Margaret and her mother are seen by a psychologist to discuss coping strategies that could help Margaret tolerate her pain more effectively.
Non-Core Biopsychosocial Principles
Psychosocial Assessment
- Understand context of Margaret’s pain symptoms in order to guide treatment recommendations that fit best for her
- Identify non-invasive strategies that may help her cope with the pain
- Determine if there is significant psychopathology or other barriers that could complicate her course
- Offer opportunities for normalization and support to Margaret and her family
How Has the Pain Affected Margaret’s Functioning?
What we know so far:
- Good student
- Plays basketball
- Many friends
- Family history of anxiety
- Since the onset of pain, she reports:
- Difficulty concentrating at school
- Trouble eating and weight loss
- Social withdrawal
- Significant worry
Margaret and Her Mother Meet with the Psychologist
Confirm Absence of Significant Psychopathology
Rule out significant mental health concerns such as:
- Suicidal ideation
- Panic attacks
- Inability to attend school or complete school work
- Significant impairment of sleep or appetite
- Abuse of alcohol, street drugs, or prescribed
- opioids to cope with distress
Coping Skills
What coping skills and resources does Margaret already have in place?
- Assess and reinforce current coping skills
- Take medication
- Distraction (watching television)
- Assess and reinforce family and peer social support
- Mom
- Friends
- Determine if she has attempted any psychological approaches to pain management and her openness to trying them
Margaret Discusses Coping Skills with Her Psychologist
Psychosocial Assessment of Family Members
- Acknowledge that Margaret’s chronic pain affects the entire family
- Assess for related stressors and concerns that may be present
- Provide support and problem solve with family members regarding issues that may interfere with pain treatment
Assessment of Family By Psychologist
Pain Management Strategies
There are many pain management strategies that have been demonstrated to help improve function and reduce pain interference, including:
- Relaxation exercises such as diaphragmatic breathing, progressive muscle relaxation, guided imagery, and autogenic training
- Identifying and managing triggers of pain
- Increasing communication skills and socialization
- Pacing activities
- Improving sleep
- Exercise
- Thinking constructively
Relaxation Exercises
- Reduce tension to reduce both pain and anxiety
- Diaphragmatic breathing can induce feelings of calm and relaxation
- Progressive muscle relaxation teaches how to actively reduce muscle tension
- Mastering techniques typically requires personalized instruction with specific guidance/regular practice
The Psychologist Discusses Pain Management Strategies
Summary
- Psychosocial assessment of chronic pain
- Allows for better patient-centered, contextualized care
- Facilitates identification of suitable pain, management options
- Psychological pain management strategies offer non-invasive, effective treatment options
