AAPP President’s Update

8/11/26

Dear AAPP Members and Friends,

I hope everyone is finding time this summer to slow down, recharge, and enjoy the longer days. Reflecting on my own family, I know summer can get so hectic! Still, it’s hard to believe that we are already well into the second half of 2026, and it has been an incredibly busy year at the American Association of Pain Psychology.

While some of our work may not yet be visible, our Board has been working hard behind the scenes to strengthen AAPP’s infrastructure and lay the groundwork for some exciting things ahead. One of our major priorities this year has been reworking and improving the AAPP website. Our goal is to make it easier to navigate and, more importantly, to develop it into a valuable resource for our members and the broader pain psychology community. I’m incredibly excited about where we are headed.

We have also been busy planning educational programming for the remainder of the year. Providing high-quality, clinically relevant education is a vital part of AAPP’s mission, and we have some great events in the works. I’m looking forward to sharing more details with you soon.

Another initiative I’m particularly excited about is the development of an annual AAPP awards program. We hope to create a tradition of recognizing individuals who are making meaningful contributions to pain psychology through clinical practice, research, education, mentorship, and service. We are still working through the details, but I love the idea of having an opportunity each year to celebrate the people who are helping move our field forward. Stay tuned for details on how to nominate yourself or a colleague soon!

More broadly, I have been thinking a lot this year about finally growing and creating a unique space for those of us in the field of chronic pain. Pain psychology continues to grow and evolve, and psychologists and other behavioral health professionals have such an important role in multidisciplinary pain care. I want AAPP to be a place where people working in this field can connect with one another, learn from each other, and feel part of a larger professional community.

Building an organization takes time, and sometimes the most important work happens quietly in the background. This year has been very much about building that foundation while also creating new opportunities for our members. I’m incredibly appreciative of our Board and everyone who has contributed their time, ideas, and energy to this work.

I hope you all enjoy the rest of your summer. I’m excited about what we are building together and look forward to sharing more with you this fall.

Warmly,
Melissa Canter, PsyD
President, American Association of Pain Psychology

4/9/26

Dear AAPP Members and Friends,

It is a privilege to share my first message as your President for 2026. I have huge shoes to fill as I step into Dr. Kimeron Hardin’s role. This year, our primary goal as the Board of the American Association of Pain Psychology is to foster a deeper sense of Community for those of us dedicated to this field. We often hear how isolating it can feel to work in healthcare, particularly given the current complexities of the chronic pain landscape.

We are at our best when we are connected. To that end, our leadership team is dedicated to three key pillars this year:

• Growing Our Professional Family: We are launching a major initiative to expand our membership. By bringing more diverse voices into AAPP, we strengthen our collective influence and ensure that the highest standards of pain psychology reach more people globally.
• Creating Space for Connection: We recognize that this work can be taxing. We are providing a dedicated spaces for peer consultation and social engagement. Whether you need to navigate a complex case or simply want to connect with colleagues who truly understand the work, we want AAPP to be your professional home.
• Empowering the Next Generation: We are expanding our subcommittees with a specific focus on student mentorship. By fostering the talent of those entering the field, we are securing the future of pain psychology and ensuring our committees reflect the energy and diversity of our rising stars.

Our mission is not just to advance a field, but to support the people—you—who make that advancement possible. I invite you to get involved in a subcommittee, join an upcoming social hour, or invite a colleague to join our mission.

Welcoming New Leadership

Finally, I am delighted to introduce three new members to our Board:

• Dr. Katherine L. Applegate is a clinical health psychologist and Associate Professor in Psychiatry and Behavioral Sciences at the Duke Health School of Medicine. She has been practicing at Duke for 27 years and serves at the Director of Psychological Services for the Duke Spine Center. Dr. Applegate is also involved in the educational mission at Duke Health by supervising the Pain Psychology rotation for the Psychology Internship Program and by participating on the Curriculum Committee for the Duke Health School of Medicine. 
• Dr. Jennifer DelVentura. She is a licensed psychologist, board certified in clinical health psychology, with a career-long specialization in research and psychological treatment of chronic pain. Dr. DelVentura spent over decade of her career in the Department of Veterans Affairs, embedded in interdisciplinary pain clinics and providing therapy, managing programs, conducting research, and providing clinical supervision of interns and postdoctoral residents.  She now maintains a private practice in Seattle, WA treating adult patients with chronic pain.
• Joseph Anderson-Gutiérrez is a clinical psychology doctoral candidate with training in health psychology, chronic pain, psychological assessment, and neurodivergent-affirming care. He completed his doctoral coursework at The Chicago School and is currently completing his APA-accredited internship at the VA Puget Sound Health Care System.

Please join me in welcoming them as we embark on this exciting year together. I am honored and proud to lead this incredible and talented group of board members. Our board is a fun bunch of people with a sense of humor that makes me laugh every time we meet! Let’s make 2026 a year of connection, mentorship, and unprecedented growth.

With gratitude, 

Melissa Canter, PsyD
President, American Association of Pain Psychology (AAPP)

1/13/2026

First off, I want to thank all of our members for an exceptional and exciting 2025!  Despite some of the events last year that may have challenged us as individuals and as healthcare providers, AAPP has continued to provide high quality educational opportunities that allow us to shape the field of pain management.

I have some exciting news about change at AAPP to announce, beginning with introducing our new president for 2026, Melissa Canter, PsyD, recently our co-secretary and also a past president.  I am particularly excited that Dr. Canter is taking on this role because in my experience, she is both well-qualified for the position, and she is highly-energized around developing pain psychology as a healthcare specialty.  Congratulations Dr. Canter!

