“I believe there are a few key reasons that contribute to the lack of pain training for therapist and psychologists,” Dr Darnall told Clinical Pain Advisor. “First, there is a tendency to view pain as a medical issue that should be treated medically.  Often, psychology is sought for ‘coping’ with the medical issue of pain. In truth, regardless of one’s medical diagnosis, psychological factors directly modulate pain processing and are primary treatment. But most people who are not pain specialists do not know this.”

The researchers also found that 30% of medical providers identified patients’ reluctance to see a psychologist as a major barrier in accessing a psychologist for pain. “It is not known whether such reluctance is the due to financial burden, lack of confidence in a psychological approach to pain management, or other reasons,” the authors wrote.

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Dr Darnall noted that physicians can work to change the stigma of using a psychological approach for treating pain.

“We need [to] begin speaking a common language about pain, and have a unified view and treatment approach that includes psychology as a primary aspect of pain care, not just the ‘last resort’ when medical treatments fail,” she said. “The latter leaves patients feeling stigmatized when medicine fails them, and in most of these cases their pain has never been treated comprehensively — that is not their fault. That said, we must better train therapists and psychologists so that they are equipped to treat the pain referrals that are sent to them.”

Dr Darnall added that “it took the ‘opioid crisis’ and the ‘pain crisis’ to begin to illuminate the focal role of psychology in the experience of pain. With better pain education for all clinicians at all levels of training, pain will be best addressed and patients empowered to help themselves as a key aspect of their care plan.”

Reference

Darnall BD, Scheman J, Davin S, et al. Pain Psychology: A Global Needs Assessment and National Call to Action. Pain Med. 2016; doi:10.1093/pm/pnv095.