A/Professor Nicholas has been working in the pain field since 1980 as a clinical psychologist, researcher and educator. From 1980-87 he worked at a multidisciplinary pain service at Westmead Hospital, Sydney, where he completed his PhD evaluating a cognitive-behavioural pain management program for chronic low back pain patients. From 1988-90, he established and directed a multidisciplinary CBT pain management program at St Thomas’ Hospital, London. This was a research-based project funded to compare inpatient versus outpatient CBT pain management for patients with chronic pain conditions. From 1991 to early 1994 he lectured on the post-graduate clinical psychology training program at the University of NSW, Sydney, where he also held the position of psychology clinic director. Over that period he also worked as a consultant on pain management with a number of hospital pain clinics in Sydney. From 1994 to the present he has held a conjoint hospital and university position at the University of Sydney (faculty of Medicine, Northern Clinical School) and the Royal North Shore Hospital where he established and continues to direct a multidisciplinary CBT pain management program. Since 1996, he has also been a founding faculty member of the multidisciplinary Postgraduate Diploma and Masters degree course in pain management, where he teaches on the psychological assessment and management of pain. This is now a web-based course with students from around the world. In addition to coursework teaching, A/Professor Nicholas has also been supervising research-based PhD students in the field of pain since 1992. In addition to his publications in journals and book chapters on psychological aspects of pain, its assessment and management, he and some colleagues from the Pain Management & Research Centre have written the widely-recognised self-help manual for people with chronic pain, called Manage Your Pain. A/Professor Nicholas has presented papers and/or workshops on pain at IASP conferences in Adelaide, Vancouver, Vienna and San Diego, as well as refresher courses at the Vancouver and (recent) Sydney meeting. He has also taught or presented invited papers on pain management at multidisciplinary meetings and courses in Malaysia, Hong Kong, Australia, United Kingdom, Sweden, Germany, Brazil, and New Zealand. Most recently he has been invited to join the Scientific Program Committee for the IASP’s next World Congress (12th) in Glasgow, 2008.
Developing pain management programs in Asian countries
To date, he has been involved in the development of a program at the Selayang Hospital in Kuala Lumpur (Malaysia) since 2002, in collaboration with Dr Mary Cardosa. In Hong Kong he has also provided training and support for a program at the Alice Ho Miu Ling Nethersole Hospital since 2003, in collaboration with Dr PP Chen. Currently, Dr Chen and his colleagues are in the final stages of preparing a Chinese language translation of Manage Your Pain. It is hoped that this will be available later in 2006. Most recently (2005) A/Prof Nicholas and senior members of his staff have also been assisting in the development of a new program, also based on ADAPT, at the Tan Tock Seng Hospital in Singapore, in collaboration with Dr. B. Lee. In each of these countries the support provided has been aimed at training the local pain team to a level of competence that will enable them to conduct a pain management service appropriate to local needs and conditions. Results achieved to date at each of the programs indicate that this is being achieved.
Associated with this work he has been a guest speaker on pain management at the Anaesthesiology Commissioned Training (for all pain services) in Hong Kong (2004) and again in 2005 for the Hong Kong College of Anaesthesiologists.
Integration of psychological principles into cross-disciplinary pain management.This is reflected in his teaching on the post-graduate (multidisciplinary) masters and diploma pain management courses, and the physiotherapy training program at the University of Sydney, his clinical work (e.g. at St Thomas’ Hospital in London and at the PMRI), as well as his research (e.g. the recently completed large NHMRC funded project with physiotherapists investigating the relative value of exercises versus advice for people with sub-acute low back pain) and in materials he has developed for different professional groups (eg. the WorkCover (NSW) report and guidance material on injured workers with non-red flag conditions; and currently his work with the Australasian Faculty of Occupational Medicine to develop an online training module for doctors dealing with ‘yellow-flag’ conditions). His membership of the inaugural leadership team for the IASP Special Interest Group on Pain and Movement (2001-2005) is also a reflection of his commitment to interdisciplinary pain management.
This interest was reflected in his presentations as plenary speaker at the 2004 UK Pain Society conference in Manchester; at the 2005 conference of the Malaysian Association for the Study of Pain in Kuala Lumpur and at the 2005 conference of the 7th SIMBIDOR (Brazilian Symposium and International Meeting on Pain) in Sao Paulo, Brazil.
