Interest in the use of psychosocial interventions to help older adults manage pain is growing. In this article, we review this approach. The first section reviews the conceptual background for psychosocial interventions with a special emphasis on the biopsychosocial model of pain. The second section highlights three psychosocial interventions used with older adults: cognitive behavioural therapy, emotional disclosure, and mind-body interventions (specifically mindfulness-based stress reduction and yoga). The final section of the paper highlights important future directions for work in this area.

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Background Living with Inflammatory Bowel Disease (IBD) has been associated with increased psychosocial stress among pediatric IBD populations. Elevated psychological stress can exacerbate disease activity and IBD symptoms like abdominal pain, which in turn can negatively impact children’s mental health. There is an increasing need for mind-body interventions that can improve biopsychosocial processes among youth with IBD. Mindfulness-based interventions (MBIs) have been shown to be efficacious in improving emotional distress, pain, and inflammation in a range of pediatric and adult chronic illness/pain populations. Few studies have explored MBIs in pediatric IBD. Using virtual reality (VR) as the medium for an MBI in pediatric IBD has great potential given the increasing prevalence of VR in children’s hospitals, the immersive nature of the technology, and the high acceptability of VR among youth. Aims 1) Assess the feasibility and acceptability of mindfulness-based virtual reality (MBVR) among youth with IBD; 2) Assess the preliminary efficacy of MBVR on anxiety and pain. Methods Youth at an outpatient IBD clinic were offered MBVR. Our team developed a 6-minute MBVR experience, “MediMindfulness-Transitions” (Stanford University & Weightless Studios), that focused participants’ awareness on a natural environment (e.g., waterfall in meadow, northern lights) and their breath. Participants rated their level of anxiety and pain on VAS scales (0-100mm) immediately before and after the MBVR experience. Paired t-tests were used to assess changes in patient reported outcomes (SPSS 26). Patients also completed a satisfaction survey and provided qualitative feedback. Results The sample included 52 participants with IBD (M=15 yrs; 69% Crohn’s disease; 58% Male; 62% White). MBVR was easily integrated into clinic flow (offered before or after MD visit) and there was 100% treatment compliance. There were high levels of enjoyment (M=4.4, range 1–5) and relaxation (M=4.3, range 1–5) post-intervention; 50% of the sample reported MBVR was an ideal length and were extremely interested in using MBRV at home. Qualitative data revealed areas of enjoyment and suggestions for future use (Table 1). Exploratory efficacy analyses revealed MBVR decreased anxiety (16.54 ± 20.56 vs 7.10 ± 13.27, p < 0.001) and pain (9.5 ± 16.19 vs 3.04 ± 6.22, p < 0.01). One patient experienced worsening of their anxiety symptoms. Conclusion MBVR was shown to be feasible and have high acceptability among youth with IBD. The results demonstrated preliminary support for MBVR reducing acute anxiety and pain. This study suggests MBVR could be a promising mind-body therapy for youth with IBD. Future studies should explore the efficacy of MBVR during IBD procedures and treatments (e.g., blood draws, MRIs, infusions) and whether longer-term use of MBVR improves biopsychosocial outcomes.