When speak of pain program models, are talking of clinics or programs

developed specifically for patients with pain. Does not mean this is the
only place pts with pain receive treatment. As you all are aware, any
clinic or inpatient program is likely to treat pts that have pain as one of
their problems. Difference is that here we are talking about specialty
treatment approaches specifically for pain. By definition, the referred
patients will be those with more complex pain problems that have not
responded to treatment in other clinics or programs.
Basically are 5 models of pain treatment programs. Are in order from
the least complex to the most complex. Generally, as move down the
list, required resources increase as do the training needs of staff and
the complexity of referred patients.
Type of model implemented in a particular setting depends on:
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Pain Consultation Team - 2 or more individuals who serve in an

advisory capacity regarding the treatment of difficult pain cases. May
simply meet and review the record or may see the pt collectively or
individually.
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Multidisciplinary outpatient pain programs vary considerably in their

scope and focus. May involve as few as 2 disciplines or as many as 8-
10 or more. Goal is to provide more intensive pain treatment services
which cut across specific discipline lines. Program framework typically
is cognitive-behavioral, with the goal of reducing the frequency of
maladaptive behaviors and increasing frequency of appropriate
behaviors. At this level major goal no longer is limited to pain relief.
Instead, interested primarily in increasing activity levels and muscle
strength, and decreasing pain behaviors, eliminating reliance on certain
medications such as narcotic analgesics or muscle relaxants, and
reducing depression, and social isolation.
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Table of the typical roles associated with disciplines represented on

chronic pain teams. Programs vary by which disciplines are
represented on each team. Some treatments may be done by one of
several disciplines, if training is provided. Example: Relaxation training
and OT at Tampa VAMC.
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Typical roles of adjunctive team members. Some may also be team

members, but less involved in the day to day functioning of the
program. Others may not be team members, and services might be
requested when needed by consultation.
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Example: An organized group of clinics, programs, and chronic pain

services capable of providing the highest level of care. Really is what
we have at Tampa, though not called that. Not aware of any others.