Development and application of pain management for injured workersAs persisting pain has been well-documented as a principal risk factor for long-term sickness absence in injured workers, A/Prof Nicholas has been heavily involved in promoting the application of effective pain management strategies in this area. This has involved research (eg. with the Coal Services Health staff in the Hunter Valley of NSW) as well as clinical work (at the PMRI) and training (in the development of training materials for WorkCover (NSW), and guidance materials for the Victorian WorkCover Authority and the Australasian Faculty of Occupational Medicine). His recent collaboration with international leaders in this field at the Liberty Mutual funded invited conference in Hopkinton (USA) (the Hopkinton Conference on Improving Return to Work Research, in Boston, 2005); has been another important step in this area (the December 2005 edition of the Journal of Occupational Research contains the papers developed by the participants at this meeting and provides an up-to-date overview of research on return to work issues). His paper in the reference work by Professor Linton from Sweden should also be seen in this context. (Reducing disability in injured workers: the importance of collaborative management. In Linton SJ (ed). New Avenues for the Prevention of Chronic Musculoskeletal Pain and Disability, Pain Research and Clinical management, Vol 12. Elsevier Science BV (pp. 33-46) 2002).
Development of psychologically-based pain management interventionsThis has been a continuing interest since the mid-1980’s and is reflected in his PhD from the University of Sydney and Westmead Hospital, and subsequent work at St Thomas’ Hospital (London) and a number of programs in Australia that A/Prof Nicholas has helped to establish. This includes the ADAPT program at PMRI as well as programs in other Australian centres (eg. the START program at the Barbara Walker Centre for Pain Management at St Vincent’s Hospital, Melbourne; the Geelong Hospital pain management program; the pain management program at the Hunter Integrated Pain Service at the Royal Newcastle Hospital; The Northern Rivers (NSW) pain program at the Lismore Base Hospital, the INTERVENE programs for Coals Services Health (in Singleton and Warners Bay, NSW), as well as the programs at St George Hospital and Royal Prince Alfred Hospital in Sydney).
Other contributions in this area include:
- A white paper (2004) on cognitive behavioural treatments for chronic pain by the Faculty of Pain Medicine (Australia & New Zealand College of Anaesthetists);
- Invited expert input on psychological approaches in the new Australian NHMRC guide to the management of acute pain (2005);
- A refresher course on CBT pain management and a workshop on psychological assessment and management of pain at the International Association for the Study of Pain (IASP) triennial World Congress on Pain in Sydney (2005)
- A large, 5-year research grant to evaluate the application of self-management strategies for older Australians with persisting non-cancer pain. This was awarded by the Australian Health Ministers Advisory Council (AHMAC) Priority Driven Research grants fund (2005-2009).
- Australian Health Ministers Advisory Council (AHMAC) Priority Driven Research grant. “Chronic pain in elderly Australians: randomised controlled trial of self-management”.
- A/Prof M Nicholas, Dr T Newton-John, Dr F Blyth. Total 0,000, 2006-20010. NHMRC Project Grant N1987 465091 “Controlled clinical trial of desensitization to chronic pain”. A/Prof M Nicholas, Dr A Sharpe; Total 5,250, 2007-2009.
- Nicholas MK, Tyler JPP. Characteristics, attitudes and personalities of AI donors. Clinical Reproduction and Fertility, 2, 47-54, 1983.
- Tyler JPP, Nicholas MK, Crockett NG, Driscoll GL. Some attitudes to artificial insemination by donor. Clinical Reproduction and Fertility, 2, 151-160, 1983.
- Nicholas M K, Wilson P H, Goyen J. Operant-Behavioral and Cognitive-Behavioral Group Treatment for Chronic Low Back Pain. Behaviour Research and Therapy, 26, 225-238, 1991.
- Pither CE and Nicholas MK. Psychological approaches in chronic pain management. British Medical Bulletin, 47, 743-761, 1991a.
- Pither CE and Nicholas MK. Identification of iatrogenic factors in the development of chronic pain syndromes: Abnormal treatment behaviour? In M.R. Bond,J.E. Charlton and C.J. Woolf (Eds.). Proceedings of the VIth World Congress on Pain; Pain Research and Clinical Management, Vol. 4. Amsterdam: Elsevier, 1991b.
- Nicholas MK, Wilson PH and Goyen J. Comparison of Cognitive-behavioural group treatment and an alternative non-psychological treatment for chronic low back pain. Pain 48, 339-347, 1992.
