Assessment of Chronic Pain in Rehabilitation: Outcomes Measures in Clinical Trials and Clinical Practice.

Objective: Chronic pain, or pain that lasts for months or even years, is prevalent among patients in rehabilitation settings, and treatment is costly. People with chronic pain often suffer physical limitations and emotional distress. As new treatments become available and clinical trials are initiated, it is important to measure outcomes in an effort to determine the efficacy of treatment interventions. This article provides a review of the core domains of outcomes assessment among people with chronic pain, including recommendations for outcome measures to be used in clinical trials and clinical practice settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cluster Analysis and Chronic Pain: An Empirical Classification of Pain Subgroups in a Spinal Cord Injury Sample.

Objective: To determine the existence of homogeneous spinal cord injury (SCI) pain subgroups. Design: Prospective longitudinal design. Participants: Persons with traumatic onset SCI (N = 1,334) with self-reported pain, pain interference, and depression. Outcome Measures: Pain (Numerical Rating Scale); pain interference (item from the Short Form-12); and depression (Brief Patient Health Questionnaire). Results: Multivariate clustering revealed 4 SCI pain subgroups: low pain (low pain intensity, pain interference, and depression); positive adaptation to pain (high pain intensity, low pain interference and depression); minimal distress (high pain intensity, high pain interference, and low depression); and chronic pain syndrome (high pain intensity, pain interference, and depression). Conclusions: The characteristics of homogeneous SCI pain subgroups may be important for clinicians to consider in treatment planning and research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessing the Costs, Benefits, Cost-Benefit Ratio, and Cost-Effectiveness of Marital and Family Treatments: Why We Should and How We Can.

The vast majority of outcome studies examining the effects of marital and family treatments focus exclusively on indicators of and changes in familial functioning and individual members' psychosocial adjustment, but fail to measure, report, or analyze treatment costs, benefits, cost-benefit ratio, or cost-effectiveness. Because of growing concerns about spiraling health care costs, clinical and economic outcomes constitute equally important and complementary aspects of any evaluation of marital and family treatments. The twofold purpose of this article is to define different components of cost analyses of health-related interventions, including marital and family treatments, and to describe methods for calculating and integrating clinical and cost outcome information when evaluating marital and family treatments. There are significant opportunities to promote the use of such treatments by conducting and reporting the results of cost analyses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Review of the Role of Religion and Spirituality in Chronic Pain Populations.

Objective: To review the current literature on the relation between religiosity-spirituality and health outcomes in chronic pain populations, to discuss the clinical implications of this research, and to provide suggestions for future studies. Conclusions: Additional religion-spirituality research and clinical intervention with chronic pain populations is warranted for several reasons. First, many persons with chronic pain use religious and spiritual beliefs and activities to cope with pain. Second, a relation between religion-spirituality and various health outcomes has been documented. Third, there is a lack of research on potential mediators of the relation between religion-spirituality and health in chronic pain populations. Fourth, well-designed spiritual or religious behavioral interventions for patients with chronic pain are sparse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pharmacological Management of Chronic Pain: I. Fibromyalgia and Neuropathic Pain.

This brief review surveys pharmacotherapy for some of the most common forms of chronic pain: musculoskeletal pain and neuropathic pain. Head pain is among the most common types of chronic pain, but will be discussed in a separate column. Because the extensive pharmacopoeia for pain cannot be distilled into a brief article, this summary focuses only on psychotropic agents used in the management of chronic pain. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Testing a Model of Pain Appraisal and Coping in Children With Chronic Abdominal Pain.

This prospective study of children with recurrent abdominal pain (N=133; ages 8-15 years) used path analysis to examine relations among dispositional pain beliefs and coping styles, cognitions and behavior related to a specific pain episode, and short- and long-term outcomes. Children believing they could not reduce or accept pain appraised their episode-specific coping ability as low and reported passive coping behavior. Dispositional passive coping had direct effects on both episode-specific passive coping and long-term symptoms and disability. Accommodative coping (acceptance and self-encouragement) was associated with reduced episode-specific distress, which itself predicted reduced depressive symptoms 3 months later. Results suggest that coping-skill interventions for children with chronic pain should target reductions in passive coping and consider the potential benefits of accommodative coping strategies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Feasibility of a Cognitive Restructuring Intervention for Treatment of Chronic Pain in Persons With Disabilities.

