• Identify the type of pain your client is experiencing for which applications of applied behavioral science are appropriate (e.g., arthritis, bone or joint pain, muscle pain, fibromyalgia, migraine headaches, cancer pain, post-surgery, etc.).
 Jessica a 35 year old lady, a formally very active lady, was involved in a tragic car accident leaving her with damage to her vertebrate, causing her constant back pain. She is becoming very depressed at her now dependency, being stuck in a wheelchair. She is starting to gain weight from the depression, and is no longer motivated to attend physical therapy.

• Describe any psychological factors and emotional states of your client which appear to impact her or his mental and physical health (e.g., depression, anxiety, general level of satisfaction with life).
 Jessica has become so depressed, at times she does not want to even get out of bed. She is not use to relying on other to care for her, and feels like a burden to her one and only daughter. She feels held back from all the normal activities that she use to participate in, going jogging, dancing, and even having to quit her full-time job. She is in such pain, it makes it hard for her to even move, although she is supposed to be attending physical therapy, she feels like she sees no improvement and it’s causing her pain, so she has cut back from going. With this depression and over eating, this can lead to further problems if she does not change her eating habits. This can lead to obesity, and further more even more complications. “Obesity predisposes individuals to a variety of health risks, including high blood pressure, high cholesterol, cardiovascular disease, type 2 diabetes, asthma, and sleep apnea( McCarthy; DeLisa; Getzfeld; McCarthy; Moss-King; Mosser;Privera; Spence;Walker; Weinberg; Yousself- Morgan, 2016. Section 3.4, par 3).

 • Indicate the client’s locus of control and health motivation. Utilize terminology outlined in your reading.
 Jessica at times has no motivation. Her depression has gotten the best of her. With the help and support of her daughter, she realizes she needs to push through these physical therapy sessions or she will be stuck in that wheelchair for good. Since she loves the outdoors, her daughter is now taking her to the park to the walking chair, encouraging her to push herself, while still being able to enjoy the outdoors that she so dearly misses. She is now changing her eating style, and attending physical therapy sessions again. She has faced the facts, and realized she needs a change in her lifestyle if she wants to get better. Her motivation is growing and her depression is subsiding.

• Identify any additional stressors your client is experiencing that may exacerbate her or his pain experience.
With her negative thinking she was becoming more depressed. She would get frustrated and give up when she couldn’t achieve something on her own.

 • Based on the reading, identify at least one pain management technique you believe would best reduce the pain experience in this situation.
Because of Jessica’s love for the outdoors I believe, Mindfulness – based stress Reduction can help with her depression. This has been shown to “ reduce stress and anxiety symptoms, negative mood related feelings, depression, and even increase self-esteem and improve overall functioning”( 4.3, par 21). Being able to just be outdoors, watching sunsets, enjoying the outdoors can help lift her spirits and give her a new outlook on life. “ Meditation can be a great healing process.
“techniques, such as diaphragmatic breathing, progressive muscle relaxation, distraction, medi-tation, and guided imagery have been shown to significantly reduce pain”( Haozous, Doorenbos; Ardith; Stoner,2016 par 2).

• Examine the application of your selected pain management technique in relation to the same situation within a different culture. Explain the role of the perception of pain and the impact of culture on perception of pain, identifying and usage trends of applied behavioral science unique to different groups.
All cultures are different, we all look to healing within our own beliefs. Many different cultures believe in more natural ways of healing. A study done on, American Indians and Alaska natives showed,”specific activities mentioned including drumming, traditional crafts such as beating and pottery, Gathering and using traditional herbs, prayer and working with a medicine person or traditional Indian medicine practitioner.”( Haozous; Doorenbos; Ardith; Stoner,2016. Pg. 238, par.1). With Indians believing in natural herbs for healing, and the love of outdoors, I believe Mindfulness- based stress Reduction would be a pain management technique they use as well.

