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espanolLos tratamientos psicologicos del dolor cronico estan ampliamente valorados y estan considerados como tratamientos basados en la evidencia. Al mismo tiempo, existen retos en el futuro para estos tratamientos, entre los cuales encontramos: a) proporcionar mayores beneficios a mas personas; b) ajustar a cada persona el tratamiento que le proporcione los mejores resultados de la manera mas eficiente; c) identificar y monitorizar los mecanismos especificos de cambio de tratamiento; d) mantener la fidelidad del tratamiento y la competencia del terapeuta a medida que se desarrollan los modelos de tratamiento. Este corto articulo discute sobre estos retos y alguna de las formas de abordarlos, incluyendo como ejemplos la aplicacion del modelo de flexibilidad psicologica y el enfoque de la Terapia de Aceptacion y Compromiso (ACT). Se argumenta que la flexibilidad psicologica puede ser particularmente util como modelo, al ayudar a investigadores y terapeutas a seguir un enfoque mas orientado al tratamiento o al mecanismo para el desarrollo del tratamiento. En cuanto a la ACT, actualmente existen mas de 11 ensayos controlados aleatorizados publicados y tres revisiones sistematicas que sustentan su beneficio para las personas con dolor cronico. Este enfoque de modelo y tratamiento puede proporcionar el tipo de abordaje que la psicologia precisa para guiar la evolucion continua del tratamiento. Sin embargo, estas no seran nuestras respuestas finales, porque ciertamente, los futuros tratamientos psicologicos seran diferentes, en algunos aspectos, de los que hacemos hoy. EnglishPsychological treatments for chronic pain are widely appreciated and regarded as evidence-based. At the same time there are challenges in the future for these treatments, including the following: a) creating larger benefits for more people, b) matching people with the treatment that is likely to give them the best results most efficiently, c) identifying and then tracking and targeting specific mechanisms of treatment change, and d) maintaining treatment fidelity and therapist competency as treatment models develop. This short article discusses these challenges and some ways to deal with them, including the application of the psychological flexibility model and a treatment approach called Acceptance and Commitment Therapy (ACT) as examples. It is argued that psychological flexibility may be particularly helpful as a model because, and helps researchers and therapist follow a more mechanism or process oriented approach to treatment development. As for ACT, there are now more than 11 published RCTs and three related systematic reviews supporting its benefits for people with chronic pain. This model and treatment approach may provide the kind of focus that psychology needs to guide continuing treatment development, and yet these will not be our final answers, because certainly psychological treatments in the future will be different in some ways from the ones we do today.

Psychological approaches to chronic pain management: where are we coming from and where might we go?