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Web-based CBT for Children With Chronic Pain

This study has been completed.
Information provided by (Responsible Party):
Tonya Palermo, Seattle Children's Hospital Identifier:
First received: February 26, 2009
Last updated: May 26, 2015
Last verified: May 2015
The purpose of this study is to develop and evaluate the feasibility and effectiveness of a web-based (i.e., internet) treatment approach for providing psychological treatment to reduce pain and improve functioning in children and adolescents with chronic pain.

Condition Intervention Phase
Chronic Pain Headache Abdominal Pain Behavioral: cognitive-behavioral therapy Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Web-based CBT for Children With Chronic Pain

Resource links provided by NLM:

Further study details as provided by Tonya Palermo, Seattle Children's Hospital:

Primary Outcome Measures:
  • activity limitations [ Time Frame: immediately post-treatment, 3 month follow-up ]

Secondary Outcome Measures:
  • parental response to pain behaviors [ Time Frame: immediately post-treatment, 3 month follow-up ]
  • depressive symptoms [ Time Frame: immediately post-treatment, 3 month follow-up ]
  • pain intensity [ Time Frame: immediately post-treatment, 3 month follow up ]

Enrollment: 48
Study Start Date: May 2007
Study Completion Date: May 2009
Primary Completion Date: March 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: CBT
Cognitive-behavioral therapy delivered via the internet in eight treatment modules for children (education, stress and negative emotions, deep breathing and relaxation, distraction, cognitive skills, sleep hygiene and lifestyle, staying active, relapse prevention) and eight treatment modules for parents (education, stress and negative emotions, operant strategies I, operant strategies II, modeling, sleep hygiene and lifestyle, communication, relapse prevention).
Behavioral: cognitive-behavioral therapy

In addition to standard medical care, the children and parents in the family CBT condition will also receive education about chronic pain, pain behaviors and operant strategies as well as training in coping skills using an interactive, engaging format on the Internet.

The Internet site will consist of three main sections: child treatment modules, parent treatment modules, and diary tracking. All users will complete 8 treatment modules (one per week) over the 8-week treatment period. Each module will require approximately 30-40 minutes to complete. There is separate specific content of the intervention for child users and for parent users.

Assignments are incorporated into each module for the participant to work on during the treatment week.

No Intervention: SMC
The standard medical care wait-list control group continued with the treatment recommendations proscribed by their pain care team.

Detailed Description:

Chronic pain is an important problem for children and adolescents owing to its high prevalence rate and significant impact on children's mood, daily functioning, and overall quality of life. Effective psychological treatments have been developed to change behaviors and thoughts important in the child's ability to cope with chronic pain. However, the majority of children do not have access to these treatments due to a variety of barriers such as geographical distance from pediatric pain treatment centers.

The purpose of this study is to develop a more accessible method of delivering effective psychological treatment to reduce pain and increase function in children. Children with chronic headache, abdominal, or musculoskeletal pain will be randomized to either receive the web-based treatment right away or to be in a wait-list control condition and receive the treatment 8 weeks later. Both groups of children will continue to receive clinical care through specialty medical clinics. Children's level of pain, their ability to perform, daily functional activities, and overall quality of life will be evaluated before treatment begins, immediately after treatment, and at a 3 month follow up.


Ages Eligible for Study:   12 Years to 18 Years   (Child, Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • chronic headache, abdominal, and/or musculoskeletal pain present over the previous 3 months
  • interference from pain in at least one area of daily functioning.

Exclusion Criteria:

  • serious comorbid chronic condition in the patient (e.g., diabetes, cancer)
  • non-English speaking
  • previous participation in cognitive-behavioral therapy.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT00853138

Sponsors and Collaborators
Seattle Children's Hospital
Principal Investigator: Tonya M Palermo, PhD Seattle Children's Hospital
  More Information

Responsible Party: Tonya Palermo, Professor, Anesthesiology and Pain Medicine, Seattle Children's Hospital Identifier: NCT00853138     History of Changes
Other Study ID Numbers: R21HD050674 ( U.S. NIH Grant/Contract )
Study First Received: February 26, 2009
Last Updated: May 26, 2015

Keywords provided by Tonya Palermo, Seattle Children's Hospital:
cognitive-behavioral therapy
chronic pain
randomized controlled trial

Additional relevant MeSH terms:
Chronic Pain
Abdominal Pain
Neurologic Manifestations
Nervous System Diseases
Signs and Symptoms
Signs and Symptoms, Digestive processed this record on September 21, 2017