Core competencies for the emerging specialty of pain psychology.

Prasad, Ravi; Ramezani, Amir; Malcore, Sylvia A.; Kerns, Robert D.

doi:10.1037/amp0000330

Cited by 21 publications

(11 citation statements)

References 90 publications

(117 reference statements)

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“…Conversely, chronic pain is known to undermine the effectiveness of treatments for common mental health and substance-use disorders (Bair et al, 2003). These data call for all mental health providers, including psychologists, and almost regardless of the specific focus of their practice, to assess patients for chronic pain and to address the management of chronic pain in their practice (Darnall et al, 2016;Edmond et al, 2019;Wandner et al, 2019).…”

Section: Defining Chronic Painmentioning

confidence: 99%

Psychological Interventions for the Treatment of Chronic Pain in Adults

Driscoll

Edwards

Becker

et al. 2021

Psychol Sci Public Interest

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The high prevalence and societal burden of chronic pain, its undertreatment, and disparities in its management have contributed to the acknowledgment of chronic pain as a serious public-health concern. The concurrent opioid epidemic, and increasing concern about overreliance on opioid therapy despite evidence of limited benefit and serious harms, has heightened attention to this problem. The biopsychosocial model has emerged as the primary conceptual framework for understanding the complex experience of chronic pain and for informing models of care. The prominence of psychological processes as risk and resilience factors in this model has prompted extensive study of psychological treatments designed to alter processes that underlie or significantly contribute to pain, distress, or disability among adults with chronic pain. Cognitive-behavioral therapy is acknowledged to have strong evidence of effectiveness; other psychological approaches, including acceptance and commitment therapy, mindfulness, biofeedback, hypnosis, and emotional-awareness and expression therapy, have also garnered varying degrees of evidence across multiple pain conditions. Mechanistic studies have identified multiple pathways by which these treatments may reduce the intensity and impact of pain. Despite the growing evidence for and appreciation of these approaches, several barriers limit their uptake at the level of organizations, providers, and patients. Innovative methods for delivering psychological interventions and other research, practice, and policy initiatives hold promise for overcoming these barriers. Additional scientific knowledge and practice gaps remain to be addressed to optimize the reach and effectiveness of these interventions, including tailoring to address individual differences, concurrently addressing co-occurring disorders, and incorporating other optimization strategies.

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Section: Defining Chronic Painmentioning

confidence: 99%

Psychological Interventions for the Treatment of Chronic Pain in Adults

Driscoll

Edwards

Becker

et al. 2021

Psychol Sci Public Interest

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“…Health professionals should have sufficient understanding of the biopsychosocial model of pain and how to appropriately assess and refer patients for behavioral health treatment. 252,283 This can be accomplished by improving training and education in pain management 26,284,285 and initiating public campaigns to reduce stigma and enhance public awareness of the biopsychosocial aspects of pain. 286 As noted in other sections of this report, the lack of health insurance coverage for psychological services has also been cited as a significant barrier to adequate pain management (see Section 3.4.2: Insurance Coverage for Complex Management Situations).…”

Section: Access To Psychological Interventionsmentioning

confidence: 99%

Self-Administered Skills-Based Virtual Reality Intervention for Chronic Pain: Randomized Controlled Pilot Study

