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Randomized Controlled Trial
. 2009 Nov;146(1-2):205-13.
doi: 10.1016/j.pain.2009.07.034. Epub 2009 Aug 19.

Randomized controlled trial of an Internet-delivered family cognitive-behavioral therapy intervention for children and adolescents with chronic pain

Tonya M Palermo  1 , Anna C Wilson, Meaghan Peters, Amy Lewandowski, Hannah Somhegyi
Affiliations
Randomized Controlled Trial

Randomized controlled trial of an Internet-delivered family cognitive-behavioral therapy intervention for children and adolescents with chronic pain

Tonya M Palermo et al. Pain. 2009 Nov.

Abstract

Cognitive-behavioral therapy (CBT) interventions show promise for decreasing chronic pain in youth. However, the availability of CBT is limited by many factors including distance to major treatment centers and expense. This study evaluates a more accessible treatment approach for chronic pediatric pain using an Internet-delivered family CBT intervention. Participants included 48 children, aged 11-17 years, with chronic headache, abdominal, or musculoskeletal pain and associated functional disability, and their parents. Children were randomly assigned to a wait-list control group or an Internet treatment group. Primary treatment outcomes were pain intensity ratings (0-10 NRS) and activity limitations on the Child Activity Limitations Interview, both completed via an online daily diary. In addition to their medical care, the Internet treatment group completed 8 weeks of online modules including relaxation training, cognitive strategies, parent operant techniques, communication strategies, and sleep and activity interventions. Youth randomized to the wait-list control group continued with the current medical care only. Findings demonstrated significantly greater reduction in activity limitations and pain intensity at post-treatment for the Internet treatment group and these effects were maintained at the three-month follow-up. Rate of clinically significant improvement in pain was also greater for the Internet treatment group than for the wait-list control group. There were no significant group differences in parental protectiveness or child depressive symptoms post-treatment. Internet treatment was rated as acceptable by all children and parents. Findings support the efficacy and acceptability of Internet delivery of family CBT for reducing pain and improving function among children and adolescents with chronic pain.

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Conflict of interest statement

Conflict of interests

The present manuscript is submitted exclusively to Pain and is not under consideration in any other journal. There are no financial relationships that might lead to a conflict of interest.

Figures

Figure 1
Figure 1
Study Participant Flow.
Figure 2
Figure 2
Internet treatment condition: Web-MAP home page (child site)
See this image and copyright information in PMC

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