Pain is an unfortunate daily experience for many individuals. Chronic pain -- lasting six or more months -- is suffered by approximately 30% of the population in the United States. These individuals wake up, function during the day and go to sleep, trying to keep pain at a minimum while, at the same time, maintaining some quality of life. They may make frequent visits to the doctor and the pharmacy. When they find relief, it is usually short-lived and comes at a cost such as dependence on narcotic medications or complete limitation of activity. Pain often becomes the central point of their existence. This practice guide describes an approach to psychological evaluation of the chronic pain patient who is being considered for surgery. A large body of research is accumulating which demonstrates that the outcome of surgical procedures aimed at chronic pain relief can be strongly influenced by psychological and emotional factors. This approach, termed "presurgical psychological screening" (PPS) uses interview and testing techniques to identify emotional, behavioral, and psychosocial difficulties which have been demonstrated to negatively impact surgical outcome. Studies show that even patients with clearly identifiable pathophysiology may respond poorly to surgery, due to issues such as pain sensitivity, medication dependence, rewards for pain behavior and personality style. Thus, some insurance carriers, rehabilitation nurses and state worker's compensation systems are encouraging, or even requiring, presurgical psychological screening in cases of surgery designed to relieve chronic pain. The first to present a comprehensive, unified approach to PPS in chronic pain syndromes, this text is designed to provide the behavioral health practitioner, as well as the trainee, with all the tools and information necessary to conduct PPS evaluations. It identifies a multitude of risk factors for poor surgical outcome and reviews research associated with each risk factor. Hands-on techniques for eliciting information from the patient about risk factors is also detailed. Toward this end, the practice guide also contains a number of forms and session outlines which can be directly utilized, or which can be altered to fit readers' needs. Models for weighing and combining surgical outcome risk factors are also provided. Thus, practitioners are able to reach valid and reliable predictions of surgical results. Finally, the text provides outlines of psychological interventions which can facilitate surgical outcome as well as surgical treatment alternatives. Upon completion of this practice guide, readers should be able to begin providing PPS evaluations which are scientifically valid, clinically sound, and which result in significant overall improvement in the treatment of chronic pain syndromes.

The success of many surgical procedures depends not only on the skill of the surgeon and the use of state-of-the-art technology, but also on the actions and characteristics of the patient. Patients' emotional and psychosocial concerns, health-related behaviours, outcome expectations, and compliance with treatment regimen can all strongly influence the ultimate effectiveness of surgery. Thus, mental health professionals are increasingly called upon to perform presurgical psychological screening (PPS) to ensure that patients are given the treatments most likely to be effective, while reducing the chances of worsening their conditions. This book presents PPS procedures for a wide range of surgery types, such as spinal surgery, organ transplantation, bariatric surgery, and plastic surgery. Drawing on both research and clinical experience, the authors explain how to conduct PPS, communicate results to patients and surgeons, and identify possible pre- or post-surgery interventions to mitigate risk factors and maximise the likelihood of surgical success. Case studies and a discussion of bioethics are included

Although there are now proven behavioral and psychological methods of dealing with and alleviating chronic pain, methods that can supplement or replace drug treatments, these are not always applied in clinical practice. This volume in the series, Advances in Psychotherapy -- Evidence-Based Practice, provides psychological and medical therapists (and students) with practical and evidence-based guidance on diagnosis and treatment of chronic pain, and does so in a uniquely "reader-friendly" manner. The book is both a compact "how-to" reference, for use by professional clinicians in their daily work, as well as an ideal educational resource for students and for practice-oriented continuing education.

Since the original publication of this landmark volume, tremendous advances have been made in understanding and managing psychological factors in pain. This revised and greatly expanded second edition now brings the field fully up to date. Designed for maximum clinical utility, the text shows how to tailor psychological treatment programs to patients suffering from a wide range of pain problems. Conceptual and diagnostic issues are discussed, widely used clinical models reviewed, and a framework presented for integrating psychological treatment with medical and surgical interventions. The second edition has been augmented with detailed case material and the latest treatment outcomes data. Thirteen entirely new chapters provide coverage of specific pain syndromes and disorders, as well as interventions for pain-related fear and preparing patients for implantable technologies.

This multidisciplinary volume provides the latest information on the role of psychosocial factors in chronic, acute, and recurrent pain. Reporting on significant advances in our understanding of all aspects of pain, the volume is designed to help practitioners, students, and researchers in a wide range of health care disciplines think more comprehensively about the etiologies, assessment, and management of this prevalent--and debilitating--symptom. Chapters from leading clinical investigators address many of the most frequently encountered pain syndromes, focusing on the interplay of somatic and psychosocial factors in the experience, maintenance, and exacerbation of pain. Issues related to evaluation, prevention, and management are explored in depth, with coverage of such topics as the role of pain management in primary care settings, the prediction of responses to pain and responses to treatment, and the influence of gender.

Pain syndromes involve a complex interaction of medical and psychological factors. In each syndrome unique physiological mechanisms are mediated by emotional states, personality traits, and environmental pressures to determine the nature and extent of pain complaints and pain-related disability. The Handbook addresses the complexities of chronic pain in three ways. Section I describes general concerns that cross-cut the different syndromes, such as the use of narcotic pain medications, the detection of deception and malingering, and the epidemiology of pain. Section II presents comprehensive reviews of a wide range of pain syndromes. Each covers basic pathophysiology, psychological factors found to influence the course of the syndrome, and syndrome-specific multidisciplinary treatment approaches. Most of the Section II chapters are coauthored by psychologists and physicians. Section III discusses pain in special populations, including the elderly and children. The Handbook is the most up-to-date, comprehensive, and integrated single-volume resource for all those professionally concerned with pain.

"Chronic Pain: An Integrated Biobehavioral Approach...offers in a single volume the most comprehensive and in-depth view of the field currently available. Drs. Flor and Turk share their collective knowledge and professional insights accumulated over three decades of extraordinary contributions to the field....The first section of the volume provides an up-to-date and highly digestible review of the foundational principles of the multidimensional experience of chronic pain and is followed by two sections on clinical assessment and treatment, concluding with a glimpse at future innovations in pain care. These later sections are simply extraordinary in integrating theory, science, and practical information that will be equally useful to novice and experienced clinicians, investigators, and policy makers." — From the Foreword by Robert D. Kerns, PhD This book integrates current psychological understanding with biomedical knowledge about chronic pain. With an emphasis on psychological factors associated with chronic pain states, this volume includes recommendations for a structured assessment plan. Using detailed treatment protocols and case examples, the authors aim to guide clinicians in developing effective individualized treatments for their chronic pain patients. The accompanying online ancillary content includes 65 appendices of sample documents and worksheets featuring detailed assessment methods and treatment protocols for use by health care professionals. Chronic Pain: An Integrated Biobehavioral Approach is essential reading for: Clinicians who treat chronic pain patients Clinical psychologists Students studying medicine, psychology, psychophysiology, and behavioral medicine Social workers Nurses Clinical investigators All those interested in the treatment of chronic pain