Objective: To determine the feasibility of a cognitive restructuring intervention relative to an education intervention for treatment of pain in persons with chronic pain secondary to disability. Study Design: Quasi-experimental. Participants: 18 adults with chronic pain and disability. Interventions: Cognitive restructuring (n = 13) or education (n = 5) group intervention. Main Outcome Measure: Average pain intensity. Results: Participants in the cognitive group reported greater pre- to posttreatment decreases in pain than those in the education group. Participants rated both interventions positively and expressed enthusiasm for psychosocial interventions for pain. Conclusions: Preliminary findings suggest that decreases in pain can occur as a result of a cognitive restructuring intervention and support the feasibility of conducting intervention trials in persons with disability-related chronic pain. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Seventeen years later: Clinical psychology in light of the 1947 Committee on Training in Clinical Psychology Report.

"Clinical psychology is both a basic and an applied area. Because of the undeveloped state of both psychology and clinical psychology, research is by far the most important responsibility of the clinical psychologist. The university has primary responsibility for integrating training in both the basic and the applied areas. The private practice of clinical psychology is of minor importance. It should be restricted." Clinical psychology "is important both because of the contribution it has made and is making to basic psychology, and because of the potential social significance of its practical contribution." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

APA-Approved Doctoral Programs in Clinical, Counseling, and School Psychology: 1976.

The American Psychological Association Committee on Accreditation has approved the doctoral training programs in clinical, counseling, and school psychology that are conducted by the institutions listed below. In the institutions listed, the approved programs are directed by the department of psychology unless otherwise indicated. Programs that have not requested evaluation, and programs that have been evaluated but not approved, are not included in the list. Inclusion of an institution in this list indicates approval of doctoral programs in clinical, counseling, and school psychology only. Inclusion or noninclusion carries no implications for other graduate programs in psychology or for programs of graduate education in other disciplines. The institutions listed below have been reported to the U.S. Public Health Service, to the Veterans Administration, and to the Surgeon General's Office, Department of the Army, as conducting at the present time approved programs of doctoral training in the areas indicated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Implications of 'Psychological Injuries' for Clinical Psychology Training Programs.

This paper uses the psychological and legal concept of "psychological injury" as an illustration of the evolving market for psychological knowledge and of necessary changes in the graduate and internship training of clinical psychologists. Our current graduate and internship training fails many of our students through neglecting important areas of knowledge and experience. In this paper, I discuss the importance of exposing graduate students to: a) the economics of mental health; b) professional roles involving knowledge dissemination outside traditional academia; c) information needs of direct and indirect consumers of psychological knowledge; and, d) communication skills necessary when interacting with nonpsychologists. Suggestions are made for the improvement of our graduate training programs, including more explicit acknowledgement of the likely career paths of most of our graduates. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Group Therapy for Students in Clinical Psychology.

It has been the experience of six graduate students in clinical psychology at the Florida State University that the adage "Physician, heal thyself might profitably be amended to "Psychologists, heal each other." Inasmuch as a psychotherapeutic group composed of clinical psychologists is rather unique, the writer feels that his group's experiences may facilitate the formation of similar groups. Some of the salient topics and issues addressed here include the attempt to acquire a group leader, secrecy, the admission of new members, the members' psychological sophistication, and the cross currents of interpersonal relations. The writer feels that perhaps this therapy group's greatest contribution relates to the generally accepted opinion that a healthy therapist is a desideratum. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Positive Affect as a Source of Resilience for Women in Chronic Pain.

A sample of 124 women with osteoarthritis or fibromyalgia, or both, completed initial assessments for demographic data, health status, and personality traits and 10-12 weekly interviews regarding pain, stress, negative affect, and positive affect. Multilevel modeling analyses indicated that weekly elevations of pain and stress predicted increases in negative affect. Both higher weekly positive affect as well as greater positive affect on average resulted in lower negative affect both directly and in interaction with pain and stress. Finally, increases in weekly negative affect and higher average negative affect related to greater levels of pain in subsequent weeks. In contrast, higher levels of overall positive affect predicted lower levels of pain in subsequent weeks. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Some Considerations Regarding the Application Process for Clinical Psychology Internships.

Discusses the application process for clinical psychology internships, focusing particularly on the areas of applications, interviews and notification. The authors offer suggestions to address problems with these areas of the application process. Regarding applications, devising a standard application form to be used by all programs would alleviate much of the burden students must now handle. An ethical code needs to be drawn up defining appropriate interviewing procedure and conduct. The solution for the difficulties involved in notification is the implementation of a computerized matching program, such as that used for medical internships. The authors suggest that these are major changes and would require much effort and expense to actualize, but they sincerely feel they would greatly improve the application procedure, making it both more efficient and less painful. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personality Evaluation in the Selection of Graduate Students in Clinical Psychology.

