Pre-Surgical Psychological Screening Results: The Psychology of Pain Blog Series 3

Contributing author, Clinical Health Psychologist William W. Deardorff, PhD, ABPP stresses the importance of pre-surgical psychological screening for patients considering an elective spine surgery.

You can see his first 2 parts in this blog series here:

See The Connection Between Pain and the Brain: The Psychology of Pain Blog Series 1

See Pre-Surgical Psychological Screenings: The Psychology of Pain Blog Series 2

Lumbar Degenerative Disc Disease Video
Not all patients who suffer from lumbar degenerative disc disease will benefit from spine surgery.
Lumbar Degenerative Disc Disease Video

This week, Dr. Deardorff describes what to expect after having a pre-surgical psychological screening.

See The Importance of Psychological Preparation for Back Surgery

Veritas Health:

What should a patient expect after undergoing a pre-surgical psychological screening?

Dr. Deardorff:

The pre-psychological screening will likely yield 1 of 3 results:

  • All clear for surgery
  • Recommend further preparation for surgery treatment
  • Avoid the surgery due to high risk for clinical failure

See Benefits of Psychological Preparation for Back Surgery

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If your psychologist recommends surgery preparation, he or she will focus the treatment plan to address concerns that were identified during the pre-psychological screening.

Examples include:

  • Treating identified depression
  • Detoxing off of too much medication
  • Undergoing a pre-operative muscle strengthening program
  • Cognitive therapy for coping with chronic pain
  • See 11 Chronic Pain Control Techniques

  • Psycho-educational approaches to manage expectations about the spine surgery outcomes
Your doctor may recommend strength training as preparation before spine surgery.
Read more:
Strengthening Exercise Program for Low Back Pain Relief.

If a patient is found to be a poor surgery candidate and it is not recommended, other treatment options might include a pain program similar to the one I mentioned previously (in The Psychology of Pain Blog Series 1).

See Preparation Before Back Surgery

Veritas Health:

Does insurance generally cover these screenings?

Dr. Deardorff:

That is very difficult to say given the overwhelming number of policies. Often, a patient will get a referral for the pre-surgical screening from the surgeon, and this can be considered as being medically necessary. In these cases, the pre-surgical screening may be covered under medical benefits (versus mental health).

In any case, the most prudent approach is to discuss the coverage with one’s insurance company ahead of time. Generally, the patient can obtain the CPT codes (the charge codes) from the psychologist doing the pre-surgical screening and ask the carrier about coverage. The pre-surgical screening will generally consist of an interview with the psychologist and psychological testing.

See Getting a Referral to a Spine Surgeon

Most spine surgeons who value pre-surgical screenings will have a psychologist they refer to often. Otherwise, you might try and find a psychologist who is a member of the North American Spine Society (NASS), American Pain Society (APS) or similar multidisciplinary professional organization. Larger spine surgery practices, especially those associated with university medical schools will have a spine psychologist as part of the treatment team.

Learn more:

How to Prepare Psychologically for Back Surgery

4 Tips to Help Cope With Chronic Pain and Depression

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