References-
Haozousus Emily A.; Doorenbos, Ardith Z.; Stoner, Susan;( 2016)Pain Management Experiences and the Acceptability of Cognitive Behavioral Strategies among American Indians and Alaska Natives Journal of Transcultural Nursing , Vol 27(3), May, 2016 pp. 233-240. Publisher: Sage Publications; [Journal Article] Database: PsycINFO
McCarthy, C. J., DeLisi, M., Getzfeld, A. R., McCarthy, C. J., Moss-King, D. A., Mossler, R., Privitera, G. J., Spence, C., Walker, J. D., Weinberg, R. S., & Youssef-Morgan, C. M. (2016). Introduction to applied behavioral science[Electronic version]. Retrieved from https://content.ashford.edu/

#2Kristine Hunt
YesterdayJan 10 at 10:51pm
Manage Discussion Entry

· Identify the type of pain your client is experiencing for which applications of applied behavioral science are appropriate (e.g., arthritis, bone or joint pain, muscle pain, fibromyalgia, migraine headaches, cancer pain, post-surgery, etc.).

My client is a 20 year old white female who suffered from multiple myeloma. She was hospitalized on and off for the last 5 years and initially not expected to survive. She did survive, however, but had to use a wheelchair and crutches during those 5 years. She was treated successfully in the hospital with medications and recently underwent a couple surgeries at the Mayo clinic in Chicago, where she had a bone graft from her hip to her thigh. She is now in full recovery with no lingering illness but she is struggling to regain her physical, as well as mental strength.

· Describe any psychological factors and emotional states of your client which appear to impact her or his mental and physical health (e.g., depression, anxiety, general level of satisfaction with life).

She presents with symptoms of depression and feelings of worthlessness because she knows that she has been a burden on her family. Her mother, who has essentially been a single mother throughout this ordeal, has had to balance raising 5 girls on her own, working fulltime and trying to pay for the medical and hospital bills. Her father, an alcoholic, left home shortly after she got sick and has only said negative things to her, telling her that she should just die because she is a burden on the family. She has also struggled with the social aspect of being in a wheelchair or on crutches throughout all of her high school career.

· Indicate the client’s locus of control and health motivation. Utilize terminology outlined in your reading.
My client seems to have a strong, internal locus of control. She has a will to live that even her doctors did not predict. She fought the odds and came back from the brink of death because she believed that she could. In her mind, she was in control of her body and certainly her mind to overcome her illness and fight off the disease that overtook her.

· Identify any additional stressors your client is experiencing that may exacerbate her or his pain experience.

Additional stressors include her inability to get a job in the field that she wanted. She applied for a flight attendant position but, because of the surgery to her leg, was denied the position. She was given a desk job instead. This is a major disappointment to her.

· Based on the reading, identify at least one pain management technique you believe would best reduce the pain experience in this situation.
I believe that she will greatly benefit from mindfulness-based stress reduction (MBSR) as a pain management technique to reduce the pain she is experiencing. She has a very positive outlook on her future and she is determined to overcome her depression and pain but she is looking for help to manage her pain, with physical and mental or emotional setbacks. MBSR is a form of training for people who experience both mental and physical distress. MBSR programs typically focus on increasing the skill of mindfulness by practices such as meditation and body scan, which is then incorporated in to everyday life to cope (Fjorback, Arendt, Ornbol, Fink, & Walach, 2011).

· Examine the application of your selected pain management technique in relation to the same situation within a different culture. Explain the role of the perception of pain and the impact of culture on perception of pain, identifying and usage trends of applied behavioral science unique to different groups.

I don’t believe that the pain management technique MBSR is widely accepted in many other cultures. I believe it would be found predominantly in first-world countries that are more open and accepting of advanced thinking and techniques for pain management. For instance, I don’t believe you would find a doctor of any kind in most third-world countries who would recommend the use of MBSR to a patient or client looking for alternative treatment for pain. In our country, we emphasize the use of many different tools to manage pain, including counseling and health psychology. In many third-world countries, people don’t have access to counseling and health psychology. They mainly just deal with the pain or perhaps get medication to help with it. Pain is part of life. People who do not have access or knowledge of such things as counseling and health psychology don’t even know there are other ways to deal with pain.