Welcome back to the Healing Pain Podcast with With Tania Parker, PT And Jolyane Aubé, BSc OT (c) Reg. NB

Pain is universal, and there should not be a language barrier to keep us from learning about it and healing. Join your host Dr. Joe Tatta as he talks with Tania Parker, PT, and Jolyane Aubé, BSc OT, about filling the gap in pain education for French-speaking Canadians. Tania graduated in physiotherapy from the University of Ottawa in 2004 with experience in acute care and home care, from pediatrics to geriatrics. Jolyane is a registered Occupational Therapist in New Brunswick, Canada. In this episode, they discuss how they help people with chronic pain to feel good again in their lives. Sharing studies, Tania and Jolyane reveal the effects of this healthcare gap among francophones when delivering essential pain education. As such, they offer a wide range of programs on chronic pain, education on pain management, and others. Tune in to learn more!

—

Watch the episode here

Listen to the podcast here

Subscribe: iTunes | Android | RSS

Filling The Gap In Pain Education For French Speaking Canadians With Tania Parker, PT And Jolyane Aubé, BSc OT (c) Reg.NB

In this episode, you will meet the dynamic duo of a physiotherapist and occupational therapist who partnered to create a French language pain education program for French-speaking Canadians. Canada has a population of nearly 35 million people. French is the official language spoken by about 23% of that population. That means that there are eight million people in Canada who speak French as their primary language.

It has been identified that many francophones, French-speaking Canadians, have poor health outcomes when compared with their anglophone counterparts. For example, the evidence tells us that they have higher rates of asthma and hypertension. They are less physically active, consume fewer fruits and vegetables and are more likely to be overweight or obese.

Our guests have identified another gap in the healthcare of francophones and that is in the delivery of essential pain education. There are very few pain education programs available to French-speaking Canadians. Physiotherapist, Tania Parker and occupational therapist, Jolyane Aubé, are filling the pain education gap for francophones in the providence of New Brunswick, Canada.

In this episode, Tania and Jolyane discuss pain education and how they came together to collaborate and develop a brief pain education program for French-speaking Canadians. Without further ado, let’s begin and learn about how a physiotherapist and an occupational therapist came together to create a French language pain education program.

—

Tania and Jolyane, how are you doing? Welcome.

It’s nice to be here.

We’re doing great. Thanks.

It’s great to be with both of you. Tania, you are a physiotherapist. Jolyane, you are an occupational therapist. I feel like we have the best of the rehab professionals here in some way. You are a dynamic duo. I’m interested to talk to you and excited to share the work that you’re doing. You both live and practice in Canada. It’s a big country. There are lots of different parts and cultures in Canada. The cultural piece to this interview is important. Jolyane, we’ll start with you and then Tanya, you can contribute as well. Give us an idea of what it’s like to live in practice in the region or the province where you are.

We’re in the North of New Brunswick. That’s on the East Coast of Canada. We’re in the Atlantic provinces. I’m in Bathurst in Campbellton. They’re small communities. We have beautiful nature out here. We live in a gorgeous place. There are challenges when you live in a small area away from the bigger centers and that’s access to professionals.

You’re in the States. We have our public health care system but there are long waiting lists. Things are slow to adapt to research sometimes. In terms of our work in private, we’re not many. People have to travel long distances in some way. COVID has been helpful for some in terms of being able to have access to care online.

It’s a beautiful place. It’s French and English communities but there are a lot of French-speaking people who are not comfortable or fluent in English where a lot of the resources are available. We practiced in both languages but we found that there was a challenge in meeting the needs of our community in French. There are not a lot of practitioners. There are waiting lists. We also try to find ways creatively to meet the needs even if we can’t give the optimal one-on-one care regularly throughout a certain time, whether waitlists, costs, distance and those kinds of things.

Pretty much the gap that we had found was that our French-speaking clients didn’t access the resources that existed out there in terms of pain education. We wanted to find something or create something that would meet their needs. That’s why we came about developing this partnership and online course.

I find too that living where we live, the community is super important. If I can support someone in their lives, then it influences the other people in the community and within their families and circles. It does a ripple effect everywhere but that was important for us.

This is interesting for me personally and professionally. I come from a background where people speak different languages. All my grandparents were immigrants or migrants. Some are immigrants from Italy. One of my grandparents was a migrant from Puerto Rico. It’s a multilingual family that I come from. Except in the United States, in most places, there are some cities where there’s a very bilingual nature to it. For example, Miami. They have a strong bilingual English-Spanish culture.

