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What is Pain Psychology?

Pain psychology is the study of how biological, cognitive, social, and environmental factors interact with pain responses.  Pain psychology also involves using the aforementioned knowledge to provide evidence-based behavioral health treatment to patients with chronic pain, to improve their pain experiences, thought patterns, and behaviors.  Clinical health psychologists and other qualified mental health professionals can deliver this treatment.

Curious why psychologists are involved in pain management? Hear Psychologist Beth Darnell, PhD provide a brief overview:

To learn more about the manner in which psychologists help with pain management, click here for a summary from APA's Help Center.

Daniel Bruns PsyD provides a thorough description of the complexities of pain and outlines the manner in which some "unexpected" treatments work.

Pain Info for patients

What Should You Know to be a Competent Pain Psychologist?

Core Competencies for the Emerging Specialty of Pain Psychology (Wandner, Prasad, Ramezani, Malcore, & Kerns, 2019) 

1. You Should Understand the Multidimensional Nature of Pain - You should be familiar with the biopsychosocial model, being able to determine the multiple factors that influence pain for a specific person.  You should possess knowledge of theories of pain.  You should have familiarity with a variety of pain conditions/medical terminology used to characterize pain/medical treatments for pain.  You should have the ability to communicate this understanding to professionals and patients in a coherent way.  
2. You Should Assess And Measure Pain Appropriately - You should have familiarity with standardized assessments to measure pain and know how to administer and interpret these assessments to inform and optimize treatment planning.
3. You Should be Able to Help Patients Manage Pain - You should be able to provide patients with evidence-based mental health treatment for their pain and comorbid mental and behavioral health issues (e.g., anxiety, smoking) and collaborate with patients’ other medical providers (physicians, psychiatrists) to optimize care.
4. You Should be Aware of How Contextual Variables Influence Pain - You should have knowledge of how cultural, institutional, societal, and regulatory influences affect pain perceptions and treatment.

Practice Guidelines for Chronic Pain:

Agency for Healthcare Research and Quality: 

Noninvasive Nonpharmacological Treatment for Chronic Pain: A Systematic Review

Noninvasive Nonpharmacological Treatment for Chronic Pain: A Systematic Review Evidence Summary

American College of Occupational and Environmental Medicine (ACOEM)2017 American College of Occupational and Environmental Medicine (ACOEM) Practice Guidelines for Chronic Pain. Chronic Pain. MDGuidelines. Westminster, CO: Reed Group, Ltd; 2017. Available at: www.MDGuidelines.com.

American Chronic Pain Association ACPA Resource Guide to Chronic Pain Medication and Treatment: An Integrated Guide to Physical, Behavioral and Pharmacologic Therapy. Co-Author: Darnall BD. Project Lead: Steven Feinberg, MD. ©2017 Edition

Assessments for Chronic Pain:

• Colorado Division of Workers’ Compensation List of Psychological Tests Commonly Used in the Assessment of Chronic Pain CO psych tests 2015 
• List of Colorado Division of Workers' Compensation approved functional and psychological tests QPOP_Table_of_approved_tests 

Spinal Cord Stimulator (SCS) Psychological Evaluation Information (Daniel Bruns) 

Dan Bruns, PsyD developed an SCS Primer and Glossary as well as a great resource which outlines Spinal Cord Stimulators and Related Therapies.

Spinal Cord Stimulator Glossary 

Predicting Surgical Outcome

Biopsychosocial Risk Factors For Spinal Cord Stimulation 

Spinal Cord Stimulator Assessment Videos & Supportive Documents

• http://bit.ly/presurgical_psych_assessment
• http://bit.ly/pain_explained
• http://bit.ly/scs_webinar_slides
• http://bit.ly/scs_webinar_Q_and_As

Links to Important Articles and Chapters:

• The Biopsychological model of pain (Gatchel, Peng, Peters, Fuchs, & Turk, 2007)
• Clinical and Forensic Standards for the Psychological Assessment of Patients with Chronic Pain (Bruns, 2014) 
• Biopsychosocial law, health care reform, and the control of medical inflation in Colorado (Bruns, Mueller, & Warren, 2012)
• Thorn. B.E. (2017). Cognitive Therapy for Chronic Pain: A Step-by-Step Guide 2nd ed. New York: Guilford Publications.

Cognitive-Behavioral Therapy (CBT) Manuals for Chronic Pain:

• Veterans Affairs CBT for Chronic Pain 
• Introduction to Literacy-Adapted Materials developed by Beverly Thorn
• CBT-Learning About Managing Pain (LAMP)- Patient Workbook (Beverly Thorn)
• CBT- Learning About Managing Pain (LAMP)- Therapist Edition (Beverly Thorn) 

Recommended Books:

Acceptance and Commitment Therapy-based Books

• Living Beyond Your Pain: Using Acceptance and Commitment Therapy to Ease Chronic Pain by Joanne Dahl and Tobias Lundgren

Cognitive Behavioral Therapy-based Books

• The Pain Survival Guide by Dennis Turk, PhD and Frits Winter
• The Chronic Pain Care Workbook by Michael Lewandowski, PhD
• Less Pain, Fewer Pills: Avoid the Dangers of Prescription Opioids and Gain Control Over Chronic Pain by Beth Darnall. Includes a guided, binaural relaxation audiofile and CD
• The Opioid-Free Pain Relief Kit by Beth Darnall, PhD. Includes a guided, binaural relaxation audiofile and CD

Emotional Awareness and Expression Therapy (EAET) Resources

• EAET Principles and Procedures
• EAET Therapist Manual
• EAET Patient Workbook

Pain Science Book (pain education)

• Explain Pain by David Butler and Lorimer Moseley

Chronic Pain Self-Management

• Living a Healthy Life with Chronic Pain by Sandra LeFort, Lisa Webster, Kate Lorig, et al.

Mindfulness-Based Stress Reduction (MBSR) 

There are several great resources for learning MBSR, Here's a link to a free resource.

Workshops and Webinars:

• APA Pain Workshop https://www.apa.org/health/pain-opioid-dependence-video-workshop
• “Psychological Approaches to Managing Pain.” Web archived, for purchase. Institute for Brain Potential. This is a 6-hour CME workshop developed and delivered by Dr. Beth Darnall. http://www.ibpceu.com/content/pdf/PMPCAS17.pdf
• “Reducing Catastrophizing to Prevent and Treat Chronic Pain” by Beth Darnall. Free and archived online: https://www.wwdpi.org/Webinars/Pages/Webinar.aspx?wbID=151 Hosted by the Work Wellness and Disability Prevention Institute of Canada.

Pain-Focused Organizations/Resources:

Agency for Healthcare Research and Quality

American Academy of Pain Medicine (AAPM)

American Chronic Pain Association

Cleveland Clinic Pain Management

International Association for the Study of Pain (IASP) & Relief News

NIH Pain Consortium 

The Pain Toolkit

Pain Medicine News 

Pain Week

Society of Behavioral Medicine-- Pain

Stanford Pain Medicine

US Pain Foundation

Finding a Pain Psychologist Near You:

APA's Psychologist Locator Page