Overview of psychological techniques

Psychological techniques are a first-line pain management strategy. Depending on the relative contribution of psychological and social factors to the pain–disability cycle, psychological techniques may be the primary intervention. It is essential that healthcare providers understand how psychological factors can influence a patient’s experience and management of pain, so they can help the individual address them effectively.

Psychological techniques are an important component of acute and chronic pain management. For acute pain, psychological intervention can assist with treatment adherence, management of painful procedures, early discharge and reduced analgesic use. For chronic pain, psychological intervention is a first-line management strategy that may improve function, quality of life, treatment adherence, mood.

Explain to patients the difference between nociception and pain, and how pain can be influenced by psychosocial factors; see Understanding pain. Encourage patients to use psychological techniques to improve their overall functioning, mood and quality of life, thereby reducing distress and disability.

All healthcare professionals can provide basic psychological techniques (eg active listening, targeted reassurance, expectation management). Formal psychological interventions (eg cognitive behavioural therapy, acceptance and commitment therapy) can be provided by psychologists when basic psychological techniques alone do not adequately benefit the patient; see When to refer to a psychologist.

Tailor psychological techniques to the needs of the individual. For example, it may be necessary to modify the intervention for people with communication difficulties or cognitive impairment. Other patient groups (eg people with psychiatric or substance-use disorders) may require specialist input before psychological techniques can be used for pain management.