Treating pain in primary care: Optimizing an integrated psychological intervention based on perspectives of psychologists, primary care providers, and patients

Fam Syst Health. 2019 Jun;37(2):120-130. doi: 10.1037/fsh0000416. Epub 2019 May 6.

Abstract

Introduction: Although behavioral health treatment can improve distress and pain functioning for patients with chronic pain, few who are referred by their primary care physician will see a behavioral health specialist. Given the benefits of integrating behavioral health into primary care, this may be an avenue for delivering a psychological intervention for chronic pain. The purpose of this study was to optimize a psychological intervention for patients with chronic pain to be delivered in primary care, utilizing the perspectives of providers and patients.

Method: Psychologists (n = 9), primary care providers (n = 9), and patients with chronic pain (n = 9) participated in separate focus groups. Participants reviewed the proposed 4-session intervention, provided feedback prompted by a set of open-ended questions, and completed a survey.

Results: Statements from focus groups were transcribed and coded into 2 thematic categories: (a) content of the intervention and (b) logistics and design. Participants believed that offering a brief, behavioral intervention for chronic pain in a primary care clinic was feasible and useful. All providers (100%) agreed or strongly agreed that they would refer a patient to this intervention, and 100% of patients agreed or strongly agreed that they would participate.

Discussion: Feedback solicited from the focus groups led to alterations to the treatment manual, such as adding a fifth session, using different psychological strategies, and logistical changes in delivery (i.e., meeting biweekly and intervisit contacts). The modified version of this intervention will be evaluated with a pilot randomized controlled clinical trial. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

MeSH terms

  • Adult
  • Chronic Pain / therapy
  • Delivery of Health Care, Integrated / methods
  • Female
  • Focus Groups / methods
  • Health Personnel / psychology*
  • Humans
  • Male
  • Pain Management / methods*
  • Pain Management / trends
  • Patients / psychology*
  • Primary Health Care / methods
  • Primary Health Care / standards*
  • Psychology
  • Qualitative Research
  • Quality Improvement
  • Quality of Health Care / standards

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