Chronic pain in adolescents: evaluation of a programme of interdisciplinary cognitive behaviour therapy

Chronic pain in adolescents: evaluation of a programme of interdisciplinary cognitive behaviour therapy

Eccleston C; Malleson PN; Clinch J; Connell H; Sourbut C

Archives Of Disease In Childhood

2003

Child; Female; Humans; Male; Pain Measurement; Adult; Treatment Outcome; Program Evaluation; Health Status Indicators; adolescent; patient care team; Chronic disease; Psychiatric Status Rating Scales; Cognitive Therapy/methods; Absenteeism; Family Therapy/methods; Pain/rehabilitation; Schools/statistics & numerical data

Aim: To determine the effectiveness of an interdisciplinary cognitive behavioural treatment for adolescents with chronic pain. METHODS: Fifty seven adolescents (mean age 14.28 years) with chronic pain and 57 accompanying adults underwent an interdisciplinary three week residential programme of group cognitive behavioural therapy. Mean chronicity of pain was 4.02 years; 75% were absent from full time education (mean absence 17 months). RESULTS: Post-treatment adolescents reported significant improvements for self report of disability (mean difference 3.37 (95% CI 0.65 to 6.09)), physical function (mean difference timed walk of 2.61 seconds (1.02 to 4.2) and sit to stand of 3.22 per minute (0.79 to 5.65)). At three months post-treatment adolescents maintained physical improvements and reduced anxiety (mean difference 1.7 (0.72 to 2.67)), disability (mean difference 4.3 (1.44 to 7.17)), and somatic awareness (mean difference 4.43 (1.53 to 7.33)). Following treatment adults reported significant improvement in their report of adolescent disability (mean difference 4.43 (2.17 to 6.7)), adult anxiety (mean difference 1.73 (0.54 to 2.92)), depression (mean difference 1.16 (0.34 to 1.98)), and parental stress (mean difference 10.81 (2.91 to 18.78)). At three months significant improvements were maintained. At three months 64% improved school attendance; 40% had returned to full time education. CONCLUSIONS: Interdisciplinary cognitive behavioural pain management (with family involvement) is a promising approach to the management of pain, pain related distress, and disability.

2003

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