Cognitive-Behavioral Therapy for Chronic Pain in Children and Adolescents

Chronic pain is a significant health problem for many children and adolescents and is often challenging for healthcare professionals to treat. Estimated to affect approximately 15% to 30% of children, chronic and recurrent pain occurs most commonly in the pediatric population without clearly identifiable underlying physical etiology, such as pain associated with irritable bowel syndrome, headaches, musculoskeletal pain, or complex regional pain syndrome. Chronic or recurrent pain may also be associated with ongoing underlying medical conditions, such as arthritis, cancer, Crohn's disease, or sickle cell disease. Cognitive-Behavioral Therapy for Chronic Pain in Children and Adolescents provides a practical guide for implementing cognitive-behavioral therapy (CBT) for children and their families coping with the consequences of persisting pain. The book is divided into three sections. The first section presents a brief history, theoretical foundations, and background concerning the development of CBT interventions for children with chronic pain conditions and summarizes research results on the efficacy of CBT. Chapters in the second section cover assessment and evaluation approaches, patient education, and how to structure and sequence CBT interventions with children and families. The last section of the book describes in detail each cognitive-behavioral intervention, including relaxation and cognitive skills and interventions directed at parents, sleep problems, physical activity, and school functioning. Extensive suggested dialogue and detailed instructions and handouts are included in the text and accompanying appendices to provide user-friendly therapist training materials for successful application of clinical techniques to children and families. Cognitive-Behavioral Therapy for Chronic Pain in Children and Adolescents is an essential, evidence-based resource for pediatric and child clinical psychologists and other mental health professionals (social workers, child psychiatrists) who work with children in pain.

Part I: Introduction to cognitive-behavioral therapy for chronic pain in children and adolescents. 1. The problem of chronic pain in children and adolescents. 2. A brief history: development of CBT in pediatric pain management. 3. The evidence base for cognitive-behavioral therapy for pediatric chronic pain. Part II: Assessment, education, and treatment planning. 4. Assessment and evaluation. 5. Education and treatment planning. Part III: Interventions. 6. Relaxation, imagery, and biofeedback training. 7. Parental intervention strategies. 8. Cognitive skills training. 9. School interventions. 10. Sleep interventions. 11. Lifestyle and physical activity interventions. 12. Conclusions and future directions. Appendices. 1. Pain diary. 2. Educational resources for parents. 3. Basic abdominal breathing instructions.. 4. Progressive muscle relaxation script for younger children (under 10 years). 5. Progressive muscle relaxation script for older children (ages 10 and above). 6. Pleasant place imagery. 7. Muscle relaxation with imagery script. 8. Relaxation practice tips. 9. Relaxation practice log and diary. 10. Parent management guidelines. 11. Point system contract and tracking calendar. 12. Privilege system contract. 13. Tips for parents to establish an effective reward system. 14. Tips for establishing good communication habits. 15. Positive coping self statements worksheet. 16. Thought record. 17. Thought-stopping instructions. 18. Thought continuum exercise. 19. School letter sample. 20. Sleep diary. 21. Tips for improving your sleep. 22. Stimulus control instructions. 23. Instructions for activity pacing. 24. Pleasant activities chart. References. Index.

Tonya M. Palermo, Ph.D., is Professor of Anesthesiology and Pain Medicine and Adjunct Professor of Pediatrics and Psychiatry at the University of Washington. She is the 2012 President of the Society of Pediatric Psychology.