Research

220 KiB

Open AccessArticle

A Pilot Study of Mindfulness Meditation for Pediatric Chronic Pain

by Lynn C. Waelde, Amanda B. Feinstein, Rashmi Bhandari, Anya Griffin, Isabel A. Yoon and Brenda Golianu

Children 2017, 4(5), 32; https://doi.org/10.3390/children4050032 - 26 Apr 2017

Cited by 26 | Viewed by 8590

Abstract

Despite advances in psychological interventions for pediatric chronic pain, there has been little research examining mindfulness meditation for these conditions. This study presents data from a pilot clinical trial of a six-week manualized mindfulness meditation intervention offered to 20 adolescents aged 13–17 years. [...] Read more.

Despite advances in psychological interventions for pediatric chronic pain, there has been little research examining mindfulness meditation for these conditions. This study presents data from a pilot clinical trial of a six-week manualized mindfulness meditation intervention offered to 20 adolescents aged 13–17 years. Measures of pain intensity, functional disability, depression and parent worry about their child’s pain were obtained at baseline and post-treatment. Results indicated no significant changes in pain or depression, however functional disability and frequency of pain functioning complaints improved with small effect sizes. Parents’ worry about child’s pain significantly decreased with a large effect size. Participants rated intervention components positively and most teens suggested that the number of sessions be increased. Three case examples illustrate mindfulness meditation effects and precautions. Mindfulness meditation shows promise as a feasible and acceptable intervention for youth with chronic pain. Future research should optimize intervention components and determine treatment efficacy. Full article

(This article belongs to the Special Issue Mind-Body Medicine in Children and Adolescents)

735 KiB

Open AccessArticle

Do Mothers Benefit from a Child-Focused Cognitive Behavioral Treatment (CBT) for Childhood Functional Abdominal Pain? A Randomized Controlled Pilot Trial

by Claudia Calvano, Martina Groß and Petra Warschburger

Children 2017, 4(2), 13; https://doi.org/10.3390/children4020013 - 15 Feb 2017

Cited by 8 | Viewed by 6202

Abstract

While the efficacy of cognitive-behavioral treatment (CBT) approaches for childhood functional abdominal pain (FAP) is well-established for child outcomes, only a few studies have reported on parent-specific outcomes. This randomized controlled pilot trial analyzed effects of a group CBT on maternal variables (i.e., [...] Read more.

While the efficacy of cognitive-behavioral treatment (CBT) approaches for childhood functional abdominal pain (FAP) is well-established for child outcomes, only a few studies have reported on parent-specific outcomes. This randomized controlled pilot trial analyzed effects of a group CBT on maternal variables (i.e., pain-related behavior, worries and self-efficacy, as well as general psychosocial strain). Methods: The sample constituted of 15 mothers in the intervention group (IG) and 14 mothers in the waitlist control group (WLC). Outcome measures were assessed pre-treatment, post-treatment and at three months follow-up. Results: Analyses revealed significant, large changes in maladaptive maternal reactions related to the child’s abdominal pain in the IG compared to the WLC—i.e., reduced attention (d = 0.95), medical help-seeking (d = 0.92), worries (d = 1.03), as well as a significant increase in behaviors that encourage the child’s self-management (d = 1.03). In addition, maternal self-efficacy in dealing with a child’s pain significantly increased in the IG as well (d = 0.92). Treatment effects emerged post-treatment and could be maintained until three months follow-up. There were no effects on general self-efficacy and maternal quality of life. Conclusion: While these results are promising, and underline the efficacy of the CBT approach for both the child and mothers, further studies, including long-term follow-ups, are warranted. Full article

(This article belongs to the Special Issue Mind-Body Medicine in Children and Adolescents)

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Review

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161 KiB

Open AccessReview

Immersive Virtual Reality for Pediatric Pain

by Andrea Stevenson Won, Jakki Bailey, Jeremy Bailenson, Christine Tataru, Isabel A. Yoon and Brenda Golianu

Children 2017, 4(7), 52; https://doi.org/10.3390/children4070052 - 23 Jun 2017

Cited by 167 | Viewed by 20521

Abstract

Children must often endure painful procedures as part of their treatment for various medical conditions. Those with chronic pain endure frequent or constant discomfort in their daily lives, sometimes severely limiting their physical capacities. With the advent of affordable consumer-grade equipment, clinicians have [...] Read more.

