Clinical and Forensic Standards for the Psychological Assessment of Patients with Chronic Pain

Pain is a subjective psychological experience that is experienced from time to time by virtually everyone. Despite pain’s subjective nature, litigation for pain and suffering has been recognized by the courts for centuries, and currently accounts for the majority of damages awarded in medical malpractice cases. Advances in technology notwithstanding, the experience of pain cannot be objectively assessed by medical imaging and must instead be assessed by psychological methods. Conducting a psychological assessment of a patient with chronic pain requires knowledge of the nature of pain and factors that might influence pain reports. Clinical and forensic examiners can benefit from knowledge of standards regarding which patients should be referred for psychological assessment, for who can perform psychological assessments, for determining which variables to assess, about psychological test selection, for test security, for interviewing the patient with chronic pain, for allowing third party observers, and for other matters. To this end, this article reviews relevant laws, case law, regulations, professional standards, clinical practice guidelines, professional practice guidelines, professional consensus statements pertaining to psychological testing and assessment methods, and presurgical psychological assessment methods. The conclusion addresses the application of these findings to the psychological assessment of patients with chronic pain.