- Williams A C de C, Nicholas MK, Richardson PH, Pither CE, Justins DM, Chamberlain JH, Hardy VR, Ralphs JA, Featherstone J. Evaluation of a cognitive behavioural programme for rehabilitating patients with chronic pain. British Journal of General Practice, 43, 513-518, 1993.
- Wilson PH, Henry J. and Nicholas MK. Cognitive methods in the management of chronic pain and tinnitus. Australian Psychologist, 28, 172-180, 1993.
- Williams, A.C.deC., Richardson, P.H., Nicholas, M.K., Justins, D.M., Morley, S., Diamond, A., Linton, S., Vlaeyen, J., Nilges, P., Eccleston, C. The effects of cognitive-behavioural therapy in chronic pain. Letters to the Editor, Pain, 65, 282-283, 1996.
- Ralphs JR, Williams A CdeC, Richardson PH, Pither CE, Nicholas MK. Opiate reduction in chronic pain patients: a comparison of patient-controlled reduction and staff controlled cocktail methods. Pain 56, 279-288, 1994.
- Nicholas M K. Chronic Pain. In P.H. Wilson (Ed) Relapse Prevention in Cognitive-Behavioural Therapy. New York: Guilford Press, 1992.
- Harding VR, Williams, ACdeC, Richardson PH, Nicholas MK, Jackson JL, Richardson IH, Pither CE The development of a battery of measures for assessing physical functioning of chronic pain patients. Pain 58 367-375, 1994.
- Nicholas MK. Compliance: A barrier to occupational rehabilitation? Jnl Occupat Rehab 5, 271-282, 1995.
- Nicholas MK. Theory and practice of cognitive-behavioral programs. In JN Campbell (Ed.) Pain 1996 - An Updated Review. IASP Press, Seattle, 297-304, 1996.
- Williams A CdeC, Richardson PH, Nicholas MK, Pither, CE Harding VR, Ralphs JA, Ridout, KL, Richardson IH, Justins DM, Chamberlain JH. Inpatient versus outpatient pain management: results of a randomised controlled trial. Pain 66: 13-22, 1996.
- Nicholas, M.K. and Sharp, T. Cognitive-Behavioural Programs: Theory and Application. In: AR Molloy and I Power (Eds), International Anaesthesiology Clinics 35 (2), 155-170, 1997
- Goodenough B, Kampel L, Champion GD, Laubreaux L, Nicholas MK, Ziegler JB, McInerney M. An investigation of the placebo effect and other factors in the report of needle pain from venipuncture in children. Pain 72, 383-391, 1997.
- Molloy AR, Nicholas MK, Cousins MJ. Role of opioids in chronic non-cancer pain. Invited Editorial in Medical Journal of Australia, 167, 9-10, 1997.
- Nicholas MK, Ayers, N., Tonkin, L. Overcoming the RTW barrier of poorly managed pain. Moving in on Occupational Injury. Butterworth-Heinemann, Australia, 1998.
- Kendall N, Main CJ, Linton SJ, Vlaeyen JW, Nicholas MK. Reply to Wallis et al., Pain 73 (1997) 15-22. Letter to Editor, Pain 1998; 78: 223-225.
- Cousins M, Harris N, Molloy A, Nicholas MK. Role of opioids in non-cancer pain. Palliative Care Today 1998;15: 6-9.
- Molloy AR, Blyth FM, Nicholas MK. Disability and work-related injury: time for a change? Medical Journal of Australia 1999; 170:150-151.
- Williams A CdeC, Nicholas MK, Richardson PH, Pither, CE, and Fernandes, J. Does randomisation affect the generality of findings from a controlled trial? The effects of patient preference versus randomisation on inpatient versus outpatient chronic pain management. Pain 1999; 83:57-65.
- Asghari A, Nicholas MK. Personality and adjustment to chronic pain. Pain Reviews 1999;6: 85-97.
- Nicholas MK. Collaborative behavioural management of musculoskeletal pain. In Update in the Management of Musculoskeletal Pain, 49-58. Alpha Biomedical Publications, Darlinghurst, NSW, 1999.
- Nicholas MK. Clinical psychology and pain management: access to ‘best practice’ collaborative care fares poorly under current health funding policies. Clinical Psychologist 1999; 4:11-17.
- Nicholas MK, Sharp TJ. A collaborative approach to managing chronic pain. Modern Medicine October 1999, 26-33.
- Sharp TJ, Nicholas M.K. Assessing the significant others of chronic pain patients: the psychometric properties of significant other questionnaires. Pain 2000; 88:135-144.