You might see signs in English and medical services provided in English. Give us the sense of where you live since there is this bilingual English-French component to it. Is it a 50/50 where everything is perfectly bilingual and available in both languages or is there still an aspect of the French-Canadian not necessarily being served as well as they could be?

Anything that’s government-run, if you want, has to be bilingual. That’s the law. That’s the healthcare system, education system or the government. The signs are all in both languages. In the private sector, businesses are able to do the needs of their population. In the Southern part of New Brunswick, there are more anglophones and then in the Northern part are more francophone or French-speaking. We’re close to Quebec, which is unilingual French. That’s one province in Canada that’s only French. Since we’re close to that border, there’s more French here.

A lot of people are bilingual. Tania and I speak both but there are still those pockets of populations of communities that don’t have English. They can maybe get around and ask questions but to be able to understand the health scare or what’s going on with their health or how to take care of themselves in terms of pain education, they wouldn’t be able to follow an English course.

Pain education is very familiar to all of us, especially our community here that has been following along with the show. To the average person, no matter where you live on the globe, pain education is something that they’ve never heard of, let alone have access to their culture and language, so to speak.

We wanted to make it pretty basic. We made it at a grade five level so we could reach the most people and make it understandable. When a lot of people go see the doctor or the health professionals, they don’t understand the information that’s being given to them. They’re too shy to ask questions, so they leave with maybe understanding half of what was told. We wanted to make sure that people understand the pain education. Whatever the modules that we covered, we wanted to make it basic.

The two of you have come together. You’re colleagues in healthcare who live in the same province. I’m curious. How did the two of you connect? It is somewhat rare. There are multi-disciplinary settings like PT, OT, speech, psychology, medicine or nursing around the globe. Those are large programs. Typically, those are for people that have significant impairment. It’s not necessarily for people that are still in the community but sometimes, they function that way. How did the two of you come together as OT and PT or Occupational Therapists and Physiotherapists and say, “Let’s work on this problem together?”

We lived in the communities that we grew up in but we crossed paths playing hockey against each other when we were in high school. We then kept crossing paths. We went to the same university but in different years. I would travel a lot and Tania would travel for work as well. We meet up randomly and chat. We both are entrepreneurs but I contract my work out to a clinic called Mind at Piece here. There was a woman at a business event. The two co-owners wanted to collaborate with Tania and had already reached out to me. We were both talking, Tania and I, about pain management and connected.

We get along and have a great time. We have different strengths. Tania is an OT in her heart. Our visions align and we have similar interests. After our first connection, we initially started with a face-to-face program, which we launched in the fall of 2021. We had been talking about this online program. We’ll talk about this a little bit but we kept working on tidbits at a time and meeting every week.

We’re also both yoga teachers. That connection helped us build the mindfulness part and the importance of it. We reap the benefits of our mindfulness practice too. We are eager to share that knowing the pain and the pain population.

When we get together, most of the time, we start with a short meditation. We practice our little rituals. We practice what we preach.

Let’s get into some of the programs that you both created. If you want to give a little piece here for the French-speaking population, that’s fine with me. We’d love to hear the name of the program, both in English and French and then tell us the overarching components of that program.

Our program is called Mieux Vivre Avec La Douleur. When translated, it’s Living Better With Pain. We’re not promising to abolish the pain. We just want people to take control of the pain rather than the pain controlling their lives. That’s the big vision behind it. We knew it was a lot of work. Plus, we wanted not to give too much work to the client, so we narrowed it down to three topics.

We’re covering deep breathing and pain education. We’re also covering relaxation and the polyvagal theory in the second module. In the third one, we’re covering pacing in terms of activities of daily living, exercise or physical activity. There are three topics that we cover. We mix the theory with the practical. There are some videos for deep breathing and short visualization videos of chair yoga. We wanted people to be able to come back to this course and say they want to do a deep breath or come back to yoga. We want them to have it as their tool.

To keep adding, you take the ones that are easy in the beginning and use those for 1 week or 2. You then try a new one and then keep going until you’re able to do most of the practices that are in the course. Along the way, we decided, “Maybe we should have a handbook too.” There are some journaling questions and we thought it’d be nice to have a PDF version, so we also created a handbook to go along with the book.

Once we finished the book, we were like, “We have a workbook on chronic pain. Who knows where that’s going to go?” We keep it simple and use the tools that seem to have the most impact on our clients. Deep breathing is a tool that my clients are going to say, “That saves me.” It’s the same thing with understanding the pacing so that you don’t overdo it or not move enough. Those are other things that we felt had the most impact, easy to absorb or simple to teach.

