Have you ever wondered how your mental and physical health affect each other?
Robert Gatchel, PhD, has spent his career exploring that question, especially as it relates to pain.
Gatchel, distinguished professor and chair of psychology at The University of Texas at Arlington, has been a key advocate for an interdisciplinary approach to chronic pain since his research on the topic was first published in the mid-1990s.
Now, this “biopsychosocial approach” — one that looks at the physical, psychological and social aspects of pain — is viewed as one of the leading evidence-based models for better understanding the cause, assessment, prevention and treatment of chronic pain.
With a background in psychophysiology, which looks at the relationship between physiological processes and thoughts, emotions and behavior, Gatchel began his work by studying debilitating chronic pain — pain lasting more than six weeks. Specifically, he developed strategies to treat chronic pain associated with jaw disorders and back injuries.
Through this work, Gatchel saw how significant a role psychosocial issues can play in a person’s ability to cope with and manage chronic physical pain.
For instance, someone unhappy with work may use pain from a back injury as an excuse to escape work or avoid seeking treatment. In other words, psychologically, the individual may not want to get well, which can hinder recovery.
“If someone on the health care team picks up on a behavioral problem (as part of a chronic pain condition), we can do something about it,” Gatchel says. “But it all depends on catching the behavioral problem, and that means treating the whole person.” .
Gatchel and his research team have conducted extensive evidence-based clinical research to evaluate hundreds of patients with acute lower back pain for psychosocial problems like mental illness, poor coping skills and stressful lifestyles. Their assessments were designed to identify those with a psychosocial disability factor. Their research found a significant correlation between psychosocial disability and some workers’ development of chronic lower back pain a year later.
Based on these findings, Gatchel developed an early-intervention treatment model for chronic disease that combines traditional medical practices, mental health treatment, physical therapy and social work.
Standard steps in Gatchel’s treatment path include:
- Treatment by a physician;
- Close monitoring and emotional coping skills taught by a psychologist;
- Physical therapy; and
- Counseling about work and living conditions by a social worker.
In addition, his research has shown that patients with chronic pain who received early intervention displayed significantly greater improvements in psychosocial functioning, pain levels, medication use, health care needs and occupational outcomes.
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Clinical psychologists assess and treat mental, emotional and behavioral disorders. They use the science of psychology to treat complex human problems to promote change.