Pain management services are a suite of specialised services, which provide detailed information and recommendation to the case owner on the most appropriate and cost-effective options for treating and managing a client’s pain.
Progressive Goal Attainment Programme (PGAP)
PGAP is a disability prevention programme designed to target psychosocial risk factors for pain and disability. The 10-week activity mobilisation programme is tailored to meet the rehabilitation needs of clients who are struggling with the challenges of a wide range of persistent pain conditions.
The psychological risk factors targeted by PGAP include catastrophic thinking, fear of movement and re-injury, and perceived disability.
PGAP is not intended to replace or alter current medical approaches to treating persistent pain conditions, but focus specifically on managing the disability associated with the injury to improve the client’s quality of life and help them return to work.
Pain Disability Prevention (PDP) Programme
PDP (as with PGAP) is a disability prevention programme designed to target psychosocial risk factors for pain and disability. The 10-week activity mobilisation programme is tailored to meet the rehabilitation needs of clients who are struggling with the challenges of a wide range of persistent pain conditions.
However, PDP services are more suitable for clients who have mental health conditions, particularly depression, and for whom pain symptoms and psychological factors are significant barriers to rehabilitation progress.
The psychological risk factors targeted by PDP include depression, catastrophic thinking, fear of movement and re-injury, and perceived disability.
Functional Reactivation Programme (FRP)
FRP is for clients whose pain has persisted for over six weeks following an injury. The programme addresses key pain-related disability factors using a physical reactivation approach.
FRP’s major goal is to return clients to independence at home or work, or help them achieve work-readiness. The rehabilitation programme consists of:
- an individual exercise programme, and
- education in pain management with practical applications of self-management principles including skills training in Cognitive Behavioural Therapy.
The exercise programme targets key pain-related disability factors using a physical reactivation approach to help clients return to the maximum possible level of functional independence and to participate in their usual activities at work and at home.
Each individualised programme is designed to be relevant to the client’s social, work/home surroundings, and within their economic means.
The service is provided in a facility where the client can have an individualised prescribed exercise programme. This may be, but is not limited to, the treatment clinic, an exercise facility, gymnasium, or swimming pool.
Pain Management Psychological Service (PMP)
PMP is for ACC-referred clients who have a persistent pain problem due to their covered personal injury which has resulted in significant behavioural, cognitive, social, or psychological dysfunction.
PMP includes a psychological assessment and provides evidence-based and best practice psychological therapies/interventions to help the client adapt to their injuries.
Comprehensive Pain Assessment Services (CPA)
CPA is delivered by a multidisciplinary team which ensures that clients with persistent pain-related disability receive a comprehensive, fully integrated, and independent clinical assessment. The emphasis is on determining functional goals for the client’s rehabilitation.
CPA consists of three separate clinical assessments followed by a team discussion. The team produces a combined ‘formulation’ with recommendations. The advantage of this approach is that the medical, functional, and psychological perspectives are substantially enhanced from a team discussion about these modalities. The functional goals and recommendations produced in the report will guide future therapies.
Activity Focus Programme (AFP)
AFP is a multidisciplinary programme given to referred client’s who, due to injury, have had a persistent pain-related disability for more than 12 weeks which has caused significant functional problems.
AFP is to help clients adopt a self-management approach to independent functioning both at work and home, despite pain.
The programme is aimed at meaningful activities and education that clients will be able to continue to follow after the AFP finishes. It uses a multimodal approach to engage the client in restoring their independence to the maximum extent practicable through:
- using multimodal activity, behaviour, intervention, and education
- adopting a self-management approach for the client to manage their pain-related disability
- enhancing the level of independence and participation in usual activities such as work and/or home tasks as identified on the client’s IRP, and
- communicating and liaising with relevant key stakeholders, eg other treatment providers and ACC, to provide a safe integrated seamless service.
Multi-disciplinary Persistent Pain Programme (MDPP)
MDPP is designed to help clients with significant pain which has persisted for 12 weeks or more. Its primary focus is to modify the client’s response to pain, rather than removing the pain stimulus. By completing an MDPP programme, a client will learn to:
- monitor their pain and implement strategies to manage pain and prevent pain escalation
- increase participation in agreed activities at home and work.
MDPP is a three-week residential programme which programme consists of interaction between the MDPP team of clinicians and the client for at least five hours per day, five days per week. Sessions may be conducted individually or in groups.
The three-week programme covers:
- information to address pain beliefs and fear of movement or activity
- individually prescribed activities and exercises
- activity-pacing skills and relaxation techniques
- problem solving, coping, and goal-setting skills
- cognitive and behavioural techniques
- counselling (conducted by a registered occupational or clinical psychologist)
- preparation for vocational rehabilitation
- occupational therapy
- medical assessment or review to monitor the client’s progress (as necessary)
- case conferences with the client, their family/whanau, and the case owner (at least weekly)
- a follow-up session at the end of the three-week programme.
Interventional Pain Management Service (IPM)
IPM helps clients with persistent pain that results from a personal injury covered by ACC. The services focus on interventions such as injections, to diagnose and treat pain and discomfort.
IPM facilitates a client’s access to specific medical interventions designed to diagnose and/or treat pain. The service is provided by vocationally registered medical practitioners from a range of medical disciplines including anaesthetics, musculoskeletal physicians, and pain specialists.
Last updated: 8 June 2009