Reader's Digest Condensed Version of "The You Model" for Pain

If I were to have a half hour of time in a video to describe occupational therapy and chronic pain from my perspective, which is the Lumigrate 'You Model" basically, I'd do it in the following way:

Make it interesting to people.  There has to be a storyline to make it entertaining in order for people who are kickin' back to want to tune in.  People relate to stories about other people -- we've been doing this for generations, around the campfire essentially.  Sometimes it's hardest to make things the simplest, but in this case, simple is going to be GRATE.  If you look at how Ken Burns' documentary about the National Parks used the storytellers over many or all episodes so we eventually felt like we really knew that expert, I'd think that would be a smart way of bringing experts into the video. 

Since we'd want to reach the lives of people with chronic pain and those who are at risk for it so they can intervene before things get ahead of them (which is a lot of work to get turned around), a story of someone who did NOT take care of things in the early stages and what happens from there would be very compelling.  It would be important to include the whole system around that person -- the family, the employer, the community. 

But none of that does any good unless the viewer becomes convinced that they have or can have the most powerful position in health care, which is being in control of their health or at least how they manage and view their health situation.  In the history of occupational therapy, which I dearly love but wouldn't spend much time on if only given 30 minutes, the volition system is the key to working with patients.  "Engage the mind and the body will follow" is the classic phrase from one of the grand dame's of the profession.  When OT first was 'invented' by an innovative nurses aid in the US Army after World War I, they utilized a lot of woodworking and carpentry, painting and gardening.  Good OTs will figure out what motivates the person or persons they are woking with and set them up with tasks that either are constructive or destructive, and then do what is called the 'just right challenge', where the person's skill level is just below what is being required for that task.  That is when people get what is called 'flow'. 

As an OT, the best thing I did was take an extra week-long course in something called "The Assessment of Motor and Process Skills" which unfortunately was too difficult to 'do' in today's fast-paced, productivitity-driven therapy environments so I did not maintain my certification.  But it was standardized so that the way I graded people I observed and rated on task performance got crunched in the computer by how 'severe' a rater I was (which was very non-giving but interestingly the same score the OTR developer of the program had, which was confirming as an OT student that I knew what I was doing).  Since she was on the faculty of my university we got a little from her in class and I chose to spend a week of vacation and MORE money learning more about it.  If you read between the lines here, my standard education didn't provide me with enough of what I needed.  And I went to a highly regarded program. 

So I'd want some of my time in a video to reach people to make that point about the medical industry; our educational system hasn't prepared us really well.  MANY very good providers are leaving health care because of the stress, the paperwork, and the falling pay and reimbursements from insurances.  One of the reasons I left patient care was because I foresaw a crisis coming, but the day I really 'got it' was when someone with fibromyalgia who wanted to see me as a patient couldn't because she had Medicaid and our clinic didn't take that insurance.  She was happy to pay her small copay, which on the disability money she received is a substantial contribution.  She had internet and I knew I'd be able to help her and many others if I maneuvered to being an occupational therapist via the Internet.   Obviously the health care system is in crisis and we don't need to belabor explaining that, but it might be good to then explain to people how THEY, a.k.a. "YOU" in "The You Model" of Lumigrate.com really might want to consider realizing that their health care has to be something they take the lead on.  

And then from my perspective, as an occupational therapist specializing in the occupation of health care (as anything that occupies time is an 'occupation'), it's important to point out that what health care providers need to be doing is routing people to valid sources of information in order for them to do more research on their own and hear their providers saying 'you're needing to make conscious choices about how you spend your resources of time, energy and money on this'.  The days of having a doctor say 'take a pill and call me in the morning' is over, and the mess from years of our being born and raised in that model has to be undone and re-established.  And to finish things up, suffice it to say that occupational therapy originated as an art of understanding people and has been condensed by pressures of money and therefore time, to be peddlers of durable medical equipment -- shower chairs, reachers, toilet risers, sock application aids, button hooks and on an on, an 'art' unto itself.  (And it's actually very complicated to do that well.)  With chronic pain patients there is much to address with modalities/gadgets and positioning in bed and things that PTs also address.  I found that on the team I worked with, I'd get them working on the You concept and tools related to their medical information and education and then focus on their learning deep breathing the very first day so they could get started on it right away and maybe be getting something from being more in touch with them Selves by the next week or so.  Because really they were going to have to know for themselves somehow how to get from where they were to where they wanted to be.  "Is this a good provider for me?", "Is this the right treatment for me?" "I have a choice of this or that, which one do I do?"

Yes, sometimes keeping it very simple is best.  And it might look easiest but it's really the more advanced way to go.  In order to make it FUN I'd show lots of light-hearted interactions as examples of the people interacting, and then I'd also realize that people don't change based on what they know in their heads, it's on what they FEEL.  Just like I worked with patients to get in touch with that feeling aspect where wisdom lies!  So we'd need to have a case example or story that would scare people a bit.  Get the emotion of someone's story and hopefully it involves a chase scene, as all shows have a chase scene.  That doesn't have to be something with wheels, but someone being in a dicey situation and whether they get out of it or not.  Like someone who has a horrendous surgery, or whose marriage is on the brink of breaking because of chronic pain, or who is depressed and at risk for substance abuse or death. 

Then we all know a good story you don't know until the end if it has a happy ending or not.  In this case, we'd want there to be a real and happy ending of someone who had taken the concepts of the You model and had life start going in a better direction, with the result being managed pain and a restored functional level and satisfactory life.  That's a lot to get into 30 minutes, but I think it's possible.  And maybe end with a love scene, as we know ALL good shows have the love aspect!  Maybe that could be the love of a family, community and even Internet community such as what exists with Lumigrate largely through facebook at this time.  

As always, I value your comments and on this one, it's really potentially with a lot of people's information they'll receive from me at stake!  Naturally, this is just an idea that's in development, but that's when it's the best time to get input from YOU, Grate Group.... ~~ Mardy

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Sun, 08/14/2011 - 7:30am

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nursingmag

Title: LumiGRATE Poster - Minimal

Joined: Aug 14 2011

Posts: 1

Re: Reader's Digest Condensed Version of "The You Model" ...

Thank You for article.take care of yourself, and stay strong against what is ignorance in our society. Mag from nursing colleges [3] center.

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