The American psychologist
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The American psychologist · Feb 2014
ReviewHypnotic approaches for chronic pain management: clinical implications of recent research findings.
The empirical support for hypnosis for chronic pain management has flourished over the past two decades. Clinical trials show that hypnosis is effective for reducing chronic pain, although outcomes vary between individuals. ⋯ Neurophysiological studies reveal that hypnotic analgesia has clear effects on brain and spinal-cord functioning that differ as a function of the specific hypnotic suggestions made, providing further evidence for the specific effects of hypnosis. The research results have important implications for how clinicians can help their clients experience maximum benefits from hypnosis and treatments that include hypnotic components.
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The American psychologist · Feb 2014
ReviewAcceptance and commitment therapy and mindfulness for chronic pain: model, process, and progress.
Over 30 years ago, treatments based broadly within cognitive behavioral therapy (CBT) began a rise in prominence that eventually culminated in their widespread adoption in chronic pain treatment settings. Research into CBT has proliferated and continues today, addressing questions very similar to those addressed at the start of this enterprise. However, just as it is designed to do, the process of conducting research and analyzing evidence reveals gaps in our understanding of and shortcomings within this treatment approach. ⋯ This article reviews the progress of CBT in the treatment of chronic pain and the challenges now faced by researchers and clinicians interested in meeting this need for development. It then focuses in greater detail on areas of development within CBT, namely acceptance and commitment therapy (ACT) and mindfulness-based approaches, areas that may hold potential for future progress. Three specific recommendations are offered here to achieve this progress.
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The American psychologist · Feb 2014
ReviewInterdisciplinary chronic pain management: past, present, and future.
Chronic pain is a significant and costly problem in the United States as well as throughout the industrialized world. Unfortunately, there have been concerns about the effectiveness of traditional medical interventions, suggesting the need for alternative chronic pain treatment strategies. ⋯ In the present article we briefly review the history of pain management, discuss the major components of a "true" interdisciplinary pain management program, focus on the evidence-based outcomes that have documented the effectiveness of such interdisciplinary pain management programs, and note the barriers that have blocked the wider use of such programs. Finally, we discuss future directions in interdisciplinary pain management.
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The American psychologist · Feb 2014
ReviewCognitive-behavioral therapy for individuals with chronic pain: efficacy, innovations, and directions for research.
Over the past three decades, cognitive-behavioral therapy (CBT) has become a first-line psychosocial treatment for individuals with chronic pain. Evidence for efficacy in improving pain and pain-related problems across a wide spectrum of chronic pain syndromes has come from multiple randomized controlled trials. ⋯ Innovations in CBT delivery formats (e.g., Web-based, telephone-delivered) and treatments based on CBT principles that are delivered by health professionals other than psychologists show promise for chronic pain problems. This article reviews (a) the evidence base for CBT as applied to chronic pain, (b) recent innovations in target populations and delivery methods that expand the application of CBT to underserved populations, (c) current limitations and knowledge gaps, and (d) promising directions for improving CBT efficacy and access for people living with chronic pain.
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The American psychologist · Feb 2014
ReviewRacial/ethnic disparities in the assessment and treatment of pain: psychosocial perspectives.
Racial/ethnic disparities not only are prevalent throughout the U. S. health care system but also have proved refractory to change. Such disparities are evident and similarly persistent in the treatment of patients with chronic pain conditions, exacting high personal and societal costs. ⋯ After each section, we suggest actions that could address identified issues related to clinical care, research, and policy. Policy recommendations generally are linked to provisions of the Affordable Care Act. We conclude with a discussion of the role that psychology should play in future efforts to address the persistent problem of racial/ethnic disparities in pain care.