We also celebrate (and grieve) the retirement from the board of our treasurer, Dr. Christopher Gilbert.  If you attended our last workshop of 2025 on Pain Reprocessing Therapy with Vanessa Blackwell, you heard the brief overview of a distinguished career in biofeedback and pain psychology by Dr. Gilbert as we sent him out into the retirement world with our appreciation and admiration for a long and effective career.

Another major change to the board directors is the departure of Dr. Allison Bicksler, who served on the board for three years, to focus on new projects and family.  I was so grateful for Dr. Bicksler’s constant enthusiasm for our work and her devotion to AAPP, taking on many projects that have helped us grow and improve.  While she is stepping away from serving on the board, she will remain an active member and as a resource for other pain psychology professionals in our community.  Best wishes and thank you for your service, Dr. Bicksler!

It would be remiss if I didn’t acknowledge that incredible depth and breadth of our continuing board members, Dr. Amanda Wagstaff, Dr. Valerie Jackson, and Dr. Marilyn Jacobs.  Being surrounded by such intellect and talent is restoring and rewarding.  They work diligently behind the scenes on every event and every positive change this organization makes and deserve accolades for those efforts.

We also would like to welcome our newest board member, Dr. Katherine Applegate, PhD, associate professor in Psychiatry and Behavioral Sciences at Duke University Medical Center.  We were all impressed with her passion for pain psychology, especially in our growth as an organization and subspecialty within health psychology.

We are still searching for a second new board member, so if you have the interest in applying, please let us know.

Last year, we were fortunate to have JJ Anderson-Gutiérrez, who is completing his training, join us as an invaluable volunteer, who worked in the background often, supporting our educational presentations and other administrative duties that kept us running.  

This will be my last column as president and I want to thank everyone who has supported me, and AAPP, over the past two years.  I am proud of the work that this board has done, including many positive changes including creating a new logo and branding, exhibiting at multiple pain conferences, adding our President’s column and Member Spotlight to the website, creating a listserv to help members keep in touch and of course eight amazing educational presentations and clinical case discussions.  A couple of highlights for me included co-writing an article on pain psychology with Dr. Marilyn Jacobs published in the American Board of Professional Psychology  (ABPP) newsletter, and AAPP’s endorsement of the Advancing Research for Chronic Pain Act sponsored by the US Pain Foundation last year.  I will remain on the board this year, assuming the responsibilities of treasurer, and supporting our organization in other ways.

Years ago, during a discussion with our esteemed former board member, and pain psychology pioneer Howard Rome, PhD, he made a comment that I’ve never forgotten.  He said that behavioral specialists have always been an essential part of the treatment of chronic pain and that we needed to assume our place as treatment leaders, not just as adjunctive or supportive professionals, in the biopsychosocial management protocols.  He was right back then, with every new advancement in our understanding of the brain-pain connections confirming our primary role in the next phase of pain management.  

Now is the time and  AAPP is the vehicle.

My deepest gratitude to all of you.  Onward!

11/11/2025

We are still basking in the glowing success of our final workshop of the year,  Pain Reprocessing Therapy in Practice:  Emotion, Complexity, and Clinical Trust presented by Vanessa Blackstone, MSW.  She is an amazing presenter, who introduced many of us to the intricacies of PRT techniques.

Part of my excitement was from the fact that we had about 20 graduate students in psychology registered for it, a hopeful sign for our specialty.  Never before has there been more opportunity for the biopsychosocial approach to pain, along with well-trained clinicians who are comfortable with working in an integrated way with other professionals.

We were also represented at the Pain Medicine Academy of Advanced Practice Providers at their inaugural annual meeting in Orlando, FL by one of our board members, Dr. Allison Bicksler.  We hope to continue close collaboration with the members of PMAAPP, since they are another growing force in the treatment of people living with chronic pain.

Our newest member benefit, access to our listserv/email list, is now established and our members are finding it useful for communication about events, research and clinical collaboration and questions.  If you have not signed up to be a part of this, please consider joining the community in a new way.

We also recognized at the 11/08/25, the service and contributions of our retiring board member and treasurer, Dr. Chris Gilbert with an award expressing our gratitude and respect for his dedication to our specialty.  Personally, it has been a real highlight to have been able to work with Dr. Gilbert so closely over the past few years and to get to bask in his intelligence, creativity and humor.  Thanks again Chris!

___________________________

I recently read the new book, “It Doesn’t Have to Hurt: A Smart Guide to a Pain Free Life” by Sanjay Gupta, MD, and I was frankly impressed at his clear explanations of sometimes complex concepts around chronic pain and the need for multidisciplinary approaches. 

It strikes me as ironic that the best books out now on chronic pain, are written by Gupta, a neurosurgeon, Haider Wairrach, MD, a cardiologist and one of our own, Rachel Zoffness, PhD, pain psychologist, and not written by traditional pain management physicians in the field.  

At times in my career, I have felt the complex push-pull between so many factors that impact our clients, from the Cartesian model of pain that still pervades our medical traditions, to the impact of a “for-profit” health care system on the types of care that are available, the impact of managed care and insurance companies on choices, and even the hierarchical organization of the medical world with physicians at the top and other types of professionals afforded less status or voice in treatment planning.

Despite the advances in research around central sensitization and the hope of neuroplastic treatments for pain, our systems seems to often trudge along, resisting the incorporation of these exciting new possibilities.  Functional MRIs, Diffusion Tensor Imaging, PET scans and Magnetic Resonance Spectroscopy and emerging hybrid methods like functional connectivity mapping and fMRI-EEG combinations, offer us exciting ways to understand the brain as it exists, but also what works to reverse negative changes.

