What is a Pain Coach: The Details

In the first blog entitled What is a pain coach? (click here to read), you can find more information about the 4 key elements behind pain coaching and the methodology I use when working with patients with persistent pain.

In this blog I want to dive a little deeper into some of the more nitty-gritty details about the world of pain coaching and how you can benefit from seeing one.

I will cover:

- who pain coaching is for,

- how you can benefit from it,

- what a pain coaching session looks like,

- what Acceptance & Commitment Therapy is

- if pain coaching is a regulated profession

- how to choose the right pain coach for you

Who can see a Pain Coach?

A pain coach can help with any kind of pain that is persistent. Persistent pain is pain which has lasted three months or more. A pain coach will not give you a diagnosis, as this is not legally allowed. So it is good to already have a diagnosis or a good understanding of what your condition is before you work with a pain coach. If you are still looking for a diagnosis, a quick fix, or a cure, then a pain coach is not the right choice for you at this time. Side: Although back pain (for example), is not necessarily a "diagnosis" per se, this is still acceptable if you have had your pain for longer than 3 months. A pain coach might be the right choice for you if you are struggling to participate in your life or are struggling to make sense of your pain, or if you are just overwhelmed by it all. A pain coach is a good choice if you have had failed physiotherapy treatments or other failed treatments.

How can I benefit from seeing a Pain Coaching?

There are many ways in which you could benefit from a pain coach. Here are some of the things that I think are possibly the most beneficial:

- Getting on the right road faster

- Less time spent going through other therapies that promise quick fixes or a cure

- Learning to orienting your actions towards meaning and the things that you value in your life

- Cultivating a deeper understanding for yourself, including self-compassion and acceptance

- Learning to understand your pain from a more open and flexible perspective

- Learning how to self-manage and control your pain even when it flares up

- Establishing a form of accountability and support to help you on your journey

What does a Pain Coaching Session look like?

I can’t tell you how other pain coaches work, but I can tell you how I like to work.

I like to spend the first session getting to know you, your situation, and what you are looking for. We will spend some time chatting and/or moving and identifying your issues; physical, psychological, and social, that you are struggling with and creating goals that are meaningful to you.

Once goals are established, we will always be working towards that. Not every pain coaching session will look the same, but the goal will always be our guiding star. With your goals in mind we can work on identified barriers and obstacles.

Working on barriers can look pretty traditional (in the physiotherapy sense) of working on exercises and techniques for movement to help you manage pain and/or flare-ups. But, it can also look like incorporating mindfulness, or awareness techniques to help cultivate a better understanding of what is happening in you when you are experiencing pain or avoiding tasks due to pain. We use techniques to help you build confidence and help you build strategies to manage your pain and continue to thrive even when we have completed our work together.

What is Acceptance & Commitment Therapy?

Acceptance & commitment therapy is a form of cognitive behavioural therapy that focuses on achieving cognitive flexibility. ACT is based on 6 different processes in a non-linear fashion, ie. no specific order and dipping in an out of each component as needed. In ACT we work towards meaningful goals, through committed action, learning acceptance, cultivating self-compassion and present moment awareness, as well as understanding and relating to our thoughts in more helpful ways. As we go deeper on your personal values, we learn to unhook from unhelpful thoughts, ideas, beliefs, and judgments, that may be getting in your way. Above all, ACT is action oriented. This is not just sitting around and talking about your feelings. It’s a form of therapy rooted in creating change and cultivating this in an open, flexible and safe state of awareness. ACT is not a cure, nor is it a miracle therapy, but it is an approach, rooted in human psychology and can be helpful not only with persistent pain problems, but also life in general. ACT originally started as a form of therapy for addictions, anxiety and depression. It has no set amount of sessions or a specific course of action. It is a very creative and open framework allowing space for the client and therapist to find a way to collaborate in whatever way they think will be helpful. My favourite thing about this approach is that it immediately levels the playing field between client and coach, since both have valuable and necessary input for the therapy to find it’s way. It truly is a collaboration between client and coach.

Is it a regulated profession?

Technically no, which means you should be somewhat careful when finding and choosing a pain coach. There is no school for pain coaches and it is not a regulated title, so technically anyone can use it. It’s a bit the same as a fitness coach or a health/wellness coach. Sometimes these types of coaches will have certain certificates or have taken courses to increase their skill set, but there is no governing body regulating their work. That being said, that’s not necessarily a bad thing.

Since a “pain coach” is an unregulated title, this means that you will have to do some research before choosing the right coach for you. Personally I have seen the term being used mostly as professionals spinning-offs from traditional healthcare titles like either physiotherapy, osteopath or chiropractic, so it is not uncommon to see that a pain coach is also practising as a one of these professions above. I am an example of that. I am a registered physiotherapist currently practising within the Dutch healthcare system, but also practice as a pain coach online outside of the healthcare system. The benefit of having a physio/pain coach combination is that you are able to work with someone who not only has a deep understanding of pain, but also of the rehabilitation process in general. Although a pain coach is not legally able to diagnose you, the physio inside them will still have great oversight on your condition and be able to manage it appropriately/refer you when necessary.

How do I choose a good pain coach?

Well, first of all, a good pain coach for you, might not be a good pain coach for someone else. It is above all else important that you feel comfortable with your pain coach. Pain coaching is hard work and requires vulnerability. You need a coach with whom you can safely share your experiences and feel that you are not being judged. This will feel different for everyone, which is why it can be beneficial to first reach out to a potential coach and try to get a feel for their personality and they way they communicate. See if it resonates with you and if you like they way that they talk and think, as this will likely be the same way they communicate with you in session as long as they are presenting themselves genuinely.

If you are interested in finding a pain coach perhaps this perspective from Trevor Barker could be helpful to you. Trevor is a person with a lived experience of pain. Here he shares his experiences with clinicians and suggests his own ‘red flag’ system to use when you are searching for a pain coach or the right clinician.

Check out ‘The knowledge exchange podcast’ featuring Trevor Barker here.

Please do not hesitate to reach out to me if you have any further questions about finding the right pain coach or are interested in working with me.

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