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Cognitive-Behavioral Interventions for Chronic Pain
Published in Andrea Kohn Maikovich-Fong, Handbook of Psychosocial Interventions for Chronic Pain, 2019
Emily Cox-Martin, Lisa H. Trahan, Diane M. Novy
In the field of pain management, Wilbert Fordyce (1977) pioneered the behavioral arm of treatment, applying learning theory and the concepts of operant conditioning to pain behaviors. Dennis Turk later expanded this approach (Turk, Meichenbaum, & Genest, 1983), including concepts of Beck’s cognitive therapy and Fordyce’s behavioral work to help develop the foundation of today’s CBT for chronic pain (CBT-CP). Researchers in the field of pain psychology have since continuously expanded upon the early work of Fordyce and Turk, building the evidence base for using CBT with this complex and challenging patient population.
Ethical Issues in the Psychological Assessment of Chronic Pain Patients
Published in Michael E. Schatman, Ethical Issues in Chronic Pain Management, 2016
C. David Tollison, Donald W. Hinnant
Pain psychology—perhaps more than any other psychological specialty—offers opportunities for regular interaction and cooperation with health professionals representing a variety of clinical and academic disciplines. In fact, as previously discussed, interdisciplinary practice is considered by most authorities as the pinnacle of pain management effectiveness and professionalism. Many pain psychologists clinically practice on a daily basis with physicians of various specialties, nurses, physical therapists, vocational specialists, and others. Although each professional functions in accordance with core discipline training—with the pain psychologist typically contributing expertise in assessment, psychotropic medication recommendations, and psychological treatment—members primarily function as a “pain team,” sharing information and collectively addressing the physical, psychological, and psychosocial needs of the patient in pain.
History-taking and examination of the patient with chronic pain
Published in Harald Breivik, William I Campbell, Michael K Nicholas, Clinical Pain Management, 2008
Paul R Nandi, Toby Newton-John
There is no definitive set of questions that should comprise the psychological interview. However, the following topic areas represent a broad set of categories for exploration in conjunction with the medical history. The clinical psychologist may also need to begin the interview with a brief explanation of the nature of pain psychology. It can be worthwhile to state openly that the purpose of the assessment is not to expose the underlying psychological causes of pain, but to explore how the persistent pain problem has impacted upon various life areas (as it so often does), so that optimum treatment plans can be developed. It can also be useful at the outset to invite the patient to change position during the interview (stand, lean against the wall, pace the room), rather than continue sitting in discomfort. Not only does this invitation help to build rapport, it is a tacit acceptance of the reality of the patient’s pain.
Do pain management apps use evidence-based psychological components? A systematic review of app content and quality
Published in Canadian Journal of Pain, 2022
Megan MacPherson, A. Myfanwy Bakker, Koby Anderson, Susan Holtzman
If developed to meet both clinician and patient needs, apps can be used as a supplementary tool in pain management to engage patients, enhance care, and potentially reduce health care costs. This successful integration into clinical practice can be achieved by developing apps with clinical implementation in mind. A major challenge in integrating mHealth in chronic pain treatment is inconsistent use of the data generated from the mHealth technology by the care team.15 In fact, patient data derived from mobile devices are rarely incorporated within electronic medical records.15,66 To ensure that mHealth interventions for chronic pain meet end-user needs and are effectively translated into clinical practice, it will be critical to continue to include end-users (e.g., physicians, nurses, patients, family members) throughout the phases of development and evaluation.58 By engaging pain psychology experts, apps will be more likely to align with current best practice guidelines and evidence-based psychological approaches for treating chronic pain.
Chronic postsurgical pain: From risk factor identification to multidisciplinary management at the Toronto General Hospital Transitional Pain Service
Published in Canadian Journal of Pain, 2019
Joel Katz, Aliza Z. Weinrib, Hance Clarke
The Toronto General Hospital TPS59–61 was established in 2014 to address the problem of CPSP with a seamless approach to perioperative pain and opioid use using multidisciplinary, integrated care. Patients are assessed and managed as early as the preoperative visit, treatment is extended into the in-hospital setting after surgery, and it is maintained for up to 6 months across the post–hospital discharge period once patients have returned home. The primary aim of the TPS is to offer timely and effective treatment to patients at high risk of developing chronic postsurgical pain and persistent opioid use after undergoing a variety of surgical procedures, including those for cancer (e.g., thoracic, breast, gastrointestinal, head and neck), cardiac disease (e.g., coronary artery bypass graft, heart valve repair), and organ transplants (e.g., kidney, lung, liver, heart, pancreas). The three major goals of the TPS are to (1) provide comprehensive pre- and postoperative pain management for patients who are at high risk of developing chronic postsurgical pain and pain disability, (2) manage opioid medication while in hospital and after discharge, and (3) improve coping and functioning in the immediate and long term to provide as high a quality of life as possible. At present, clinical services at the TPS include multimodal medication optimization by anesthesiologists, postsurgical physical therapy and acupuncture, and a pain psychology intervention consisting of pain education, mindfulness training, brief hypnosis, and a form of cognitive–behavioral treatment called acceptance and commitment therapy (ACT). The service also includes an administrative assistant and a patient care coordinator. In 2016, the TPS began a partnership with ManagingLife, whose mobile platform and app, Manage My Pain, allows TPS patients to quickly and easily track their pain on a daily basis using an Apple iPhone, Android smartphone, or a responsively designed web app through their mobile or desktop browser.62