Evidence-Based Psychological Interventions for the Management of Pediatric Chronic Pain: New Directions in Research and Clinical Practice

Abstract

Over the past 20 years our knowledge about evidence-based psychological interventions for pediatric chronic pain has dramatically increased. Overall, the evidence in support of psychological interventions for pediatric chronic pain is strong, demonstrating positive psychological and behavioral effects for a variety of children with a range of pain conditions. However, wide scale access to effective psychologically-based pain management treatments remains a challenge for many children who suffer with pain. Increasing access to care and reducing persistent biomedical biases that inhibit attainment of psychological services are a central focus of current pain treatment interventions. Additionally, as the number of evidence-based treatments increase, tailoring treatments to a child or family’s particular needs is increasingly possible. This article will (1) discuss the theoretical frameworks as well as the specific psychological skills and strategies that currently hold promise as effective agents of change; (2) review and summarize trends in the development of well-researched outpatient interventions over the past ten years; and (3) discuss future directions for intervention research on pediatric chronic pain.

Parent pain catastrophizing predicts child depressive symptoms in youth with sickle cell disease

“…Understandably, many parents may have faced multiple challenges with effectively managing their child's pain and emotional symptoms, and are likely to experience elevated parenting distress and limited perceived control over child pain. Training children and their parents in evidence‐based strategies for behavioral pain management may serve to bolster parental self‐efficacy in managing their child's pain and thus, support youth coping with illness, recurrent pain, and emotional distress …”

“…In light of research evidence supporting a trajectory in which functional improvements may precede pain control, parent training remains a critical component of chronic pain management for children and adolescents . Additionally, improving upon the quality of parent–child communication of pain management needs and reducing the focus and attention on pain, has been shown to improve child pain management . Additional behavioral treatments, such as acceptance and commitment therapy, promote psychological acceptance that pain may continue to be a part of life when treating youth with SCD and their families.…”

“…Training children and their parents in evidence-based strategies for behavioral pain management may serve to bolster parental self-efficacy in managing their child's pain and thus, support youth coping with illness, recurrent pain, and emotional distress. 33,39 Importantly, parent education and training in behavioral pain management represents a foundational element of evidence-based, cognitive-behavioral therapy for pediatric pain, which is known to reduce child pain perception and emotional distress, anxiety, and paininduced behaviors. 39 A primary aspect of parent training guidelines are rooted in teaching parents to encourage participation in functional activities, even in the context of pain (e.g., school attendance), while shifting the family attentional focus away from the child's pain and toward their ability to cope and function with pain.…”

Psicología y dolor crónico infantil

“…Desde este modelo se propone un abordaje de las conductas, emociones y pensamientos que intervienen en la experiencia del dolor (33)(34)(35), para facilitar que los niños y adolescentes puedan retomar el nivel de actividad previo a la aparición de los problemas de dolor y mejorar su calidad de vida.…”

Physical therapists’ experiences of learning and delivering a complex behavioral medicine intervention to adolescents with pain

“…Hence, comprehensive intervention models that include multiple and interacting components are needed. Such interventions typically include tailoring and permitting various degrees of flexibility (Åsenlöf, Denison, and Lindberg, 2005;Coakley and Wihak, 2017;Craig et al, 2008;Kreuter and Skinner, 2000). Scientific study of the effects of new, complex interventions is important but challenging (Craig et al, 2008), and it is valuable to capture health-care professionals' experiences and opinions of learning and delivering such interventions.…”