Online psychological treatment for pediatric recurrent pain: A randomized evaluation

Department of Psychology, University of Saskatchewan, Mental Health Services-Victoria Square, Box 3003, Prince Albert, Saskatchewan, Canada S6V 6G1.
Journal of Pediatric Psychology (Impact Factor: 2.91). 09/2006; 31(7):724-36.
Source: PubMed


To evaluate the efficacy of a distance treatment delivered through Internet and telephone for pediatric recurrent pain.
Forty-seven participants (9-16 years of age) were randomly assigned to either an Internet-based treatment or a standard medical care waitlist. Treatment employed a Web-based manual for children and parents with weekly therapist contact by telephone or e-mail. At 1- and 3-month follow-ups, participants were assessed on the outcome variables of pain and quality of life. A 50% reduction in diary pain scores was considered clinically significant.
Significant between-group differences were found: 71 and 72% of the treatment group achieved clinically significant improvement at the 1- and 3-month follow-ups, respectively, whereas only 19 and 14% of the control group achieved the criterion. No significant differences were found on the quality of life variable.
Distance methods have considerable potential for making effective treatments more accessible with lower associated costs.


Available from: Patrick J McGrath, Mar 02, 2014
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    • "Of the 35 included studies, 21 treated children and adolescents diagnosed with headache, eight treated abdominal pain, and three treated musculoskeletal pain. There were three studies that included children with multiple pain conditions: Hicks, von Baeyer, and McGrath (2006) treated children and adolescents with RAP and headache; Palermo, Wilson, Peters, Lewandowski, and Somhegyi (2009) treated children and adolescents with headache, abdominal pain, and musculoskeletal pain; and Wicksell, Melin, Lekander, and Olsson (2009) treated children and adolescents with headache, musculoskeletal pain, visceral pain, and complex regional pain syndrome. "
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    ABSTRACT: This systematic review and meta-analysis examined the effects of psychological therapies for management of chronic pain in children. Randomized controlled trials of psychological interventions treating children (<18 years) with chronic pain conditions including headache, abdominal, musculoskeletal, or neuropathic pain were searched for. Pain symptoms, disability, depression, anxiety, and sleep outcomes were extracted. Risk of bias was assessed and quality of the evidence was rated using GRADE. 35 included studies revealed that across all chronic pain conditions, psychological interventions reduced pain symptoms and disability posttreatment. Individual pain conditions were analyzed separately. Sleep outcomes were not reported in any trials. Optimal dose of treatment was explored. For headache pain, higher treatment dose led to greater reductions in pain. No effect of dosage was found for other chronic pain conditions. Evidence for psychological therapies treating chronic pain is promising. Recommendations for clinical practice and research are presented.
    Journal of Pediatric Psychology 03/2014; 39(8). DOI:10.1093/jpepsy/jsu008 · 2.91 Impact Factor
    • "Preliminary studies show that cognitive-behavioral programs are effective in reducing pain [e.g., Hechler et al., 2010; Sanders et al., 1989]. There are already evidence-based training programs that can be applied directly to children and adolescents for some chronic pain conditions, such as headaches [Denecke and Kröner-Herwig, 2000], whereas approaches to the treatment of CAP have focused more on the parents or the family [Duarte et al., 2006; Hicks et al., 2006; Levy et al., 2010; Palermo et al., 2009; Robins et al., 2005; Sanders et al., 1994]. The available data on the experience of stress and strain show, however, that children should be enabled to deal independently with their own pain experience. "
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    ABSTRACT: Hintergrund: Chronische Bauchschmerzen (CBS) sind im Kindesalter nicht nur weit verbreitet, sondern auch sehr stabil. Insbesondere psychosoziale Funktionseinschränkungen wie ein erhöhtes Stresserleben belasten die Kinder und deren Eltern und erschweren das Krankheitsmanagement; weitere komorbide Störungen können sich entwickeln. Dies legt nahe, dass eine Behandlung frühzeitig einsetzen und zudem auch die psychosozialen Aspekte mit berücksichtigen muss. Vor diesem Hintergrund wurde das kognitiv-behaviorale, kindzentrierte Gruppenprogramm «Stopp den Schmerz mit Happy-Pingu» entwickelt und evaluiert. Wie ist die psychosoziale Situation der betroffenen Kinder? Ist das kognitiv-behaviorale Programm in der Lage, psychosoziale Einschränkungen zu verbessern? Methodik: Das Programm besteht aus 6 Sitzungen für die Kinder sowie 1 Elternabend; die Trainingssitzungen fanden 1-mal wöchentlich statt. Im Rahmen einer randomisierten kontrollierten Studie wurde das Programm an 29 Kindern im Alter zwischen 6 und 12 Jahren auf seine Wirksamkeit hin überprüft. Die Evaluation erfolgte anhand eines Vergleiches zwischen Interventionsgruppe (IG) und Wartekontrollgruppe (WKG) zu den 3 Messzeitpunkten T1 (Prä), T2 (Post) und T3 (3-Monats-Follow-up). Ergebnisse: Bei den Kindern traten vor allem emotionale Probleme gehäuft auf. Die Akzeptanz des Programms war sehr hoch. Teilnehmer der IG erlebten im Vergleich zur WKG eine signifikante Verbesserung des Stresserlebens und der Coping-Strategien. Die Effektstärken sind überwiegend mittel bis hoch. Schlussfolgerungen: Multimodale kognitiv-behaviorale Ansätze scheinen geeignet, um Kinder mit CBS erfolgreich zu behandeln. Weitere kontrollierte Studien sollten unter anderem klären, welche Trainingselemente konkret für die Schmerzreduktion verantwortlich sind.
    Verhaltenstherapie 05/2013; 23(2):80-89. DOI:10.1159/000351215 · 0.48 Impact Factor
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    • "The interactive Internet-based intervention proposed in this study provided knowledge and information about dysmenorrhea self-care, auricular acupressure techniques, professional counseling, and peer support. Our results are consistent with previous findings showing the efficacy of Internet-based interventions in reducing pain [35, 36, 57, 58] but are not in agreement with the findings of Trautmann and Kröner-Herwig [59]. A systematic review shows that Internet-based programs appear to relieve pain [33]. "
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    ABSTRACT: Background. Primary dysmenorrhea is prevalent in adolescents and young women. Menstrual pain and distress causes poor school performance and physiological damage. Auricular acupressure can be used to treat these symptoms, and Internet-based systems are a flexible way of communicating and delivering the relevant information. Objective. This study investigates the effects of auricular acupressure (AA) alone and combined with an interactive Internet-based (II) intervention for the management of menstrual pain and self-care of adolescents with primary dysmenorrhea. Design. This study adopts a pretest/posttest control research design with a convenience sample of 107 participants. Results. The outcomes were measured using the short-form McGill pain questionnaire (SF-MPQ), visual analogue scale (VAS), menstrual distress questionnaire (MDQ), and adolescent dysmenorrheic self-care scale (ADSCS). Significant differences were found in ADSCS scores between the groups, and in SF-MPQ, VAS, MDQ, and ADSCS scores for each group. Conclusion. Auricular acupressure alone and a combination of auricular acupressure and interactive Internet both reduced menstrual pain and distress for primary dysmenorrhea. Auricular acupressure combined with interactive Internet instruction is better than auricular acupuncture alone in improving self-care behaviors.
    Evidence-based Complementary and Alternative Medicine 04/2013; 2013(1):316212. DOI:10.1155/2013/316212 · 1.88 Impact Factor
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