Psychological Assessment For Implantable Therapies Dr Peter Murphy

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Psychological assessment is recommended for patients undergoing spinal cord stimulation (SCS) therapy based on evidence that it leads to better outcomes. A brief psychological evaluation can identify potential mental health issues like depression or anxiety that are common in chronic pain patients and associated with poorer prognoses. It also aims to ensure patients have realistic expectations of SCS and a plan for managing their pain should the treatment not achieve the desired level of relief. While certain personality traits alone may not predict outcomes, evaluations can help optimize patient selection and preparation for SCS.

Gesundheit & Medizin Technologie

Psychological assessment for implantable therapies Dr Pete Murphy Consultant Clinical Psychologist Dept. of Pain Management Walton Centre

Is psychological assessment necessary for SCS patients? ,[object Object],[object Object],[object Object]

Psychological Assessment of Candidates for Spinal Cord Stimulation for Chronic Pain Management. Expert Panel Report 2004 ( Beltrutti … North, Turk, Melzack & others) Pain Practice vol. 4 Sept. 2004 ) ,[object Object],[object Object],[object Object],[object Object]

Why Assess ? Mental health problems common in Chronic Pain ,[object Object],[object Object],[object Object],[object Object]

Psychological factors are associated with poor outcome ,[object Object],[object Object],[object Object],[object Object],[object Object]

psychological factors contd... ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Current UK practice Survey by ACKROYD et al. 2003 ,[object Object],[object Object],[object Object],[object Object],[object Object]

So for the MDT… ,[object Object]

Psychologist can be involved at: ,[object Object],[object Object],[object Object],[object Object]

Initial clinical interview ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

State vs. Trait factors ,[object Object],[object Object],[object Object],[object Object],[object Object]

Facilitate patient risk assessment ,[object Object],[object Object],[object Object],[object Object],[object Object]

Informed consent ,[object Object],[object Object],[object Object],[object Object],[object Object]

Manage distress ,[object Object],[object Object],[object Object]

Facilitate behavioural change ,[object Object],[object Object],[object Object]

No Psychologist ? Psychometric screening & yellow flags ,[object Object],[object Object],[object Object]

Psychometric questionnaires ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

What to look for in the questionnaires ,[object Object],[object Object],[object Object],[object Object],[object Object]

Catastrophising ,[object Object],[object Object],[object Object],[object Object]

Pain Self Efficacy Questionnaire ,[object Object],[object Object],[object Object]

Pain Anxiety Symptom Scale ,[object Object],[object Object],[object Object],[object Object]

Refer to a clinical psychologist and/or PMP ? ,[object Object],[object Object],[object Object],[object Object],[object Object]

Case example 1 ,[object Object],[object Object],[object Object],[object Object]

Case example 2 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Case example 3 ,[object Object],[object Object],[object Object]

Breakdown of all MDT Recommendations

Result of SCS Trial: MDT vs No MDT (success => 50% pain relief)‏

Permanent implants - 6 month follow-up ,[object Object],[object Object],[object Object],[object Object]

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Psychological Assessment For Implantable Therapies Dr Peter Murphy

1. Psychological assessment for implantable therapies Dr Pete Murphy Consultant Clinical Psychologist Dept. of Pain Management Walton Centre

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28. Breakdown of all MDT Recommendations

29. Result of SCS Trial: MDT vs No MDT (success => 50% pain relief)‏

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