Teaching the biopsychosocial model of chronic pain: Whom are we talking to?

The biopsychosocial (BPS) model of chronic pain can be illustrated in many ways. Our aim is to adapt three illustrations of the BPS approach selected from the literature to target different groups: patients, health professionals and clinical trainees. In clinician-patient consultations, we use an illustration which shows the interactions among the BPS domains in the creation of suffering and pain behaviours in a "vicious spiral". Moreover, we help our patients understand chronic pain often does not entail remaining tissue damage. In clinical practice, we communicate to other health professionals that the relative contribution of each BPS domain varies from patient to patient. This disproportional contribution may also change dynamically over the time. In teaching clinical trainees, we combine thoroughness (i.e., focus on "details") with an understanding of the "dynamics" of pain chronification/chronic pain, i.e., focus on helping the trainee identify the mutual and joint interactions between different parts of the BPS framework. CONCLUSION: The three illustrations can be used as pedagogical tools for better-informed BPS perspectives in different settings. PRACTICE IMPLICATIONS: Clinicians need to be keen observers and adapt their communication depending on whom they are talking to.