TY - JOUR
T1 - Brief telephone-delivered cognitive behavioral therapy targeted to parents of children with functional abdominal pain
T2 - A randomized controlled trial
AU - Levy, Rona L.
AU - Langer, Shelby
AU - Van Tilburg, Miranda A.L.
AU - Romano, Joan M.
AU - Murphy, Tasha B.
AU - Walker, Lynn S.
AU - Mancl, Lloyd A.
AU - Claar, Robyn L.
AU - DuPen, Melissa M.
AU - Whitehead, William E.
AU - Abdullah, Bisher
AU - Swanson, Kimberly S.
AU - Baker, Melissa D.
AU - Stoner, Susan A.
AU - Christie, Dennis L.
AU - Feld, Andrew D.
N1 - Funding Information:
National Institute of Child Health and Human Development (R.L.L.)
Publisher Copyright:
© 2016 International Association for the Study of Pain.
PY - 2017/4/1
Y1 - 2017/4/1
N2 - Pediatric functional abdominal pain disorders (FAPDs) are associated with increased health care utilization, school absences, and poor quality of life (QoL). Cost-effective and accessible interventions are needed. This multisite study tested the effects of a 3-session cognitive behavioral intervention delivered to parents, in-person or remotely, on the primary outcome of pain severity and secondary outcomes (process measures) of parental solicitousness, pain beliefs, catastrophizing, and child-reported coping. Additional outcomes hypothesized a priori and assessed included functional disability, QoL, pain behavior, school absences, health care utilization, and gastrointestinal symptoms. The study was prospective and longitudinal (baseline and 3 and 6 months' follow-up) with 3 randomized conditions: social learning and cognitive behavioral therapy in-person (SLCBT) or by phone (SLCBT-R) and education and support condition by phone (ES-R). Participants were children aged 7 to 12 years with FAPD and their parents (N = 316 dyads). Although no significant treatment effect for pain severity was found, the SLCBT groups showed significantly greater improvements compared with controls on process measures of parental solicitousness, pain beliefs, and catastrophizing, and additional outcomes of parent-reported functional disability, pain behaviors, child health care visits for abdominal pain, and (remote condition only) QoL and missed school days. No effects were found for parent and child-reported gastrointestinal symptoms, or child-reported QoL or coping. These findings suggest that for children with FAPD, a brief phone SLCBT for parents can be similarly effective as in-person SLCBT in changing parent responses and improving outcomes, if not reported pain and symptom report, compared with a control condition.
AB - Pediatric functional abdominal pain disorders (FAPDs) are associated with increased health care utilization, school absences, and poor quality of life (QoL). Cost-effective and accessible interventions are needed. This multisite study tested the effects of a 3-session cognitive behavioral intervention delivered to parents, in-person or remotely, on the primary outcome of pain severity and secondary outcomes (process measures) of parental solicitousness, pain beliefs, catastrophizing, and child-reported coping. Additional outcomes hypothesized a priori and assessed included functional disability, QoL, pain behavior, school absences, health care utilization, and gastrointestinal symptoms. The study was prospective and longitudinal (baseline and 3 and 6 months' follow-up) with 3 randomized conditions: social learning and cognitive behavioral therapy in-person (SLCBT) or by phone (SLCBT-R) and education and support condition by phone (ES-R). Participants were children aged 7 to 12 years with FAPD and their parents (N = 316 dyads). Although no significant treatment effect for pain severity was found, the SLCBT groups showed significantly greater improvements compared with controls on process measures of parental solicitousness, pain beliefs, and catastrophizing, and additional outcomes of parent-reported functional disability, pain behaviors, child health care visits for abdominal pain, and (remote condition only) QoL and missed school days. No effects were found for parent and child-reported gastrointestinal symptoms, or child-reported QoL or coping. These findings suggest that for children with FAPD, a brief phone SLCBT for parents can be similarly effective as in-person SLCBT in changing parent responses and improving outcomes, if not reported pain and symptom report, compared with a control condition.
KW - Abdominal pain
KW - Children
KW - Chronic pain
KW - Cognitive behavioral therapy
KW - Function
KW - Parents
KW - Pediatric
KW - Psychological treatment
KW - Randomized controlled trial
KW - Social learning
UR - http://www.scopus.com/inward/record.url?scp=85018178379&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85018178379&partnerID=8YFLogxK
U2 - 10.1097/j.pain.0000000000000800
DO - 10.1097/j.pain.0000000000000800
M3 - Article
C2 - 28301859
AN - SCOPUS:85018178379
SN - 0304-3959
VL - 158
SP - 618
EP - 628
JO - Pain
JF - Pain
IS - 4
ER -