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

Laura E Simons

Status: Completed

Conditions: Musculoskeletal Pain; Chronic Pain, Widespread; Pediatric Pain

Treatments: Behavioral: Multidisciplinary Pain Management (MPM); Behavioral: Graded Exposure Therapy (GET Living)

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT03699007

1R21AR072921-01A1 (U.S. NIH Grant/Contract)

39514

Details and patient eligibility

About

The broad aim of this 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 at the Stanford Pediatric Pain Management Clinic (PPMC). The investigators will evaluate the effectiveness and acceptability of this intervention for children with high levels of pain-related fear and functional disability. If proven efficacious, it will allow for the dissemination of this innovative treatment model to others working with children and adolescents with chronic pain.

Full description

The treatment intervention to be tested in this clinical trial is Graded in-vivo Exposure Treatment (GET Living) compared to Multidisciplinary Pain Management (MPM) in adolescents with chronic musculoskeletal pain. Participants will be randomized into GET Living or MPM, and will be instructed to not seek new treatments for pain for the duration of the study. Both treatments consist of 12 1-hour patient sessions delivered twice a week across 6- weeks and 3 parent-only sessions.

Enrollment: 68 patients

Sex: All

Ages: 8 to 18 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• 8 - 18 years old; Male or Female
• Musculoskeletal pain (e.g. localized [back, limb], diffuse) not due to acute trauma (e.g. active sprain or fracture).
• Moderate to high pain-related fear ( ≥ 35 on the FOPQ-C)
• Moderate to high functional disability ( ≥ 13 on the FDI)
• English Language Proficiency

Exclusion criteria

• Significant cognitive impairment (e.g., brain injury)
• Significant medical or psychiatric problem that would interfere (e.g., seizures, psychosis, suicidality)

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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68 participants in 2 patient groups

Graded Exposure Therapy (GET Living)

Experimental group

Description:

GET Living is jointly delivered by a pain psychologist and a physical therapist. The GET Living treatment was based on a published graded in-vivo exposure treatment manual for adults with adaptations to target a pediatric audience.

Treatment:

Behavioral: Graded Exposure Therapy (GET Living)

Multidisciplinary Pain Management (MPM)

Active Comparator group

Description:

MPM is a treatment intervention that is representative of current standards of care in a multidisciplinary pain clinic setting. It consists of Cognitive Behavioral Therapy (CBT) and Physical Therapy (PT) sessions, delivered separately by a pain psychologist and a physical therapist.

Treatment:

Behavioral: Multidisciplinary Pain Management (MPM)