Introduction

Pain is a multidimensional symptom to which there are many contributors. Nociception is perceived by an individual and then expressed. Psychosocial factors such as somatization, anxiety, depression, and intrapsychic and cultural beliefs influence the perception and expression of pain. Psychological interventions are both important and helpful in the management of pain.

Currently, many comprehensive cancer treatment centers include psychological intervention as an integral part of an interdisciplinary treatment plan to address pain and pain-related problems (1). At less comprehensive cancer clinics and hospitals, there is a growing appreciation of the important interaction between biomedical and psychosocial variables. This chapter reviews assessment of the most relevant psychosocial variables and then focuses on the major psychological interventions.

Although the research literature on psychological interventions for individuals with cancer pain is relatively young, a number of different treatments have been used. The main treatments include cognitive-behavioral, psychoeducational, and supportive therapies. To maximize therapeutic effectiveness, psychological research protocols and clinical practices often combine aspects of each of these types of therapies into a “package.” Depending on the specific therapeutic technique, the format may be individual, group, or family sessions. The duration of treatment ranges from brief periods, including times of crisis, to longer term periods.

Patients with cancer have many unique problems including multiple physical, psychological, and social stresses as discussed in Chapter 5. After appropriate multidimensional assessment of patients, it is essential to individually tailor psychological interventions to their particular needs.

It is not unusual to find psychological interventions conducted by persons representing a wide variety of mental health backgrounds.