Lifestyle treatment for chronic pain management improves quality of life, confidence and function
A new study from the USC Chan Division of Occupational Science and Occupational Therapy shows that lifestyle-based occupational therapy treatment significantly improves the experiences of people living with chronic pain.
“Having quantitative evidence for occupational therapy’s effectiveness in chronic pain management is really valuable,” said Ashley Uyeshiro Simon BA ’08, MA ’10, OTD ’11, the study’s lead author and an assistant clinical professor at the USC Chan Division.
Uyeshiro Simon and her colleague, associate clinical professor Chantelle Collins BS ’07, MA ’08, OTD ’09, analyzed data gathered from people who completed a round of outpatient Lifestyle Redesign at the USC Occupational Therapy Faculty Practice. Lifestyle Redesign is an individualized treatment process through which an occupational therapist and patient focus together on weekly topics such as physical activity, body mechanics and planning for pain flare-ups. Week by week, the therapist guides the patient through exploring a given problem, gaining motivation, identifying potential solutions and building healthy habits and daily routines.
The study, which was published in the latest issue of the American Journal of Occupational Therapy, found that the Lifestyle Redesign treatment significantly improved patients’ quality of life, confidence and functional abilities. The most common diagnoses in this study included lumbar back pain, complex regional pain syndrome and myalgia including fibromyalgia.
“These types of diagnoses are long-term, difficult to manage and can’t just be fixed quickly,” Uyeshiro Simon said. “It’s in these types of cases, where the physician scratches their head without an immediate solution, that our lifestyle-based intervention can really help.”
The study is believed to be the first of its kind to directly demonstrate quantitative positive effects of a lifestyle-based treatment model delivered exclusively by occupational therapists. Although occupational therapy literature has discussed issues surrounding chronic pain since the early 1980s, a 2011 review found little evidence for occupation-based practice in chronic pain and a heavy reliance on evidence developed in disciplines outside of occupational therapy.
Uyeshiro Simon sees the study as an important contribution to expanding the profession’s body of evidence and to supporting occupational therapy practitioners in a variety of healthcare settings.
“A lot of occupational therapists work in chronic pain without realizing it — you might not be labeling it ‘chronic pain’ but you are still treating a person’s pain from an occupational perspective.”
Outcomes research is also frequently used to support claims for reimbursement from third-party payers like insurance companies, and lifestyle-based treatments can be incorporated into treatment plans for patients with chronic pain even if that pain is secondary to their primary reason for referral to occupational therapy.
With more than 100 million Americans living in chronic pain — a statistic that is intimately tied to what the Centers for Disease Control and Prevention calls an ongoing “epidemic” of nationwide opioid medication overdoses — the study affirms the value of lifestyle-based treatments as part of a multidisciplinary care plan to successfully manage chronic pain.
“The annual costs of pain management, both from direct medical expenses and from lost workforce productivity, run in the hundreds of billions of dollars,” Uyeshiro Simon said. “We’ve shown that occupational therapy can ease that burden by helping to improve everyday function and quality of life, one patient at a time.”
For as long as she can remember, Alicia Mendoza MA ’17 has admired the work of Christian missionaries. In occupational therapy she found a career with similar attributes: provision of needed services, expertise for developing community programs and individualized focus on helping people transcend their circumstances, whatever and wherever they may be.
While at USC, the Northern California native has worked with Professor Mary Lawlor on research projects and manuscript writing, has taught students as a classroom assistant and has served as the division’s co-chair of the USC Student-Run Clinic. But the biggest lesson, she says, is fueled by her faith.
“I think I’ve learned how to be with people,” says Mendoza, who will receive her master’s degree in occupational therapy this Friday during the 75th annual commencement ceremony of the USC Chan Division of Occupational Science and Occupational Therapy.
“Jesus spent time with people in their hard places, and it can be painful to just be with people when they’re suffering. But as occupational therapists, sometimes that’s the most powerful thing we can do.”
Fellowship to support writing new book on stigma
Professor Cheryl Mattingly has been honored with a 2017 Guggenheim Fellowship, one of only three USC faculty members to receive the prestigious award. She joins a diverse cohort of 173 scholars, artists and scientists from across North America selected from a pool of almost 3,000 applicants by the John Simon Guggenheim Memorial Foundation on the basis of prior achievement and exceptional promise.
Mattingly, who holds a joint appointment in the Department of Anthropology at the USC Dornsife College of Letters, Arts and Sciences, is a medical and psychological anthropologist who is inspired by phenomenology, the philosophy of ethics and narrative theory.
Her research — including Boundary Crossings, a longitudinal study of health care trajectories in 30 African-American children with illnesses and/or disabilities, their families and the practitioners who serve them — has focused on the experience of disability, family care and health disparities for minority populations. Throughout her work, she has aimed to document more than large-scale forces of social injustice.
The Guggenheim Fellowship will enable her to concentrate on her new book, Category Trouble: Stigma as Moral Experience. The book will explore recent attention to “moral striving” in anthropology that has highlighted how people struggle to transform or exceed the lives they inhabit — aspirations that can sometimes increase suffering. The writing will be more experimental than in her previous works, she said.
“Can I write compelling nonfiction short stories that also have a certain theoretical, even existential, resonance? Can my stories help us rethink stigma as a painful and personal lived experience, as a social marker of marginalized groups and also as a feature of the human condition?”
Since its establishment in 1925, the Guggenheim Foundation has granted more than $350 million in Fellowships to more than 18,000 individuals including scores of Nobel laureates, Pulitzer Prize winners, poets laureate, and members of the various national academies. The program remains an especially significant source of support for scholars in the humanities and social sciences.
