Matchmaking in pain practice: Challenges and possibilities

All people experience pain and for some, acute pain may over time develop into long-term disabling problems. Already at an early stage, it is possible to identify people at risk for long-term problems and psychologically oriented interventions can prevent future disability. However, not all people are helped by treatment. Moreover, subgroups of people suffering from pain have been identified, indicating that people with pain problems differ. The first aim of this dissertation was to improve the understanding of how people differ. The second aim was to use these individual differences and to match people to psychological treatment based on psychological profiles. The third aim was to explore what happens during treatment that might be important for outcome. The findings show that people who belonged to subgroups with elevated levels of psycho- logical factors had less favorable outcomes over time than people with no elevations. Moreover, people with elevations in several psychological factors had even less favorable outcomes. Psychological treatments aimed at preventing future disability performed well, but using profiles to match people to treatment did not improve outcomes further. Finally, a number of psychological factors were valuable targets for treatment: if the treatments successfully produced change in people’s thoughts and emotions related to pain the treatment outcomes were better. The findings are summarized in a flow chart showing the recommended clinical approach to people seeking care for acute pain problems.