The guidelines presented by the New York State Workers Compensation Board provide fundamental principles for conducting psychological evaluation and intervention in non-acute pain. These directives are crafted to assist mental health professionals in identifying appropriate methods for assessing and treating psychological issues within the context of comprehensive care.
Mental health professionals with expertise in psychological evaluation and intervention can depend on the guidance outlined by the Workers Compensation Board to make informed decisions about the most suitable approaches for their clients.
It is important to emphasize that these guidelines are not intended to replace clinical judgment or professional expertise. The psychological evaluation and intervention process should involve collaboration between the mental health professional and the client, considering individual circumstances and needs.
Evaluation
- Patients who do not progress as expected after an injury may benefit from a formal psychological or psychosocial evaluation to identify barriers to recovery.
- A thorough psychological assessment can help pinpoint comorbid psychiatric risk factors (e.g., psychosis, active suicidality) and secondary risk factors (e.g., job dissatisfaction), with appropriate referrals made accordingly.
- Ongoing assessment for potential barriers to recovery, such as psychological issues or yellow flags, should be integrated throughout the patient’s care.
- The insights gained from such evaluations can enhance clinicians’ understanding of the patient, facilitating the development of more effective treatment plans and rehabilitation strategies.
- Psychometric testing, when necessary, can be a valuable tool in assessing mental health conditions, pain conditions, cognitive function, and motivation, as well as aiding in treatment and vocational planning.
- Some of these tests are available in multiple languages and are designed at a sixth-grade reading level, although having a provider fluent in the patient’s primary language is preferred. Professional language interpreters should be utilized if necessary.
- Tests with validity scales, like the MMPI, are particularly useful when considering potential secondary gain issues or the accuracy of the illness presentation.
Intervention
- Incorporating psychosocial treatment early in the management of non-acute pain is crucial once the issue is identified.
- Psychosocial interventions, including psychotherapeutic treatment and cognitive-behavioral therapy like biofeedback and relaxation training, can be effective.
- These interventions should focus on enhancing patient coping mechanisms, adaptation skills, self-management, self-efficacy, and reducing disability.
- Treatment settings may vary, from individualized models to multidisciplinary or interdisciplinary pain management programs.
- Medication may be prescribed by the treating physician or psychiatrist to address diagnosed conditions.
- The routine prescription of sedative or hypnotic medications should be postponed until after a psychiatric evaluation and diagnosis, when appropriate.
- All psychological or psychiatric interventions should be accompanied by a thorough assessment and treatment plan with clear behavioral goals, timeframes, and specific interventions outlined.
