Three years ago, Novadic-Kentron addiction care centre launched a program targeting medication addiction for people with chronic pain. We asked Matthijs Elderman, a psychologist at Novadic-Kentron, to share the professional challenges when working with patients with chronic pain.
About Matthijs Elderman
Matthijs Elderman is a psychologist at the addiction care centre Novadic-Kentron. Three years ago, they launched a program targeting medication addiction for people with chronic pain. Novadic-Kentron receives patients suffering from chronic pain for several years, who take medication and/or other addictive substances for long enough to develop an addiction but can still not manage their pain independently. The team at Novadic-Kentron got interested in Reducept VR treatment that can help people understand their nervous system, learn the main pain education concepts and do exercises to enhance their pain management skills. Before Novadic, Matthijs used to work at a rehabilitation centre with chronic pain patients.
How Reducept is implemented in the integrated treatment for addiction and persistent pain
The idea of adding Reducept to the rehabilitation program belongs to Katinka Damen, GZ-Psycholoog and Pain program manager at Novadic-Kentron. In her words, "The Reducept’s vision fits in seamlessly with the methods we use to treat persistent pain, such as graded activity, desensitisation, ACT and pain education. Patients find Reducept a positive addition to the treatment. It affects unconscious processes involved in pain, in combination with the more behavioural and conscious patterns that we focus on in treatment."
Patients with chronic pain and medication addiction can get up to 12 Reducept sessions at Novadic-Kentron. Each session is 30-40 minutes long and is scheduled weekly. In Matthijs’s experience, the learning curve occurs around the sixth or seventh session. After that, it’s crucial to keep practising to make the brain respond to pain differently automatically. During each session, he talks with patients about their experiences and asks them how they can implement the new knowledge and skills in their daily lives. This way he ensures highly positive results of his treatment program.
We have asked Matthijs to share the professional challenges when working with patients with chronic pain.
Challenge 1: Patients are hesitant or sceptical about new forms of treatments
Many patients are enthusiastic about trying Reducept, even though they find it odd and surreal to see the brain from the inside. This group of people shares positive feedback. They note that Reducept relaxes them and lowers pain while doing exercises.
The other group of patients has a different opinion. They say, “I’m not sure about it, it sounds nice to do, but I don't think it will help me”, or “I don't think it's for me, it reminds me of a video game that my son plays, and I don't want to do it.” Digital forms of treatment still have a long way to go before becoming a norm. Until then, professionals have to face hesitation and lack of trust when suggesting digital therapy to patients.
Solution 1: Motivation and openness is key
The inner motivation of a patient is key. The more open patients are to trying something new, the better is the treatment effect. Matthijs explains: “I think it's about being open to trying something else as treatments. And also, stick to it, try two-three times, and only decide if it works for you. I would say, give it a good try.”
Challenge 2: A lack of time to provide good pain education
Healthcare specialists, in general, are familiar with pain education, but they lack an understanding of how to offer it to patients. The sessions are too short, and there are too many patients during the day. It's a lot of work.
Solution 2: Hands-on experience is educational
The advantage of Reducept is an immersive educational experience for patients delivered through VR mini-games. Instead of talking about pain and conceptualising it with traditional materials like books and videos, patients get VR glasses and can see how pain works with their own eyes. The Reducept protocol gives a clear outline of key learning points that a professional can bring up to discuss with a patient. By focusing on combining theoretical and practical approaches, patients learn faster how to adjust their thoughts and behaviour regarding their pain, which ultimately leads to its reduction.
“What I find difficult to explain is that the glasses don't provide the pain reduction itself, but they can help learn the ability to manage pain, which may lead to pain reduction”, says Matthijs.
Challenge 3: Patients with a long history of pain not always know how to deal with it
The official guidelines say that psychological intervention should be provided in the first line of treatment when a patient just starts experiencing pain. Despite that, people in addiction care centres still lack knowledge about managing their pain. The lack of discussions about pain experiences between patients and professionals and between patients and other people leads to less effective treatment results.
Solution 3: Proactive communication helps motivate patients
At Novadic-Kentron, patients start rehabilitation with group sessions where they learn key concepts of pain education, get familiar with main psychological techniques and become more aware of different treatment options. After 1.5-2 months, they start VR sessions. By then, patients already recognise the information from the group sessions, and they have also discussed it with others. This way, Matthijs says, “this knowledge is not necessarily very new for them, but it's more applicable through group discussions, interpretations with the practitioner, and later, through VR immersion.”
Lastly, we asked Matthijs to share, if there would be only one thing that patients needed to know, what would it be?
Train. Don’t say “It’s hurting, and I can't do anything about it.” There are many ways to retrain pain complaints. People have to be motivated to do something about it. Retraining your brain to react to pain differently is a mental and physical effort, but you get the results if you put the effort.”
Are you also a healthcare professional who would like to bring innovation into your work? Get in touch with us to learn how to integrate digital therapy into your practice.
Novadic-Kentron and Reducept: How pain education can be integrated into painkillers addiction treatment