Children must often endure painful procedures as part of their treatment for various medical conditions. Those with chronic pain endure frequent or constant discomfort in their daily lives, sometimes severely limiting their physical capacities. With the advent of affordable consumer-grade equipment, clinicians have access to a promising and engaging intervention for pediatric pain, both acute and chronic. In addition to providing relief from acute and procedural pain, virtual reality (VR) may also help to provide a corrective psychological and physiological environment to facilitate rehabilitation for pediatric patients suffering from chronic pain. The special qualities of VR such as presence, interactivity, customization, social interaction, and embodiment allow it to be accepted by children and adolescents and incorporated successfully into their existing medical therapies. However, the powerful and transformative nature of many VR experiences may also pose some risks and should be utilized with caution. In this paper, we review recent literature in pediatric virtual reality for procedural pain and anxiety, acute and chronic pain, and some rehabilitation applications. We also discuss the practical considerations of using VR in pediatric care, and offer specific suggestions and information for clinicians wishing to adopt these engaging therapies into their daily clinical practice. Full article

(This article belongs to the Special Issue Mind-Body Medicine in Children and Adolescents)

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243 KiB

Open AccessReview

A Mind–Body Approach to Pediatric Pain Management

by Melanie L. Brown, Enrique Rojas and Suzanne Gouda

Children 2017, 4(6), 50; https://doi.org/10.3390/children4060050 - 20 Jun 2017

Cited by 24 | Viewed by 10620

Abstract

Pain is a significant public health problem that affects all populations and has significant financial, physical and psychological impact. Opioid medications, once the mainstay of pain therapy across the spectrum, can be associated with significant morbidity and mortality. Centers for Disease and Control [...] Read more.

Pain is a significant public health problem that affects all populations and has significant financial, physical and psychological impact. Opioid medications, once the mainstay of pain therapy across the spectrum, can be associated with significant morbidity and mortality. Centers for Disease and Control (CDC) guidelines recommend that non-opioid pain medications are preferred for chronic pain outside of certain indications (cancer, palliative and end of life care). Mindfulness, hypnosis, acupuncture and yoga are four examples of mind–body techniques that are often used in the adult population for pain and symptom management. In addition to providing significant pain relief, several studies have reported reduced use of opioid medications when mind–body therapies are implemented. Mind–body medicine is another approach that can be used in children with both acute and chronic pain to improve pain management and quality of life. Full article

(This article belongs to the Special Issue Mind-Body Medicine in Children and Adolescents)

210 KiB

Open AccessReview

Mind–Body Therapy for Children with Attention-Deficit/Hyperactivity Disorder

by Anne Herbert and Anna Esparham

Children 2017, 4(5), 31; https://doi.org/10.3390/children4050031 - 25 Apr 2017

Cited by 29 | Viewed by 15695

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is pervasive among the pediatric population and new treatments with minimal adverse effects are necessary to be studied. The purpose of this article is to review current research studying mind–body therapies for treatment of children diagnosed with ADHD. Literature was [...] Read more.

Attention-deficit/hyperactivity disorder (ADHD) is pervasive among the pediatric population and new treatments with minimal adverse effects are necessary to be studied. The purpose of this article is to review current research studying mind–body therapies for treatment of children diagnosed with ADHD. Literature was reviewed pertaining to the effectiveness of movement-based therapies and mindfulness/meditation-based therapies for ADHD. Many positive effects of yoga, Tai Chi, physical activity, and meditation may significantly improve symptoms of ADHD among children. Full article

(This article belongs to the Special Issue Mind-Body Medicine in Children and Adolescents)

239 KiB

Open AccessReview

Mind–Body Interventions for Pediatric Inflammatory Bowel Disease

by Ann Ming Yeh, Anava Wren and Brenda Golianu

Children 2017, 4(4), 22; https://doi.org/10.3390/children4040022 - 03 Apr 2017

Cited by 19 | Viewed by 12387

Abstract

Pediatric inflammatory bowel disease is an autoimmune disease that causes chronic inflammation of the gastrointestinal mucosa. There is emerging evidence that the brain–gut connection affects inflammatory bowel disease (IBD) patients more than previously thought. This is evidenced by comorbid mood disorders, irritable bowel [...] Read more.