- Vickers R, Cousins MJ, Nicholas MK. A biosychosocial perspective of chronic facial pain. Modern Medicine, 2000; November, 42-48.
- Nicholas MK, Molloy AM, Tonkin, L and Beeston, L. Manage Your Pain. ABC Books, Sydney, 2000.
- Cohen M, Nicholas MK, Blanch A. Medical assessment and management of work-related low back or neck-arm pain: more questions than answers. Journal of Occupational Health Safety Australia and New Zealand 2000;16:307-317.
- Nicholas MK, Wright M. Management of acute and chronic pain In: Milgrom J and Burrows GD (eds). Psychology and Psychiatry: Integrating Medical Practice (pp. 127-145) John Wiley and Sons LTD. 2001
- Asghari A, Nicholas MK. Pain self-efficacy beliefs and pain behaviour. A prospective study. Pain 2001; 94:85-100.
- Nicholas MK, Molloy A. Chronic pain control. New Ethicals Journal 2002; December: 63-70.
- Nicholas MK. Reducing disability in injured workers: the importance of collaborative management. In Linton SJ (ed). New Avenues for the Prevention of Chronic Musculoskeletal Pain and Disability, Pain Research and Clinical management, Vol 12. Elsevier Science BV (pp. 33-46) 2002.
- Nicholas MK. Cognitive behavioural therapy for chronic pain patients. Medicine Today Supplement August 2003:12-17.
- Blyth FM, March LM, Nicholas MK, Cousins MJ. Chronic pain, work performance and litigation. Pain 2003;103: 41-47
- Dehghani M, Sharpe L, Nicholas MK. Selective attention to pain-related information in chronic musculoskeletal pain patients. Pain 2003;105:37-46.
- Nicholas MK. Managed care policies and pain management programs. Editorial, Anaesthesia Analgesia 2003 97:1.
- Stewart MJ. Maher CG. Refshauge KM. Herbert RD. Bogduk N. Nicholas M. Advice or exercise for chronic whiplash disorders? Design of a randomised controlled trial. BMC Musculoskeletal Disorders 2003; 4(1):18.
- Jolliffe CD, Nicholas MK. Verbally reinforcing pain reports: an experimental test of the operant model of chronic pain. Pain 2004; 107: 167-175.
- Asghari,.A., Nicholas, MK. Pain during mammography: the role of coping strategies. Pain 2004; 108: 170-179.
- Dehghani M, Sharpe L, Nicholas MK. Modification of attentional biases in chronic pain patients: a preliminary study. European Journal of Pain 2004; 8: 585-594.
- Moseley L, Nicholas MK, Hodges PW. Pain differs from non-painful attention-damaging or stressful tasks in its effect on postural control patterns of trunk muscles. Experimental Brain Research 2004;156(1):64-71.
- Moseley L, Nicholas MK, Hodges PW. A randomised controlled trial of intensive neurophysiology education in chronic low back pain. Clinical Journal of Pain 2004; 20: 324-330.
- Nicholas MK. When to refer to a pain clinic. Best Practice & Research Clinical Rheumatology 2004; 18 (4): 613-629.
- Nicholas MK, Tonkin L. Application of cognitive-behavioural principles to activity-based pain management programs. In K. Refshauge and E. Gaff (eds). Musculoskeletal Physiotherapy: Clinical Science and Evidence Based Practice, Elsevier, Oxford, pp. 277-293, 2004.
- Taylor R, Lovibond PF, Nicholas MK, Cayley, C, Wilson PH. The utility of somatic items in the assessment of depression in chronic pain patients: a comparison of the Zung Self-rating Depression Scale (SDS) and the Depression Anxiety Stress Scales (DASS) in chronic pain, clinical and community samples. Clinical Journal of Pain 2005; 21: 91-100.
- Blyth FM, March L, Nicholas M, Cousins M. Self-management of chronic pain: a population-based study. Pain 2005; 113: 285-292.
- Nicholas MK. Psychology of pain, sensitisation, habituation and pain. Encyclopedic Reference of Pain. Robert F. Schmidt, William D. Willis (eds) Springer-Verlag (in press).
- Nicholas MK. Psychological predictors of chronicity. Encyclopedic Reference of Pain. Robert F. Schmidt, William D. Willis (eds) Springer-Verlag (in press).
- Nicholas MK. Operant perspective of pain. Encyclopedic Reference of Pain. Robert F. Schmidt, William D. Willis (eds) Springer-Verlag (in press).
