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(p. 424) Response 

(p. 424) Response
Chapter:
(p. 424) Response
Author(s):

Robert Gatchel

and Rob Haggard

DOI:
10.1093/med:psych/9780199733668.003.0046
Page of

date: 19 September 2019

While not clearly spelled out in the reference to the stepwise approach, this entire chapter actually describes the process of the stepwise approach to assessment and treatment of chronic pain populations. This case study was specific to one particular patient’s case, but many of the critical points may be generalized to all patients in an interdisciplinary pain program. Some of these include a thorough medical evaluation for confirmatory findings regarding prior diagnoses and to rule out any comorbid factors that might impair the patient’s rehabilitation. The medical intake evaluation should also evaluate range of motion, areas of tenderness, and neurological symptoms, as well as gate and posture. Intake questions for the behavioral medicine personnel to address include ascertaining whether there are any clinical symptoms of depression, including suicidal ideation, anxiety, or other diagnostic criteria for a comorbid mood disorder that need to be addressed apart from the pain management program. In further defining these comorbid conditions, drug dependence/opioid dependence would be screened for and treatment options explored based upon findings....

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