Pain Psychology and the Biopsychosocial Model of Pain Treatment: Ethical Imperatives and Social Responsibility.

Abstract

Worldwide, the need for more effective treatment for pain has steadily gained recognition as the cornerstone of patient-centered care. Nationally, the Institute of Medicine’s (now Academy) report on Relieving Pain in America [1] and the National Pain Strategy [2] both specify a need to treat pain comprehensively, and to better educate clinicians across disciplines as to the importance of multidisciplinary pain care. Despite the psyche’s integral role in the experience of pain, few individuals or professionals are aware that pain is defined as an aversive “sensory and emotional experience,” [3] and even fewer understand how to address the emotional aspects of the pain experience. We underscore the ethical imperative to orient students, the public, medical care providers, and mental health professionals to the integral role of psychological factors in the experience of pain. In doing so, we hope to have the opportunity to steer the health of the population toward more effective treatment for pain. Anecdotally, pain specialists and many primary care providers have long experienced difficulty referring individuals with chronic pain to psychologists skilled in pain treatment, or to therapists who address pain in the psychotherapeutic context. In part, the difficulty was attributed to a lack of health care insurance coverage for psychological services, or to strict limitations in coverage that rendered treatment insufficient and ineffective. Enactment of the Mental Health Parity Act, an aspect of the Patient Protection and Affordable Care Act [4], has led to improvements but barriers persist …