The National Association for Chronic Pain Control (NACPC) developed in 1990 in response to the numbers of people living with chronic pain in the United States. An entire industry had developed to control pain so that employees could work longer and retirees could lead more productive lives, but a major concern had emerged in the process: more and more people were dependent upon high-powered, often addictive prescription drugs. NACPC viewed searching for alternative treatments and interventions as urgently needed. The mission of this national organization was originally stated as: ‘‘To eliminate chronic pain through the advancement of research; to provide and enhance the quality of life and support for all affected; and to educate the public so that no one faces a life of pain.’’ As charitable donations grew, and a major public relations campaign spread, multiple chapters of the NACPC began to spring up all over the country. By the year 2000, there were more than 100 chapters in place and at least 30 more developing. The NACPC chapter in Arizona was established in 1993, one of the earliest local chapters to come on board. Located in Phoenix, where many people had moved from cold climates to take advantage of hot temperatures that seemed to help their aches and pains, interest had quickly mounted. As the chapter had grown and incorporated as a nonprofit organization, a board of directors composed of 12 members hired a CEO, in 1994. By 2000, this chapter was a thriving organization with three paid full-time program coordinators, in addition to the CEO and an administrative assistant. Each of the three coordinators was responsible for a specific program initiative—advocacy, education, andservice. A policies and procedures manual was developed, along with an organizational chart (see Figure 2.1) to depict the relationships among staff positions.
In 2008, the Phoenix NACPC held a strategic planning retreat. There, it became clear that the three programs (advocacy, education, and direct service) were not very integrated with one another. The advocacy program coordinator said that she was not certain how what she did varied from what the education program coordinator did. Both were going out into the local community talking about the NACPC, and telling the public about chronic pain. Sometimes, they found their speaking engagements overlapped. The direct service coordinator had a different problem. He felt that no one really respected what he was trying to do, and that the organization was so advocacy- and research-oriented that actual intervention with victims of pain and their caregivers had all but been forgotten. ‘‘And this is the bread of butter of what we should be doing,’’ he said. ‘‘Without direct intervention through information and referral, care consultation, support groups and counseling with real people, we are not addressing community needs.’’