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HELP: Empowering people to live their best lives with pain

Think Therapy 1st discuss their pioneering results-based pain management programme



Through the launch of the Holistic Education for Living with Pain (HELP) programme, Think Therapy 1st is helping to give new hope to people living with pain. NR Times learns more about the first-of-its-kind initiative which is set to change the lives of countless people who too often suffer in silence


While pain is something that is all too often dismissed, leaving people struggling to manage their daily lives with few places to turn for practical support, for Think Therapy 1st (TT1st) comes the opportunity to use their expertise to make a life-changing difference. 

As pioneers of a pain management programme which saw 100 per cent of participants report improved functioning as a result, and vast decreases in the level of pain in daily activities such as socialising – where the pain rating reduced from an average of 7.6/10 pre-programme to 2.6/10 afterwards – the team wanted to create an even more compelling offering for those in need of bespoke support. 

While the initial pain programme was an occupational therapy (OT) only project, now, with the launch of the Holistic Education for Living with Pain (HELP) programme, TT1st have extended their MDT to include psychologists and physiotherapists.

A HELP participant

A unique programme in the field of pain, HELP is delivered on a one-to-one basis over a four-to-six month period, and importantly is delivered in a person’s own everyday environments. 

Participants are empowered to live their lives through the power of education, with the onus on the activities and tasks they can do, rather than what their pain has restricted them from, re-opening the possibility of returning to leisure, work or the employment market. 

And while TT1st does not make any claims to reduce levels of pain through HELP, the vast majority of participants do experience a reduction in pain as a result of their involvement. 

For Helen Merfield, managing director of TT1st, the expansion of the initial pain programme is a welcome opportunity to tackle the issue of pain in new and impactful ways. 

“We got awesome results from the programme, but we could only help a small cohort. We felt we needed to reach out to more people with a wider spectrum of conditions, pain is something I feel very passionately about and people need support,” she says. 

“I’ve always felt that people with pain get a bad rap, they’re often just told it’s all in their mind. And while the mind might play a part, no one consciously chooses to be in pain, they don’t get up in the morning and decide ‘I’m going to have pain today’. 

“We want people to be living their best lives in spite of – or as I like to say ‘to spite’ – their pain. We HELP them to recover a life that has meaning and purpose.

“We wanted to help a wider population but wanted to test it on a smaller scale first. And because the results were so great, we have invested in making it even better – and hopefully the results will be even better too.”

Leading the HELP programme, which launched earlier this month, is Steph Fleet, a pain specialist OT who joined TT1st in 2020 and who Helen credits with “taking the bull by the horns” in breathing new life into the company’s pain offering. 

Through adding in psychology, with TT1st working alongside neuropsychology specialists at Sphere Rehab, HELP is bringing together experts in their field to deliver the best possible results to clients.

Dr Katherine Dawson, director at Sphere, said: “Partnering together in the development of a stepped care functional model to inform when therapy is indicated (as well as identifying different levels of intensity) is a great opportunity to deliver positive client experiences and outcomes.

Steph Fleet

“We are also really looking forward to exploring how technology can help with early interventions in the functional management of pain.”

Under Steph’s guidance, HELP has been created to be tailored to the needs of each client. If psychology input is required, their needs are determined through the use of a newly-developed algorithm by Sphere. 

Clients will be screened at the assessment to determine which mix of disciplines they require, OT only, OT and physiotherapy, OT and psychology or all three.

With a fixed fee pricing structure, HELP can be completed in a timescale to suit the needs of each individual client, with a specially-designed workbook and a raft of resources – including podcasts and video – to support them through the process. 

“Pain is something that doesn’t get talked about like it should, I feel really strongly for anyone experiencing any level of pain that unless you talk about it and develop some strategies, then it’s just going to keep continuing and holding you back,” says Steph, who won the rising star accolade at the Advancing Healthcare Awards 2022 in recognition of her client-focused work.

“They’re going to learn how to manage their pain, so that they’re able to do the things that they need to do, but also the things that they want to do, despite their pain experience. They will learn lots of techniques and develop tools to do that.

“We wanted to create a programme that was flexible and exactly what people want and need, and already, although HELP is new, we are seeing some brilliant results.

“I’ve got a client who’d been standing in an almost brace-like position, her knees and back have been bent, as if she’s about to run. 

“The physical reason for this position had resolved, so we talked about it in terms of her brain being hyper-alert to danger, therefore she was defaulting into this position essentially being ready to run. 

“I helped her see she no longer needed to be ready to run and the danger had passed and it was safe to straighten up.

“She has done that for a week and her pain experience has dropped massively, because she’s standing in the right position again and recognising that she’s not in imminent danger.  

“So that conversation, and the strategies we came up with, have enabled her to see positive change.”

The client, Juliet from Dorset, said: “The key thing I’ve been taking away to help me when Steph’s not with me is becoming aware of my standing position. 

A HELP participant

“I’m telling myself that I can stand up straight and I recognise that I’ve been locked in my traumatic experience. I’m now much more aware which has helped me to progress. 

“Improvements are being made and my perception of pain has reduced a lot”.

Helen continues: “It’s all about tailor-making it for everyone. 

“Although there are fixed components, there are more components than required because not everyone will need everything. Some people will need more of one type of support than another. 

“But what we see is that because it’s tailored, they start seeing improvement almost from day one, there’s so much education involved that we are teaching them to be their own therapist, putting them back in charge of their pain experience rather than it running their life.” 

One big difference to other pain management programmes is the delivery in a participant’s own environment, be that their home or places they spend time or need to access. 

“The majority of current programmes on offer are great, but they’re not delivered in an environment where people are actually living their lives, they’re often in a a completely different environment,” says Helen. 

“While people may get a solid two or three weeks to focus solely on education and therapy, they leave and have to come back to real life. The programme finishes and they just go home. They’ve learnt all of this information, but how do you actually apply that when you’ve got a family, kids, a dog running around?

“What you thought could transfer quite easily because it all made total sense when you were on the course now goes out of the window, and you find that within three or four months they’re back to where they were before.

“That’s why delivering it in a person’s own environment, with all of their daily routines and tasks around them, is so important. So that even after

A HELP participant

we leave them, when they have a new environment, whether it’s a new job, they’ve moved house or they’re just going to a different cafe, they’ve got the tools they need in their toolkit to keep them safe in that environment.”

Steph adds: “HELP is also unique when compared to others which are in a group setting. There’s nothing wrong with a group session, but this makes it so individualised and so accessible for the person.”

“And then we take the education and learning we have delivered and we put it into practice, with support from an OT, physio or psychologist, depending on what they need. We’re going to do it with them, in their environments with the world happening around them and model it with them, which is why we get such great results.”

And with such a pioneering programme to work with, Steph, who has a Masters in rehabilitation, is delighted to have the opportunity through TT1st to make a difference. 

“All the clients I’ve worked with over the years have experienced pain to some degree, whether that’s psychological pain or physical pain,” says Steph. 

“And I’ve always found it really interesting how it can really limit people’s abilities and last longer than many of the physical challenges they manage to overcome. 

“Rehabilitation is my absolute passion but pain kept on coming back as something that affected so many people and doesn’t get talked about. The individual often feels that it’s their fault – and then I came to TT1st and had the opportunity to really jump into helping them.”