Cognitive Behavioral Therapy for Childhood Abdominal Pain

Cognitive behavioral therapy (CBT) can be effective for children with functional abdominal pain (JAMA Pediatr 2013; 167: 178-84).  Thanks to Ben Gold for this reference.

This prospective, randomized study recruited 200 children and their parents.  One group of child-parent dyads received ‘social learning and cognitive behavioral therapy’ (SLCBT) and the other group ‘education and support’ (ES).  Over the course of a year, children in the SLCBT group reported greater baseline decreases in gastrointestinal symptom severity and better pain-coping responses.  Parents in the SLCBT group reported greater decreases in ‘solicitous responses’ to their child’s symptoms along with decrease in maladaptive beliefs regarding their child’s pain.

The intervention in the SLCBT group was three 1-hour sessions approximately 1 week apart in which parents were taught social learning strategies 1) to reduce ‘solicitous responses’ to illness behavior, and 2) to model /reinforce healthier ways to respond to gastrointestinal discomfort.  Then, assessments were made at 1 week, 3 months, 6 months, and 12 months.

This study shows that CBT can be effective for functional abdominal pain, if you can find skilled therapist and families willing to participate.

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14 thoughts on “Cognitive Behavioral Therapy for Childhood Abdominal Pain

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  3. Jay, we are being introduced to functional abdominal pain through our nine-year-old daughter. She has had a two-month history of stomach pain, and all tests, scopes, etc. have been negative. We start our sessions with a child psychologist in a couple of days. I am hopeful that this may be of some benefit, but I am very concerned as our daughter’s response to this has been extreme. She has pain every day. As parents, we are at a loss because this isn’t something tangible. We can’t “make it better”. She isn’t eating and doesn’t want to leave the house. Have you seen extreme emotional responses to functional abdominal pain before? We are just trying to learn what we can to adapt to our new reality.

    • Stephen,

      I cannot comment much on your daughter’s situation as I have not seen her. In general, the degree of pain that one experiences does not distinguish functional and nonfunctional pain. Functional pain is associated with frequent anxiety and emotional responses. A book for parents and physicians that has been useful for some patients has been Lonnie Zeltzer’s Conquering Your Child’s Chronic Pain. Another book frequently recommended by our psychiatrists: Be the Boss of Your Pain: Self-care for Kids.

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