Despite existing barriers, I feel that palpable change is happening, albeit slowly.  There seems to be a growing recognition that a “search and destroy” approach to pain, ablating the offending body part and the focus on symptom reduction with pharmaceuticals, is giving way to discoveries that will make the work we do in pain psychology of prime importance and value.

If you are reading this, you are a part of a breathtaking birth of an important new specialty.

Until next year!

9.17.25

Hello AAPP members and friends!

Over the past few weeks, the board members of AAPP have grappled with some of the recent changes at the Department of Health and Human Services and specifically new directions at the Center for Disease Control. We are an organization that has made it a part of the mission to provide pain psychology educational opportunities that are grounded in science and evidence. Because of the sudden and sometimes misguided changes at the highest levels, we have noticed other similar health care organizations issuing statements of strong support and belief in science as a guiding force in policy decisions.

We have created such a statement for AAPP and I wanted to begin my column with this post:

The American Association of Pain Psychology (AAPP) has for many years provided continuing education for a multi-disciplinary community of clinical specialists working with chronic pain management. Our strategies and techniques are grounded in peer-reviewed research supporting a biopsychosocial approach to chronic pain.

AAPP’s activities are rooted in psychological science. Our advocacy for a biopsychosocial approach to pain medicine, integrates peer-reviewed research and evidence-based practices. Our continuing education and resource-sharing initiatives reflect our commitment to scientific integrity, ensuring that our multidisciplinary community is prepared to provide ethical, effective, and science-driven care for both youth and adults living with chronic pain.

Therefore, the recent minimizing and bypassing of evidence-based treatments being promoted by Robert F. Kennedy, Jr., Secretary of Health & Human Services, is distressing. In particular, the dismantling of proven effective vaccination programs is incongruent with his wish to “. . . restore this agency to gold standard science.” What he says is at odds with what he has done and what he is still doing.
We are especially concerned about the health risks associated with the loss of access to vaccinations. The condition of chronic pain patients will likely worsen with the added burden of communicable disease that are targeted by vaccines.

Additionally, pain science has reported exacerbation of chronic pain following medical disorders in vulnerable populations (e.g., Covid-19 infections). While some patients with chronic pain also report vaccine-related pain increases, AAPP supports the rights of patients to make vaccination decisions in consultation with their health care teams. These decisions involve weighing complex risks and benefits beyond the purview of national health care policy. Mr. Kennedy’s actions will have the practical effect of eliminating vaccine access for many of the most vulnerable chronic pain populations.

Therefore, we strongly advocate for the use of scientific and peer review processes in all areas of health care policy. We support the individual consumer’s right to make healthcare decisions guided by medical and scientific expertise informed by empirical evidence, rather than personal prejudice.

I have two other exciting pieces of news to announce as well.

First, we have finally created an AAPP mailing list!  This will work as a “listserv” much like other organizations that will allow members to post relevant questions, events and information to other members and help our community become even more connected!  It has been a goal to make this happen for almost two years and all of our resources and efforts are finally coming to fruition!   If you are a paid member, you will be receiving an email with your personal invitation and link to join the list soon.  Our list will be moderated, which will allow us to reduce spam or other commercial posts that would not be relevant to our goals and content.  Please take a moment to read over the disclaimer and rules for posting.

Second, we have our first half-day clinical skills webinar this year, coming up on November 8^th entitled Pain Reprocessing Therapy in Practice: Emotion, Complexity and Clinical Trust, presented by Vanessa Blackstone, MSW, Executive Director of the Pain Psychology Center, and co-author of The Pain Reprocessing Therapy Workbook.  She has trained hundreds of providers internationally and regularly speaks on chronic pain, neuroplastic symptoms and integrative mind-body care.  Vanessa also teaches in the Orofacial Pain Clinic at UCLA.

At the end of this presentation, participants will be able to:

1. Describe the five clinical foundations of Pain Reprocessing Therapy and its application in treating neuroplastic pain.
2. Identify three strategies to help clients engage with emotional content and build trust in the therapeutic process.
3. Apply three PRT techniques in complex cases, including integration of parts work, workbook tools, and approaches for navigating protective responses.

Please mark your calendars for this exciting event!

5.19.25

We are very excited about our next two educational webinars on Pain Reprocessing Therapy (PRT)!   We are fortunate to have a two-parter, with the first focused on the research and key concepts of PRT and the second on clinical applications.  Both are not to be missed as cutting-edge treatments that are focused on pain reduction and elimination!

In the coming weeks, we will also be hosting another live clinical case discussion

For my column this month, I decided to go very personal.  It’s a long one, so I hope you can bear with me.

In November of last year, I was about to hit the game-winning shot (at least in my imagination) in a game of pickleball, when I felt like someone suddenly struck the back of my left calf and I went down.  Later, I found out that I had a complete Achilles rupture and on January 16th, I had a repair surgery, and I spent the next couple of months in a walking boot with frequent icing, elevation and wearing a compression stocking.  

I watched my left calf shrink to half of what it was, and had a whole host of aching, numbness and many other “weird” sensations as the ankle/leg and foot healed. Sleeping with a heavy boot on, and your foot constantly elevated, is tricky.  Using a knee scooter tested my patience more than once while showering with a chair was an intricate production. I now know, from personal experience, that the “thigh bone’s connected to the hip bone” which is then connected to the “back bone”.  Walking with what feels like a bent axel carries consequences throughout the body.

Since January, I have slowly but steadily improved in discomfort and function, but this experience has been a valuable education for both my personal growth and my professional practice.  My temporary disabled parking permit expired a few weeks ago and I’m back to walking in regular shoes.  Some days, I really miss that placard.

