Occupational Therapy and Pain Management
An Interview with Sheila Szafran, OTR-L
| This month PainEDU interviews Sheila Szafran, an occupational therapist, about her 25 years of experience working in pain management. Sheila works at Beacon Pain Services in South Portland, Maine where she directs a multidisciplinary pain management team and provides occupational therapy for upper extremity work injuries. |
 |
|
--------------------------------------------------------------------------------------------------------------------------
Questions
1: What training and experience have prepared you, as an occupational therapist, to work with people with pain?
 2: What unique skills and perspectives does an occupational therapist bring to the pain team?
3: Are there specific groups of people with pain who are most responsive to your interventions?
4: Do you assess work environments?
5: People often think of occupational therapists are being inventive and able to create ways for people to adapt. Do you find adaptive equipment useful in your work?
6: What further education and/or continuing professional development are available to occupational therapists?
7: What do you see as the future role for occupational therapy in the field of pain management?
|
-------------------------------------------------------------------------------------------------------------------------- Evelyn Corsini:
What training and experience have prepared you, as an occupational therapist, to work with people with pain? Sheila Szafran, OTR-L: Every occupational therapist has skills to work with people in pain. We are trained to assess activities of daily living (ADLs), work and school function, leisure pursuits, habits, routines and family and social relationships. Intervention is directed at fostering improvement in these occupations. Much of my continuing education is in chronic pain and fibromyalgia. 
EC: What unique skills and perspectives does an occupational therapist bring to the pain team? SS: The occupational therapist brings a holistic perspective and collaborative view of the needs of the client with pain to the team. Occupational therapists are concerned with psychosocial and environmental factors that contribute to pain and the impact of pain on occupations of daily life. The occupational therapist has the distinct advantage in a group of pain professionals of keeping the team focused on client-centered objectives.
EC: Are there specific groups of people with pain who are most responsive to your interventions? SS: People with pain who do the best with occupational therapy intervention are those able to articulate functional goals. Those who are motivated by disability income, an unsatisfactory return-to-work environment or a solicitous family do not respond as well. I am most gratified when a client thanks me for helping them recognize that engaging in an occupation, sometimes as a return-to-work, can be satisfactory and even rewarding despite pain.
EC: Do you assess work environments? SS: Work site evaluations are often done to facilitate a successful transition. This involves the client and therapist at the job site looking at behaviors and equipment that can be modified in order to keep pain levels controlled throughout the workday.
EC: People often think of occupational therapists are being inventive and able to create ways for people to adapt. Do you find adaptive equipment useful in your work? SS: Clients are often surprised by what can be accomplished with adaptive equipment and activity modification. My favorite piece of equipment, purchased at Target for $20, is a long handled weeder. By placing the tool over the center of the weed, pushing it into the ground with a foot, withdrawing the tool and "popping" the weed into a bucket, clients are able to continue a favorite activity even with low back pain. There are many adaptive equipment options for pain patients.
EC: What further education and/or continuing professional development are available to occupational therapists? SS: Occupational therapy is an evolving profession requiring lifelong learning. Most states have licensure that specifies a minimum amount of education to renew. In Maine, we document 36 hours every two years. As healthcare has become more complex, there is a greater emphasis on post professional degree attainment. I am currently pursuing a Master of Science in Occupational Therapy degree at Boston University. I hope to continue in their clinical doctorate program with a specialization in chronic pain treatment.
EC: What do you see as the future role for occupational therapy in the field of pain management? SS: In addition to continuing client-centered treatment, the occupational therapist will have a larger role in pain management by directing programs and performing case management. The necessary skills, talents and compassion will allow them to bridge the medical side of the team (physicians, nurses, PTs) with the psychosocial side (psychologist, social work, vocational) and continue to make all treatment client-focused.
|
