Making memories - shaping children's future pain with Dr Melanie Noel

10/26/20 • 67 min

The Words Matter Podcast with Oliver Thomson

Welcome to another episode of The Words Matter Podcast.

On this episode I'm speaking with pediatric pain scientist and psychologist Dr Melanie Noel.

Melanie is an Associate Professor of Clinical Psychology at the University of Calgary, and a full member of the Alberta Children's Hospital Research Institute and the Hotchkiss Brain Institute.

She teaches and supervises within the CPA-accredited Clinical Psychology Graduate Program in the Department of Psychology at the University of Calgary.

And her behavioural research lab is based within the Vi Riddell Children's Pain and Rehabilitation Centre at Alberta Children's Hospital.

Melanie completed her PhD in Clinical Psychology and Dalhousie University Canada, and held a Post-Doctoral Fellowship in Pediatric Pain Research at the Seattle Children's Research Institute.

The overarching aim of her research is to understand and harness the influence of cognitive-behavioral factors, like pain memories, on children’s pain trajectories using developmental frameworks. Her interests cover the areas of acute pain (such as painful medical procedures such as surgeries or vaccinations) and chronic pain in a variety of clinical and healthy populations.

Her clinical interests include child clinical and pediatric psychology populations, with particular interest in the intersection between children's physical and mental health.

So in this episode we talk about:

public health messaging in relation to pain, in particular the influence of these messages on children.
the nature and prevalence of paediatric chronic pain, and some of the key predictors for such pain states.
diagnostic uncertainty for children with chronic pain and their parents.
her research in the area of children's anxiety and pain memories as cognitive-affective mechanisms underlying trajectories of pediatric pain and future pain as adults.
the dynamic and dyadic relationship between a parent’s mood and behavioural responses to a child’s chronic pain and how parents’ protective responses (such as pain catastrophising) influence a child’s pain experience.
her strategies to reconstruct and re-frame a Childs pain experience to engender more positive behaviours and attitudes towards pain.
At the end of the show you’ll hear our surprise that Melanie and I share a common experience, with her having triplets and me being a triplet.

So this was an absolutely fascinating talk, with someone really at the edge of knowledge in this crucial field. Melanie’s sheer enthusiasm and passion for her work is a joy to listen to as well as her compassion for the participants and patients that are involved in her work.

On many instances the conversation is directed to the role of parents, rather than clinicians; but this episode has huge value for those without children, and significant value even if you never see children in your clinical work.

If you seek to obtain an understanding of where your adult patient’s pain beliefs, emotional responses and behaviours may originate from this podcast offers a real insight.

Find Melanie on Twitter @MelanieNoel

If you liked the podcast, you'll love the Words Matter online course in effective language and communication when managing back pain - ideal for all MSK therapists and students (discounts for students available)

Follow Words Matter on:

Instagram @Wordsmatter_education @TheWordsMatterPodcast

Twitter @WordsClinical

Facebook Words Matter - Improving Clinical Communication

Welcome to another episode of The Words Matter Podcast.

On this episode I'm speaking with pediatric pain scientist and psychologist Dr Melanie Noel.

Melanie is an Associate Professor of Clinical Psychology at the University of Calgary, and a full member of the Alberta Children's Hospital Research Institute and the Hotchkiss Brain Institute.

She teaches and supervises within the CPA-accredited Clinical Psychology Graduate Program in the Department of Psychology at the University of Calgary.

And her behavioural research lab is based within the Vi Riddell Children's Pain and Rehabilitation Centre at Alberta Children's Hospital.

Melanie completed her PhD in Clinical Psychology and Dalhousie University Canada, and held a Post-Doctoral Fellowship in Pediatric Pain Research at the Seattle Children's Research Institute.

Her clinical interests include child clinical and pediatric psychology populations, with particular interest in the intersection between children's physical and mental health.

So in this episode we talk about:

public health messaging in relation to pain, in particular the influence of these messages on children.
the nature and prevalence of paediatric chronic pain, and some of the key predictors for such pain states.
diagnostic uncertainty for children with chronic pain and their parents.
her research in the area of children's anxiety and pain memories as cognitive-affective mechanisms underlying trajectories of pediatric pain and future pain as adults.
the dynamic and dyadic relationship between a parent’s mood and behavioural responses to a child’s chronic pain and how parents’ protective responses (such as pain catastrophising) influence a child’s pain experience.
her strategies to reconstruct and re-frame a Childs pain experience to engender more positive behaviours and attitudes towards pain.
At the end of the show you’ll hear our surprise that Melanie and I share a common experience, with her having triplets and me being a triplet.