As a pain psychologist, in most sessions, the topic is centered on pain sensation.  Yes, there are often many complaints about inability to do things that they used to do with ease, but functional loss often takes a back seat to the suffering they experience around the pain itself.  Even with my many years of experience working in functional restoration programs, with strong focus on exercise and improvement of life quality, I missed some of the finer points of living with a disability.

Some of my lessons from living with a disability:

Normal ambulation is a blessing, and when this is limited, it takes more time to do everything.  Even with the most empathic friends and family, their pace often is quicker, and that means constant pressure to “keep up”.

Your body carries the consequences of pain and injury in many other areas of the body, through compensation and through altered posture and mechanics and muscle atrophy.  What started as pain in my Achilles area, ended with calf, hamstring, hip and back discomfort.

It is humbling to ask for help after a lifetime of independence.  Along with that, there is a difference in good motivation to get back to normal, and just plain hard-headedness.  The support I needed has been both physical and emotional, and I try to focus on gratitude and humility, versus embarrassment and shame.

Reduced activity, and increased comfort foods, can quickly lead to putting on a few pounds and changes in your body in ways that can make life more challenging.   In the past, I could just go for an extra few runs or walks and adjust my activity accordingly, but seven months of hard activity limitation alters this ability.

Mindfulness is a key path to coping.  Thankfully, this is a practice that has helped me with many parts of my life and has been the key to accepting the impact of the frustrations around the limitations.

Keeping my focus on long-term improvement versus short-term gains keeps me patient.  Past injuries have always resolved relatively quickly compared to this one, and my prior experiences did not match the realities associated with this type of recovery.  Intellectually, I understood the process would be long before I started to understand it emotionally, i.e. the head got it before the impatient heart.

Expecting the unexpected.  As this injury has improved slowly, I have experienced a variety of symptoms, from stinging, to burning, to “zaps” and tons of swelling.  At first, these sensations were worrisome, and elicited several “urgent” calls to my PA and surgeon.  I learned that as healing happens, these unanticipated events are normal and not to catastrophize about them.  Having heard this from my clients many times over the years, nothing is like personal experience of living with the unknown.

Work helps me with a sense of purpose and value that transcends my functional capacity right now.   Work is both a welcome distraction from recovery,  and it also has helped me feel less dependent on others in some ways, and makes me feel useful.

Balancing hope with reality.  Several medical professionals, including my surgeon and physician assistant, have subtly tried to keep me realistic in my expectations, with the PA saying specifically “your Achilles will never be the way that it was”.  My defiant self always wants to prove the doubters wrong and sometimes, I learn lessons the hard way.  Now, I sit with the possibility that life will be different than before, and I allow myself to feel a host of emotions around this.  I also practice focusing on even the smallest of gains, rather than the steps that are seemingly going backwards.

Self-compassion is the key.  Some of us were raised with harsh motivational strategies, like shaming and guilt.  While they sometimes work to get me moving, especially in the short-term, over a lifetime, those inner voices of self-criticism wear me down.  Finding my self-compassionate inner encourager is much healthier and soothing.

Although dealing directly with the pain has been a priority in many ways during sessions, I realize that I often talk to my clients less about the practical aspects of their functional limitations.

It’s times like these that make me reflect on my life outside the tunnel of injury and recovery and remind me to focus on the support and care that I receive from others right now, from family and friends to colleagues, rather than what is missing or not going particularly well.  I am grateful particularly for my work with AAPP and our talented board members.

This injury has been an opportunity to gain a new, deeper appreciation for my clients’ feelings about their own experience with acute and chronic disability, and the toll it can take on emotional well-being and for this, I am also grateful.

3.26.25

Hackathons!

Recently, I was invited to participate in the American Academy of Pain Medicine’s opening session of the Hacking Pain Hackathon as a part of their annual meeting.  Perhaps it’s my limited experience outside of my psychotherapy world, but I had to Google what a “hacka-thon” actually was before deciding if I wanted to participate.

What I found was that hackathon is a short-term event where people from a variety of backgrounds collaborate to solve a problem or create a product. Hackathons are often focused on software development, and can be hosted by companies, universities, or hospitals.

While intrigued by this description, I still struggled to understand my part in this process.

Turns out, I will be presenting to UT-Austin students in many different fields, from  engineering to tech, and I would be a part of explaining  dilemmas in our field of pain psychology, barriers to preventing quality care, and encouraging opportunities to solve some of these barriers.  

After the presentations by the various experts in pain, the audience then begins a collaborative process of creative problem-solving around the barriers to delivery of care.

The more I learn about hackathons, the more excited I am by the prospect of what people from various other walks of life  can bring to solving our community’s problems.  

Thanks to AAPM for organizing this exciting approach and for including AAPP in this program.

New Projects

We are very close to starting the first AAPP ListServ, which we have  been preparing for over the past year.  One of our goals has been to provide a platform for our members to connect with each other, to network and to share important information around pain psychology.

We assume most of you have been a part of listservs in the past, but if you have not participated before, they offer easy and convenient ways to build community, streamline communication, message archival for later retrieval about a topic or content and an efficient way of disseminate information and facilitate discussions.

Often, people working in pain psychology work in isolation or small groups, and lack regular interaction with other mental health professionals working with pain.  This is a chance to find people working in similar places doing similar work and reduce that sense of working as a lonely island in the stream.

