None listed
Conditions
Brief summary
Severe chronic pain affects up to 8% of adolescents, with many suffering from significant emotional distress and physical disability. This often limits school attendance and impacts on the family as a whole. This pilot randomised controlled trial aims to evaluate an intervention designed to help these families. The project tests an innovative service delivery model with interdisciplinary pain management being provided in face-to face workshops followed with Telehealth sessions delivered to the family home. The treatment team is led by a Physiotherapist and also includes an Occupational Therapist and Clinical Psychologist.
Interventions
PACE is a structured (Cognitive Behavioural) CBT pain intervention involving:
Week One - The child and one parent or guardian will attend a 7 hour group workshop at Princess Margaret Hospital (PMH). Adults and children will participate in sessions in seperate rooms with up to 7 other participants and two staff members. Topics will include: The Neuroscience of Pain, Cognitive Strategies, Activity Management & Exercise, School, Communication, Mindfulness, Sleep, Flare Up and Set Back Planning and
PACE is a structured (Cognitive Behavioural) CBT pain intervention involving: Week One - The child and one parent or guardian will attend a 7 hour group workshop at Princess Margaret Hospital (PMH). Adults and children will participate in sessions in seperate rooms with up to 7 other participants and two staff members. Topics will include: The Neuroscience of Pain, Cognitive Strategies, Activity Management & Exercise, School, Communication, Mindfulness, Sleep, Flare Up and Set Back Planning and Where to From Here? Week 2 to 5 - The family will be allocated a "key-worker" who is either the program physiotherapist, occupational therapist or clinical psychologist. The child and their parent or guardian will have seperate, individualised weekly Telehealth support sessions of up to 30 minutes with their keyworker. These will include a video link similar to Skype. These sessions will reinforce topics and skills learnt in the workshop. The three program therapists will meet weekly to discuss the participant's progress and provide interdisciplinary support. Children who score over clinical thresholds on the Revised Children Anxiety and Depression Scale will be allocated a clinical psychologist as their keyworker. Week 7 - the child and their parent/guardian will attend a 4 hour review at PMH The treatment team will be led by a physiotherapist and included a Clinical Psychologist and Occupational Therapist. All treatment will have a strong Cognitive Behavioural framework and there will be strong "cross-linking" between disciplines. The children will be asked to complete charts related to activity management, cognitive strategies and flare up and set back planning. These will be monitored in the Telehealth sessions. Parents will be monitored by verbal questioning with the emphasis on supporting skills aquisition.
Sponsors
Anna Hilyard
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
11 Years to 17 Years
Healthy volunteers
No
Inclusion criteria
*Age 11 to 17 years old. *Experience pain on average at least 4 days a week. *Pain present for greater than 3 months (includes Chronic Widespread Pain Syndrome, Fibromyalgia, Headaches, Functional Abdominal Pain). *Under the care of a medical specialist at Princess Margaret Hospital and untreated pathology (other than their chronic pain syndrome) excluded. *One adult family member willing to participate. *No major changes in the patient’s medical management anticipated in the next four months. *Family have access to phone, Internet and e-mails at their home, community health centre or other convenient location.
Exclusion criteria
*High dependency on analgesic medication. *Fatigue as their primary symptom. *Current or previous treatment for cancer. *Pain explained by identified pathological process (eg rheumatological disease or inflammatory bowel disease). *Language barriers or hearing, literacy or learning difficulties that would affect the patient or parent’s ability to comprehend the principles taught on the Program. *Co-existing psychiatric or psychosocial issues were considered more relevant to the patient’s reduced function than their pain was. *Significant mental health disorder including Bipolar Disorder, Psychosis, active suicidality or Eating Disorders. *Documented developmental delay. *Currently participating in other rehabilitation program or cognitive behavioural therapy.
Outcome results
None listed