The supervising physician or psychologist can consult on difficult cases or to resolve impasses in treatment. Provide a menu of choices for the patient. Patients cooperate better with treatment protocols when they play a role in choosing their protocol. Discussing options from which the patient can choose increases the patient s sense of ownership and commitment to the treatment plan. Understand the patient s thinking about his or her disorder.
Patients frequently have unarticulated, unexpressed theories of their disorders.
Without understanding the patient s private explanation for the chronic pain syndrome, the healthcare professional and patient may end up working at cross-purposes. During the initial phase of treatment, the psychologist should carefully assess any preexisting psychological or interpersonal problems that contribute to or are aggravated by the chronic pain syndrome. For example, a family history is often useful for assessing how both the marital family and the family of origin have dealt with similar illnesses in the past. Certain preexisting psychological problems such as a history of depression or anxiety disorders can be aggravated by the experience of chronic pain, and a careful history regarding these matters should be taken. Finally, the presence of a personal injury lawsuit or disability claim can be a complicating factor in treatment, slowing recovery by presenting incentives to remain ill.