Examined the opinions of clinical psychologists regarding the selection of graduate clinical students to include some type of formal personality evaluation, in addition to the usual academic considerations. In view of the strong feelings often expressed on both sides of this question, it was felt that a questionnaire sampling the opinions of clinical psychologists regarding it would be of professional interest and possibly of some assistance to graduate departments attempting to cope with the problem.. Brief questionnaires were sent to a randomly selected sample of 100 members of Division 12 (Clinical) of the APA. In reply to the question: "Should a formal personality evaluation be used as a criterion for selecting applicants for graduate study in clinical psychology?" 84% of those responding checked "Yes," and 16% checked "No." In assessing how extensive such an evaluation should be, the following alternatives or combinations of them were provided: thorough personality analysis, screening for obvious handicapping problems, and screening for possession of professionally "desirable" characteristics. 20% selected the first alternative, 27% chose the second, 11% checked the third, 27% combined the second and third, 2% marked the first and third, 4% indicated all three, and 9% did not reply to this question. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological Treatments for Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis.

This study conducted a systematic review to assess the quality of existing literature on psychological treatments for irritable bowel syndrome and to quantify the evidence for their efficacy. Three independent reviewers (2 from England, 1 from the United States) coded the quality of 32 studies, 17 of which provided data suitable for meta-analysis. Meta-analysis of efficacy data (50% reduction of symptoms) gave an odds ratio of 12 (95% confidence interval = 5.56-25.96) and a number needed to treat of 2. Psychological treatments are, as a class of interventions, effective in reducing symptoms compared with a pooled group of control conditions. Questions regarding the relative superiority of specific psychological treatments and influence of active versus nonspecific treatment effects remain unanswered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

It's time to Rework the Blueprints: Building a Science for Clinical Psychology.

The aims in this article are to connect the conceptual structure of clinical psychological science to what the author believes to be the omnipresent principles of evolution, use the evolutionary model to create a deductively derived clinical theory and taxonomy, link the theory and taxonomy to comprehensive and integrated approaches to assessment, and outline a framework for an integrative synergistic model of psychotherapy. These foundations also provide a framework for a systematic approach to the subject realms of personology and psychopathology. Exploring nature's deep principles, the model revives the personologic concept christened by Henry Murray some 65 years ago; it also parallels the interface between human social functioning and evolutionary biology proposed by Edward Wilson in his concept of sociobiology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychology in the Schools, School Psychology Review, School Psychology Quarterly and Journal of Educational and Psychological Consultation Editors Collaborate to Chart School Psychology's Past, Present, and "Futures".

This introduction will briefly describe the special journal issues that will be offered in Psychology in the Schools (PITS), School Psychology issues Review (SPR), School Psychology Quarterly (SPQ), and Journal of Educational and Psychological Consultation (JEPC) on topics related to the conference. For almost a half-century, students in school psychology have investigated the "Boulder" and "Thayer" conferences, studying and exploring our foundation as scientist-practitioners and brooding over the "school" in school psychology. In a notable alliance, SPR and SPQ are publishing the proceedings of the conference jointly. As part of the School Psychology Futures Conference: Special Journal Issues se- series, Psychology in the Schools will publish a special issue entitled: Shortage of ries, School Psychologists in the April 2004 issue. School psychology quarterly will also be sponsoring a special issue addressing the faculty shortage in school psychology and related difficulties. Consultation emerged as a major thread throughout the School Psychology Futures Conference as participants brainstormed problems and solutions to meet the critical issues faced by school professionals as they work towards improving educational and mental health outcomes for children and families. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

APA-Approved Internships for Doctoral Training in Clinical and Counseling Psychology: 1976.

The American Psychological Association Committee on Accreditation has approved for doctoral training in professional psychology the internships offered by the agencies listed below. The criteria for evaluating these programs can be obtained from the Educational Affairs Office. The current criteria for accreditation of internship training programs no longer make the distinction between clinical and counseling internship programs; therefore, the separate listing of approved programs by professional specialty has been dropped. Readers desiring information on training goals offered at specific agencies are encouraged to write directly to the agencies. Each of the agencies listed has met the same qualitative standards with respect to adequacy of training. The list is alphabetical by agencies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)