Also, if you missed our incredible first webinar of the year, Patient Sociopolitical Concerns in Pain Psychology Practice: Legal, Ethical, & Professional Responses, hosted by Marilyn Jacbos, PhD, ABPP and Allison Bicksler, PsyD, it was a huge success and spoke directly to the concerns that many of our members have expressed about current events.  Stay tuned for our next hot topic in coming weeks!

1.31.25

As we step into 2025, I find myself pausing to reflect on the fresh start this new year brings—a symbolic opportunity for renewal, growth, and the pursuit of new aspirations. For those of us who remember the days of writing checks, it often took a few attempts (and voided checks) to get the date right. Now, here we are, fully embracing 2025, and the American Association of Pain Psychology (AAPP) is poised to embark on an exciting and impactful year.

This year, AAPP is committed to fostering deeper connections among our members while expanding our membership to strengthen our collective purpose and drive growth. Our mission remains clear: to support mental health professionals dedicated to alleviating suffering and improving the lives of those in need. However, we recognize that the transition to a new U.S. administration brings both opportunities and challenges. The shifting political landscape, with its distinct policies and priorities, may impact our clients, our work, and the broader societal context in which we operate.

Many of our board and general members have expressed concerns about how these changes—ranging from staffing and funding decisions to policy shifts—will affect our ability to deliver services, secure grants, and advocate for mental health and pain management. Austerity measures, in particular, may strain our capacity to provide care, creating frustration and, at times, a sense of overwhelm. Rest assured, every member of the AAPP board shares these concerns and is dedicated to addressing them head-on.

At AAPP, we are committed to staying at the forefront of advocacy for our patients and our profession. This year, we will devote significant energy to developing policy recommendations, creating guidelines, and responding to administrative changes that may conflict with our values. For example, last year, we established two new committees: one focused on membership growth and the other on advancing diversity, equity, and inclusion (DEI) within our organization. Despite recent rollbacks in government-supported DEI initiatives, we remain steadfast in our commitment to fostering an inclusive environment that acknowledges both our shared humanity and our unique differences. If you share this passion, we invite you to join us in advancing these critical goals.

To further strengthen our community, we are excited to announce the upcoming launch of our listserv, which will enable members across the country and around the globe to connect more freely. This platform will help reduce feelings of isolation among practitioners and foster a greater sense of belonging. As we often say, engagement is the antidote to despair!

As we kick off our 2025 programming, I am thrilled to share details about our first webinar of the year, led by two esteemed board members, Marilyn Jacobs, PhD, ABPP, and Allison Bicksler, PsyD. This session will focus on ethics in the practice of pain psychology, reflecting our unwavering commitment to the highest ethical standards as an organization.

I also encourage you to read the recent New York Times Magazine article, “Chronic Pain is a Hidden Epidemic: It’s Time for a Revolution”. This piece offers an insightful overview of the current state of pain management and highlights promising new mind-body strategies that emphasize psychosocial and interdisciplinary approaches. Our board has prepared a response to the article, which is available on our website and will hopefully soon be published in print.

Finally, I’d like to share a few updates about our board leadership for 2025. I am honored to continue serving as president, alongside our treasurer, Chris Gilbert, PhD. This year, our secretary duties will be shared by Amanda Wagstaff, PhD, and Allison Bicksler, PsyD. Our exceptional board also includes Marilyn Jacobs, PhD, Melissa Canter, PhD, and Valerie Jackson, PhD. Leading our committees are Consuelo Flores, PhD (Membership Committee) and Heather Martarella, PsyD (DEI Committee).

Your input and energy are vital to our success. Together, we can navigate the challenges ahead and seize the opportunities that lie before us. Stay engaged, stay alert, and stay connected!

Warm regards,
Kimeron Hardin, PhD, ABPP
President, AAPP

12.13.2024

As we settle into the holidays and the end of 2024, this time of the year is often a time of reflection for the year and making plans for the future.

AAPP has had a busy year and is worthy of some reflection.

We started the year with several objectives designed to strengthen the organization and establish some broader name recognition, which would allow us to increase our numbers and, therefore, our impact on the pain world.

Several new projects included a new logo and website design, exhibiting at multiple pain conferences, including the American Academy of Pain Medicine, Pain Week, the Society of Pediatric Psychology Society Annual Conference (SPPAC), and developing our first committees on membership and DEI.

To improve communication with our members, we also added two recurring features to the website, the “President’s Column” and “Member Spotlight.”  Both were highly successful and will remain a regular part of our website.

We also began developing collaborative relationships with other pain organizations this year including the US Pain Foundation, the American Chronic Pain Association, and the Pain Medicine Academy of Advanced Practice Providers.

Additionally, we continued our provision of high-quality paid educational seminars including:

• A Primer  on Biofeedback Devices for Pain Management by Anu Kotay, PhD
• CDC Opioid Guidelines 2022 and the Utilization of Buprenorphine by Abhishek Gowda, MD
• Explain Pain 2.0:  An Evening with Lorimer Moseley, PhD, AO
• Pediatric Pain Management:  Theory, Assessment and Treatment by Jeffrey Gold, PhD

We also included this year several clinical case consultation groups for discussion of difficult cases and professional practice issues that were highly successful, and we plan to continue into the new year.

Two of our board members, Dr. Marilyn Jacobs and I, recently published an article in the On Board newsletter of the American Board of Professional Psychology, on the value of ABPP board certification to our work in establishing AAPP and promoting pain psychology as a unique specialty.

Looking forward to the new year,  we plan to launch an  AAPP listserv for our members, to allow for more direct communication and sharing of important announcements and other professional information. If you’ve been on other listservs before, please tell us what would be most useful. We also hope to start developing more pain psychology practice guidelines and continue increasing the visibility of AAPP with other organizations and associations.

