| Spinal cord stimulators are implanted medical devices used for pain management in certain types of chronic pain disorders. Psychological evaluations are generally required by physician implanters and insurance companies. While pre-SCS psychological evaluations are generally standard practice, the body of literature describing psychological evaluation procedures outside the research setting is limited. The purpose of the current research project was to: assess and describe contemporary practices in the psychological evaluation of candidates for spinal cord stimulators, such as the domains assessed and the methods used; and identify practices that are associated with participants' confidence in the predictive ability of the evaluations conducted.;An online survey was used to gather data regarding current practices in pre-SCS psychological evaluations from practitioners recruited through mail list servers, e-mail, mail, and telephone contact. Participants provided information in both closed- and open-ended formats for the following areas: psychological assessment methods used, such as interviews and psychological tests; psychological issues assessed, both in the domains of psychiatric disorders and in other psychosocial and behavioral issues; issues of greatest concern when formulating recommendations for approval, delay, or denial for surgery; types of pre-SCS recommendations most typically provided; and overall percentages of patients for whom recommendations for approval, delay, or denial of implantation are made. Participants also provided information regarding: relationship with the physician implanter; level of perceived pressure from the implanter to provide approval for surgery; and level of confidence in the ability of their evaluations to identify patients who will have poor outcomes with SCS implantation due to psychological factors.;Sixty-nine psychologists (44.9% female) completed the survey. All but four were licensed at the doctoral level, with the remainder in the process of completing doctoral training or licensure. Clinical interviews were used by all participants in the pre-SCS psychological evaluation process, with 65 using psychological tests. Participants indicated a relatively high degree of confidence in the ability of their psychological evaluations to identify patients who are unlikely to have a positive outcome, on a scale of 0-10 ( M = 7.80, SD = 1.17, Mdn = 8.00, n = 62). Hypothesis testing did not reveal any significant associations between evaluator confidence and either the number of evaluations conducted or the numbers of issues assessed.;Information is reported related to the psychological issues assessed; pre-SCS recommendations, indications and contraindications; training; and other issues. The current study appears to be the first that surveys the practices of psychologists in the field who conduct pre-SCS psychological evaluations. Our data provide insight into practices, beliefs, and recommendations of practitioners that may be of value in continued efforts to optimize the content, evolution, and promulgation of resources used in the psychological assessment, treatment, and preparation of candidates for SCS. |
