1step2life supports patient functioning
Treatment of severe chronic pain is complicated because it sets up a negatively reinforcing cycle.
1step2life emphasizes increasing function and treatment adherence rather than logging pain. In addition, 1step2life is the only app with a caregiver mode. Parents key members of the treatment team.
1step2life lets people living with pain set weekly goals in six major areas:
- Diet & Hydration
- Stress reduction/meditation/biofeedback
- Taking medications
- Daily functioning
Daily logging of mood and activities keep the focus on improving functioning and returning to life, rather than on pain.
1step2life encourages best caregiving practices
Parents and partners can track the functioning of the person they are caring for as well as their own mood and self care. The app encourages behaviors that build relationships and reinforces positive practices, including rewards, distraction, balancing challenge and support, and encouraging engagement in activities other than pain.
Effective support is critical for patient success. As Benore, Fahrenkamp, Zhakunets, & Banez (2020) write:
“Some families feel hopeless in this process – dwelling on the months of academic decline and perceived lack of support. Other families become defensive – ready to fight and validate the suffering of their child. Still others fully understand their needs, yet lack the ability to successfully advocate for their child, falling into a passive role in this process.”
1step2life empowers patients and caregivers by giving them tools to engage in the pain rehabilitation process effectively.
Using 1step2life to improve practice
1step2life can be used with pain education materials to:
- Reduce patient decline between first contact and first appointment
- Support treatment adherence
- Help patients maintain functioning and health, reducing comorbidities and patient disability
1step2life: Understanding the science
1step2life is based on cutting edge developmental and rehabilitation science.
1step2life is based on a philosophy of chronic pain rehabilitation articulated in Zeltzer & Schlank’s (2005) classic book Conquering Your Child’s Chronic Pain.
- All pain is real
- Don’t ask about or focus on pain
- Improved functioning comes before reduced pain
- Scaffold progress, supporting maximum patient autonomy and self-governance
- Embrace healthy lifestyle changes, including exercise, good diet and hydration, and excellent sleep hygiene
- Look at pain within the whole context of the patient’s life
- Relieving chronic pain and returning to developmentally appropriate activities is rarely a quick fix and is much more likely to occur in a series of small steps.
Nancy Darling, Ph.D.
Nancy Darling, PhD, 1step2life’s founder, is a developmental psychologist. For the last 35 years, she has studied parenting, governance transfer, and adolescent compliance in the US, Chile, Italy, Japan, the Netherlands, the Philippines, Spain, Sweden, Tanzania, and Uganda.
When her son was diagnosed with severe chronic migraines, she was struck by the overlap between core areas of pain rehabilitation – particularly lifestyle changes – and those areas where adolescents were least likely to comply and most likely to lie to their parents. Her recent research provides insight into both adolescents’ and parents’ beliefs about the limits of doctors’ legitimate authority and the effect of those beliefs on adherence.
1step2life explicitly encourages parents and other caregivers to act as effective coaches. Research on five continents shows that adherence is highest when parents support adolescent autonomy and challenge their adolescents to push themselves to do their best while providing consistent unconditional support.
Patients start where they are.
Users record progress with just a touch: I made it to the kitchen, texted a friend, walked the dog, or got to school on time. Exercise, diet, stress reduction, caring for self and others, playing with pets, and reaching out to friends. It’s there. By recording everyday triumphs, people living with pain can keep their focus on what they CAN do rather than what they can’t. Users can add their own goals: exercises from their physical therapist, daily biofeedback, or talking to friends. Whatever is important to them.
1step2life is designed to focus on success. If users report that they haven’t gotten dressed, we won’t ask if they’ve been to work.
Daily mood tracking allows users to visualize the links between well-being, functioning and – if they’re tracking it – pain. Several decades of research show that children and adolescents are much more responsive to success and reward than they are to punishment or avoiding pain. 1step2life is designed to take advantage of this principle.
1step2life provides patients and families with the tools they need to make effective lifestyle changes.
When Dr. Darling’s son went to the Cleveland Clinic Pediatric Pain Rehabilitation Program, one metaphor really struck her. They said “If you live with chronic pain, you’ve got two choices. You can cuddle up with it on the couch or you can take it with you and live your life. Because the pain is going to be there.”
Research says that when you get up and function with pain the pain gets better over time. The longer you put your life on hold and wait for things to get better, the worse the pain gets. It’s a vicious cycle.
Breaking that cycle is tough. It’s tough for patients. It tears the heart out of the people who love them. They’re not going to do it all at once. They’re not going to do it every day. But by focusing on what they CAN do and what they DID do, patients can make progress.
And take back their lives. One step at a time.
We can help.
Interested in adopting the 1step2life app for your practice? Contact us directly! We would be happy to work with you to integrate 1step2life into your practice.can provide training and support.