AAPP would like to welcome our newest members:

Vanessa Wall, PsyD

Mauricio Lask, PsyD

Mark Detzer, PhD

Virginia Grundler, PsyD

Zoe Gillespie, PhD

Elysia Soria, PsyD

Iulia Gambro, PhD

As always, we are interested in your feedback and hearing about your needs for the future.  You can reach us at info@aapainpsychology.org 

10.9.2024

Living with chronic pain is challenging for many reasons.  Even the most resilient person, can become frustrated, exhausted, and despondent.  The need to treat chronic pain using a biopsychosocial approach is now recognized as an essential approach. Pain psychology is no longer an adjunctive treatment, but a primary one.

A few weeks ago, I had the pleasure of representing AAPP at Pain Week in Las Vegas.  Several hundred people stopped by the booth with impassioned pleas for resources, which I provided as best I could. Others offered words of support for our mission.

A few excellent presentations addressed the value of pain psychology, including those by Susan Fitts, PsyD, Beth Darnall, PhD, and Ravi Prasad, PhD.  However, the vast majority were focused on medical interventions and pharmaceutical symptom management. This reflects standard clinical practice within the specialty, resulting in poor patient outcomes.

This is a key inflection point in the history of chronic pain management.  We are witness to exciting developments in the evidence base surrounding the complexity of the pain experience, its neuroanatomy, and innovative treatment approaches. Pain psychology’s role in these efforts is central.

AAPP has a historic commitment to educating pain psychologists. For over a decade, we’ve provided excellent presentations by top professionals in our field.  We will continue to offer these educational opportunities. In addition, we are developing new initiatives. These include practice guidelines for pain psychologists, defining the scope of the field, defining our specialty within the insurance industry, increasing our presence in graduate and postdoctoral training, supporting biopsychosocial pain research, and engaging in political action and mental health policy.

We need your help! To be effective, pain psychologists and allied professionals must work together to build a dynamic path forward in expanding “whole person” treatments for chronic pain conditions. Please ask your friends and colleagues to join us as members and reach our goals!

7.17.2024

In 1990, early in my pain psychology career, working with people living with chronic pain was quite different than it is today. At that time, there was a burgeoning awareness that the traditional Western approach to chronic pain was not solving the problems and that somehow, the “psychosocial” part of the biopsychosocial model was important, but not yet an established part of treatment protocols. I had exactly zero training in pain or pain psychology in my first pain clinic experience as an intern at Duke University Medical Center, but I was young, had some background in health psychology in general, and had the enthusiasm to try to learn and absorb as much as I could from the professionals around me.

The pivotal work of George Engel (1981) on the biopsychosocial model of clinical treatment had a strong influence on my thinking at the time, expanding my consideration of the multiple layers of illness upward into the larger social, global, and universal realms and downward to the cellular level.

When my first book came out in 1996, The Chronic Pain Control Workbook (2nd edition), Ellen Catalano and I made a rough attempt to incorporate psychological concepts into the management of chronic pain. I was proud of my work bringing new psychosocial approaches and education to people living with pain in ways that could help them begin to assume more control over the quality of their lives without relying solely on physicians to solve the problem. Yet not long after it was published, a pain fellow at the academic center, where I worked, mentioned that he had seen the book in passing and laughed at the thought that such a book could provide anything useful to people living with severe, chronic pain. I have to admit that I was a bit crestfallen, but the contrast between the medical and the psychological worlds could not have been clearer to me at that moment.

Although Melzack and Wall’s GateControl concept was surely interesting to the pain specialists, making theoretical connections between the cognitive and emotional aspects of the brain to the experience of pain, it clearly planted a seed for change in the way that chronic pain is now approached. How that theory could be applied to clinical practice, however, has taken time and faced many barriers including a general resistance to systemic change in medical education and practice, socioeconomic and insurance disparities, and a lack of advanced training for psychology professionals with an interest in providing care to the pain populations.

Fortunately, once medical practitioners realized the benefits of referring their long-term, chronic pain patients for psychological care, the trend has exploded with most pain practices associating themselves, formally or informally, with a mental health professional willing to work with sometimes medically complex people.

I, for example, have worked exclusively in pain management for the entirety of my professional career across many settings, which allowed me to have incredible opportunities to understand the exciting and effective interventions out there, and what my typical clients were experiencing. Having been through the “surgery is the only option” many times and then through the opiates are the safe and best way to ease suffering phase, and more recently, the “neuromodulation implant” age, I have gained so much awareness from my clients about their successes and failures with these approaches.

Some of the most exciting advancements of late include the use of brain imaging for people living with chronic pain. We are learning about connections between various processing centers in the brain and pain in ways that we could only surmise through clinical experience and practice.

We now understand more about why treating chronic pain in the same ways that we were taught to manage acute pain is incorrect, and in some cases, harmful. While acute pain is viewed as rising up the spinal cord to the brain, chronic pain is now understood to descend from the brain, often with little input from the original site of injury.

It was a fallacy that acute pain treatments would work for chronic pain and in part, according to Haider Warraich, MD, author of “The Song of Our Scars: The Untold Story of Pain,” was responsible for the opioid epidemic and the prevention of other treatments that might have been helpful. He notes that brain imaging has revealed that the limbic system, or emotional brain, is much more involved in the experience of chronic pain than in acute pain. To the nervous system, he says, chronic pain is more like an emotion that we feel in a part of our body. His final point is that the ideal approach to pain management is interdisciplinary and that recognizing that pain is worsened by psychological factors does not make it “less real.”

