Chronic Pain Program Development: Old Town Clinic, Central City Concern

Abstract

Jessica Gonzales and Jennifer Theusch began their partnership with the Old Town Clinic in the spring of 2009 as part of a pilot fieldwork occupational therapy program sponsored by Pacific University. Jennifer and Jessica worked under the guidance of a supervising occupational therapist for their unique level II mental health fieldwork rotation. Together they performed a needs assessment and gap analysis to determine a strategic fit for occupational therapy at the clinic. The students worked to solidify an occupational therapy program at the clinic that would integrate into the existing system and begin the process of providing services for the clients. As the relationship between Pacific University and The Old Town Clinic continued the clinic expressed an interest with assistance to develop an interdisciplinary chronic pain program. Jessica and Jennifer choose to return to the clinic during their third and final year of graduate studies for their innovative practice project. Jessica and Jennifer delved into evidenced based research regarding current chronic pain programming. The students visited a chronic pain rehabilitation institute to meet with an occupational therapist and discuss trends and gain insight in the arena of chronic pain. While researching chronic pain programming Jessica and Jennifer determined appropriate models for practice in this area. These models helped to frame program and evaluation design. The clinic expressed interest in a comprehensive evaluation tool for chronic pain clients. During their research Jessica and Jennifer determined typical areas of assessment for individuals with chronic pain. Once these areas were determined the students began to review common assessments used to evaluate these specific regions. The assessment list was narrowed to those which were accessible and were supported by evidence. Once the assessments had been chosen work on drafting the evaluation tool began. The evaluation tool was developed over two and a half months. It took seven drafts and many hours of research. The tool was evaluated during two focus groups and piloted twice with Old Town Clinic clients. The students received professional insight and feedback from the clinic medical director, occupational therapists, and their supervising professor. Once the evaluation tool was completed the students began the process of determining how the information obtained in the tool could be best expressed in an evaluation tool summary template. After two drafts and feedback from the supervising professor the evaluation tool and summary template were ready for use at the clinic. The clinic determined the chronic pain evaluation tool would be used for all chronic pain clients. Results from the tool would be used to screen clients to different pathways for intervention. It was determined one of these pathways would be occupational therapy individual or group intervention. Jessica and Jennifer returned to research to assist with the determination of appropriate evidence based group topics for chronic pain treatment. Approximately seventeen group topics were researched as possible occupational therapy group interventions. These topics are currently being used to educate chronic pain clients to improve occupational performance and enhance occupational functioning in daily activities