Role of Psychology in Interdisciplinary Pain Management

At the 2018 American Academy of Pain Medicine Annual Meeting, Patricia Cole, PhD, from Shirley Ryan AbilityLab discussed the role of psychology in an interdisciplinary pain management program.

The initial psychological assessment for an interdisciplinary pain management focuses on whether there are any contra-indications pain management including:

• Significant cognitive impairment. If the patient has cognitive impairment such as limited short-term memory they are not a good candidate.
• Making sure their emotional status is stable enough for the pain management program so that they are not a threat to themselves or others.

It is important for the patient to be ready for a change to their condition. They need to be willing to accept that there is no magic cure for their pain and instead they need to focus on improving their function and improving their coping mechanisms.

The targeted areas for psychological assessment are:

• Cognitive factors. What are their pain beliefs.
• Psychological barriers to pacing, exercise, relaxation, etc.
• Emotional management skills.
• Stress management skills.
• Need for family education and counseling.
• Need for vocational counseling.

In the psychological counseling for pain management the goals are to help the patient have less pain and greater function. This is done by helping the patients change their behaviors, thoughts, and attitudes.

Components of Pain Psychotherapy

• Education on mind-body connection.
• Mindfulness training.
• Stress management skills.
• Emotion regulation skills.
• Coping skills training.
• Family education (hurt/harm, support vs solicitous reactions).

Psychological Techniques in Pain Management

• Motivational interviewing.
• Cognitive behavioral therapy.
• Dialectical behavioral therapy.
• Acceptance and commitment therapy.

The patient is in the multidisciplinary pain management program for 8 hours per day. The day includes a variety of therapy including physical and psychological.