GET Living: Graded Exposure Treatment for Children and Adolescents With Chronic Pain

N/ACompletedNCT01974791

Boston Children's Hospital34 enrolled

Overview

The broad aim of the study is to implement and evaluate the efficacy of Graded Exposure Treatment (GET Living) to target elevated pain-related fears in children with chronic pain. Pain-related fear is an important psychological factor associated with poor outcomes in children suffering with chronic pain. To examine the efficacy of GET Living in addressing pain-related fears the investigators propose to use a sequential replicated randomized single-case experimental phase design with multiple measures. The specific aims are to 1) evaluate the effectiveness and acceptability of individually tailored GET Living for children with high pain-related fear and functional disability and 2) define anatomical and resting state connectivity patterns in the brains of children and adolescents with complex chronic pain prior to and after participation in GET Living.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Chronic Pain Neuralgia Musculoskeletal Pain Headache

Eligibility

Sex: ALLMin age: 8 YearsMax age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Pain-related fear (score \>40 on the Fear of Pain Questionnaire (FOPQ (Simons et al., 2011a)) * Musculoskeletal, neuropathic limb or back pain, or headache * Functional limitations (score \> 12 on the Functional Disability Inventory (FDI (Kashikar-Zuck et al., 2001; Walker and Greene, 1991)). Exclusion Criteria: * Significant cognitive impairment (e.g., intellectual disability) * Serious psychopathology (e.g., active suicidality). * Acute trauma (e.g., spondylolithesis, disk herniation, fracture, acute tendonitis) * Systemic disease in active inflammatory state * Biomechanical deficit that would limit ability to engage in exposure activities (e.g. severe muscle atrophy) * Making gains in current physical therapy or have not had physical therapy, but it is clearly indicated

Outcomes

Primary Outcomes

Decrease in Fear of Pain

Time frame: Decrease in Fear of Pain from Baseline to end of treatment at 6-weeks, on average

Secondary Outcomes

Decrease in Functional Disability

Time frame: Decrease in Functional Disability from Baseline to end of treatment at 6-weeks, on average

Improvement in School Functioning

Time frame: Improvement in School Functioning from baseline to end of treatment at 6-weeks, on average

Decrease in Pain Catastrophizing

Time frame: Decrease in Pain Catastrophizing from baseline to end of treatment at 6-weeks, on average

Decrease in Pain Intensity

Time frame: Decrease in Pain Intensity from baseline to end of treatment at 6-weeks, on average

Increase in Physical Activity

Time frame: Increase in Physical Activity from baseline to end of treatment at 6-weeks, on average