There are 4 kinds of pain control centers.
The first is what Gerbershagan (1980) describes as a major
comprehensive type that deals with all modalities and all kinds of pain
syndromes. The second is a comprehensive inpatient program. The program
looks like a hospital in thatit has a large space with beds and a full time
professional and supportive staff. This type of program requires an extensive
record review before admission, routinely carries out psychological assessments
(before admission, during the program and upon discharge from the program),
involves consultants of several specialties, organizes educational material,
training and research programs and will provide a large variety of therapeutic
modalities. The third type is a syndrome-oriented program, which provides
a thorough evaluation and treatment of particular pain syndromes such as low
back pain, myofacial pain, headaches, etc. These can be mono- and
multidisciplinary inpatient and outpatient facilities. The fourth type is a
modality oriented center which may also use monoultidisciplinary
patient work up schemes and will apply certain limited treatment modalities such
as nerve blocks, psychotherapy, transcutaneous electric nerve stimulation
(TENS), neurosurgery, etc.
When involved in a pain management program, the patient in pain can
either be in the hospital as an inpatient or do their therapy as an outpatient,
coming to the hospital or clinic several times a week. The inpatient approach
has pros and cons. First, the program can be quite expensive (being hospitalized
from 4 to 8 weeks), with a large cost of thousands of dollars. Blackwell
(1984)believes that the inpatient approach should be used when an individual
requires detoxification from multiple drugs has many physical complaints that
require evaluation and assessment has a severe physical impairment; and when the
outside environment may impede progress in the program
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