While science is helping to validate the effectiveness and validity of our practices as pain psychology providers, many barriers remain to quality care for people living with chronic pain.

At this time, there are no guidelines for the practice of pain psychology, there are no global certifications, and very little graduate training in this field of specialization. Scientific discoveries and understanding sometimes take years to impact training and practice.

We must come together, as pain psychology professionals, to both develop the training and the standardization of practice if we want to see substantial change in the way that chronic pain is treated.

We need your talent, your curiosity and your creativity as we build the American Association of Pain Psychology.

If you care about this field helping to speed up the effective care of people living with chronic pain, please consider getting involved with the organization at whatever level you can spare. You are welcome to be a part of this developing association and help us make the future for our patients and our professional colleagues. We have a particular need right now for committee members for our DEI and Membership committees so please consider giving back to your profession and your specialty in pain psychology!  Please email your interest to us at info@aapainpsychology.org

Engel, G. L. (1981). The Clinical Application of the Biopsychosocial Model, J of Medicine and Philosophy, 6, 101-123.0360-5310/81/0062

Katz J, Rosenbloom BN. The golden anniversary of Melzack and’s gate control theory of pain: Celebrating 50 years of pain research and management. Pain Res Manag. 2015 Nov-Dec;20(6):285-6. doi:10.1155/2015/865487. PMID: 26642069; PMCID: PMC4676495.

Warraich, H. 2022. The Song of Our Scars:  The Untold Story of Pain. Basic Books: New York.

6.12.2024

May just ended, yet I thought I’d take a moment to celebrate Mental Health Awareness Month here in June. This is a reminder to take some time to check in with your body and mind and to make mental health awareness a regular part of your life not just one month a year.

Our organization was founded on a desire to provide excellent mental health care for people living with pain. We chose to do this by providing quality, advanced educational training in pain psychology for professionals to ensure that our clients receive the best treatment possible.

Today’s column, however, will be focused on self-care for our members. As many of you know, working as a healthcare provider can be exhausting. Beyond the physical demands of a busy practice, most of us use a lot of energy as we listen carefully, run through the diagnostic and therapy plan options, and establish and maintain rapport, sometimes with clients who were referred to us reluctantly and may not always be initially receptive to what we have to offer.

My question for you today is how are you taking care of yourself?

Most of us offer guidance regularly to our clients on self-care strategies and techniques. Yet, sometimes, we find ourselves out of balance. We are putting more energy into work, meetings, or home chores than we’d like. Often reaching a crescendo of long hours and intrusion into sleep patterns. We end up sacrificing our walks, exercise, nutritional habits, and other ways that we restore and refresh.

Self-care is the cornerstone of being an effective mental health professional. It allows us to sit and listen with less distraction. We model through action and demeanor for our community. Our goal is to gain personal insights that will be useful as we guide others toward effective choices.

In an excellent literature review by *Posluns and Gall published in the International Journal of Advanced Counseling in 2019, they found that a proactive stance toward self-care can help reduce negative outcomes experienced by practitioners and improve the care of clients. They noted that there is good empirical evidence supporting the consideration of self-care domains of awareness, balance, flexibility, physical health, social support, and spirituality. Among the specific strategies for cultivating these domains include:

Mindfulness and meditation training

Regular self-reflection

Expressive writing and journaling

Leisure activities

Variation in work activities

Non-work related passions and relationships

Time management and taking breaks

Flexible work hours and locations

Realistic work goals

Peer consultation

An open attitude and adaptability

Self-compassion

Professional development

Sleep hygiene and balanced diet/hydration

Exercise

Social support

Spiritual practice

Meaningful or purposeful work or hobbies

This is a reminder to take some time for you to check in with your body and mind and to make mental health awareness a regular part of your life, not just a one month a year.

4.26.2024

Part of my goal with the President’s Corner this year is to keep members informed about our current and upcoming events and projects. In this column, I have multiple exciting  events and projects to share, which I plan to do at the end. Another goal for me is to share more about our mission and larger goals, and that’s where I want to start this piece.

AAPP began in 2010 organized by a few isolated mental health professionals who were working with clients living with chronic pain in the San Francisco Bay Area, most with very little direct training in pain medicine and varying levels of experience in the field. At the time there were no requirements for training in pain, and the few courses that did offer instruction were part of a larger and more general health psychology track. There were a handful of internship and postdoctoral experiences in pain, each turning out — at best — a few dozen clinicians with significant pain management knowledge. Also at the time there were increasing numbers of jobs for mental health professionals, primarily and even exclusively in pain management clinics or programs.

These career paths were being created by advances in the understanding of the complexity of pain and the nervous system via models such as the Gate Control Theory and later, the Neuromatrix Theory. The growing awareness of limitations of traditional clinical medical practices to produce significant change for large numbers of people living with pain also were leading to increased collaboration between with mind and body professionals.

Early in my own career, my typical referral was for crisis management in people with long-standing and complex pain issues that had reached the end of their emotional rope. Most came with great skepticism and looming hopelessness that life could be better, especially after physicians “ran out” of interventional options. Eventually, after many serious conversations with my referring physicians and begging for a look at people earlier in the pain process, I started seeing clients before the hopelessness and desperation had set in, and who were more open to learning better skills for pain management. Any time I ran across another mental health professional working in pain management I felt almost immediate kinship, both with the struggle we shared to better understand pain management and to help our clients living with pain. Over time, we established loose connections and referral networks between us until our conversations began to turn towards forming a group that was more substantial and reliable.

