Mental health conditions that commonly co-occur with chronic musculoskeletal pain contribute to greater health care utilization. Improved screening and early intervention for these disorders in primary care may improve patient outcomes and stem high rates of care utilization of veterans.

This conceptual article aims to propose a framework of understanding the risk and resistance factors that contribute to the adjustment of spousal caregivers of chronic pain patients (SCCPP). A comprehensive review of literature related to caregivers of patients with chronic pain was performed. Findings from the review were applied to the Wallander et al.’s Risk and Resistance Model of Adjustment, specifically examining outcomes among SCCPP. No statistical results are presented in this conceptual article. We advocate for the need to study and test the adjustment process of SCCPP in a systematic, comprehensive, and theory-driven manner to further understand caregivers’ strengths and challenges. This will allow for further rehabilitation interventions to address risk factors and promote resistance factors, allowing for more inclusive mental health care for SCCPP.

T he purposes of this review article are to gather existing evidence on the contributing factors in affecting the psychosocial adjustment among people with chronic pain, and to promote a comprehensive conceptual framework in this topic by adapting Wallander and colleagues' (1989) Risk and Resistance Model of Adjustment. Our intention is to promote future empirical research that will validate this working conceptual framework and will provide and clinical guidelines for rehabilitation professionals who work with people with chronic pain.

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