If you seek to obtain an understanding of where your adult patient’s pain beliefs, emotional responses and behaviours may originate from this podcast offers a real insight.

Find Melanie on Twitter @MelanieNoel

Follow Words Matter on:

Instagram @Wordsmatter_education @TheWordsMatterPodcast

Twitter @WordsClinical

Facebook Words Matter - Improving Clinical Communication

Previous Episode

Biopsychosocialising practice and speeding up the change with Dr Kieran O’Sullivan

Welcome to another episode of The Words Matter Podcast.

In this episode I’m delighted to speak with Physiotherapist Dr Kieran O’Sullivan.

Kieran graduated as a physiotherapist from the University College Dublin in 1999. In 2004 he completed an MSc in Manipulative Therapy at Curtin University of Technology, Perth, Western Australia. In 2005, he started lecturing at the University of Limerick.

In 2008 he was awarded specialist member status by the Irish Society of Chartered Physiotherapists. From 2016-2019, he took a 3-year career break to act as Lead Physiotherapist at the Sports Spine Centre at Aspetar, Qatar, and he shares his experience of this in the episode.

His research interest is musculoskeletal pain and injury, particularly persistent spinal pain. He completed his PhD on persistent low back pain.

In this episode we talk about:

The progression of the BPS model and the barriers and facilitators influencing this progression.
His experience of working within the different cultural and social contexts at Aspetar, Qatar.
The systemic, organisational and structural factors related to clinicians practice behaviour and the challenges of implementing a BPS framework.
The 'swinging pendulum' argument of the the BPS model in MSK practice.
How we might inadvertently trivialise, invalidate or stigmatise patients experiencing MSK pain.
His ideas around approaching MSK colleagues who hold misconceptions, unhelpful beliefs or adopt outdated treatment models.
A communication strategy which has been affiliated with him - the 'Kieran O’Sullivan talk back Technique'

Kieran has been a frequently requested guest, and it’s clear why. I really enjoyed talking to Kieran, his calm, warm and wise words were really effective in charting a way forward to overcome some of the challenges of implementing a biopsychosocial approach to practice.

Kieran is on Twitter @kieranosull

Subscribe to www.wordsmatter-education.com , and if you liked the podcast, you'll love the Words Matter online course in effective language and communication when managing back pain - ideal for all MSK therapists and students.

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Twitter @WordsClinical

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Next Episode

Psychologically informed practice - How far we’ve come and how far we haven’t with Steven Vogel

Welcome to another episode of The Words Matter Podcast.

In this episode I speak with Steven Vogel. Steven is Deputy Vice-Chancellor (Research) at the University College of Osteopathy and Editor in Chief of the International Journal of Osteopathic Medicine.

He has twice been a member of National Institute for Health and Clinical Excellence (NICE) Guideline Development Groups formulating NICE clinical guidelines for back pain and sciatica.

Steven led the large Clinical Risk Osteopathy and Management (CROaM) study which examined adverse events and outcomes related to osteopathic interventions.

His main research interests focus on back pain, clinicians’ beliefs and attitudes and more recently, reassurance, communication and consent, safety and manual therapy, patient reported outcomes, self-management rehabilitation strategies used in practice with people with low back pain, and the effects of cognitive and affective reassurance.

In this episode we talk about:

What constitutive ethical and professionally agnostic musculoskeletal care (see Steve's paper here).
The early research into psychology of LBP, of which he was a crucial part (see here here and here).
The cyclical nature of current arguments (hands on/of/psycho/manipulation etc).
The different levels (fizzy drink scale) of psychologically-informed practice, and the psychological processes involved in clinical practice.
The challenges of developing these skills in clinicians, and the questions up for debate such as 'what does it mean to be BPS orientated' and 'what sorts of training bests develops those competencies'?
The frequent situation where psychological interventions have high face validity, make sense to us an clinicians but show small effect sizes when clinically trialled.
We talk about his seminal 2013 systematic review work on cognitive and affective reassurance.
Signs of progress and lack of progress of for PIP
The challenge of measuring BPS-ness and the empirical actions and observable behaviours associated with such a clinical orientation.

Steven is is perhaps the most measured, rational and composed individual I know. He remains totally zen even when being faced with some the highest intellectual dishonesty in the manual-physical-osteopathy spheres.

It was an absolute pleasure speaking with Steve about his seminal work as a pioneer of psychologically-informed musculoskeletal care, and reflect on how far we have come and how much further we have still to go.

Find Steven on Twitter @UCODVC_Research

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