Self-management Programs

Self-management Programs

By Michael McGillion, RN, PhD and Sandra M. LeFort, PhD, RN

Agencies that are providing the Chronic Pain Self-Management Program as of November, 2011 (PDF)

Self-management programs: History and overview

In the 1980s and 90s, self-management programs began to be developed for people with chronic conditions. Because chronic conditions are common, it became clear that self-management education and training for people was a very important part of being as healthy as possible. Unlike traditional patient education, self-management education programs focus on a collaborative partnership between people with chronic conditions (like chronic pain) and health care professionals. At the centre of this partnership are your priorities, challenges, or the everyday problems you face in living with a chronic condition.

Self-management programs begin with helping you talk about these problems. For example, at the beginning of a chronic pain self-management program, you would be encouraged to talk about how your chronic pain affects your daily life. From there, the program works to help you be as well as possible and achieve your life goals. Self-management programs are designed to help you make realistic goals and achieve them, using a number of self-management strategies. It is the process in which self-management is taught that makes it effective. Classes are highly participative, where mutual support and success builds your confidence in your ability to manage your health and maintain an active and fulfilling life.

Is there a self-management program available for people living with chronic pain in Canada?

Yes, the program available in Canada for chronic pain is The Chronic Pain Self-Management Program. This program is a workshop given two and a half hours, once a week, for six weeks, in community settings such as senior centers, churches, libraries, and hospitals. Workshops are facilitated by two trained leaders, one or both of whom are non-health professionals with chronic pain themselves.

Subjects covered in the Chronic Pain Self-Management Program include:

  • techniques to deal with problems such as stress and tension, anger, frustration, depression, fatigue, and isolation
  • appropriate exercise for maintaining and improving strength, flexibility, and endurance
  • appropriate use of pain medications
  • communicating effectively with family, friends, and health professionals
  • nutrition
  • pacing activity and rest
  • how to evaluate new treatments.

Each participant in the workshop receives a copy of the companion books, Living a Healthy Life With Chronic Conditions, 3rd Edition and the Chronic Pain Self-Management Workbook.

How was the Chronic Pain Self-Management Program developed?

The Chronic Pain Self-Management Program, known as the CPSMP, was developed by Sandra LeFort, PhD, MN, RN in 1996 at McGill University in Montreal and later updated at Memorial University, St. John's, Newfoundland, Canada, with Lisa Cardas, RN of Toronto, Ontario. The CPSMP was developed in conjunction with Dr. Kate Lorig and the staff of the Stanford Patient Education Research Center. It was derived from Stanford's Arthritis Self-Management Program and the Chronic Disease Self-Management Program. It was revised in 2008 and a new Chronic Pain Workbook was written to accompany the program.

The CPSMP was developed for people who have a primary or secondary diagnosis of chronic pain. Pain is defined as being chronic or long term when it lasts for longer than three to six months, or beyond the normal healing time of an injury. Examples of chronic pain conditions are:

  • chronic musculo-skeletal pain (such as neck, shoulder, or back pain)
  • fibromyalgia
  • whiplash injuries
  • chronic regional pain syndromes
  • repetitive strain injury
  • chronic pelvic pain
  • post-surgical pain that lasts beyond six months
  • neuropathic pain (often caused by trauma)
  • neuralgias (such as post-herpetic pain, and trigeminal neuralgia)
  • post stroke or central pain

The CPSMP may also benefit those who have conditions such as persistent headache, Crohn's disease, irritable bowel syndrome, diabetic neuropathy, or those who experience severe muscular pain due to conditions such as multiple sclerosis.

How do I find out where the Chronic Pain Self-Management Program is offered?

Since 2008, Dr. LeFort and Ms. Cardas have offered training sessions to groups in  British Columbia, Alberta, and Ontario. If you require more information about where a CPSMP workshop may be given near you, please contact Dr. Sandra LeFort at lefort@cpsmp.com.