For more 50 years psychologists have applied behavioral science to the problem of persistent pain, proposed solutions and tested these. The treatments this has produced have evolved and improved in several respects during this time.  Now psychological treatments for persistent disabling pain are among the safest and most effective treatments one can receive. And yet, challenges remain. Results could be more complete, for more people, in more domains of functioning, and these results could be more durable. We could perhaps one day break down barriers to treatment access, around the world, and make these treatments even more efficient to deliver than they are now.

This lecture will outline the role psychology plays in understanding and treating chronic pain. It will also describe new developments in the field, new research directions that could be taken in the future to meet the challenges described. It is proposed that treatments in the future will improve if our research takes a greater focus on the individual, their goals and needs, and evidence-based processes of change. This research will need to incorporate a new perspective, from a nearly sole reliance on approaches that emphasize large numbers of people observed very few times, toward the inclusion of methods that rely on large numbers of observations from a relatively small number of people over time. This approach to treatment development and testing is idiographic, and includes what we mean when we say personalized treatment, individually-tailored treatment, and process-based therapy, among other names.