overcome co-occurring disorders that impede recovery, and effectively intervene with skilled therapeutic approaches.

What you’ll learn…

Explore the neuroscience behind the unique risks of opioid abuse
Identify warning signs – when pain management turns into addiction
Tailored strategies to overcome the barriers to opioid use disorder treatment
Screening tools and treatment approaches for co-occurring disorders
Non-pharmacological interventions – Available options and what you need to know

Program Information

Objectives

Characterize how the addictive properties and physical impacts of opioids on the body increase the risk for deadly overdose, and specify how this information informs treatment approach.
Communicate how clinicians can assess ongoing opioid use treatment to evaluate effectiveness, and outline steps that can be taken to modify treatment when needed.
Articulate how screening tools can be used with opioid addicted clients to identify co-occurring disorders that can negatively impact treatment outcomes.

Outline

The Relationship Between Pain and Opioid Misuse

Summary of brain centers that are affected by pain
The pain-opioid Paradox
Vulnerability factors that are associated with opioid misuse

What Neuroscience Reveals About Opioid Abuse VS Other Substance Abuse

How chronic opioid use changes the brain
The pleasure factor (how dopamine fits with opioid use)
The social factor (how opioids mimic the chemical responses of social connections)
The connections between important decision-making sections of the brain and long-term opioid abuse

Barriers to Opioid Use Disorder Treatment

Separation of the mental health and addiction treatment systems
Detox vs. maintenance treatment
Availability and affordability
Overcome self-stigma, and shame

Identify and Treat Co-Occurring Disorders

The impact of co-occurring disorders on treatment outcomes
Screening procedures and tools
What to do about chronic pain - Treatment considerations and planning
Validity in co-occurring treatment research
Risks associated with co-occurring treatment options

Impact of Non-pharmacological Treatment Options

Mindfulness as an intervention
Motivational strategies for improved outcomes

Target Audience

Physical Therapists
Physical Therapist Assistants
Occupational Therapists
Occupational Therapist Assistants
Licensed Massage Therapists
Chiropractors
Athletic Trainers
Nurses
Nurse Practitioners

Integrative Approach for Chronic Pain Syndromes: Multifaceted Solutions for Managing Fibromyalgia & Myofascial Pain

Are you comfortable with treating patients who have chronic pain? Patients with chronic musculoskeletal pain present considerable challenges in assessment and in selection of effective therapeutic interventions. Many have been to numerous practitioners seeking results unsuccessfully, despite taking many drugs, becoming opioid addicts, and trying a variety of therapies. Some have been misdiagnosed. This course clearly describes the two main categories of chronic pain conditions: fibromyalgia syndrome (FMS) and myofascial pain syndrome/chronic musculoskeletal pain (MPS). Participants will learn to recognize these syndromes and the co-morbid conditions commonly associated with them. Research evidence will be presented to describe the clinical tests used by medical providers in determining appropriate diagnosis of FMS or MPS. The latest in best practices to manage FMS and MPS is discussed with current evidence-based research. This information is a must for any practitioner who treats patients suffering with chronic FMS or MPS.

Program Information

Objectives

Compare the clinical characteristics of fibromyalgia and myofascial pain syndrome/chronic musculoskeletal pain.
Define trigger points and give examples of types of trigger points that may contribute to mobility and pain impairments in chronic pain syndromes.
Discuss research describing interventions for promoting functional outcomes for people with fibromyalgia and myofascial pain clinicians may incorporate into program design to address chronic pain successfully.

Outline

Hour 1:

Who Addresses Chronic Pain?
Assessment and Management o Fibromyalgia (FMS) & Myofascial Pain
The Cost of Pain
Impact of Pain on Lifestyle and quality of Life
Medical issues with FMS: GI, Immune System, Hormonal, Fatigue
Mobility Impairments
Exercise for FMS

Hour 2:

Research on FMS
Myofascial Pain/Myalgia/Chronic Musculoskeletal Pain (MPS)
What about Myofascial Trigger Points (TPs)
Differentiate MPS from FMS
Myofascial Release/Fascial Mobilization
Muscle Energy and PNF
Visceral Manipulation
Lifestyle and Movement Education
Sample interventions for Painful Muscle Tension: Myofascial Release, Positional Release, Muscle Energy demonstrations

Target Audience

Physical Therapists
Physical Therapist Assistants
Occupational Therapists
Occupational Therapist Assistants
Licensed Massage Therapists
Chiropractors
Athletic Trainers
Nurses
Nurse Practitioners

Contributions of the Abdominal Ganglia in Chronic Pain

No system in the body works alone, gets injured alone or heals alone. There is no such thing as an isolated injury in the body. There is no such thing as isolated healing. The opioid crisis has brought clarity that conventional approaches to chronic pain management are inadequate. Thus, the time to look beyond the ‘norm’ for how we can do better is now! Chronic debilitating pain is solvable in most instances with the proper skillset and patient participation. Discover techniques to achieve sympathetic/parasympathetic balance of the nervous system to reduce chronic muscle tension. Additionally, this session will examine how the abdomen relates to full body chronic pain issues and identify an elusive cause of chronic pain. Don’t miss this opportunity to expand your clinical skillset and improve treatment outcomes.

Program Information

Objectives

Investigate the four abdominal ganglia and why they matter in chronic pain.
Develop a manual assessment technique of the abdominal ganglia.
Analyze the relationship of the abdominal ganglia and pain to the vagus nerve.
Construct techniques for stimulation of the abdominal ganglia.

Outline

Abdominal Ganglia 101
- Celiac, Superior Mesenteric, Inferior Mesenteric, Hypogastric
- Anatomy and relationships between ganglia
- Diaphragm pressure influence
- Sympathetic reflex spinal referrals
Assessment and resets
- Manual palpation
- Manual resets
- Using vibration and diaphragm doming
- Lumbar lymph node intestinal wave

Target Audience

Chiropractors
Physical Therapists
Physical Therapy Assistants
Occupational Therapists
Occupational Therapy Assistants
Other Rehab Health Professionals

Low Back Pain

Patients are frustrated by the lack of continuity in messaging and recommendations for dealing with pain. With this evidence-based guide to managing low back pain, you’ll learn progression and regression strategies to achieve patient goals, mind-body practices that will improve functional outcomes, graded exposure techniques to reframe the pain experience, and strategies for external cues to re-pattern motion to be more effective and efficient.

Program Information

Objectives

Implement a biopsychosocial (BPS) framework centered around communication and compassion to improve therapeutic alliance and client self-efficacy.
Develop useful analogies and ways to reframe pain and other negative emotions to help clients realize their strengths in the rehabilitation process.
Incorporate "Emotional Programming" into your current therapeutic prescription to help clients connect mind-body training.

Outline

Chronic Low Back Pain, Overall Well-Being & the Biopsychosocial Model

Foundations of Pain science – Pain isn’t always a pathoanatomical response
Understanding the context
Three L’s: Listen, Language, Lead
How to normalize a pain experience
Reframing pain -Managing misinformation
Why “stop moving” is rarely the answer
Mitigating neurologic threat
Graded exposure 
Shared decision making and self-efficacy

Techniques to Reduce Pain, Improve Function and Enhance Quality of Life

Utilize BPS concepts to guide movement entry points
Develop full body training programs that promote resiliency
Strength and mobility interventions for patients of all ability levels
Proximal stability and distal mobility
Breathwork
Increasing sensory awareness (reconnect pathways reinforcing recognition of region)

Target Audience

Physical Therapists
Physical Therapy Assistants
Athletic Trainers
Massage Therapists
Chiropractors