Inspiring a Discipline to Take on Pain
It can be difficult enough to persuade one person to recognize pain as a crucial issue, let alone an entire discipline, but that’s exactly what Mayday Fellows Shirley Otis-Green (left) and Terry Altilio (right) are trying to do. Altilio and Otis-Green have used their Mayday Pain & Society Fellowships to enhance their efforts to call attention to the important role social work plays in quality pain management. The driving force which infused their Mayday application and projects was the need to educate social workers and the greater pain community about the potential for social work to address the psychosocial, policy and ethical aspects of pain.
“It’s important for us to look at pain as not just a physical problem, but a full body, multi-dimensional experience,” Otis-Green said. “Ideally, we need a collaborative, interdisciplinary team approach to address the experience of pain that someone might have.”
While social workers have skills to address the multifaceted experience of persons who live with pain, most do not have pain management on their radar screen. With training and mentorship, they can help with practical aspects of the pain experience as well as use cognitive behavioral techniques, like relaxation skills and visualization exercises, pain diaries and family interventions to assess and enhance the quality of life of patients and their families.
For patients experiencing pain, social workers may educate, advocate and provide mental health services, especially important for those patients at risk of being undertreated for pain. Social workers practice in settings where vulnerable populations are cared for and they can give voice to the very young, very old, and those who are at the end of life, as well as those who are unable to clearly communicate their symptoms.
“Everything I do is colored and influenced by the workshop and coaching. It was a wonderful training because it highlighted for us how to take what we do and convey it in a more market-friendly way,” says Otis-Green, who feels more confident in her ability to ask reporters the right questions and effectively convey clear messages about social work and efforts to improve pain care.
And this confidence is getting their message far – Otis-Green wrote a letter to the editor which was published in the March 2007 issue of the American Journal of Critical Care, pitched a news brief about the importance of social work and pain management to NASW CA News, and Altilio submitted an invited entry on social work and pain management to the Encyclopedia of Social Work in addition to writing a segment on pain to the National Association of Social Workers (NASW) consumer web page “Help Starts Here.” The same organization hosted Altilio in a teleconference in November 2007 on Pain: An Introduction and an Opportunity for Social Work Involvement.
The intensive media training proved useful when Otis-Green participated in the National Association of Social Workers Health Specialty Section national teleconference titled “Treating the Psychosocial Aspects of Pain Management.” She has also been interviewed by several radio stations and has developed what she calls a “more sophisticated appreciation for the media.” Altilio was interviewed with a nurse colleague for a series of Web-based talk shows “Let’s Talk Pain,” produced by the Let’s Talk Pain coalition.
Both Otis-Green and Altilio continue to be active in educating social workers about their potential to intervene in pain and symptom management, frequently speaking at professional conferences across the nation. Otis-Green developed a pain course called “Promoting Excellence in Pain Management and Palliative Care for Social Workers.” Now, in its fourth year, the course received the 2008 Healthcare and Aging Network Award for “Innovation and Quality” from the American Society on Aging. Altilio continues to teach pain and symptom management in a national social work curriculum in end of life and in both New York University and Smith end-of-life post graduate certificate programs,
Currently, Otis-Green and Altilio are editing a text on palliative social work to be published by Oxford University Press intended both for practicing clinicians and for educators who will mentor the next generation of social workers. They are infusing messages about pain management principles throughout the text and will continue to create opportunities to enhance the role of social work in the all aspects of pain and symptom management.
Shirley Otis-Green, MSW, LCSW, ACSW, OSW-C, is a 2006-07 Mayday Fellow and a Senior Research Specialist at the Division of Nursing Research and Education at City of Hope National Medical Center.
Terry Altilio, LCSW, ACSW, is a 2006-07 Mayday Fellow and is a Coordinator of Social Work for the Department of Pain Medicine & Palliative Care at Beth Israel Medical Center.