Group medical visits provide social support for chronic pain patients

More than one in five U.S. adults lives with chronic pain, which isolation and stigma can worsen. Group medical visits allow multiple patients with a common condition to receive care alongside health education and peer support.

This study examined how group medical visits facilitate four types of social support: emotional, appraisal, informational, and instrumental. Qualitative data was collected within a randomized trial at San Francisco safety-net clinics. Patients were assigned to group visits consisting of 12 weekly two-hour sessions of clinical care, pain education, mindfulness, gentle movement, and discussion.

Groups were co-facilitated by primary care and behavioral health clinicians, as well as a movement and mindfulness instructor. Patients reported all four types of social support. The nonjudgemental space and trust built within the group encouraged emotional support, such as removing shame over late arrivals or absences, and also from naming and discussing grief.

Facilitators gave appraisal support by disclosing their own setbacks and peers offered affirmations that encouraged self-compassion. Informational support came from the curriculum and from peers, who traded tips like using frozen water bottles for plantar fasciitis. Instrumental support included peers bringing food to share and facilitators referring participants for counseling and other care. 

Why it matters: Through deliberate facilitation and peer exchange, group medical visits mobilize four reinforcing forms of social support as core therapeutic processes. Group medical visits are one model of biopsychosocial chronic pain management in primary care.