All Psychological Articles

Behavioral Medicine: How to Deliver CBT for Pain in Primary Care Settings

Cognitive behavioral therapy (CBT) for pain management is based on the cognitive behavioral perspective of pain.1 The cognitive behavioral model is grounded in the notion that pain is a complex experience that is influenced by underlying pathophysiology and the patient’s thoughts, feelings, and behaviors (see Figure 1).2 Thus, CBT interventions can work to engage patients

Behavioral Medicine: How to Utilize Acceptance and Commitment Therapy in Primary Care

Chronic pain is a complex phenomenon characterized by biological, psychological, and social mechanisms and has been found to be best treated using interdisciplinary approaches.

Behavioral Medicine: How Clinicians Can Reduce the Stigma Attached to Chronic Pain

There is substantial evidence that individuals with chronic pain commonly experience stigmatization by others.1 The result of a devalued personal quality that deviates from the expected norms in medical and broader social settings2 is not new in the field – a decade ago, the Institute of Medicine (IOM) reported testimonies from more than 2,000 individuals with chroni

Psychedelics for Chronic Pain: Is It Time?

The results of our recent election were remarkable for several reasons, some not having anything to do with our new president.

Adherence and Relapse – How to Maintain Long-Term Gains in Patients with Chronic Conditions

Approximately 125,000 people with treatable diseases die each year in the US because they do not take their medication as prescribed, while 10% to 25% of hospital and nursing home admissions result from uninitiated or incomplete prescribed treatment plans.1,2 On the research side, clinical trials report average nonadherence rates of 43% to 78% among patients receiving medication for

Behavioral Medicine: Managing Anxiety and Maladaptive Behaviors

This column marks the fourth in a series review of the Kreitler and Kreitler system developed for the treatment of pain and focuses on the behavioral component of pain distress.

Connecting the Dots: How Adverse Childhood Experiences Predispose to Chronic Pain

Studies worldwide have shown a relationship between traumatic events in childhood and later development of chronic pain. Inside the connections and possibilities for preventing trauma-based, adult-onset chronic pain.

Optimizing Care Using a Trauma-Informed Approach

Although pain can present under myriad conditions and often occurs in concert with a variety of physical and mental health comorbidities, there is evidence suggesting that childhood trauma or adverse childhood experiences may convey risk for the development, maintenance, severity, and exacerbation of chronic pain.

Significance of Mental Health Indicators in Women with Chronic Pelvic Pain

Chronic pelvic pain (CPP) is a complex condition that continues to be misunderstood and undertreated.

The Sensory Component of Pain: Modifying Its Emotional and Cognitive Meaning

The relevance of psychotherapy in chronic pain management is questioned far less than it used to be, due in large part to investigations into the social and psychological components of pain.

The Perseverance Loop: The Psychology of Pain and Factors in Pain Perception

Pain is a normal feature of the human experience. Commonplace pain has a particular psychology that provides the foundation for all pain management behavior. A normal psychology of pain seeks to explain the shared experience of pain that is uncomplicated and short-lived.

When Pain Clinicians Have to Be the Villain: Communication Strategies to Bridge the Divide

How pain practitioners can ease communications and bridge the divide with patients who may be frustrated by their chronic pain condition, including when they may be tapering off opioids.

A Different Perspective to Explain Challenges in Patient-Provider Communication

With no clear evidence to improve talking about biopsychosocial elements of chronic pain, the authors propose one research perspective.

How to Avoid Patient Alienation When Discussing Stress

Anecdotal examples of how to start a conversation around stress with patients trying to manage chronic pain.

Agonism and Antagonism of the Muscles of the Shoulder Joint: An SEMG Approach

The author shares clinical evidence for the use of surface electromyography (SEMG) to restore a healthy and functional range of motion, using the shoulder as an example.

Fear-Avoidance and Chronic Pain: Helping Patients Stuck in the Mouse Trap

How clinicians can approach catastrophic thinking and other diversion tactics used by struggling patients living with chronic pain.

Pain Assessment Tools for Malingering in Patients with Chronic Pain

with David Cosio, PhD, ABPP Malingering may concern physicians (and insurers), but neither malingered pain nor malingered pain-related disability can be reliably identified using current assessment methods, a study has found.1

Chronic Pain and the Psychological Stages of Grief

How clinicians can help patients work through the feelings of grief and loss when faced with a lifetime of intractable, chronic pain.

Managing Pain in Adults with Intellectual Disabilities

A lack of verbal cues and an inability to self-report may make it difficult to assess or treat pain in this vulnerable population.

Pain Catastrophizing: What Practitioners Need to Know

Beth Darnall, PhD, addresses patterns of negative pain appraisal in patients, known as pain catastrophizing.

Chronic Pain and Psychopathology in the Veteran and Disadvantaged Populations

A pilot study compared different types of DSM-5 disorders identified among Veterans who suffered from mixed, idiopathic chronic pain.

Polarizing Topics in Chronic Pain

A review of the associations between chronic pain and psychopathology, including sexual dysfunction, gender dysphoric, paraphilic, and behavioral addictive disorders.

Chronic Pain in Children

Sleep disturbances aggravate PTSS and chronic pain in youth patients.

Group CBT and Education May Improve Chronic Pain Among Low-Literacy Patients

CBT has been shown to work with low-income, low-literacy populations for treating chronic pain.

Challenging the Chronic Pain Personality Profile

A reader writes in about the mental health misconceptions of chronic pain patients.

Is There a Chronic Pain Personality Profile?

Patients living with intractable pain may present with a particular personality profile that requires a unique assessment and treatment approach under the APA DSM-5.

Obsessive-Compulsive Disorder & Chronic Pain

Obsessive compulsive and related disorders (OCD) now have their own assessment and treatment plans, yet patients with chronic pain may be suppressing symptoms.

Theory of Motivated Information Management and Coping With Death

Religion and spirituality play a significant role in a patient's ability to cope with the stress and uncertainty of death and dying.

Transformative Care for Chronic Pain and Addiction

A health coaching model for pain management focused on patient-centered care offers better outcomes.

Look at the Patient’s Life Story, Then Implement a Management Plan

Michael R. Clark argues that a full review of the biopsychosocial experiences and history of each chronic pain patient should be considered in devising a treatment plan.

How do you handle end-of-life care in a patient who does not know they are dying?

Patients cannot carefully and comfortably plan for a good death if they are not aware that they are dying; physicians are encouraged to have a goals-of-care discussion and consider referring such patients to palliative care services.

Anxiety and Pain

Managing anxiety disorders in patients with chronic pain requires management distinct from depression, PTSD and OCD.

Treatment of Chronic Exhaustion and Chronic Fatigue Syndrome

Cognitive behavioral therapy and exercise offer best treatment to manage pain and related symptoms in patients with chronic fatigue syndrome.

Mental Health & Vocational Rehabilitation: Information for Pain Management

Depression, anxiety, and PTSD can heighten a person's sense of pain, often resulting in co-morbid mental health issues and chronic pain. Learn how physicians can help patients cope with pain and get their personal and work lives back on track.

Behavioral Medicine: How to Incorporate CBT Into Pain Management

There is a great deal of evidence to support the effectiveness of various cognitive-behavioral interventions for reducing pain intensity and improving a patient’s coping skills. Behavioral medicine approaches aim to modify the overall pain experience, help restore functioning, and improve the quality of life of patients who suffer from chronic pain.

Can Weight Loss Help Reduce Psoriatic Arthritis Symptoms?

Obesity is a risk factor for psoriatic arthritis (PsA) Learn how increased adipose tissue can trigger an inflammatory cascade leading to PsA and how weight loss can help reduce the trend.

New Technique Shows Promise as Adjunct In Chronic Pain Management

Learn how the Bio-Acoustical Utilization Device (BAUD), a biofeedback device, has shown promise in the management of patients with central sensitization and chronic pain.

Improving the Sex Lives of Patients With Chronic Pain

Sexual problems affect an alarming number of patients with chronic pain. Fortunately, there are a variety of strategies to help physicians discuss sexual function and make sex satisfying again for patients with chronic pain.

Sexual Therapy for Patients with Chronic Pain

Talking to your patients about their sexual history is just as important as taking a medical history. Treating sexual dysfunction lowers pain levels, reduces stress, and improves quality of life.

Biofeedback: Information for Pain Management

Biofeedback, along with hypnosis, can be used as a tool to help patients modulate or control their body's reaction to painful situations. Learn more about how biofeedback works in pain management.

Can Behavioral Medicine Be Brought into Standard Practice?

How to bring behavioral medicine into standard pre-operative and post-operative counseling for pain control.

Targeting a Saboteur of Surgical Outcomes: Pain Catastrophizing

Pain catastrophizing is a negative cascade of cognitive and emotional responses to actual or anticipated pain. For instance, one may worry a great deal about the possibility that their pain will worsen. Or they may find themselves fearfully ruminating that there may be a serious yet unknown medical problem underlying their pain.

Addressing Psychosocial Factors in Pain Management in the Emergency Department

In addition to assessing pain levels through a self-report scale, it is also important to assess psychological factors, such as catastrophizing and anxiety, to adequately manage acute and chronic pain in the emergency department.

Spirituality Assessments and Interventions In Pain Medicine

For many people with chronically painful conditions, spiritual beliefs shape the way they view their pain or provide strategies to manage their pain. Research results have supported the use of spiritual practices in helping patients cope with pain, reduce pain intensity, and lessen the degree to which pain interferes with the activities of daily living.

History of Pain: The Psychosocial Assessment of Pain

Over the past 30 years, we have seen tremendous changes in the diagnosis and treatment of pain—including a better understanding of pain as the 5th vital sign. The prevalence of pain is striking.

Persistent Acute Lower Back Pain: The Importance of Psychosocial Evaluation

Physicians need to recognize the ‘yellow flags’ that help identify patients at risk of developing chronic pain. Early intervention is key to prevention of disease progression.

Mission Impossible—Developing a Program to Help Chronic Pain Patients

Hear the story of a pain patient who overcame her pain and now helps others through coaching.

PPM Editorial Board Discusses Mental Deterioration in Pain Patients

We surveyed the Practical Pain Management Editorial Board members and asked them how a pain practitioner can effectively manage a pain patient who is experiencing mental deterioration.

How to Manage Unmotivated Pain Patients

How to motivate an unmotivated pain patient. How do you get them to want to participate in their treatment plan? Tips from a pain psychologist.

Formulation: The Four Perspectives of a Patient in Chronic Pain

Patients with chronic pain are usually referred to a psychiatrist out of frustration. The patient is frustrated with their pain management. The physician is frustrated with the patient’s poor response to treatment. Read how to better understand your chronic pain patients.

Etiology of Chronic Pain and Mental Illness: The Biopsychosocial Component

It has been well established that there are high levels of comorbidity between chronic pain conditions and mental health disorders. Moreover, psychiatric conditions, such as depression, anxiety, substance abuse, personality disorders, and post-traumatic stress disorder (PTSD), occur more frequently in patients with chronic pain than in the general population.

Identifying Psychological Factors That Influence Surgical Outcomes

Pain relief is the primary reason why patients in the United States undergo elective surgery. However, it has been reported that approximately 10% of patients who undergo surgery will develop chronic pain. This article points out a number of psychological factors that should be kept in mind before elective surgery is considered in patients experiencing persistent or chronic pain.

The Role of Psychology in Pain Management

Article provides an overview of the various roles that psychology and psychologists play in pain management for chronic pain patients.

The Psychiatric Model of Treating Chronic Pain

This article discusses the psychiatric model of treating chronic pain, including a discussion of why psychiatric illnesses do not need to be present in order for the psychiatric model to be successfully used in achieving the multidisciplinary goal of biopsychosocial balance.

Assessment and Treatment of Chronic Pain

Evaluating a chronic pain condition from a one-dimensional biological perspective is limiting, and often fails to fully explain the patient’s symptoms. Consequently, assessment requires not only the examination of the biological dimension, but of the psychological and social dimensions as well.

Considerations in Treating Intractable Pain

Intractable Pain (IP) patients not only present unique factors that differentiate them from other patient groups, but also each individual’s background, personality, coping skills, etc. requires additional adaptation.

Effective Non-Drug Treatment of Depression

A review of the evolution in electrical and photo stimulation for effectively treating depression in chronic pain patients.

Group Psychotherapy for Chronic Pain Patients

Several years ago, I had quite limited time available for direct clinical work with patients with chronic pain. As the waiting time for a new appointment increased, so too did my discomfort with asking patients in urgent need of help to wait for treatment.

Dramatically Disturbed Patients in Interdisciplinary Pain Programs

The dramatic personality disorders of the Cluster B type, which can wreak havoc in an interdisciplinary pain treatment program, present clinics with a dilemma in handling these troublesome patients.

Co-Existing Psychological Factors

The patient's personality and emotional state may adversely affect the use of medication such as opioids and treatment outcomes. Why it's important to consider the mental and emotional health of your chronic pain patients.

Biofeedback Pain Interventions

In some disorders, such as migraine and tension headaches, up to 80% of patients could benefit from biofeedback. Should you be using it in your chronic pain patients?

Psychological Dimension of Pain Management

A comprehensive approach to pain management must address the psychological dimension with special emphasis on the patient's own unique psychological response to chronic pain.

Taxonomy of Pain Patient Behavior

This article discusses the taxonomy of pain patient behavior. Perspectives on understanding motivations of patients exhibiting functional overlay and effectively dealing with the confounding behavioral aspects are also discussed.

Thinking About Pain

In this article, you'll find out how psychologically based pain management can provide pain relief for pain patients.

The Perfect Treatment and Evaluation Tool

Renowned sEMG expert, Jeffrey R. Cram, PhD, shares his thoughts on biofeedback for chronic pain patients.

The Pain Relationship

Finding out what pain may be trying to communicate is essential in helping your patients deal with their maladies. This article discusses the pain relationship.

Providing Valuable Input

Psychological assessments play a major role in the treatment of chronic pain. Article discusses how psychology can be used as part of an integrated approach.

The Mind-body Connection

This article addresses the mind-body connection. Frequently, pain physicians must treat the depression that often accompanies chronic pain.

Getting Off the Pain Roller Coaster

Identifying the psychological aspects of pain can lead patients on the right track to recovery.

Treat the Pain First—Worry about Psyche Problems Later

Does severe chronic pain cause psychiatric symptoms? Article discusses the role of the pain physician in treating chronic pain patients who have psychiatric symptoms.

Raising Pain Tolerance Using Guided Imagery

Patients can derive not only symptomatic relief but actual physiologic healing in response to treatments that primarily work through beliefs and attitudes about an imagined reality. Read about how psychological treatments can be used for chronic pain patients.

Psychologists as Primary Care Providers

Psychologists are trained in advanced skills that intrinsically lend themselves to the management of chronic pain and complex health care problems.

Reducing Pain and Anxiety During Reduction of a Fracture

A reduction of a fractured wrist—normally performed in an emergency department—was safely and successfully performed by an orthopedic surgeon at a soccer tournament medical facility with the benefit of psychological techniques and deep breathing.

Adjunctive Psychiatric Pain Management Treatment

The psychiatric/psychological modality is a crucial component of comprehensive treatment for chronic pain.

Personality Disorders and the Bipolar Spectrum

Discussion of recognition and management of a variety of personality disorders in a pain clinic setting.

The Biopsychosocial Approach

The biopsychosocial model has led to the development of the most therapeutic- and cost-effective interdisciplinary pain management programs and makes it far more likely for the chronic pain patient to regain function and experience vast improvements in quality of life.

Co-Morbid Psychological Disorders in Interventional Pain Management

Depression, anxiety, interpersonal issues, personality disorders, and cognitive decline may decrease the effectiveness of interventions.

Chronic Pain and Biopsychosocial Disorders

The BHI™ 2 Approach to Classification and Assessment.

Family Dynamics and Chronic Pain

Accompanying depression and anxiety impacts a chronic pain patient’s family dynamics and requires a multidisciplinary, holistic approach to address associated issues.