Our intent with that is we did those 3 modules but we want the videos to be 5 minutes-ish. The module can be broken down into even smaller pieces because it can be challenging to focus, concentrate or stay, whether it’s on your computer or phone that you’re watching or listening to the program. The shorter, the better. That was one piece. From the first module, which is pain education, we bring back the elements throughout as well.

I like what you said there. Shorter is better. That’s an important point. It’s what I appreciate about what the two of you created. As professionals, when someone asks us, “What’s the cause of pain?” We’re like, “Let’s see. You’re not moving your body or sleeping. You don’t understand what pain is. You don’t understand short-term pain and long-term pain. Your diet’s poor and there’s trauma in your history.” The list goes on.

I saw a post online. Someone did this post about, “Pain is a bio-psycho-social experience. Here are all the things in the bio, psycho and social. There are one zillion ways to put these combinations together to overcome pain.” There’s truth in that because some people need more sleep education than others. Some people need more movement because they have fear of movement than others. What you two have accomplished is taking the most salient or important components of various pain education programs and putting them into a short program. The training pieces or the modules in the program are short, concise and easy for people to understand, which is important.

That was a challenge to figure out for me. It was so many things. It’s unique. It’s not a cookie-cutter. This is a process as we go session to session, discussion to discussion and the trial of things. We know that this program isn’t a fix-all like Tania mentioned. It’s information. These are tools that we have seen clients grab to and run with. It’s been one of the elements or some of the elements in their process towards living better with pain.

This is an introduction for people. It’s a way to engage people in a conversation and some education and start that pain recovery process.

I hope people share it with their loved ones, the people they live with or their family members. It’s concise, short and enough for others in their families to also understand. They might come to a session and agree, “I’ll come home,” and then their environment is similar. The environment’s behaviors or supports are the same but they’re trying to change how they do things. It makes it even harder. I hope that people will also take it and share it.

This is a starting block. We’re starting with this one, which is the basic information. We’ll see. There are so many forces that we can add on like sleep, physical activity, trauma, diet or nutrition. We built this because that’s what our population needed. The ideas that we have to keep going are other things that we’ve seen where there’s a lack. We’re like, “We could fill that gap by doing this.” There are lots of opportunities. It’s a starting box. It’s a learning for us and also for our clients. As it goes, we’ll fine-tune it and keep building.

We hope that clients connect with Jolyane and me and our format so that they start with this one and then maybe buy the next course or want to do one-on-one sessions with us. We can do it virtually so that has opened up a whole new population. We want them to understand the pain and even educate their surroundings. Even a family doctor doesn’t understand chronic pain. A lot of people are told, “There is nothing wrong with you. You shouldn’t have pain.” They’re stuck there and are like, “I still have pain.”

When they come to see us, we understand it and say, “You have pain. Your pain is valid.” It’s a huge weight off their shoulders. I tell my clients, “You know more about chronic pain than your family doctor does.” A little bit of our role too is to educate other health professionals. We’re going to keep going in that direction to educate people because people need to know.

You created the program. Plus, you have a workbook that you created for the program, which is great because some people like to learn via video and audio and other people like to read. You’re able to target all the ways that we learn as humans, which is great. Maybe I missed this. Are you delivering this live online or is this prerecorded and people go through it?

It’s prerecorded and people go through it independently. There are limits to having it prerecorded for a person and then committing and sustaining by listening to every piece. There’s a challenge but what Tania and I could offer at this point is prerecorded. I hope eventually, we can do it as a coaching model. That would be dynamic where maybe they’re live or prerecorded but you have a couple of coaching calls through it. That’s in the future. That’s one of our multiple ideas.

Tell me why it’s important to have an OT and a physiotherapist come together for this type of collaboration.

First of all, it has been good. Jolyane and I have done training and pain education. There are not many health professionals that work in the chronic pain field. Also, for Jolyane to bring her a more functional approach, it’s more about the pacing of your house cleaning or meal prep. For me, it’s to do it more in the pacing of physical activity, whatever that looks like for somebody. We both bring in our expertise to the table. We discuss this. We’re a good team. We work well together. Having the professionals with the mindset of the OT and the PT together brings more value to our clients.

There are many similarities but we have different strengths. We might view certain things from slightly different angles and it adds to it. At the end of the day, what is important is less the fact that we have the OT or PT hat. We work well together. Those different perspectives align towards the similar values, hopes and goals that we have for our practices as professionals but also for the people that live in our community.

What’s been the response of the people that have gone through the program already? This is very new for them. Not only is pain education new but online might be new and the French component to it is something they haven’t been introduced to before.

