Skip to main content
PMC home page
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 2003 Oct;88(10):881–885. doi: 10.1136/adc.88.10.881

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

C Eccleston 1, P Malleson 1, J Clinch 1, H Connell 1, C Sourbut 1
PMCID: PMC1719328  PMID: 14500306

Abstract

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 2.61seconds (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.

Full Text

The Full Text of this article is available as a PDF (93.5 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bursch B., Walco G. A., Zeltzer L. Clinical assessment and management of chronic pain and pain-associated disability syndrome. J Dev Behav Pediatr. 1998 Feb;19(1):45–53. doi: 10.1097/00004703-199802000-00008. [DOI] [PubMed] [Google Scholar]
  2. Eccleston Christopher, Morley Stephen, Williams Amanda, Yorke Louise, Mastroyannopoulou Kiki. Systematic review of randomised controlled trials of psychological therapy for chronic pain in children and adolescents, with a subset meta-analysis of pain relief. Pain. 2002 Sep;99(1-2):157–165. doi: 10.1016/s0304-3959(02)00072-6. [DOI] [PubMed] [Google Scholar]
  3. Fearon I., McGrath P. J., Achat H. 'Booboos': the study of everyday pain among young children. Pain. 1996 Nov;68(1):55–62. doi: 10.1016/S0304-3959(96)03200-9. [DOI] [PubMed] [Google Scholar]
  4. Fordyce W. E., Fowler R. S., Jr, Lehmann J. F., DeLateur B. J. Some implications of learning in problems of chronic pain. J Chronic Dis. 1968 Jun;21(3):179–190. doi: 10.1016/0021-9681(68)90015-5. [DOI] [PubMed] [Google Scholar]
  5. Goodman J. E., McGrath P. J. The epidemiology of pain in children and adolescents: a review. Pain. 1991 Sep;46(3):247–264. doi: 10.1016/0304-3959(91)90108-A. [DOI] [PubMed] [Google Scholar]
  6. Kazdin A. E., Weisz J. R. Identifying and developing empirically supported child and adolescent treatments. J Consult Clin Psychol. 1998 Feb;66(1):19–36. doi: 10.1037//0022-006x.66.1.19. [DOI] [PubMed] [Google Scholar]
  7. Kibby M. Y., Tyc V. L., Mulhern R. K. Effectiveness of psychological intervention for children and adolescents with chronic medical illness: a meta-analysis. Clin Psychol Rev. 1998 Jan;18(1):103–117. doi: 10.1016/s0272-7358(97)00049-4. [DOI] [PubMed] [Google Scholar]
  8. Kovacs M. Rating scales to assess depression in school-aged children. Acta Paedopsychiatr. 1981 Feb;46(5-6):305–315. [PubMed] [Google Scholar]
  9. Main C. J. The Modified Somatic Perception Questionnaire (MSPQ). J Psychosom Res. 1983;27(6):503–514. doi: 10.1016/0022-3999(83)90040-5. [DOI] [PubMed] [Google Scholar]
  10. Malleson P. N., Connell H., Bennett S. M., Eccleston C. Chronic musculoskeletal and other idiopathic pain syndromes. Arch Dis Child. 2001 Mar;84(3):189–192. doi: 10.1136/adc.84.3.189. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. McCracken L. M., Gross R. T., Eccleston C. Multimethod assessment of treatment process in chronic low back pain: comparison of reported pain-related anxiety with directly measured physical capacity. Behav Res Ther. 2002 May;40(5):585–594. doi: 10.1016/s0005-7967(01)00074-2. [DOI] [PubMed] [Google Scholar]
  12. Morley S., Eccleston C., Williams A. Systematic review and meta-analysis of randomized controlled trials of cognitive behaviour therapy and behaviour therapy for chronic pain in adults, excluding headache. Pain. 1999 Mar;80(1-2):1–13. doi: 10.1016/s0304-3959(98)00255-3. [DOI] [PubMed] [Google Scholar]
  13. Perquin C. W., Hazebroek-Kampschreur A. A., Hunfeld J. A., Bohnen A. M., van Suijlekom-Smit L. W., Passchier J., van der Wouden J. C. Pain in children and adolescents: a common experience. Pain. 2000 Jul;87(1):51–58. doi: 10.1016/S0304-3959(00)00269-4. [DOI] [PubMed] [Google Scholar]
  14. Perquin C. W., Hazebroek-Kampschreur A. A., Hunfeld J. A., van Suijlekom-Smit L. W., Passchier J., van der Wouden J. C. Chronic pain among children and adolescents: physician consultation and medication use. Clin J Pain. 2000 Sep;16(3):229–235. doi: 10.1097/00002508-200009000-00008. [DOI] [PubMed] [Google Scholar]
  15. Reid G. J., Gilbert C. A., McGrath P. J. The Pain Coping Questionnaire: preliminary validation. Pain. 1998 May;76(1-2):83–96. doi: 10.1016/s0304-3959(98)00029-3. [DOI] [PubMed] [Google Scholar]
  16. Sanders M. R., Shepherd R. W., Cleghorn G., Woolford H. The treatment of recurrent abdominal pain in children: a controlled comparison of cognitive-behavioral family intervention and standard pediatric care. J Consult Clin Psychol. 1994 Apr;62(2):306–314. doi: 10.1037//0022-006x.62.2.306. [DOI] [PubMed] [Google Scholar]
  17. Spence S. H. A measure of anxiety symptoms among children. Behav Res Ther. 1998 May;36(5):545–566. doi: 10.1016/s0005-7967(98)00034-5. [DOI] [PubMed] [Google Scholar]
  18. Varni J. W., Thompson K. L., Hanson V. The Varni/Thompson Pediatric Pain Questionnaire. I. Chronic musculoskeletal pain in juvenile rheumatoid arthritis. Pain. 1987 Jan;28(1):27–38. doi: 10.1016/0304-3959(87)91056-6. [DOI] [PubMed] [Google Scholar]
  19. Walker L. S., Greene J. W. The functional disability inventory: measuring a neglected dimension of child health status. J Pediatr Psychol. 1991 Feb;16(1):39–58. doi: 10.1093/jpepsy/16.1.39. [DOI] [PubMed] [Google Scholar]
  20. Williamson Gail M., Walters Andrew S., Shaffer David R. Caregiver models of self and others, coping, and depression: predictors of depression in children with chronic pain. Health Psychol. 2002 Jul;21(4):405–410. doi: 10.1037//0278-6133.21.4.405. [DOI] [PubMed] [Google Scholar]
  21. Zigmond A. S., Snaith R. P. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983 Jun;67(6):361–370. doi: 10.1111/j.1600-0447.1983.tb09716.x. [DOI] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES