Jensen, M. P., & Turk, D. C. (2014). Contributions of psychology to the understanding and treatment of people with chronic pain: Why it matters to ALL psychologists. American Psychologist, 69(2), 105-118. http://dx.doi.org.proxy.library.vcu.edu/10.1037/a0035641
In this introduction to a special issue on chronic pain in American Psychologist, Drs. Jensen and Turk make a strong case for why ALL psychologists should know about psychological treatments for chronic pain. After highlighting the magnitude of individual and societal costs associated with chronic pain, the article offers an overview of the important contributions that psychologists have made to our understanding of this prevalent health care problem. Along the way, the review describes psychological models of chronic pain, including behavioral, physiological, cognitive and coping, and central neurophysiological models. The article also recommends future directions in chronic pain research, including better understanding of the mechanisms involved in successful pain management treatments, promoting the use of technologies such as telehealth and smart-phone apps, individualized treatment matching, and exploring the effectiveness of combined treatments. The article concludes by arguing that the expertise that psychologists have in behavior, the brain, and their interaction is especially useful in understanding the biopsychosocial nature of chronic pain and its management, as well as chronic pain’s downstream impact on adjustment and well-being. As such, psychologists are well positioned to have a central role in developing and providing treatments for chronic pain. Psychologists should be aware of effective chronic pain management techniques because they may generalize to the treatment of other behavioral health concerns such as insomnia, fatigue, and pruritus.
I SELECTED THIS ARTICLE BECAUSE chronic pain is a frequent problem for patients treated in rehabilitation settings and is often associated with significant secondary harm to individuals, family members, and society. A reinvigorated interest in chronic pain management has occurred in recent years, perhaps brought to light by increased attention to what has become known as the “opioid overdose crisis” (e.g., https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis; Jones, M.R., Viswanath, O., Peck, J. et al. Pain Ther (2018). DOI: 10.1007/s40122-018-0097-6). From bench to bedside, from opinion polls to the impact of media messages, psychologists have been working to better understand and manage chronic pain and its impact on society. This article, published a few years prior to President Trump’s declaration that the opioid crisis was a public health emergency on October 26, 2017, provides a useful framework for psychologists to understand models of chronic pain and potential roles for making a positive impact on the lives of those affected by it. As federal policy and clinical practice standards move toward reducing long-term opioid analgesic treatment for the management of chronic pain, rehabilitation psychologists are in an excellent position to inform programs that help patients and providers ethically manage opioid tapering, develop and administer treatment strategies that fill the void, and promote substance abuse prevention and treatment programs to assist those with chronic pain.
THIS MONTH’S REHABILITATION SCIENCE SPOTLIGHT was provided by Scott D. McDonald, PhD, a clinical psychologist working in the Spinal Cord Injury and Disorders Center of the Hunter Holmes McGuire VA Medical Center; Division 22 Liaison to the APA Board of Scientific Affairs and Member of the Division 22 Science Committee.