Mental Health: Clinical Psychology and Psychiatry

Some people are confused when they find out that part of coming to the Pain Centre involves seeing a Clinical Psychologist or Psychiatrist. Others get upset or offended, assuming that this means that we "think they are crazy" or that we "don't believe their pain is real". This is not the case at all. The problem of pain is typically much greater than just the physical problem itself. People with chronic pain suffer from sleep problems, depression, anxiety, relationship problems, unemployment, low self esteem, and so on. These problems are common and understandable when one considers the toll that having physical pain everyday can have on someone.

Psychiatrists and clinical psychologists are both part of the Pain Centre's multidisciplinary team involved, with the "physical" doctor, in the assessment and management of all patients attending the centre. The roles of the psychiatrist and clinical psychologist are similar. Psychiatrists are doctors who train in the field of psychiatry following medical school. From their training, they have knowledge of mental and physical illnesses and their management. Also, like other doctors, they are able to prescribe medication. Psychologists are also university trained and they have special expertise in the psychological or 'talking' therapies.

Clinical Psychology

Throughout the assessment, the Clinical Psychologist will ask you not only about the pain itself but what your experience has been living with chronic pain. They will ask about how your day-to-day life has been affected by your pain. By gathering this information the Clinical Psychologist can then begin to work together with you to develop strategies that may help you manage the secondary problems that come with chronic pain, moving towards a better quality of life.

The Clinical Psychologist is also involved in presenting psychological concepts in the pain management group programmes offered at the Pain Centre.

At the Pain Centre the Clinical Psychologist can see patients for a course of individual sessions focusing on pain management strategies.  Some patients may need ongoing assistance from a clinical psychologist in the community, for which your GP can organise a referral.

Psychiatry

A Psychiatrists' knowledge and expertise is similar to that of a Psychologist. However, one of the main differences is the training undertaken between the two disciplines.

The reason for the combined assessments is so that each patient's problems can be assessed in a holistic manner. As well as assessing their pain problem, this includes assessing how the patient's problems affect their emotions and how their problems affect their ability to function; this may include their ability to work, socialise and fulfil roles such as being a husband or wife, father or mother. The assessment will also involve inquiring about possible co-existing conditions, such as depression and anxiety disorders, which are commonly seen in chronic pain sufferers. It is important to assess for and try to manage all these areas to be able to optimise the well-being of the patient who suffers from chronic pain.

The Psychiatrist's role in management of patients with chronic pain, along with other members of the multidisciplinary team, includes development of a comprehensive plan to try to help lower the patient's pain levels and to help them be able to cope with, and manage, their pain at an optimal level. This comprehensive management plan sometimes includes relaxation, behavioural and cognitive strategies. The Psychiatrist may also suggest psychiatric treatments, such as antidepressant medication, if a mental illness is present.