title: Brief telephone-delivered cognitive behavioral therapy targeted to parents of children with functional abdominal pain: a randomized controlled trial.
abstract: Pediatric functional abdominal pain disorders (FAPDs) are associated with increased health care utilization, school absences, and poor quality of life (QoL). Cost-effective and accessible interventions are needed. This multisite study tested the effects of a 3-session cognitive behavioral intervention delivered to parents, in-person or remotely, on the primary outcome of pain severity and secondary outcomes (process measures) of parental solicitousness, pain beliefs, catastrophizing, and child-reported coping. Additional outcomes hypothesized a priori and assessed included functional disability, QoL, pain behavior, school absences, health care utilization, and gastrointestinal symptoms. The study was prospective and longitudinal (baseline and 3 and 6 months' follow-up) with 3 randomized conditions: social learning and cognitive behavioral therapy in-person (SLCBT) or by phone (SLCBT-R) and education and support condition by phone (ES-R). Participants were children aged 7 to 12 years with FAPD and their parents (N = 316 dyads). Although no significant treatment effect for pain severity was found, the SLCBT groups showed significantly greater improvements compared with controls on process measures of parental solicitousness, pain beliefs, and catastrophizing, and additional outcomes of parent-reported functional disability, pain behaviors, child health care visits for abdominal pain, and (remote condition only) QoL and missed school days. No effects were found for parent and child-reported gastrointestinal symptoms, or child-reported QoL or coping. These findings suggest that for children with FAPD, a brief phone SLCBT for parents can be similarly effective as in-person SLCBT in changing parent responses and improving outcomes, if not reported pain and symptom report, compared with a control condition.
authors.affiliation: School of Social Work, University of Washington, Seattle, WA, USA.
authors.forename: Rona L
authors.initials: RL
authors.lastname: Levy
authors.affiliation: Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Tempe, AZ, USA.
authors.forename: Shelby L
authors.initials: SL
authors.lastname: Langer
authors.affiliation: Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Miranda A L
authors.initials: MAL
authors.lastname: van Tilburg
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
authors.forename: Joan M
authors.initials: JM
authors.lastname: Romano
authors.affiliation: School of Social Work, University of Washington, Seattle, WA, USA.
authors.forename: Tasha B
authors.initials: TB
authors.lastname: Murphy
authors.affiliation: Department of Pediatrics, Vanderbilt University, Nashville, TN, USA.
authors.forename: Lynn S
authors.initials: LS
authors.lastname: Walker
authors.affiliation: Oral Health Sciences, University of Washington, Seattle, WA, USA.
authors.forename: Lloyd A
authors.initials: LA
authors.lastname: Mancl
authors.affiliation: Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Robyn L
authors.initials: RL
authors.lastname: Claar
authors.affiliation: School of Social Work, University of Washington, Seattle, WA, USA.
authors.forename: Melissa M
authors.initials: MM
authors.lastname: DuPen
authors.affiliation: Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: William E
authors.initials: WE
authors.lastname: Whitehead
authors.affiliation: Prime Health Clinic, Federal Way, WA, USA.
authors.forename: Bisher
authors.initials: B
authors.lastname: Abdullah
authors.affiliation: St. Charles Health System, Bend, OR, USA.
authors.forename: Kimberly S
authors.initials: KS
authors.lastname: Swanson
authors.affiliation: HealthPoint, Bothell, WA, USA.
authors.forename: Melissa D
authors.initials: MD
authors.lastname: Baker
authors.affiliation: Alcohol and Drug Abuse Institute, University of Washington, Seattle, WA, USA.
authors.forename: Susan A
authors.initials: SA
authors.lastname: Stoner
authors.affiliation: Gastroenterology, Seattle Children's Hospital, Seattle, WA, USA.
authors.forename: Dennis L
authors.initials: DL
authors.lastname: Christie
authors.affiliation: Gastroenterology, Group Health Cooperative, Seattle, WA, USA.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Feld
mesh_terms: D015746:Abdominal Pain / Q000523:psychology / Q000534:rehabilitation*; D000223:Adaptation, Psychological; D058443:Catastrophization; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010147:Pain Measurement; D010290:Parents / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology; D013689:Telephone