Psychological interventions for chronic pediatric pain: state of the art, current developments and open questions

SUMMARY Chronic pain, especially headache and recurrent abdominal pain, affects a sizable number of children and adolescents. In this selective overview, the need and rationale for psychological approaches to the treatment of chronic pediatric pain will be explored, and current developments and open questions will be addressed. Thus far, research has mostly focused on the efficacy of various psychological interventions such as relaxation, biofeedback and cognitive-behavioral interventions, specifically for headaches and recurrent abdominal pain. Yet, the differential efficacy of the various psychological interventions still awaits empirical evaluation. In fact, in the past decade, the focus of research has shifted more towards developing and evaluating treatment formats that target specific subgroups of patients, such as multimodal inpatient treatment programs for severely affected youth. On the other hand, much research has been devoted to self-help treatment formats such as internet-based intervention programs. Rather surprisingly, the role of parents in the treatment of chronic pediatric pain is far from being understood, which may be best accounted for by the fact that psychological interventions were mostly adapted from treatment programs in adults rather than being specifically developed for children and adolescents. Conclusions for clinical practice and research are outlined.