Being a teenager is not easy. The hormones are raging, the acne is blazing and no one quite understands you. But imagine on top of the usual teenage woes, you are dealing with pain your peers can’t comprehend like chronic migraines or back pain.
Teens in the best of circumstances can find it difficult to make friends, fit in and keep up with their studies. But how can a teen attend school when they are in so much pain it’s difficult to sit through an 80-minute class? If they can’t attend school, how can they graduate? How can they build relationships with their peers? It’s no surprise they may start to fall behind their classmates and become reclusive.
Fortunately for teens like these, Kathy Reid, a nurse practitioner with the Stollery Pediatric Chronic Pain Services is giving them a better chance of graduating, by providing resources to manage their pain and a boost of self-confidence. Kathy is the leading force behind Chronic Pain 35, a 10-week cognitive behavioural therapy class run through the Stollery Children’s Hospital, the first of its kind in Canada. High school students with chronic pain learn coping techniques while getting three credits closer to graduating. In fact, according to Kathy, the teens are learning more about pain than most of the doctors and nurses they will ever encounter.
In addition to attending class once a week, either in person or through teleconference, students are expected to complete homework. The work includes setting goals to improve their health or communicate their needs more effectively. Every student must also complete a copy of a set-back plan which outlines what they will do when their pain flares.
A key part of the course is group discussion time, where students discuss strategies to manage pain, the challenges they face and how they can overcome the challenges. Many of the teens in the program are suffering from an invisible illness making it difficult for their peers to understand the struggles they face. “We don’t have a pain scanner, we don’t have tests or blood work to test for pain,” says Kathy, “It’s so empowering for them because so many of these teens tell me they’ve never met anyone else who understands what they are going through … we’ve certainly had some friendships and peer support develop out of this.”
The students also get to explore their creative side. Students are required to complete a project that demonstrates what they’ve learned in the course and the projects have taken the form of essays, poetry, paintings, collages, sculptures, music and more. “The teens absolutely loved the idea of being creative,” says Kathy, “they started bringing in creative projects to help express their personal meaning of pain and how they’re going to change their life based on what they’ve learned.”
But the course wasn’t always a source for high school credits. Kathy recognized that her students were benefiting greatly from the course, and when she saw an opportunity to help these teens graduate, she was determined to find a way to see it through.
“In 2010 I started thinking, there’s got to be a way to get these teens credits,” explains Kathy, “I looked at what students were doing to get extra credits.” Kathy began digging into what credits are and how students can get them. She knew high school students needed 100 credits to graduate, but where could those credits come from?
She started small, working with local schools to share what teens were learning when they came into the program, how many hours they were spending in the course and how the students were demonstrating their learning. She continued spreading the word and soon schools across the province were willing to grant special credits for the course, then called Pain 101.
Some schools would give one credit, some would give three and there was even one who gave six because the student continued to do projects. It quickly become apparent Kathy needed to push the course at the provincial level. “There was no consistency whatsoever, so that’s when I thought, I’m going to start approaching Alberta Education,” says Kathy. She was turned down the first time she approached Alberta Education, but she was not going to take no for an answer.
Through persistence, getting in touch with the right people and showing off the projects, poetry and artwork the students had created, she got buy in. In February 2015, the curriculum was approved as Chronic Pain 35, a provincially recognized three-credit course. Since then, over 40 teens have earned their three credits.
“For some of those teens, this has made the difference between graduating and not graduating,” says Kathy. “To see these teens get their life back on track, and to know that this course helped them get there is huge. It’s been huge to help these teens get their credits, but it’s also been huge to help them communicate their needs at the school level.” For example, some students have worked out a balance with their school where they split their time between attending school and outreach learning.
Outside of the course, the Stollery Pediatric Chronic Pain Services team advocates for the students within their schools. “We talk to schools all the time about what we’re doing and how they can help support the teens,” says Kathy. They also write letters to schools ensuring their students have the accommodations they need to learn effectively. For example, if a student suffers chronic daily headaches, they will ask the schools to increase exam time, allow the student to write in private a room and make sure they can have a water bottle with them.
“These teens inspire me every day when I come to work,” says Kathy, “every time I get another project handed to me, I’m in awe.” And it’s not just the growth of her students she finds rewarding. “For these teens to understand their pain for themselves and for their families to understand it and then for them to go out and teach other people about it, is so important.”
Kathy’s paper on the program, Supporting Teens with Chronic Pain to Obtain High School Credits: Chronic Pain 35 in Alberta was published in November 2016. Learn more about the program and see some of the student’s artwork at adlc.ca/chronicpain.