Psychophysiology in an Adult Hospital

Introduction Every hospital patient is admitted with his or her own blend of acute and chronic problems. By definition, these diseases and disorders embody varying degrees of psychophysiological dysregulation, problems that may shrink or remit when addressed thoughtfully using the tools of self-regulation. Baylor All Saints Medical Center in Fort Worth, Texas, has a long history of using psychophysiological interventions as part of the broad approach to patients’ health. For the past 4K years, the hospital has funded an in-house psychophysiologist. In this article, we tell the stories of two composite representative patients to illustrate psychophysiological services used in this adult hospital setting. Finally, we conclude by addressing reimbursement issues and exploring future directions. The psychophysiologist works primarily within the Martin Center for Chronic Pain Management, an interdisciplinary program that helps a wide range of patients (see Table 1). The team is composed of a psychologist, a physical therapist, a master’s prepared nurse, and the psychophysiologist. The psychophysiologist is a licensed mental health provider who is also certified in biofeedback and clinical hypnosis. The team conducts an integrated assessment for referred patients and creates a treatment plan. The client may then be invited to enter a comprehensive interdisciplinary pain (CIP) program, offered individual treatment components within the center, or referred for outside services. The CIP program offers ‘‘skills not pills.’’ Clients come to the program two afternoons per week, for 4 to 5 hours each day. The program lasts 6 to 8 weeks, depending on the clients’ response to treatment. It is behaviorally oriented, with a focus on teaching clients to manage pain. Most clients experience a reduction in pain, take less pain medication, and report improved sleep and reduced negative affect. The emphasis is on individual treatment rather than treatment groups. Clients served come from diverse life circumstances, some who have had problems with chronic pain for 6 months, and some for decades. A description of a typical client’s progress through the psychophysiological component of this program follows.