This form is based on the McGill Pain Scale and is a very important form, especially when you are working with clients who suffer from chronic pain.
Without an accurate record it's very difficult to prove to the client that their pain has been reduced as a result of your treatment plan.
In the case of chronic pain this form should be completed by the client at the time of the first visit with fresh forms being completed following set numbers of treatments.
On this form you can see check areas for the different words that often relate to the same sort of pain (because everybody's vocabulary is different), so we have our area where they can nominate the words that describe their pain.
Then they come down and record the frequency and duration of pain, what type of pain it is, what makes the pain worse, what makes the pain better, the number of hours over the last 24 hours that they were actually in pain, any pain killers that they used.
Next they indicate their pain on a level of one to ten, indicate on the model where the pain is and what sort of pain it is, whether it's numbness, pulsating, throbbing, burning, stabbing, pins and needles, radiating and where it's radiating to.
As I said, this form when you're working with clients in pain is imperative.
Say for example you've been working on a client for a little while and they filled out one of these forms when they first came and saw you, and they come back about four weeks later after a number of treatments and they say,
"Look I'm still in pain"
All you do is you get them to fill out a new form and then compare the new form to the form that they filled out when they first came and saw you.
Now this is done in their own hand, this is their report, not your report.
Now they can then see that, perhaps when they first came and saw you they had a pain level of eight that was constant, now they have an intermittent pain of three.
So they might still be in pain, yes it's true, but there has been an improvement.
The problem when you're dealing with pain is that all the client knows is that they're still in pain, they were in pain when they first came and saw you and they're still in pain.
They may not have sat down and analysed and thought about things. They may not have realised that their pain has changed. All they know is that they're in pain.
So it's your job to do the recording, do the progress charting, so that you can indicate to them that they are improving. This is great psychologically as well, because when they can see that, by filling out these forms themselves, these aren't your notes, these are forms they fill out themselves and they can see an improvement that is a great psychological step forward in their well-being.