Less Pain, More Gain: Expanding Psychological Treatments for Chronic Pain

Many Americans, especially older ones, seek ways to manage their chronic pain. An article in a recent issue of Psychological Science in the Public Interest called for greater emphasis on psychological treatments for chronic pain as a first line of treatment. This approach contrasts with the view that anything other than biomedicwal treatment is merely an alternative treatment.

One step toward making this change is to address how the public views psychological interventions, such as cognitive-behavior therapy. Most patients currently perceive these treatments as ways to learn to cope with pain rather than to reduce pain. However, cognitive-behavior therapy can in fact reduce pain intensity, and sometimes more effectively than medication.

Another step is to address barriers to access. In-person care may be difficult for older adults, particularly for those without transportation or with mobility limitations. As demonstrated by the recent increase in virtual care sessions during the pandemic, access can be improved even for homebound older adults. Expanding this treatment delivery method and developing a consistent process across care providers can potentially help improve quality of life for many older adults.

Cognitive-behavior therapy effectively reduces chronic pain, regardless of how many sessions are attended. Although multi-session cognitive-behavior therapy is regarded as the strongest treatment, not all patients may be interested in or have time for this type of treatment. Expanding single-session treatments and offering them virtually may be helpful to those who would otherwise turn to pain medication. The article even suggests that “digiceuticals”—the digital health tool equivalent of pharmaceuticals—may be the future of chronic pain management.

While the opioid epidemic has highlighted the benefits of moving away from medication-based treatments, the article emphasizes that psychological treatments will not always be able to take the place of opioid treatment. It isn’t a “one or the other” situation; instead, there are multiple options for treatment and the focus must remain on person-centered care. To reach this point, however, it is important to expand access to psychological treatments like cognitive-behavior therapy for chronic pain.

 

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Source:

Darnall BD. Psychological treatment for chronic pain: Improving access and integration. Psychological Science in the Public Interest. 2021;22(2):45-51.

 

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