Darnall¹,

Krishnamurthy²,

Tsuei³

et al. 2020

JMIR Form Res

104

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Background Patients with chronic pain often have limited access to comprehensive care that includes behavioral pain management strategies. Virtual reality (VR) is an immersive technology and emerging digital behavioral pain therapy with analgesic efficacy for acute pain. We found no scientific literature on skills-based VR behavioral programs for chronic pain populations. Objective The primary aim of this study is to evaluate the feasibility of a self-administered VR program that included content and skills informed by evidence-based behavioral treatment for chronic pain. The secondary aim is to determine the preliminary efficacy of the VR program in terms of average pain intensity and pain-related interference with activity, stress, mood, and sleep, and its impact on pain-related cognition and self-efficacy. The tertiary aim was to conduct a randomized controlled trial (RCT) and compare the VR treatment with an audio-only treatment. This comparison isolated the immersive effects of the VR program, thereby informing potential mechanisms of effect. Methods We conducted an RCT involving a web-based convenience sample of adults (N=97) aged 18-75 years with self-reported chronic nonmalignant low back pain or fibromyalgia, with an average pain intensity >4 over the past month and chronic pain duration >6 months. Enrolled participants were randomly assigned to 1 of 2 unblinded treatments: (1) VR: a 21-day, skills-based VR program for chronic pain; and (2) audio: an audio-only version of the 21-day VR program. The analytic data set included participants who completed at least 1 of 8 surveys administered during the intervention period: VR (n=39) and audio (n=35). Results The VR and audio groups launched a total of 1067 and 1048 sessions, respectively. The majority of VR participants (n=19/25, 76%) reported no nausea or motion sickness. High satisfaction ratings were reported for VR (n=24/29, 83%) and audio (n=26/33, 72%). For VR efficacy, symptom improvement over time was found for each pain variable (all P<.001), with results strengthening after 2 weeks. Importantly, significant time×group effects were found in favor of the VR group for average pain intensity (P=.04), pain-related inference with activity (P=.005), sleep (P<.001), mood (P<.001), and stress (P=.003). For pain catastrophizing and pain self-efficacy, we found a significant declining trend for both treatment groups. Conclusions High engagement and satisfaction combined with low levels of adverse effects support the feasibility and acceptability of at-home skills-based VR for chronic pain. A significant reduction in pain outcomes over the course of the 21-day treatment both within the VR group and compared with an audio-only version suggests that VR has the potential to provide enhanced treatment and greater improvement across a range of pain outcomes. These findings provide a foundation for future research on VR behavioral interventions for chronic pain.

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“…While this table is not intended to be exhaustive or comprehensive, nor is it intended to overlook the interdisciplinary collaboration and contribution of other psychosocial PPC team members, it provides a starting point to understand the scope of activities pediatric psychologists involved in PPC are currently providing or are well-equipped to provide, and from which training competencies for PPC may be initially established. Pediatric psychologists in PPC are encouraged to look to subspecialities like pain psychology (Wandner et al, 2019), primary care psychology (McDaniel et al, 2014), and clinical health psychology (France et al, 2008), among others, for methods of competency development and gaining consensus.…”

Section: Professional Competenciesmentioning

confidence: 99%

Introduction to the special issue on palliative care, end-of-life, and bereavement: Integrating psychology into pediatric palliative care.

Thompson¹,

Kentor²

2021

Clinical Practice in Pediatric Psychology

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Objective: While most pediatric palliative care (PPC) teams do not yet routinely include psychology, roles for pediatric psychologists in PPC are expanding. The goals of this Special Issue are to promote awareness of the breadth and depth of PPC, highlight the diverse and growing roles for psychologists as PPC clinicians, scientists, educators, and advocates, and showcase the latest interdisciplinary PPC research. Method: The nine articles in this collection describe key PPC concepts and research approaches, the value of the interdisciplinary team in PPC, the impact of child illness and child loss on caregivers, needs of grieving families, ethical challenges in PPC and at end-of-life, and disparities among underrepresented and historically marginalized populations. Results: The series of articles curated for this Special Issue illustrate the many contributions psychologists offer to the field of PPC. Conclusion: PPC-specific training and development of core competencies are necessary pathways to improve future integration of pediatric psychologists in pediatric care delivery, research, and advocacy. Implications for Impact StatementPsychologists are being increasingly recognized as offering unique and valuable contributions to the field of pediatric palliative care (PPC) as clinicians, researchers, educators, and advocates. This Special Issue has been curated to be helpful to trainees, PPC psychologists, and non-PPC psychologists alike, as well as our interdisciplinary PPC team members, as we strive to further establish our discipline as integral to the PPC field.

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Core competencies for the emerging specialty of pain psychology.

Cited by 21 publications

References 90 publications

Psychological Interventions for the Treatment of Chronic Pain in Adults

Psychological Interventions for the Treatment of Chronic Pain in Adults

Self-Administered Skills-Based Virtual Reality Intervention for Chronic Pain: Randomized Controlled Pilot Study

Introduction to the special issue on palliative care, end-of-life, and bereavement: Integrating psychology into pediatric palliative care.

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