Behavioral Medicine Consultation

The role of psychology in the field of behavioral medicine has grown significantly over the past decade. At the UC Davis Medical Center, our psychologists are an integrated part of the pain management treatment team in both the inpatient and outpatient settings. Behavioral medicine focuses on the impact of pain on patient's lives. Our program implements effective coping strategies for each patient that will optimize medical outcomes and restore function to the patient.

Psychological services are integrated into the following services:

1. Treatment planning for each patient suffering from chronic pain;
2. Pre-surgical and post-surgical evaluations and follow-up consultations;
3. Pre-surgical and post-surgical evaluations and follow-up consultations for implantable technologies for pain management, such as spinal cord stimulators and medication pumps;
4. Differential psychiatric diagnosis and treatment planning;
5. Treatment planning around issues of noncompliance, addiction, or problem behavior.

Our goal of psychotherapeutic intervention is to restore our patient's control over perceived levels of pain, increased levels of physical and emotional functioning, and reduce the amount of suffering they experience secondary to their pain. Available services listed below. 

This type of therapy is directed toward accomplishing specific goals, brief interventions focused on stabilizing mood, increasing levels of activity, and provides effective coping tools that facilitate improved quality of life for our patients.

This group setting is time-limited psychotherapy, utilizing a group format to provide psychoeducation, support and skills needed to optimize levels of adjustment to chronic pain and facilitate improved functioning in home, school, job or social settings.

The biofeedback programs utilized in our clinic employ the mind to control pain by teaching patients to recognize and use physical body states to gain increased control over pain perception and the entire experience of pain. Electromyographic (EMG) feedback measures help patients recognize when muscles are contracted or relaxed, and this, paired with visual imagery or relaxation skills, can help patients reeducate muscles to relax, instead of guarding against pain. Modern biofeedback equipment monitors changes in skin temperature, muscle contraction, and/or galvanic skin response. All of these measures are helpful in preventing aggravation of pain caused by stress or tension.

Our hypnosis programs help patients learn to control their pain by developing alternative images and experiences to pain. While exactly how it works is unclear, it is thought that trance states alter brain waves and that hypnosis can activate regions of the brain that can impede pain. Interrupting the pathway from a painful site to the receptor in the mind is another way that hypnosis is thought to be effective in managing pain. Some researchers believe that by dividing consciousness and widening the gap between selective attention and selective inattention, patients become more available for social influence and are better able to make use of suggestions made by the therapist in changing their experience pain, and gaining greater control over it.

The use of standardized forms of psychological and neuropsychological tests is useful in gaining a full portrait of patients who are experiencing pain. This portrait enables our team to provide an effective treatment plan for each patient. Test results can help with differential diagnosis, help identify strengths or weaknesses in coping styles, and reflect patterns of responding or behaviors that are likely to occur in response to pain and suffering.

Ravi Prasad, Ph.D. Professor Director, Behavioral Medicine