AAPM Task Force: Enhanced Pain Psychology Training Needed for Psychologists

PALM SPRINGS, Calif. — There may be a need for a major transformation in the way psychologists, psychology predoctoral students, and psychology postdoctoral students are educated in treating pain.

“I do not know why pain psychology is not part of the American Psychiatric Association (APA), but I speculate that it has long been folded under the purview of Health Psychology,” Beth Darnall, PhD, American Association of Pain Medicine (AAPM) Psychology Task Force co-chair and clinical associate professor in the division of pain medicine at Stanford University told Clinical Pain Advisor. “With the enormous national need for a direct focus on pain, it’s time for it to become a subspecialty in its own right.”

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This pain psychology needs assessment, conducted by Dr Darnall and colleagues, was the first high-level needs assessment for pain psychology services and resources in the United States.

Dr Darnall; Judith Scheman, PhD, AAPM Psychology Task Force co-chair from the Center for Neurological Restoration at the Cleveland Clinic;and Sara Davin, PhD, AAPM Pain Psychology Task Force Member from the Center for Neurological Restoration at the Cleveland Clinic, presented their findings this week at AAPM’s annual conference. Their report was published in Pain Medicine. 

For their assessment, the researchers administered brief online surveys to 6 groups: psychologists and therapists, individuals with chronic pain, pain physicians, primary care physicians and physician assistants, nurse practitioners, and directors of graduate and postgraduate psychology training programs. They received 1991 responses.

From the survey responses, the researchers found that:

• Psychologists and therapists expressed low confidence and low perceived competency in addressing physical pain, and expressed high interest in pain education and the need for pain education.
• Across stakeholder groups, there was broad support for pain psychology, and there was global support for a national initiative to increase pain training and competency in US therapists.
• Directors of graduate and postgraduate psychology training programs expressed unanimous interest in a no-cost pain psychology curriculum that could be integrated into existing programs.
• Primary care physicians, physician assistants, and nurse practitioners cited poor insurance coverage and not enough specialty pain psychologists as the biggest barriers to accessing psychologists with expertise in pain.
• Individuals with chronic pain cited lack of knowledge about psychological pain treatment and lack of a clear pathway to identifying a psychologist qualified to treat pain as the main barriers to accessing psychologists with expertise in pain.
• The researchers noted that 20% of individuals with chronic pain cited poor insurance coverage as a barrier to accessing psychologists with expertise in pain, and that it is possible that percentage would have been higher if knowledge about pain psychology had been greater.

According to the authors, these results demonstrate “a clear need … for enhanced pain psychology training for the psychologists and therapists who treat the estimated one-third of Americans living with pain.”