A Brief History of Pain Training and Education

The Pain Training and Education (PTE) courses have been developed over many years, and have always had a close association with the Physiotherapy Pain Association (PPA).
The PPA’s Study Day titled “The Biopsychosocial Assessment of Acute Low Back Pain” was delivered in June 1997 by various speakers. Subsequently, in response to feedback and demand from PPA members, Paul Watson and Heather Muncey went on to develop a one-day course teaching physiotherapists how to use a systematic biopsychosocial assessment process. This study day was then delivered by Heather and Paul for the PPA and other organisations, on several occasions over the next few years. Heather invited me to take on a role in the delivery of this course in 2001.

The next stage in the development of PTE courses was the delivery of another PPA study day, in 2003, by me and Heather Muncey. This was titled the “Cognitive Behavioural Approach to Physical Therapy for Beginners”, and introduced physiotherapists to key cognitive and behavioural methods which can be integrated within physiotherapy-led rehabilitation. The course was popular, and was delivered by the two of us in a number of venues in the UK, and also in Australia.

Both of the above study days were one-day courses, and the next logical step was to combine them into a two-day course which moved from biopsychosocial assessment into the development of a treatment plan integrating cognitive and behavioural approaches. This two-day course was well received when it was first delivered at the University of Southampton in 2004. Heather Muncey and I continued to deliver this two-day course for the next four years, and we took on the name of “Pain Training and Education”. We also co-delivered a more advanced two-day course, in collaboration with Prof Frank Keefe, Professor of Psychology and Neuroscience at Duke University, which was delivered in 2005 and again in 2006. Heather and I then became involved in other projects (the development and evaluation of a pain Self-Management Programme, and a Ph.D., respectively) which left little time for teaching.

The next step happened when the Physiotherapy Pain Association reviewed their educational strategy in February 2011, and identified a clear need for an introductory course in biopsychosocial assessment and cognitive behavioural management, suited to the needs of physiotherapists working in musculoskeletal outpatient settings, pain clinics and pain management programmes. It was apparent that the knowledge and skills that such a course should cover were an identical match to the two-day PTE introductory course. This was perhaps unsurprising, as the course was designed for PPA members in the first place, and had been refined by Heather and I by responding to the helpful feedback from course delegates over many years. PTE and the PPA agreed to collaborate in the delivery of the courses, and the first two-day “introduction to the cognitive behavioural approach to the management of pain” course was delivered for the PPA in September 2012.

Heather Muncey had by this time retired from clinical work, and had also decided to step back from her teaching role. Emma Bartlett was able and ready to take on the vacancy left by Heather, and every PTE Introductory course since has been delivered by Emma and I. We try to deliver the course in different venues around the UK, and have so far taught in London, Huddersfield, Bristol, Liverpool, Glasgow, and Nottingham.

The PTE courses have been shaped by feedback from delegates over many years, and a consistent message from a number of physiotherapists in recent years has been a desire for more teaching about managing pain-related insomnia. PTE were very pleased to deliver the first “Pain and Sleep – Managing the Interactions” course in March 2015, delivered by Andrew Green and Alex Westcombe. They were co-editors of “Sleep: Multi-Professional Perspectives”, and Andrew has co-edited a second book, “An Occupational Therapists Guide to Sleep and Sleep Problems”. The course was very well received, and we hope to deliver it again in the future.

Pete Gladwell