Workshops
ON SATURDAY May 21, 2022
08:30 - 12:30 (incl. coffee break) Tips and tricks on how to make Pain Science Education for cancer patients ‘stick’ along the cancer care continuum.
Max 30 participants.
13.30 - 16.30, incl coffee break Chronic pain and nutrition: what do we know and what can we do?
Max 30 participants.
08:30 - 12:30 (incl. coffee break) Exposure in vivo: from theory to practice.
Max 40 participants.
13.30 - 16.30, incl coffee break Get to know Acceptance and Commitment Therapy (ACT).
Max 30 participants.
Detailed workshop info
Tips and tricks on how to make Pain Science Education for cancer patients ‘stick’ along the cancer care continuum.
Max 30 participants.
Pain is one the most persistent, debilitating and undertreated problems across disease states, including during and after cancer treatment. The success of contemporary Pain Science Education (PSE) for people with persistent musculoskeletal pain (MP) has generated new possibilities to better assist people with pain during and after cancer treatment. However, PSE can be difficult. This course will discuss learnings from twenty years of research and clinical implementation of PSE in musculoskeletal pain. However, instead of simply transferring current PSE practice to cancer populations, several issues need to be considered. We will discuss important modifications needed to tailor PSE to cancer populations, including consideration of cancer-specific mechanisms such as chemotherapy-induced neuropathy, hormone therapy related arthralgia, and radiotherapy-related fibrosis. Also, how to integrate the unique psychosocial and cognitive sequelae of cancer, and prioritisation of cure over residual symptoms within the health care system will be discussed. Finally and centrally, the course will provide tips and tricks on how to make PSE stick depending on the treatment phase. We will discuss the rationale for PSE in the perioperative stage and how we need to adjust the format, content and delivery method compared to PSE for cancer survivors with persistent pain after finishing treatment. Mean topics are:
- Lessons learned from musculoskeletal pain science education: tailoring PSE to cancer populations
- Unique psychosocial considerations when delivering PSE in cancer populations
- How to implement PSE along the cancer care continuum: tips and tricks.
Next to providing theoretical background, the course will combine live demonstrations of PSE from experienced practitioners with practice time for the attendees.
Upon completion of these course attendees:
- will be able to explain the rationale behind, intent, and conceptual strategy for delivering pain science education during all cancer treatment phase
- will have acquired operational knowledge and skills on how to adapt and deliver pain science education in the cancer population
- will be able to understand and integrate the complex biopsychosocial nature of pain into the cancer populations that they work with.
Course leaders are members of CarEdOn:
Prof. Dr. An De Groef
interest lie in the evaluation, prevention and treatment of different comorbidities, including pain, in different cancer populations. She is an experienced researcher and has extensive (inter)national experience in educating students and clinicians in the field of pain and oncology. She works as a FWO postdoctoral researcher at the University of Leuven and the University of Antwerp and assistant professor at the University of Antwerp.
Dra. Lore Dams
is a PhD researcher at the University of Antwerp and KU Leuven and is a physiotherapist and manual therapist. She has clinical expertise in cancer rehabilitation in general and will defend her PhD dissertation on the effectiveness of pain science education in the perioperative stage after breast cancer surgery in September 2021.
Drs. Vincent Haenen
is a PhD researcher at the University of Antwerp and KU Leuven Vincent in the field of pain in cancer patients. Before moving into research, he was a full-time physiotherapist in Switzerland and Belgium. When time permits, he likes to share recent updates in research in the form of infographics to inspire physiotherapists to stay informed and to inform the general public via social media.
KEY PUBLICATIONS:
- De Groef, A., et al., EduCan trial: study protocol for a randomised controlled trial on the effectiveness of pain neuroscience education after breast cancer surgery on pain, physical, emotional and work-related functioning. BMJ Open, 2019. 9(1): p. e025742.
- De Groef, A., et al., Best-Evidence Rehabilitation for Chronic Pain Part 2: Pain during and after Cancer Treatment. J Clin Med, 2019. 8(7).
- Van der Gucht, E., et al., Effectiveness of perioperative pain science education on pain, psychological factors and physical functioning: A systematic review. Clin Rehabil, 2021: p. 2692155211006865.
