Vocational counseling is an important component of the psychological approach to chronic pain. Each patient is evaluated to determine work history, educational background, vocation skills and abilities, and motivation to return to work.

The vocational counselor can determine whether past work skills and current aptitudes can be transferred to alternative occupations if necessary. The vocational counselor works with the patient regarding legal rights and obligations for each state such as workers’ compensation, and helps the patient set realistic vocational goals.

They also help the patient to improve overall vocational functioning. The modern approach to the treatment of chronic pain is multidisciplinary. Typical programs combine physical therapy interventions with behavioral and psychological approaches.

These consist of the components mentioned above, of education, relaxation training, and cognitive-behavioral techniques in both group and individual formats.

Vocation counseling is used to reduce functional impairment and disability, improve coping strategies, enhance effective use of pain medications, and decrease use of healthcare resources.

The exact structure of the pain management program varies according to the setting and the type of population served.


The result of pain management program must be measured in objective and quantifiable terms. These outcome measurements include use of medication, walking distance, strength, flexibility, sitting tolerance, pain behaviors, vocational placement, and use of healthcare resources.

When comparing one program with another, it is important to evaluate each program in terms of types of patients accepted, types of treatments offered, criteria for improvement, and follow up time.

Ideal pain rehabilitation candidates can achieve an 80% to 90 % success rate. As the incidence of psychosocial problems and secondary gain issues increases, however, this rate drops to 40% to 50%. With major psychiatric or secondary gains, the success rate drops to 20% or less.