Pain management is like a 3-legged stool—interventions, medications, and psychological education and counseling. Without all 3 legs, the stool will fall.
When I first began work in the field of pain psychology, I wanted to be as helpful as I could be to my patients and to be seen as fully prepared and competent by my referral sources. However, as I began to read books and attend conferences “to get up to speed,” I was overwhelmed by the variety of services and offerings that experienced practitioners offered. Along with ever-present traditional cognitive-behavioral psychotherapy, I also learned about a variety of other interventions: progressive muscle relaxation; guided imagery; hypnosis; technology-assisted treatments such as virtual reality; activity pacing; sleep hygiene; patient education; psychodynamic psychotherapy; interpersonal therapy; assertiveness training; family therapy; desensitization. … The list went on and on.
When I traveled to pain conferences to learn new skills, I had trouble deciding which sessions to attend. I had no plan or schema to organize my training or my psychology services. I also did not have unlimited resources to attend every conference and learn every possible pain intervention technique.
After several years of clinical practice (it’s been 16 years now), I began to construct a schema to help organize where to start—where I should start in my continuing education and where I should start with my patients when they presented for therapy. I have presented this schema at professional meetings a few times and others tell me they have found it helpful. The following is a summary of my experience.