Cognitive Behavior Therapy Tailored to Anxiety Symptoms Improves Pediatric Functional Abdominal Pain Outcomes: A Randomized Clinical Trial

What is it about?

This article discusses the design, implementation, and results of a stepped-care model in the treatment of pediatric patients with functional abdominal pain disorders. Within the model, there were three steps: 1) enhanced usual care during a medical visit to a gastroenterologist, 2) 4 sessions of cognitive-behavioral therapy for pain management plus medical treatment as usual, and 3) 6 sessions of cognitive-behavioral therapy for anxiety and pain management plus medical treatment as usual. Decision making regarding the level of care to provide was based on response to the enhanced usual care and anxiety symptoms. Use of the stepped-care approach was compared to medical treatment as usual. Findings support that a paucity of teens with functional abdominal pain disorders require only enhanced usual care, and cognitive-behavioral therapy yields greater reductions in pain-related disability and anxiety than medical treatment as usual.

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Why is it important?

A stepped-care approach has been supported in multiple pediatric populations, such as teens presenting to their pediatrician with depressive symptoms, to increase access to care for children who may benefit from psychological intervention. As psychology continues to become embedded within specialized pediatric medical clinics, there is a need to consider ways through which medical providers can triage patients to their psychology partners, based on the brief patient-provider interaction that occurs during a specialized clinic visit. The researchers provide clear, empirically-driven recommendations about how providers within a gastroenterology clinic might quickly, yet systematically determine whether psychological care is warranted.