ABSTRACT
The cornerstone of the PPS is the evaluation interview. It is during this interview that the practitioner has the opportunity to understand the patient's pain problems and how they affect work, family, economics, and lifestyle. The patient's attitude toward the surgery and motivation for improvement in functioning can also be determined. However, interviewing a spine surgery candidate presents unique problems for the behavioral health practitioner. Despite the practitioner's best efforts at helping the surgeon prepare the referral, the patient may not understand why the evaluation is necessary. The patient may or may not know that the outcome of the interview will affect the chances of receiving an operation. Confidentiality issues may also come into play. Thus, initial defensiveness, distrust, and anger often must be overcome.
