Progressive Goal Attainment Program

[Diane]

Michael Sullivan at McGill: Originator of PGAP. Download his 44 page CV linked into next link
Next available training: Winnipeg, November 2011
Concept: see download of course for info.

Michael Sullivan was a guest lecturer at CPA Congress this year. He is rather brilliant (like most McGill types, i.e., Melzack) and is really helping the PT profession in Canada be less physical and more therapist. I'm going to go to his course in Winnipeg if there is still room. Everything about it makes sense, and is biopsychosocial with no flimflam. Such a better choice than last year's Jay Shah. At last..

[Jordan]

Hi Diane,

I took Mick's PGAP course in April and thoroughly enjoyed it. PGAP puts together a clear program that teaches providers to use the measures validated for recognizing psychosocial risk factors (fear avoidance, catastrophizing, perceived injustice, and disability beliefs) for poor rehabilitation outcomes and to target these psychosocial risk factors using the program. The key message I took home was using this behavioural intervention to 'help patients behave in ways that are incongruent with their disability beliefs', an idea that I use with all patients who have unhelpful pain attitudes and beliefs.

The only thing I didn't love about the program is that it doesn't provide any optimism for patients regarding the potential for changing pain. He makes it clear that the program is to decrease disability and gain return to work and that we should not be suggesting to the patient that he/she may experience decreases in discomfort. While I agree there is some merit to shifting the focus to participation in activities, work and social roles, I do like to provide my patients with some education on neuroplasticity because as David Butler says, neuroplasticity should provide us with optimism for people with pain.

For the above reason, I have taken to providing an intensive pain neurophysiology education program prior to implementing the PGAP program. I think it provides a potent combination, but I havn't used it with a large enough group of patients to draw too many conclusions on effectiveness. Maybe this data will be something to publish in the future.

Anyway, you are going to love this course. Even if you don't use the standardized PGAP program, there is lots of good information to apply in practice and the course manual provides 445 key resources to explore. Enjoy! I look forward to hearing your review of the course.

[Diane]

Thank you for that excellent overview Jordan. I have my application ready to send today. Hope they still have a spot for me.

My understanding is that it was the ortho div that brought him in. If that is true, it means the ortho div may be evolving quickly, at least the Canadian one.