Exposure in vivo: from theory to practice.
Max 40 participants.
In various chronic pain conditions, exposure in vivo has shown to be effective in reducing pain-related fear, disability and improving quality of life. Deriving from the fear-avoidance model of chronic pain and rooted in learning theory and experimental fear conditioning research, exposure in vivo treatment aims at increasing functioning despite the pain, not at pain reduction. Reducing the impact of pain-related fear through extinction learning, as is aimed for during exposure in vivo treatment, is complex and fragile. Research in a variety of anxiety disorders revealed new insights in how to optimize inhibitory learning and prevent relapse to occur.
Therapists from the department of Rehabilitation from location Maastricht University Medical Centre (currently part of Adelante) have extensive experience with the application of exposure in vivo. In this workshop, we will present how to apply techniques to improve inhibitory learning during exposure in vivo for pain-related fear in adolescents and adults with chronic pain. Furthermore, we give insight in how to recognize pain-related fear as underlying mechanism in chronic pain. Attendees have after completion of this course insight in:
- What level of functioning patients can achieve after treatment.
- How to motivate patients for exposure in vivo treatment.
- How to practically design optimal exposure in vivo sessions?
- How to deal with pain-experiences during treatment?
COURSE LEADERS
Dr. Marlies den Hollander
started to work as an occupational therapist in Maastricht University Medical Center+, where her interest in chronic pain began. In 2005, Marlies started to work as an psychologist after obtaining her Master’s degree in Mental Health. In 2009 she started as a part-time PhD-student, which she completed in 2018. Since 2017 she is working as a clinician and as a senior-researcher at Adelante Centre of Excellence in Rehabilitation.
Dr. Thijs van Meulenbroek
obtained his Master’s degree in Physical Activity and Health in 2008. Afterwards, he started to study physical therapy. After graduating in 2012 he started to work as a physical therapist in the outpatient pain-rehabilitation at Adelante Rehabilitation location Maastricht University Medical Center+. In 2016 he started as a part-time PhD student, which he is hoping to finish this year.
REFERENCES
- Glombiewski, J, Holzapfel, S, Riecke, J, et al.(2018). Exposure and CBT for chronic back pain: An RCT on differential efficacy and optimal length of treatment. J Consult Clin Psychol, 86(6), 533–545.
- Vlaeyen, J, Morley, S, Linton, S, et al. (2012). Pain-Related Fear: Exposure-Based Treatment for Chronic Pain: IASP Press.
- Lopez-de-Uralde-Villanueva I, Munoz-Garcia D, Gil-Martinez A, et al. (2016) A Systematic Review and Meta-Analysis on the Effectiveness of Graded Activity and Graded Exposure for Chronic Nonspecific Low Back Pain. Pain Med. 17(1), 172-188.
- den Hollander M, Goossens M, de Jong J, et al. (2016) Expose or protect? A randomized controlled trial of exposure in vivo vs pain-contingent treatment as usual in patients with complex regional pain syndrome type 1. 157(10), 2318-2329.
- Vlaeyen J & Linton S (2012) Fear-avoidance model of chronic musculoskeletal pain: 12 years on. Pain. 153(6), 1144-1147.
- Crombez, G, Eccleston, C, Van Damme, S, et al. (2012). Fear-avoidance model of chronic pain: the next generation. Clin J Pain, 28(6), 475–483.
- Craske M, Hermans D, & Vervliet B (2018). State-of-the-art and future directions for extinction as a translational model for fear and anxiety. Philos Trans R Soc Lond B Biol Sci.; 373(1742).
- den Hollander M, de Jong J, Onghena P, et al. (2020). Generalization of exposure in vivo in Complex Regional Pain Syndrome type I. Behav Res Ther. 124:10351.
- van Meulenbroek T, Conijn A, Huijnen I, et al. (2020). Multidisciplinary treatment for hypermobile adolescents with chronic musculoskeletal pain. JRM-CC. 3;100033.
Chronic pain and nutrition: what do we know and what can we do?
Max 30 participants.
