Psychological Process and Clinical Translation
An underlying goal of research on placebo effects is to develop a deeper understanding of the phenomenon, so as to strategically incorporate it into improved patient care. Although this opportunity for translation currently holds much promise, there remains substantial uncertainty as to how exactly our knowledge of placebo effects can guide specific intervention techniques. We suggest that this translation process will be facilitated by increasing the investigation of the psychological component of this psychobiological phenomenon. For example, although much has been learned about the neurobiological mechanisms involved in placebo effects, it remains unclear how this knowledge will be used to develop accessible tools for practitioners looking to activate placebo responses in a clinical setting. Because placebo effects are largely driven by a patient's subjective interpretation of the clinical encounter and the interpersonal context surrounding treatment, clarifying the psychological processes at play could aid translation of research effort to clinical interventions.
Further, existing research suggests that contextual cues, physician characteristics, or ritualistic features of healthcare encounters can be manipulated to enhance placebo effects. Importantly, the ultimate success of any such intervention will depend on whether the interventions produce therapeutic benefit by evoking the desired changes in a patient's appraisals, cognitive processing, and affective states. Thus, the feelings and thoughts (conscious or nonconscious) patients have about the treatment event – their psychological processes – are critical to promoting therapeutic placebo responses because they take center stage in mediating the link between the therapeutic context and placebo responding.