Behavioral and Cognitive-Behavioral Interventions with Pediatric Populations

Abstract

A B S T R A C TClinical outcome studies have established cognitive-behavioral therapy (CBT) as an efficacious treatment for children and adolescents presenting with a variety of problems, such as anxiety and maladaptive behaviors. Findings to date are also very promising for the use of CBT techniques with children and adolescents who have chronic medical illnesses, including obesity, encopresis, severe and persistent feeding problems, recurrent headache, recurrent abdominal pain and acute procedural pain. This article provides an overview of behavioral/cognitive-behavioral theory, intervention and the important role outcome-based research plays in the development of this treatment modality. CBT interventions utilized with various pediatric populations are described, and the results of outcome-based research employing these techniques are examined. The Chambless criteria are used to determine the efficacy of specific interventions based upon the number, size and outcomes of studies utilizing CBT treatments with pediatric populations. Case examples are included to further illustrate the effectiveness of these interventions for children and adolescents with chronic medical conditions. K E Y W O R D S empirically supported treatment, feeding, obesity, pain, pediatric psychology B E H AV I O R A L A N D C O G N I T I V E -B E H AV I O R A L therapies have permanently altered the landscape of non-pharmacological treatment for emotional and behavioral disorders.The evidence-based techniques derived from these treatment models have been proven efficacious through research on their application to a wide range of patient populations and conditions, such as anxiety and depression. These models have also given rise to therapeutic techniques that have applicability beyond the scope of mood and behavioral disturbances. This is particularly true within the specialized field of pediatric psychology, where behavioral/cognitive-behavioral therapies, have demonstrated efficacy in the treatment of recurrent pediatric headache (Holden, Deichmann, & Levy, 1999), recurrent abdominal pain (Janicke & Finney, 1999), medical procedure-related pain Clinical Child Psychology and Psychiatry

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