The purpose of the Interdisciplinary Assessment is to determine if the patient is a suitable candidate for the treatment approach offered in the Intensive Program at the Michael G. DeGroote Pain Clinic. This assessment takes place over one or two days.
As part of the Assessment, the patient attends an orientation session to learn more about the program and the treatment approach offered here. They then meet with the Assessment Team - Physician, Psychologist and another Clinician such as an Occupational Therapist or Social Worker. Following this they meet individually with each of the assessors.
The physician will participate as a member of the interdisciplinary team to review the documents provided. This would include review of all previous diagnostic investigations and treatment plans. As part of the assessment the physician will use both qualitative and quantitative tools that have been validated in the literature. The assessment of co-morbidities that could affect the treatment plan and possible outcome of therapy will be evaluated. The risk for addiction, sleep and mood disorders, and inappropriate use of opioids will be components of the assessment. The physician also assesses medical stability to participate in the rehabilitation program, i.e. uncontrolled hypertension, uncontrolled asthma, unstable coronary symptoms, etc. Where possible, a diagnosis will be identified and treatment plans consistent with national and internationally accepted treatment guidelines will form part of the recommendations.
The Psychologist performs an assessment in order to investigate the contribution of psychological factors to patients’ chronic pain problems, and to diagnose common co-morbidity in chronic pain such as depression and anxiety. Assessment consists of an interview and administration of psychometric instruments to assess various pain-related variables such as pain-related disability, mood, anxiety, catastrophizing, coping strategies, readiness for change, and acceptance of pain. Personality assessment is also undertaken. The Psychologist renders DSM-IV diagnoses as appropriate as well.
The clinician reviews the patient’s current level of functioning, tolerances, barriers and obstacles to managing their pain more effectively. They also collect data on personal, family, and employment history. As well, they determine if they are able to set goals aimed at increasing their level of functioning and activity involvement even though their pain continues.
The assessment details and findings are discussed at a Case Summary Meeting amongst the Assessment Team and a decision is made about the patient’s suitability for treatment at the Program. A thorough assessment report detailing the assessment findings and recommendations is provided.
The psychological component of the initial assessment in our Program is only one part of the overall interdisciplinary assessment for consideration of recommending an individual with chronic pain to the intensive four-week interdisciplinary chronic pain management Program. The initial assessment includes medical and functional aspects in order to be comprehensive and to abide by the biopsychosocial model. Individuals with chronic pain need to be assessed and treated within the biopsychosocial model utilizing multiple disciplines and considering multiple factors to best address the complexity of chronic pain. Such multiple disciplines are involved in the Intensive Program and are working together at the same time, not in a piecemeal and compartmentalized fashion. Patients with chronic pain are best treated using multimodal treatment rather than unimodal ones. The psychologist is involved integrally throughout this process: From the screening (via questions pertaining to emotional status variables) to the initial assessment (psychological component) to the treatment and program evaluation phases of the patient’s trajectory.