Clinical Psychologist Recruitment Crisis in Pain Services: Webinar explores ‘why work in the field of pain’?

Chronic pain — defined as pain that has persisted for more than three months — is thought to affect around 28 million people in the UK.

Delegate feedback included:

  • Pacing and timing was excellent. Content provided was detailed and informative without being overwhelming.
  • Hearing someone’s personal journey living with persistent pain was really profound!
  • Excellent range of discussions and involvement of a person who has experienced chronic pain.

 

The ninth in the series of Connect Health Change webinars ‘Clinical Psychologist Recruitment Crisis in Pain Services: Why work in the field of pain?’ took place on 24 February 2021.

Chronic pain — defined as pain that has persisted for more than three months — is thought to affect around 28 million people in the UK and, according to the Royal College of General Practitioners, is a presenting condition in around 22% of primary care consultations[1].

Interdisciplinary pain services value the input of a range of different professionals including psychologists, such as health and occupational psychologists, as well as psychological therapists such as CBT therapists or psychotherapists. Historically, the professional group it has often been hardest to recruit to work within interdisciplinary pain services, has been clinical psychologists. Therefore, this webinar focused specifically on clinical psychologists’ work in the field of pain.

 

Gail Sowden, National Lead for Pain, Connect Health and Chair of a British Pain Society SIG (Special Interest Group) was chair for the session. She explained:

Currently there is a national shortage of qualified clinical psychologists across the UK which has further exacerbated the challenge of recruiting specifically into pain services. The purpose of this webinar was therefore to raise the profile of pain amongst prospective trainee psychologists, trainee and qualified psychologists by answering two questions – why work as a clinical psychologist in the field of pain and what does it involve?

 

The webinar featured:

Dr Tess Maguire, Clinical Psychologist and Clinical Director for the Doctorate in Clinical Psychology at the University of Southampton, addressed the difficulties in psychology recruitment and what the role brings.

So why might clinical psychologists be important in health services. Well clinical psychologists have key skills and training in assessing difficulties and delivering both individual and group therapies, but we do so much more, including working with and developing teams. We hold leadership positions, we formulate treatments for complex difficulties not only in clients or patients, but within the wider system. We’re being asked to support colleague’s well-being both formally and informally, and often will work really innovatively using a range of therapeutic models, pushing the frontiers of creating and developing the best treatments. Finally, we’re really keen on research and auditing, to ensure what’s provided is well understood and effective.

In 2016 there were between 12- 27 HCPC registered clinical psychologists for every 100,000 people in the population, and we know there’s a growing need for psychological therapies and support which is only going to get more intense in the wake of the national pandemic. So, there is a real need to focus on training, recruitment and retention of clinical psychologists.

 

Nikki Ellis, Patient Champion and person with lived experience of pain, Wolverhampton Pain Service went on to passionately describe her personal journey to living a fulfilled life with pain.

I am someone who has lived with persistent pain for over 12 years and I’m at a point in my life where I can manage my symptoms and recognise my limitations. However my pain journey is ongoing, unpredictable and ever-changing. All I can do is prepare myself and use the tools that I have learned. I know this now but when my journey began, I was completely unprepared. I had absolutely no concept of what living a life with pain would be like or how it would affect my life.

There was a point in my journey where I stopped going to the doctor, even when I had new symptoms, because I didn’t see the point. I was so fed up with being pushed aside and misunderstood. I know from my own experience and from speaking with other pain patients, the main thing we want is for someone to listen – and I mean actively listening – not just for facts and statistics or things you can tick off a list. But for thoughts, emotions and letting us feel comfortable enough to open up, letting us tell our stories without rushing us or cutting us off and show that you’re really taking it in.

I realise now that instead of trying to fix the pain, we can tackle other areas such as sleep, stress, exercise and mental health. I’m passionate about speaking about the importance of managing your mental health and how it impacts your physical health. I was able to pause my life and think about the type of person I want to be. I’ve become a new version of myself and I like the new me.

 

Dr Lizzie Doherr, Clinical Psychologist, Lincolnshire Pain Management Service, Connect Health, described a day in the life of a pain psychologist.

I lead the psychology team in Lincolnshire and I’ve been working there for 1.5 years but I made the move to work in pain after spending the first 19 years of my career in neurological rehabilitation in a community team. My role is broadly divided up into two – firstly client-facing work. This is a mixture of one-to-one clinics, individual assessments and therapy work. I do joint sessions alongside colleagues for complex cases and I’m involved in co-facilitating our educational programmes. These bring together large groups of people living with persistent pain. The groups are called PRISM which stands for Practical Re-engagement In Self-Management. In addition, I co-facilitate Pain Management Programmes (PMPs) which are either face to face groups lasting 8 weeks or virtual programmes lasting 5 weeks. All PMPs are based around the ACT model.

Secondly non-client facing work which involves being part of MDT review panels. If a clinician/physio is not sure how best to support a client, we come together and discuss the case in depth to decide what’s the next best course of action. I also supervise the psychology team and offer reflective supervision to the wider pain team.

 

Dr Lance McCracken, Professor of Clinical Psychology and Head of the Division of Clinical Psychology, Uppsala University in Sweden explored some of the myths of working in pain.

I come to you today from Sweden but for 18 years I worked in the NHS and I’ve worked in chronic pain management for 25 years. I have never regretted my choice to go into pain management and I dare you to get into pain management and not like it.

Chronic pain is such a huge problem. In the general adult population, the number one cause of years lived with disability is lower back pain. There is a massive amount of supportive evidence for psychological treatments for pain. Outcomes including disability, quality of life, emotional functioning, social functioning, return to work and even healthcare use – all can be positively impacted by psychological treatments.

The UK has played a very important part in the history of pain treatment and especially in the history of development of ACT for chronic pain. This includes the introduction of the first interdisciplinary service for chronic pain. I think what is really neat about cognitive behavioural approaches, is how they address deep and interesting issues in human experience, performance, well-being and behaviour change. We’re really digging into the heart of what it means to be a human being and then using that understanding to develop treatments.

 

The webinar brought together some fantastic insight from experts with many years of experience working with patients in addition to strong research credentials. See the accompanying Q&A summary for links to further reading.

Watch the webinar again which includes further insight from the speakers including a full Q&A session:

Wednesday 24 February 2021

Speaker Biographies

Q&A Summary

Further reading