ABSTRACT
This chapter describes the challenges we have faced in developing an integrated and multidimensional pain service, that aims to treat the person in pain rather than target pain as a symptom that signals that something is physically wrong. The gate model suggested that sensory inputs interacted in the spinal cord to help modulate neural transmission and pain sensations. The International Association for the Study of Pain was formed in 1973 specifically as an interdisciplinary organization. Patients referred to the service typically underwent a multidisciplinary assessment with a pain medicine specialist, a physiotherapist and either a clinical psychologist or liaison psychiatrist. Psychologists were sceptical of the biomedical interventions and believed that pain management for patients with persistent pain should focus solely on functional restoration guided by psychology and physiotherapy. Many patients who were previously very biomedically focused have used the group as a stepping stone to progress to individual psychotherapy work.
