Randomized controlled trial of an Internet-delivered family cognitive-behavioral therapy intervention for children and adolescents with chronic pain.
Open accessAbstract
Cognitive-behavioral therapy (CBT) interventions show promise for decreasing chronic pain in youth. However, the availability of CBT is limited by many factors including distance to major treatment centers and expense. This study evaluates a more accessible treatment approach for chronic pediatric pain using an Internet-delivered family CBT intervention. Participants included 48 children, aged 11-17 years, with chronic headache, abdominal, or musculoskeletal pain and associated functional disability, and their parents. Children were randomly assigned to a wait-list control group or an Internet treatment group. Primary treatment outcomes were pain intensity ratings (0-10 NRS) and activity limitations on the Child Activity Limitations Interview, both completed via an online daily diary. In addition to their medical care, the Internet treatment group completed 8 weeks of online modules including relaxation training, cognitive strategies, parent operant techniques, communication strategies, and sleep and activity interventions. Youth randomized to the wait-list control group continued with the current medical care only. Findings demonstrated significantly greater reduction in activity limitations and pain intensity at post-treatment for the Internet treatment group and these effects were maintained at the three-month follow-up. Rate of clinically significant improvement in pain was also greater for the Internet treatment group than for the wait-list control group. There were no significant group differences in parental protectiveness or child depressive symptoms post-treatment. Internet treatment was rated as acceptable by all children and parents. Findings support the efficacy and acceptability of Internet delivery of family CBT for reducing pain and improving function among children and adolescents with chronic pain.
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Pilot data demonstrated that internet-delivered pain management reduced barriers of access to care and was effective at reducing pain-related disability.
“Pilot data demonstrated that internet-delivered pain management reduced barriers of access to care and was effective at reducing pain-related disability [121].”
From Best-evidence for the rehabilitation of chronic pain part 1: Pediatric pain (2019) · cites this paper as [121]
The Results (section 4.3.1; page unavailable) report significantly lower activity limitations after Internet treatment than in the wait-list group, supporting reduced pain-related disability. The Introduction and Discussion describe Internet delivery as a way to improve access, but do not demonstrate that this trial reduced barriers to care. (LLM, conf=0.88)
Experimental — accuracy not yet measuredCCBT has been used for 25 different clinical disorders, not only mental health conditions.
“Furthermore, CCBT has been used for 25 different clinical disorders [27], not only mental health conditions [59-62].”
From Computerized cognitive behavior therapy for anxiety and depression in rural areas:a systematic review (2015) · cites this paper as [61]
Several cognitive-behavioral oriented Internet interventions have been studied for use with chronic pain.
“Several cognitive-behavioral oriented Internet interventions have been studied for use with chronic pain (e.g., [14; 10; 46])”
From Internet-enhanced management of fibromyalgia: A randomized controlled trial (2010) · cites this paper as [46]
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- Authors
- Palermo, T. M., Wilson, A. C., Peters, M., Lewandowski, A., & Somhegyi, H.
- Affiliations
- Oregon Health & Science University (US)
- George Fox University (US)
- Lewis & Clark College (US)
- Corresponding author
- Palermo, Tonya M.
- Venue
- Pain
- Published
- 2009-11
- Volume
- 146
- Issue
- 1
- Pages
- 205-213
- ISSN
- 0304-3959 (ISSN-L)
- PMC
- PMC2760656
- OpenAlex
- W2088188917
- Cited by
- 368
- References
- 37
- Citations by year
- 2026: 7 · 2025: 7 · 2024: 9 · 2023: 13 · 2022: 8 · 2021: 27 · 2020: 17 · 2019: 28 · 2018: 27 · 2017: 19 · 2016: 37 · 2015: 32 · 2014: 31 · 2013: 36 · 2012: 33
- FWCI
- 20.17
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute of Child Health and Human Development
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD050674, R21HD050674, K24HD060068)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- online intervention, children and adolescents, headache, abdominal pain, musculoskeletal pain, activity limitation, pain intensity, relaxation training, treatment acceptability, functional disability
- MeSH terms
- Adolescent, Child, Chronic Disease, Depression, Female, Follow-Up Studies, Humans, Male, Motor Activity, Pain, Pain Measurement, Patient Acceptance of Health Care, Patient Compliance, Socioeconomic Factors, Cognitive Behavioral Therapy, Treatment Outcome, Patient Satisfaction, Sample Size, Internet, Pain Management
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