Talking about chronic pain and rehabilitation: Challenges for patients and practitioners

If patients with chronic pain experience that their pain strongly interferes with their daily life activities, their general practitioner or a medical specialist may refer them to a chronic pain rehabilitation centre. There, interdisciplinary teams of healthcare professionals aim to guide patients in exploring how they can deal with their pain differently, in order to improve their functioning and quality of life. However, a recent study by Stinesen, Sneijder and Smeets, shows that conversations between patients and their healthcare professionals about pain and disability can be challenging.

The authors collected data at various rehabilitation centres in the Netherlands: Adelante, Heliomare, Libra and SJG Weert. Together these centres provided the authors with audio recordings of nine intake interviews for chronic pain rehabilitation.

A detailed analysis of these intakes from a discursive psychology perspective, shows that patients and practitioners do not treat patients’ pain-related disability as a matter of course. Disability is in fact negotiated in interaction. Using fragments of talk, the authors also illustrate that conversations about pain-related disability and improving functioning involve challenges for both patients and practitioners. For example, the authenticity of patients’ pain-related disabilities is at stake. The authors also illustrate that the discursive strategies by which patients  ̶  consciously or unconsciously  ̶ work up the authenticity of their pain-related disabilities, can make it more difficult for practitioners to steer the conversation towards social and psychological factors that may contribute to the patient’s pain-related disabilities and that potentially could be targeted to increase the patient’s functioning. Insights from this study may help practitioners to reflect on and further develop their communication practices.

Publication: Stinesen B.B., Sneijder P., Smeets R.J.M. (2021) Negotiating (Dis)ability in the Context of Chronic Pain Rehabilitation: Challenges for Patients and Practitioners. In: Lester J.N. (eds) Discursive Psychology and Disability. Palgrave Studies in Discursive Psychology. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-71760-5_4