It hasn’t been launched yet. With this work, family life and all the things, we’ve kept moving forward. Every week, we move a little forward. We also brought on Caroline. She does all the online stuff for us. We’ve been working on small bits. It’s close and all filmed but we need to fine-tune the finishing product. We then want to have 3 or 4 people go through it and give feedback. We’ll make some ads based on that feedback and then we’ll launch it. That’s where we’re at.

What’s interesting is we did create a Facebook page in French for Mieux Vivre Avec La Douleur. We called it Me choisir pour mieux vivre avec la fibromyalgie. We target fibromyalgia. We have been posting some things and some of our videos there. People write back. It was very neat. I met one of the ladies that kept commenting. She was so excited and happy with the resources.

The clients that I’ve discussed it with are excited and are waiting for it to come out. We’re close. We’re aiming in September 2022 for the first launch and probably in 2023, we’ll be able to get the thing going. It’s been a long process. It’s a lot longer than we thought it would be. That’s what happens. We still have our one-on-one clients. We have our families. We’re still pacing ourselves through this process and going with the flow. It’s been fun. Like a lot of things, the first time we do it, it’s a lot of work but in the next ones, we know the drills. If we’re building other courses, that’ll be a lot smoother.

I also believe the fact that working together helped us stay accountable to keep going. These ideas aren’t necessarily new in our heads. It’s that maintenance to keep going. That was important. It’s that partnership of working and being accountable to each other.

How do you see this expanding? If you had a little crystal ball and we could look forward, how would you like to see this program grow?

I’m hoping that we can eventually have a coaching-type model. That’s a bit more dynamic. I’d also like to have other programs. It might be a module on what Tania mentioned, which is sleep hygiene or a whole yoga module. It could be those different topics. What I’m hoping is we get feedback. It helps us be clearer about those topics.

One of my clients had asked me for a book in French about people’s experiences through living better with pain. I found one in English but I didn’t find any in French. The fact that we collaborated taught me another way of thinking. I’m not a writer. I don’t know where to start. You can pull someone that does write. You pull someone here and there. We have these ideas. Maybe we’ll have a show in French or something like that. Who knows?

As we start to wrap up, I’d like you to share the URL of where everyone can find your work and the information. Tell us the name again both in French and English and then give us that URL where they can find you.

The course is called Mieux Vivre Avec La Douleur. In English, it’s Living Better With Pain. The website where they can go is SynergiPhysio.com.

I want to thank both of you for joining us on the show and telling us about a bilingual French-English creation of a pain education program, which we all know is desperately needed. At the end of every episode, I ask you to share this episode with your friends, family and colleagues on Facebook, LinkedIn, Twitter or Instagram. You can find us on Instagram. Get out there and look for us. You’ll find me @DrJoeTatta. Tag me and let me know how you enjoyed this episode and other episodes on topics similar to this. It has been a pleasure spending time with you. We’ll see you next time.

Important Links

• Tania Parker
• Jolyane Aubé
• Me choisir pour mieux vivre avec la fibromyalgie – Facebook
• @DrJoeTatta – Instagram
• https://www.Facebook.com/SynergiPhysio

About Tania Parker

Tania graduated in physiotherapy from the University of Ottawa in 2004. She has experience in acute care, home care, from pediatrics to geriatrics.

In 2016, she became a yoga teacher and developed a passion for chronic pain. In 2019, she opened Synergi Physio, a private clinic focussing on the treatment of chronic pain.

During the pandemic, she pivoted to offer virtual therapy and explored the world of online courses. Her mission is to help people with chronic pain believe they can feel good again.

About Jolyane Aubé

Jolyane Aubé is a registered Occupational Therapist in New-Brunswick Canada. She graduated with a Bachelors in Science of Occupational Therapy from the University of Ottawa in 2002. Jolyane has worked within the community mostly in private practice offering a range of services in physical and mental health rehabilitation in clinic, in homes and at work.

She offers Occupational therapy rehabilitation for individuals with mental health challenges and chronic conditions such as persistent pain which is affecting their ability to engage in day-to-day meaningful activities. She also offers ergonomic assessment, workplace accommodation assessments and return to work programming.

Jolyane has continued pursing further training in Cognitive therapies, chronic pain, mental health, yoga, mindfulness and Coaching which she integrates in her Occupational Therapy practice. Jolyane presently offers her services at the Mind at Peace center – centre mieux-être in Bathurst, NB and continues to collaborate with professionals and organisations in her community to better serve her community.