| One-Minute Clinician

Pain Management and the Role of Psychology

The CDC guidelines and also the National Pain Strategy emphasize the role of behavioral factors, of pain psychology in the experience and treatment of pain. Most primary care physicians may not be aware of the critical role that psychology plays in the pain experience and in patient’s treatment needs. The CDC guidelines in particular, which were issued earlier this year, recommend the limiting of opioids for chronic pain. They advocate for alternatives, such as pain psychology treatments, cognitive behavioral therapy as being really the primary gold standard approach at this time. Unfortunately, we don’t have the infrastructure in place to appropriately steer patients towards these psychological treatments. Some patients do have the luxury of accessing good pain psychology treatment, but many do not. At this point, there’s a need to invest in the infrastructure, the proper education of clinicians, to ensure that all patients have the access to the treatments that the guidelines promote.

Federal efforts that would facilitate better education are greatly needed. We also need to ensure that there’s good insurance coverage for these treatments that work. And ultimately, we need platforms that will allow clinicians, and also patients, to identify skilled pain psychology practitioners. And I would also say that from a policy perspective, additional funding for pain research is needed so that we can continue to innovate and develop treatments that are focusing on rapid access to targeted treatments. Right now, we don’t have good systems for any of these. So, there are multiple barriers that need to be dismantled.

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