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Systematic Review and Meta-Analysis of Psychological Therapies for Children With Chronic Pain
Open accessAbstract
OBJECTIVES: This systematic review and meta-analysis examined the effects of psychological therapies for management of chronic pain in children. METHODS: Randomized controlled trials of psychological interventions treating children (<18 years) with chronic pain conditions including headache, abdominal, musculoskeletal, or neuropathic pain were searched for. Pain symptoms, disability, depression, anxiety, and sleep outcomes were extracted. Risk of bias was assessed and quality of the evidence was rated using GRADE. RESULTS: 35 included studies revealed that across all chronic pain conditions, psychological interventions reduced pain symptoms and disability posttreatment. Individual pain conditions were analyzed separately. Sleep outcomes were not reported in any trials. Optimal dose of treatment was explored. For headache pain, higher treatment dose led to greater reductions in pain. No effect of dosage was found for other chronic pain conditions. CONCLUSIONS: Evidence for psychological therapies treating chronic pain is promising. Recommendations for clinical practice and research are presented.
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“There is substantial evidence suggesting these interventions are effective at reducing pain severity, disability, and psychological distress (e.g., anxiety) in children with chronic pain [13,14,15].”
From Best-evidence for the rehabilitation of chronic pain part 1: Pediatric pain (2019) · cites this paper as [14]
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“Cognitive techniques such as cognitive restructuring, problem-solving, and positive self-talk, have been shown to be effective techniques for reducing negative thoughts associated with pain and related disability [10,13,14].”
From Best-evidence for the rehabilitation of chronic pain part 1: Pediatric pain (2019) · cites this paper as [14]
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“This is not necessarily an argument against conventional treatment, which has established positive effects (Bruce et al., 2017; Fisher et al., 2014)”
From Dispositional Mindfulness and Its Relationship With Distress and Functioning in Adolescents With Chronic Pain and Low-Level Pain. (2018) · cites this paper as Fisher et al., 2014
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“Within pain conditions, psychological interventions have been found to effectively reduce pain in headache, abdominal pain, and musculoskeletal conditions, and functional disability in abdominal and musculoskeletal pain [14].”
From Best-evidence for the rehabilitation of chronic pain part 1: Pediatric pain (2019) · cites this paper as [14]
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Bandolier's Little Book of Pain
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A new method for the treatment of recurrent abdominal pain of prolonged negative stress origin
Alfvén, G., & Lindstrom, A. (2006) · Acta Paediatrica · doi:10.1111/j.1651-2227.2006.00028.x · Cited by 30
Abram, H. S., Buckloh, L. M., Schilling, L. M., Wiltrout, S. A., Ramírez-Garnica, G., & Turk, W. R. (2007) · Children s Health Care · doi:10.1080/02739610701377939 · Cited by 20
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2 of the 101 references couldn’t be matched to a known paper.
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An introduction to implementation science for the non-specialist
Bauer, M. S., Damschroder, L. J., Hagedorn, H., Smith, J. L., & Kilbourne, A. M. (2015) · BMC Psychology · doi:10.1186/s40359-015-0089-9 · Cited by 2,168
Katzman, M. A., Bleau, P., Blier, P., Chokka, P., Kjernisted, K., Van Ameringen, M., & the Canadian Anxiety Guidelines Initiative Group on behalf of the Anxiety Disorders Association of Canada/Association Canadienne des troubles anxieux and McGill University (2014) · BMC Psychiatry · doi:10.1186/1471-244x-14-s1-s1 · Cited by 1,090
Vaccines for preventing pneumococcal infection in adults
Moberley, S. A., Holden, J., Tatham, D. P., & Andrews, R. M. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd000422.pub3 · Cited by 970
Faßnacht, M., Dekkers, O. M., Else, T., Baudin, É., Berruti, A., de Krijger, R. R., Haak, H. R., Mihai, R., Assié, G., & Terzolo, M. (2018) · European Journal of Endocrinology · doi:10.1530/eje-18-0608 · Cited by 976
Health impact assessment of active transportation: A systematic review
Mueller, N., Rueda, D. R., Cole‐Hunter, T., de Nazelle, A. J., Dons, E., Gerike, R., Götschi, T., Panis, L. I., Kahlmeier, S., & Nieuwenhuijsen, M. J. (2015) · Preventive Medicine · doi:10.1016/j.ypmed.2015.04.010 · Cited by 831
Metadata
- Authors
- Fisher, E., Heathcote, L., Palermo, T. M., de C Williams, A. C., Lau, J., & Eccleston, C.
- Affiliations
- King's College London (GB)
- Venue
- Journal of Pediatric Psychology
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-03-06
- Volume
- 39
- Issue
- 8
- Pages
- 763-782
- ISSN
- 0146-8693 (ISSN-L)
- 1465-735X
- PMC
- PMC4148613
- OpenAlex
- W2142456684
- Cited by
- 710
- References
- 101
- Citations by year
- 2026: 7 · 2025: 7 · 2024: 6 · 2023: 13 · 2022: 17 · 2021: 41 · 2020: 33 · 2019: 35 · 2018: 49 · 2017: 37 · 2016: 61 · 2015: 129 · 2014: 148
- FWCI
- 18.57
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Pediatric Psychology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- The University of Bath Online Publications Store (The University of Bath) (submittedVersion)
- Pure (University of Bath) (submittedVersion, other-oa)
- UCL Discovery (University College London) (submittedVersion)
- Research Portal (King's College London) (submittedVersion, other-oa)
- Funders
- Action Medical Research
- National Institute for Health and Care Research (13/89/29)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (K24HD060068)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- chronic pain, children, psychological intervention, headache, abdominal pain, musculoskeletal pain, neuropathic pain, pain-related disability, depression, anxiety, sleep, treatment dosage, pediatric pain management
- MeSH terms
- Child, Humans, Psychotherapy, Treatment Outcome, Chronic Pain, Pain Management
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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