Clinicians

The clinical process of working with children with long-term conditions is complex. Clinicians are often aware of multiple interacting variables that can affect change and use these variables as important parts of formulation and treatment. Treatments are normally driven by available resources, staff, their skills, and space, and financial support. Diagnosis is often unhelpful to the clinician in the therapy process with chronic pain because it offers little guidance, and individualization of the therapy is often necessary. Outcomes are commonly individualistic, based on agreed outcomes that are relevant and important for the patient and that are driven by the therapy rationale. Outcomes are rarely calculated in percentages and are often normatively related. Importantly, acceptable outcomes to patients are often the subject of therapy and can change in the process (e.g., from pain relief to greater functioning with pain).

If measurable outcomes are used, then they relate to a range of functional abilities that may be restricted by pain, not purely to the level of pain, although this is the headline purpose of referral for assessment and treatment and the common parlance of funding discussions.

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