Initially, our organization started in the San Francisco Bay Area and was named the Northern California Association of Pain Psychologists, later changed to the American Association of Pain Psychology, our current moniker, to reflect a growing interest from people outside the Bay area and California. While grateful for the important research on this topic that was constantly happening in academic circles, the clinical needs seemed to eclipse the growth of our highly specialized subspecialty with health psychology.

Our early goals for AAPP were simple: to provide a place for professionals to connect and share, and also to begin to provide cutting-edge education and training for interested professionals. For the past decade we have succeeded in providing high quality pain education, at first through live events, and now through streaming and webinars. Past speakers have included such luminaries as Sean Mackey, MD, Peter Levine, PhD, and Janina Fisher, PhD, to name a few.

This year, our stable of presenters began with an excellent talk on “A Primer on Biofeedback Devices for Pain Management” by Dr. Anu Kotay. Our next event by Abhishek Gowda, MD, on June 16^th, will address the most recent changes to the 2022 CDC Opioid  Guidelines and the Use of Buprenorphine. Later in the year, we are excited to welcome Dr. Jeffrey Gold, on September 5^th, on the use of virtual reality with pediatric pain; also, Dr. Lorimer Mosely, author of “Explain Pain,” for a live and streamed event from UCSF on  October 3rd. Dr. Moseley’s talk will be our first live and in-person event (“hybrid”) since the pandemic, so we are particularly excited about this.

Aside from our usual goal of providing quality education, we also are stepping up our effort to provide opportunities for our members to meet for consultation and peer discussions on complicated cases or issues. Our board member, Allison Bicksler, PhD, is taking the lead with this project, and we believe that this will help us fill a need we’ve been hearing from our members over the past couple of years for connection and mentoring.

Lastly, our other big news is that we have begun developing specialty committees for members interested in helping us expand our outreach and growth. Our first two committees will be our Membership Growth committee, headed by Dr. Consuelo Flores, to help us grow our membership numbers by reaching out to clinicians who might not have heard of us; and our Diversity committee, chaired by Dr. Heather Martarella, which is committed to expanding our membership into underrepresented professional communities and clients. If you might be interested in joining one of our first two committees, please let us know at info@painpsychology.org.

Thank you and hope to see you soon!

__________________________________________________________

Hello everyone!

Marilyn Jacobs and I have just returned from the 2024 American Academy of Pain Medicine conference in Scottsdale, AZ full of excitement and a sense of accomplishment from manning the AAPP booth over the weekend.

There were around 450 RSVP’d attendees plus an unknown number of “day of” registrations.  The overwhelming majority of attendees were physicians and other pain providers such as nurse practitioners and physicians-in-training with a sprinkling of psychologists and other mental health providers and students.

Our booth looked amazing with Darlene’s help getting the banner and the table skirt and brochures together.  The packet of abstracts and references were also quite the hit.

Although the actual number of psychologists stopping by our table was small, most of the medical providers indicated that they worked closely with at least one mental health provider and all of those indicated that they would be passing our information along to them and encouraging them to join.

Some of the current leadership of AAPM stopped by for extended chats about our organization including the immediate past president, Dr. Farshad Ahadian and Dr. Robert Wailes, the AAPM delegate to the AMA house of delegates.  Other notable people stopping by included Dr. Sean Mackey and Beth Darnall, PhD from Stanford.  It appears that membership numbers for psychologists are down for the organization and this year there were no pain interest group meetings leading Dr. Darnall to comment that AAPP is poised to fill a large gap for pain psychology practitioners.

I have to say that Marilyn was a real tiger when it came to drawing people in, and then engaging them in stimulating conversation about the importance of pain psychology.  Her breadth and depth of knowledge about pain medicine and integrated care was on full display and was quite impressive for our organization.

We don’t have hard numbers yet, but my guess if that we handed out over 100 flyers and 75% of our high quality pens (which were spontaneously acknowledged to us) so Chris was right about keeping an eye on our merch throughout the day.  Many of the people who stopped by had never heard of us before, so I believe that our larger mission of getting our organization’s name and mission out there was met.

About 40 people gave us their business card or name and contact info as a part of the raffle drawing for the three books.  Our winners were extremely excited to pick up their prizes and posed for pictures that we can include on the website.

During our time between visitors, we made a list of ideas about how to improve this process and continue to do outreach for members.

We ultimately believe that we should continue to exhibit at future conferences based on this experience.

Now that the banner, table skirt and flyers are created, it should be much easier to set up at future conferences.  I believe that Amanda mentioned a pediatric conference coming up.  Marilyn and I also think it would be great to have representation at APA’s convention in Seattle from August 8-10 in case someone is interested in representing us there.

Here are a few pictures of our experience and the winners from our book raffle.

Explain Pain | By Dr. David Butler & G. Lorimer Moseley Awarded by AAPP to: Sunannika Palec, M.D. Interventional Pain Medicine, Physical Medicine and Rehabilitation Post Doctoral Fellow Montefiore Medical Center, Einstein Campus Bronx, New York [Research Project in the U.S. from Phitsanulok, Thailand]

The Pain Chronicles: Cures, Myths, Mysteries, Prayers, Diaries, Brain Scans, Healing, and the Science of Suffering | By Melanie Thernstrom Awarded by AAPP to: Chandramouli Iyer, M.D., FIPP, DABA Anesthesiology, Pain Management UT Southwestern Medical School Dallas, Texas LTC US Army Reserve Pain Clinic Dallas Veterans Affairs Medical Center Dallas, Texas

The Story of Pain: From Prayer to Painkillers | By Joanna Bourke Awarded by AAPP to: Eric Pearson, M.D. Anesthesiology, Pain Management, Interventional Pain Medicine Meridian Total Pain Care Meridian, Mississippi