New patients are evaluated in our interdisciplinary Pain Rehabilitation Clinic. Based on the evaluation, patients may be referred for outpatient treatment, day hospital treatment, or inpatient treatment. Outpatient therapy is available at Kennedy Krieger Institute for patients in the surrounding geographic area including Physical Therapy, Occupational Therapy, and Cognitive-Behavioral Therapy. Some patients may be referred for additional evaluation by specialists in Neurology, Genetics, Gastroenterology, Physical Medicine & Rehabilitation, or Psychiatry. Patients who have been discharged from the inpatient unit at Kennedy Krieger or day hospital care often have follow-up care in the Pain Rehabilitation Clinic. Follow-up visits are typically scheduled with a pain medicine specialist in the Pain Rehabilitation Clinic.
Day Hospital Care:
For patients who would benefit from intensive daily therapy without the need for hospitalization, we recommend our comprehensive rehabilitation day hospital program. This program fills a unique niche by providing support for pain rehabilitation in a more familiar, school-like environment. Our program prepares children to participate as fully as possible in school and other day to day activities after discharge, enhancing their overall quality of life.
Our pain management team includes specialists in rehabilitation medicine, cognitive-behavioral therapy, physical therapy, occupational therapy, neuropsychology, social work and education. Consultation to psychiatry is available to assess and treat the anxiety and depression that sometimes occurs with chronic pain.
The treatment team helps patients set attainable goals for each day to maximize success. The primary goal for all patients is to learn to manage their pain during a full day of therapies, education and other functional activities, with carryover into the home setting. The team is available to families each day to provide ongoing support in reinforcing pain management strategies. We require parents to participate in several weekly sessions for training and support in the care of their child during the rehabilitation process and beyond.
This level of care is for patients who need intensive, round-the-clock care with daily therapies and close medical monitoring. All patients admitted for chronic pain learn and practice pain and symptom coping strategies. To maximize success, we help patients and families set attainable goals for each day. As a patient becomes better able to manage and cope with his or her pain, we gradually increase physical demands. This gradual increase in physical demands helps patients learn to pace their daily tasks and activities and learn when and how to relax. The medical team assesses medications and makes adjustments as appropriate over the course of the hospitalization.
Initial evaluation period: We encourage parents/guardians to be present for the initial evaluation period (which lasts for approximately the first three days of admission), and we invite one parent to spend the night during the evaluation process, if they choose. After the evaluation period, we strongly encourage parents to avoid overnight stays so that patients can focus on their rehabilitation goals and adjusting to the hospital setting. Additionally, we may set some restrictions for visitors during daytime hours. We discuss these restrictions at the family meeting held about 3 days after admission. We offer pain education and training for family members and caregivers throughout the inpatient stay.
The inpatient team has extensive experience in working with children and adolescents with chronic pain. The team includes specialists in pediatrics, cognitive-behavioral therapy, physical therapy, occupational therapy, neuropsychology, social work, education, therapeutic recreation and child life. In addition, the team often requests consultation from other disciplines including Pediatric Rehabilitation, Gastroenterology, Nutrition, Speech-Language Pathology, Audiology, Assistive Technology and Psychiatry.