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A randomized controlled trial of a cognitive-behavioral family intervention for pediatric recurrent abdominal pain
Paul M Robins1, Suzanne M Smith, Joseph J Glutting
1The Children's Hospital of Philadelphia, Department of Psychology, 3405 Civic Center Blvd., CSH 15, Philadelphia, PA 19104, USA. robinsp@email.chop.edu.
Insights
Adding cognitive-behavioral family treatment (CBT) to standard medical care significantly reduced recurrent abdominal pain (RAP) and school absences in children. This combined approach offers a promising intervention for pediatric pain management.
Area of Science:
- Pediatric Gastroenterology
- Child Psychology
- Behavioral Medicine
Background:
- Recurrent abdominal pain (RAP) is a common condition in children, often leading to significant distress and healthcare utilization.
- Standard medical care (SMC) alone may not fully address the complex biopsychosocial factors contributing to RAP.
Purpose of the Study:
- To evaluate the efficacy of combining short-term cognitive-behavioral family treatment (CBT) with standard medical care (SMC) for pediatric RAP.
- To compare the outcomes of SMC plus CBT against SMC alone in managing children's recurrent abdominal pain.
Main Methods:
- A randomized controlled trial involving children recently diagnosed with RAP.
- Participants were assigned to either SMC or SMC plus CBT groups.
- Outcomes assessed included child/parent-reported pain, somatization, functional disability, school absences, and physician contacts.
Main Results:
- The SMC plus CBT group reported significantly less child and parent-reported abdominal pain compared to the SMC-only group, both immediately post-intervention and up to one year.
- Significantly fewer school absences were observed in the combined treatment group.
- No significant differences were found in functional disability or somatization between the groups.
Conclusions:
- Short-term CBT, when integrated with SMC, effectively reduces the sensory experience of recurrent abdominal pain in children.
- The findings support the value of combining medical and psychological interventions for pediatric RAP.
- Further consideration of the cost-benefit of integrated care models is warranted.
Objective:
To investigate whether the combination of standard medical care (SMC) and short-term cognitive-behavioral family treatment (CBT) in the treatment of recurrent abdominal pain (RAP) was more effective than SMC alone.
Methods:
Children recently diagnosed with RAP via physician examination were randomized into SMC (n = 29) and SMC plus CBT (n = 40) groups. Outcome measures included multiple dimensions of child and parent reported child pain, somatization, and functional disability, and school absences and physician contacts.
Results:
Children and parents participating in the combined SMC + CBT intervention reported significantly less child and parent reported child abdominal pain than children in the SMC intervention immediately following the intervention and up to 1 year following study entry, as well as significantly fewer school absences. Significant differences in functional disability and somatization were not revealed.
Conclusions:
These results, in combination with previous studies, add support to the effectiveness of CBT intervention in reducing the sensory aspects of RAP. Results are discussed with respect to the cost-benefit of integrated medical and short-term psychological services.