The development of chronic pain is one of the most seen sequelae in the cancer survivor population. Literature reports the presence of pain in approximately 40% of 5-year survivors. Specifically, in breast cancer survivors, chronic pain is estimated to be present in at least 50% of this population. On the other hand, chronic musculoskeletal pain is one of the leading causes of disability and decrease in quality of life. It has huge economical, psychological and social impacts on individuals, society and health institutions. While the incidence of chronic pain in these populations keeps rising, effective treatment options are still lacking. In general, 60% of those with chronic pain still experience pain after one year. Despite our increased understanding of the mechanisms explaining chronic pain, there is still much to learn about the development and persistence of chronic pain in breast cancer survivors and chronic musculoskeletal pain.
Within the view of a lifestyle approach for chronic pain, diet and nutrition are gaining attention. For example, evidence indicates that well-nourished breast cancer survivors report better functions and less symptoms including pain. Additionally, emerging literature highlights a place for diet as a regulator in chronic pain via management of inflammation, oxidative stress and brain plasticity, possibly leading to a decrease in pain.Moreover, unhealthy dietary behavior has an impact on the occurrence, maintenance and management of chronic pain.
Participants will gain evidence based knowledge about the role of nutrition in chronic (musculoskeletal) pain and in breast cancer (survivors) and dietary guidelines and interventions for chronic pain At the end of the course particpants know how to calculate the healthy eating index for their own diet and know how to use it in clinical practice.
COURSE LEADERS
Dr. Anneleen Malfliet
Anneleen Malfliet is an assistant professor and postdoctoral researcher at the Vrije Universiteit Brussel. She is also a member of the Pain in Motion international research group. Her research and clinical interest go out to chronic pain with a special interest in chronic spinal pain, pain rehabilitation, central sensitization, nutrition and diet.
Dra. Sevilay Tumkaya Yilmaz
Since June 2018, Sevilay Tumkaya Yilmaz has been involved as a doctoral researcher at the Vrije Universiteit Brussel and in the “Pain in Motion” international research group. Her research focus is “The link between nutrition and chronic pain in breast cancer survivors.”
Drs. Ömer Elma
Omer Elma is a PhD researcher at the Vrije Universiteit Brussel since 2018. He is also a member of “Pain in Motion” international research group. His research focus is “the link between chronic musculoskeletal pain and nutrition”.
Max 30 participants.
It is an experienced based workshop in which every attendee can experience different processes based on a self-introduced existing problem or unpleasant inner experience (such as thoughts, feelings, physical pain or memories). You can think, for example, of the struggle between providing care or performing research versus your own physical and mental capacity. The 6 processes are used to explore what it would be like to relate differently to your problem and possibly take a step in a meaningful direction. The workshop starts with a brief introduction about the theory and rationale of ACT. Experience based exercise are about:
- How to connect to a problem.
- Mapping the problem through creative hopelessness and six processes of ACT.
- Exploring steps towards values.
At the end of the course attendees have:
- Insight in theory behind ACT and knowledge about the six main therapeutic processes.
- First experiences how these processes work and their possible effects.
Do you dare to take this challenge? If you join the course, it is expected to work on simple problems by yourself.
COURSE LEADERS
Martina Thaler
works as a sociotherapist / art therapist in the pain department at Adelante care group. She has over 11 years’ experience in using ACT in chronic pain and is also trained as a mindfulness and compassion training.
Jule Elmanowski
works as a physiotherapist in the pain and neurology department at Adelante Zorggroep and working as a clinical researcher at the expertise center for rehabilitation and audiology. She has 6 years’ experience working with ACT both within my work as a therapist, as well as experientially for myself as a researcher.
Carla Palmen
works as a psychosomatic physiotherapist in the pain department of Adelante care group. Since 2009 she works intensively with ACT also is a teacher in the National ACT course for rehabilitation teams. Furthermore, she is trained as a mindfulness trainer and in training to become a compassion trainer.
REFERENCES
- Hayes SC, Strohsahl KD, Wilson KG. Acceptance and Commitment Therapy, an experiential approach to behaviour change. New York: The Guilford Press; 1999.
- Gijs Jansen & Tim Batink. Time to ACT! Basisboek voor professionals. Uitgeverij Thema, 2014.