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CBT helped children cope with abdominal pain

Children who received cognitive-behavioral therapy and social learning intervention reported decreases in gastrointestinal symptom severity and greater improvements in coping with abdominal pain, according to study results.

“Long-term maintenance of treatment gains is an important goal of any treatment trial,” the researchers wrote. “Similarly, ease of administration (ie, brevity and minimal invasiveness) is also a desirable treatment characteristic, particularly in pediatric practice.”

Rona L. Levy, MSW, PhD, MPH, of the University of Washington, and colleagues studied the effectiveness of a brief intervention designed for children with functional abdominal pain and their parents. The intervention consisted of three sessions of social learning and cognitive-behavioral therapy (CBT) spaced 1 week apart, created to teach parents and their children how to think about and cope with pain “in ways that encouraged wellness rather than illness behavior,” according to the researchers.

Two hundred children and their parents were randomly assigned either to the CBT intervention or an education and support intervention — which consisted of an equal amount of time dedicated to gastrointestinal system and nutrition education. Symptoms of pain and coping skills were assessed at baseline, 1 week, 3 months, 6 months and again at 12 months, using a series of valid measures, including the Faces Pain Scale-Revised and the Adults’ Responses to Children’s Symptoms.

Children in the CBT group reported greater decreases from baseline to 12 months in gastrointestinal symptom severity (estimated mean difference: –0.36; 95% CI, –0.63 to –0.01) and greater improvements in pain-coping responses (estimated mean difference: 0.61; 95% CI, 0.26-1.02) vs. children in the control arm. Compared with parents in the control group, parents assigned to CBT reported greater decreases in solicitous responses to their child’s symptoms (estimated mean difference: –0.22; 95% CI, –0.42 to –0.03) and greater decreases in maladaptive beliefs about their child’s pain (estimated mean difference: –0.36; 95% CI, –0.59 to –0.13).

“[G]iven the relative low cost of this intervention, pediatricians should consider the incorporation of these strategies into their treatment plan for children with this common complaint,” the researchers wrote. “The opportunity that some pediatric practices have to colocate a mental health specialist in an office or clinic may also help make this therapy more available.”

Disclosure: The researchers report no relevant financial disclosures.