- Nicholas, MK. Chronicity, Prevention. Encyclopedic Reference of Pain. Robert F. Schmidt, William D. Willis (eds) Springer-Verlag (in press).
- Nicholas MK, Molloy AR, Brooker C. Using opioids with persisting, noncancer pain: A biopsychosocial perspective. Clinical Journal of Pain. 2006 Feb;22(2):137-46.
- Asghari.A, Nicholas MK. Personality and Pain-Related Beliefs/Coping Strategies: A Prospective Study. Clinical Journal of Pain. 2006 Jan;22(1):10-8.
- van Leeuwen M, Blyth FM, March LM, Nicholas MK, Cousins MJ. Chronic pain and reduced work effectiveness: the hidden cost to Australian employers. European Journal of Pain 2006; 10: 161-166.
- Franche R-L, Baril R, Shaw W, Nicholas MK, Loisel P.. Workplace-based return-to-work interventions: Optimizing the role of stakeholders in implementation and research. Journal of Occupational Rehabilitation 2005; 15 (4): 525-542.
- Molloy AR, Nicholas MK, Asghari A, Beeston LR, Dehghani M, Cousins MJ, Brooker C, Tonkin L. Does a combination of intensive cognitive-behavioral pain management and a spinal implantable device confer any advantage? A preliminary examination. Pain Practice. 2006 Jun;6(2):96-103.
- Nicholas MK, Asghari A. Investigating acceptance in adjustment to chronic pain: is acceptance broader than we thought? Pain. 2006 Oct;124(3):269-79.
- Finniss DG, Murphy PM, Brooker C, Nicholas MK, Cousins MJ. Complex regional pain syndrome in children and adolescence. European Journal of Pain. 2006 Nov;10(8):767-70.
- Nicholas MK. The Pain Self-Efficacy Questionnaire: Taking pain into account. European Journal of Pain. 2007 Feb; 11(2):153-63.
- Blyth FM, Macfarlane GJ, Nicholas MK. The contribution of psychosocial factors to the development of chronic pain: the key to better outcomes for patients? Pain. 2007 May;129(1-2):8-11.
- Nicholas MK. Mental disorders in people with chronic pain: an international perspective. Pain 2007 Jun;129(3):231-2.
- Nicholas MK, Asghari A, Blyth FM. What do the numbers mean? Normative data in chronic pain measures. Pain. 2007 (in press).
- Pengel LH, Refshauge KM, Maher CG, Nicholas MK, Herbert RD, McNair P. Physiotherapist-directed exercise, advice, or both for subacute low back pain: a randomized trial. Annals of Internal Medicine. 2007 Jun 5;146(11):787-96.
Reports or other publications:
- Williams, A.CdeC., Pither, C.E. and Nicholas, M.K. Report (1987-1992) Input Pain Management Programme, St. Thomas’ Hospital, London. For the Kings Fund, The Special Trustees for St. Thomas’ Hospital and the South East Thames Regional Health Authority (UK), 1992.
- Kirkwood, K., Glare, P., Nicholas, M. and Painter, L. (1995). Report on the Management of Persistent Pain in RPAH Patients with HIV/AIDS. For the AIDS Bureau, Central Sydney Area Health Service.
- Cohen, M.L., Nicholas, M.K. and Blanch, A. (1996) Identification of Medical Factors Influencing Return to Work Following Low Back or Cervicobrachial Pain. For WorkCover (NSW).
- Member of Consultative Group for the NHMRC project: Acute Pain Management: Scientific Evidence (1998).
- Nicholas MK. Report on differential responses to MVA-induced pain: normative data. Motor Accident Authority of NSW, 2005.
Invited reports from WorkCover (NSW):
- On determination of psychological impairment in work injuries (2001)
- Work Hardening, Work Conditioning, and Pain Management (2002)
- Training Manual in CB principles for activity-based programs (2004)
Invited report from Faculty of Pain Medicine (ANZCA)
Invited report for Victoria WorkCover Authority (2005)
- A white paper on the use of CBT pain management approaches for patients with chronic pain conditions
- Clinical Framework for the delivery of psychology services to injured workers. P. Cotton, MK Nicholas et al. (September, 2005)
Invited author of training course by the Faculty of Occupation Medicine (RACP), 2005.
- To develop on-line training module for physicians on management of psychosocial ‘yellow flags’ in injured workers. Planned launch in 2006.