Mattingly said she was stunned at the news she had won a Guggenheim, but added that she felt a special connection to the honor.
“There is deep significance for me in receiving a Guggenheim because of the program’s long history as a supporter of innovation and creativity, especially in the arts and humanities,” Mattingly said.
“Although anthropology is generally classified as a social science, I have always been a humanities-oriented type. One reason I gravitated toward anthropology as a discipline was because its research approach and methods encouraged us to listen carefully to the stories people told us and to record those stories ‘in their own words.’”
Mattingly is perhaps best known to occupational therapists for her scholarship, beginning in the 1980s, on the clinical reasoning of occupational therapy practitioners. Along with Maureen Fleming, Mattingly’s 1991 articles published in the American Journal of Occupational Therapy as well as their 1994 book, Clinical Reasoning: Forms of Inquiry in a Therapeutic Practice, are considered seminal works on the topic of occupational therapists’ clinical reasoning and actions during patient care encounters.
AOTA advocacy success: Evaluation payments expected to rise as CMS corrects error
Last week, clinical professor Katie Jordan met with representatives from the Centers for Medicare & Medicaid Services to raise concerns on behalf of the American Occupational Therapy Association regarding what was believed to be an error resulting in decreased Medicare reimbursements for occupational therapy evaluations.
AOTA began investigating concerns raised by occupational therapy practitioners beginning in January about unexpected Medicare payment cuts. At the meeting, CMS explained that a technical error committed on CMS’ behalf sometime in 2016 was the root cause for the payment cuts, and that retroactive payments to providers will be forthcoming.
Jordan serves as the American Occupational Therapy Association’s alternate representative to the Relative Value Scale Update Committee, often referred to as “RUC.” In this role Jordan offers relative value recommendations for new and revised CPT payment codes on behalf of non-physician health professionals such as occupational therapists.
“We were elated to get a positive response from CMS made possible by AOTA staff and volunteers collaborating to take quick and direct action,” Dr. Jordan noted.
Read the full article at the American Occupational Therapy Association.
Dr. Grace Baranek to lead USC’s occupational science and occupational therapy program
By John Hobbs MA ’14
Updated article was originally released on Aug. 23, 2016.
The USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy welcomes newly appointed associate dean and chair, Grace Baranek on Feb. 1.
Baranek comes to USC from the University of North Carolina at Chapel Hill, where she had been a faculty member for 20 years. She was most recently the associate chair for research in UNC’s Department of Allied Health Sciences and a professor in the Division of Occupational Science and Occupational Therapy.
“There is no one better among those in the occupational science and occupational therapy community to lead our program into its next phase of excellence,” said Florence Clark, the division’s outgoing chair and associate dean who has served as its administrative leader since 1989. “I am excited to see what Dr. Baranek will create as we enter into the 100th anniversary of the occupational therapy profession and the 75th anniversary of occupational therapy at the University of Southern California. There is no doubt that her leadership will give USC Chan a very special luster and take it to new heights through its exceptional educational programs, innovative practice and scientific discovery.”
The August 2016 announcement of Baranek’s appointment came after an extensive nationwide search, led by Dr. Avishai Sadan MBA ’14, dean of the Herman Ostrow School of Dentistry of USC, after Clark announced her intention in 2015 to step down from administrative duties to focus on research and teaching.
“It has been an incredible honor to work shoulder to shoulder with Florence,” Sadan said. “She’s a force of nature, and I can confidently say the occupational science discipline and occupational therapy profession have taken quantum leaps because of Dr. Clark’s hard work and scholarship.”
The USC Chan Division of Occupational Science and Occupational Therapy, like the USC Division of Biokinesiology and Physical Therapy, is a division within USC’s dental school.
Focus on Autism
Baranek received a bachelor’s degree in occupational therapy from the University of Illinois at the Medical Center before pursuing her master’s and PhD degrees in psychology from the University of Illinois at Chicago.
Her body of research is heavily geared toward autism and related development disorders — a key area of study for USC Chan.
Baranek is a nationally and internationally recognized expert in the field of autism spectrum disorder (ASD). Her research concentrations include early identification and intervention for children with ASD and related developmental disorders as well as understanding the impact of sensory experiences upon the lives of individuals with ASD.
In addition to publishing numerous research articles on autism — including one that won the American Occupational Therapy Association’s Cordelia Myers AJOT Best Article Award and another that earned her the American Journal of Speech-Language Pathology 2013 Editor’s Award — Baranek has added to the science behind autism by conducting interdisciplinary research.
She was co-director of the Program for Early Autism: Research, Leadership and Service, an interdisciplinary project at UNC Chapel Hill aiming to develop early assessment and intervention tools for ASD. She also served as the principal investigator of the Sensory Experiences Project, a 10-year research grant studying sensory features among children with autism spectrum disorder.
Baranek has been an AOTA Fellow since 2005, an AOTF Academy of Research member since 2008 and maintains active memberships with the American Occupational Therapy Association, the International Society for Autism Research and the International Society for Occupational Science.
While Baranek assumes her position on Feb. 1, she has already been involved with the division’s ongoing international initiatives. In October, alongside Clark and USC Provost Michael Quick, she welcomed a delegation from Peking University Health Science Center to USC to announce a new partnership that will create one of the first graduate program in occupational therapy in China.
Clark will take a year-long sabbatical before returning to focus on teaching, research and continuing to expand USC Chan’s global presence throughout Asia and the Pacific Rim.