Trauma-informed Approach to Pain and Human Aspects of Care
Includes a Live Web Event on 08/05/2025 at 8:30 AM (EDT)
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5 August 2025 at 8:30 a.m. EDT
This Global Year 2025 webinar is free to all.
This webinar is presented on behalf of the Pain and Trauma Special Interest Group.
Many patients attending pain management services have previous experiences of trauma, with disclosures often emerging during treatment. Clinicians can find this hard and may lack skills, confidence and training to deliver psychologically informed care. Struggling to support people living with complex and chronic conditions, where distress is commonplace in clinical encounters and can lead to professional demoralization and burnout. Emotions are central to human experience, relationships and an inextricable part of care. Distress is a common and often reasonable response within persistent pain care contexts, especially for people who have experienced trauma. However, distress is often pathologized and individualized and poorly navigated by physiotherapists. In this presentation we describe how current physiotherapy practices can be rational, task orientated, and focused the body in pain. Such approaches can unintentionally neglect other dimensions of the human experience, including emotions. This may negatively impact clinicians and patients, risk re-traumatization, and limit the development of trusting and safe therapeutic relationships and spaces. We draw from sociological theories of emotions to propose a more relational approach to care, shifting the focus beyond the individual in pain to include the physiotherapist and the many social, cultural, political, and structural forces that influence relation-centered care. We explain why this is necessary when working with people who have experienced trauma. We will also present findings from a qualitative service evaluation exploring patients’ experiences when engaging with persistent pain services. Emerging themes suggest patients can feel safe in a ‘bubble’ of care as compared to the threat of outside, experience a transformation over time toward sense-making and discovery but there is a risk of re-traumatization. We offer recommendations to inform clinician training and practice. Psychologically Informed Collaborative Conversations (PIC-C) is a co-produced training and supervision package that has been shown to be effective in improving the skills and confidence of physiotherapists managing adults with pain. It is also suitable for delivery for pediatric professionals and has a positive impact on physiotherapist’ confidence in using psychologically informed ways of working. An important theme from participant feedback was the emotionally challenging nature of the training but that this ultimately was a valuable and affirming experience. Finally, we will draw on the experiences of providing rehabilitation in UK-Med’s Emergency Medical Team Response in Gaza to explore the application of a trauma-informed approach to experiences of acute and persistent pain, historical trauma, ongoing stress, and life-changing injuries. Building on the previous content shared in the session, examples will demonstrate how physiotherapists can consider in their treatment the emotional experiences and social, cultural, political, and structural forces that shape the person’s lived experience of pain. Additionally, examples will illustrate how a de-pathologizing approach to understanding cultural idioms of distress and cultural healing practices can be integrated into physiotherapy clinical practice as a method of embodying a trauma-informed approach to pain. As feasible, the presenter will integrate the lived experiences of rehab providers in Gaza. The webinar will conclude with an interactive session enabling further exploration of attending to the human aspects of care.
Learning Objectives
· Define and articulate psychologically informed and trauma informed practice in terms of their own practice.
· Identify learning needs with regard to psychologically informed and trauma informed practice including engaging a more relational approach to care.
· Compare and contrast the implementation of psychologically informed and trauma informed practice in different frameworks and contexts including relational frameworks and response to emergency situations.
Speakers
- Miriam Dillon
- April Gamble
- Clair Jacobs
- Lester Jones
Miriam Dillon
Post Doctoral Research Fellow
School of Social Science, University of Queensland
Miriam is an experienced physiotherapist and post doctoral research fellow at the School of Social Science at the University of Queensland, Australia. She has worked in various areas of physiotherapy before focusing on chronic pain physiotherapy over the last 8 years. She completed a masters in musculoskeletal physiotherapy at the University of Queensland, before undertaking her doctoral research. Miriam’s research takes a critical approach, utilising a variety of sociology theories and qualitative methodologies to challenge taken for granted norms within physiotherapy care. Her research traces distress in persistent pain care exploring how distress is produced within the clinic, and how it is recognised and navigated by physiotherapists. Miriam is passionate about increasing awareness of the social, cultural and emotional aspects of health and illness experiences and care, in order to provide more equitable and care for all people.
April Gamble, PT, DPT
UK-Med ; Wchan Organization for Victims of Human Rights Violations, Iraq
April Gamble earned their Doctor of Physical Therapy in the USA. They have been living full time in the Kurdistan Region of Iraq since 2017. They have over ten years of experience in community-driven efforts to develop persistent pain, mental health, and trauma-focused rehabilitation. April is the Senior Health Advisor in UK-Med where they lead the integration of rehabilitation and mental health and psychosocial support into disaster responses and the most globally deployed Emergency Medical Team. April is the Physiotherapy Director at Wchan Organization for Human Rights Violations in Kurdistan, leading interdisciplinary rehabilitation services for survivors of torture and war trauma. They are also one of the founding members of the Community of Practice for Fostering Excellence in Trauma-Informed Pain Rehabilitation, a group of rehabilitation professionals from the Middle East and North Africa (MENA) Region collaborating to promote contextually relevant pain care in the region. April contributes to funding efforts, research activities, program and service development projects, and professional education initiatives in the USA, Kurdistan, Federal Iraq, Armenia, and the greater MENA Region. In addition to numerous conference presentations, April’s publication credits include textbooks chapters in international texts and clinical research trials and systematic reviews in peer reviewed international journals.
Clair Jacobs, MSc
Vice-Chair of Pain and Trauma SIG
.INPUT Pain Management, St Thomas’s NHS trust
Clair works clinically as Physiotherapy Clinical Lead at INPUT Pain Management, Guys and St Thomas NHS Trust alongside Pain and Leadership teaching both in the Physiotherapy Division at Brunel University and External as Sen. Lecturer (Professional Practice) Physiotherapy. Clair has worked in chronic pain management for most of her career in secondary and tertiary service including overseas. She is interested in psychologically informed and narrative approaches in health care graduating in Narrative Medicine, Columbia University and Narrative Based Approaches. She is serving on national and International committees including Co-Chair of the Physiotherapy Pain Association and Co-Education Lead since 2019 and Vice-Chair of Pain and Trauma SIG, IASP (previously Pain of Torture, Organized Violence, and War SIG).
Lester Jones, PhD
Secretary, Pain and Trauma SIG
Singapore Institute of Technology
Lester Jones is an experienced educator and APA-titled Pain Physiotherapist. He has had academic positions in the United Kingdom, Australia and now Singapore (since 2018), where he is a Senior Lecturer at Singapore Institute of Technology. Much of his scholarly work has been exploring pain as a multidimensional experience and includes the application of the Pain and Movement Reasoning Model which he co-created. He was the first physiotherapist awarded MScMed(PainMgt), the inaugural chair of APA National Pain Group and was the lead tutor on pain topics for La Trobe University's Masters program for Sports and Musculoskeletal Physiotherapy. He is currently into his third term on the Pain Association of Singapore Council. He is the Secretary of the International Association of the Study of Pain (IASP) SIG Pain and Trauma (formerly Pain related to Torture, Organised Violence and War). Since September 2022, he is an elected member of the IASP Council.
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