Pediatric inflammatory bowel disease is an autoimmune disease that causes chronic inflammation of the gastrointestinal mucosa. There is emerging evidence that the brain–gut connection affects inflammatory bowel disease (IBD) patients more than previously thought. This is evidenced by comorbid mood disorders, irritable bowel symptoms concurrent with quiescent IBD, and the potential of psychosocial stressors to trigger IBD flares. Mind–body interventions such as psychotherapy, relaxation, mindfulness, biofeedback, yoga, and clinical hypnosis offer an adjunct to standard medical treatment for IBD. We will review the current evidence base for these mind– body interventions in the treatment of pediatric IBD, illustrate a case study, and offer suggestions for future research for this promising field. Full article

(This article belongs to the Special Issue Mind-Body Medicine in Children and Adolescents)

210 KiB

Open AccessReview

Review of Randomized Controlled Trials of Massage in Preterm Infants

by Anna-Kaisa Niemi

Children 2017, 4(4), 21; https://doi.org/10.3390/children4040021 - 03 Apr 2017

Cited by 47 | Viewed by 10126

Abstract

Preterm birth affects about 10% of infants born in the United States. Massage therapy is being used in some neonatal intensive care units for its potential beneficial effects on preterm infants. This article reviews published randomized controlled trials on the effects of massage [...] Read more.

Preterm birth affects about 10% of infants born in the United States. Massage therapy is being used in some neonatal intensive care units for its potential beneficial effects on preterm infants. This article reviews published randomized controlled trials on the effects of massage in preterm infants. Most studies evaluating the effect of massage in weight gain in premature infants suggest a positive effect on weight gain. Increase in vagal tone has been reported in infants who receive massage and has been suggested as a possible mechanism for improved weight gain. More studies are needed on the underlying mechanisms of the effects of massage therapy on weight gain in preterm infants. While some trials suggest improvements in developmental scores, decreased stress behavior, positive effects on immune system, improved pain tolerance and earlier discharge from the hospital, the number of such studies is small and further evidence is needed. Further studies, including randomized controlled trials, are needed on the effects of massage in preterm infants. Full article

(This article belongs to the Special Issue Mind-Body Medicine in Children and Adolescents)

229 KiB

Open AccessReview

Clinical Hypnosis, an Effective Mind–Body Modality for Adolescents with Behavioral and Physical Complaints

by Anju Sawni and Cora Collette Breuner

Children 2017, 4(4), 19; https://doi.org/10.3390/children4040019 - 24 Mar 2017

Cited by 33 | Viewed by 13305

Abstract

Mind–body medicine is a system of health practices that includes meditation/relaxation training, guided imagery, hypnosis, biofeedback, yoga, art/music therapy, prayer, t’ai chi, and psychological therapies such as cognitive behavioral therapy. Clinical hypnosis is an important mind–body tool that serves as an adjunct to [...] Read more.

Mind–body medicine is a system of health practices that includes meditation/relaxation training, guided imagery, hypnosis, biofeedback, yoga, art/music therapy, prayer, t’ai chi, and psychological therapies such as cognitive behavioral therapy. Clinical hypnosis is an important mind–body tool that serves as an adjunct to conventional medical care for the adolescent patient. Clinical hypnosis specifically uses self-directed therapeutic suggestions to cultivate the imagination and facilitate the mind–body connection, leading to positive emotional and physical well-being. There are many similarities between clinical hypnosis and other mind–body/self-regulatory modalities such as visual imagery, mindfulness meditation, yoga, and biofeedback that incorporate experiential learning and mechanisms for change. They may be viewed as subtypes of the hypnotic experience and share the common experience of trance as the entrée into self-empowered change in physiologic and psychological states. Clinical hypnosis can be used by health care providers to teach adolescents coping skills to deal with a wide variety of conditions such as chronic headaches, recurrent abdominal pain, anxiety, depression, grief and bereavement, phobias, anger, family stressors, sleep disorders, or enuresis. Clinical vignettes are given to help illustrate the effectiveness of hypnosis in adolescents. Full article

(This article belongs to the Special Issue Mind-Body Medicine in Children and Adolescents)

1181 KiB

Open AccessReview

The Role of Mindfulness in Reducing the Adverse Effects of Childhood Stress and Trauma

by Robin Ortiz and Erica M. Sibinga

Children 2017, 4(3), 16; https://doi.org/10.3390/children4030016 - 28 Feb 2017

Cited by 87 | Viewed by 37494

Abstract

Research suggests that many children are exposed to adverse experiences in childhood. Such adverse childhood exposures may result in stress and trauma, which are associated with increased morbidity and mortality into adulthood. In general populations and trauma-exposed adults, mindfulness interventions have demonstrated reduced [...] Read more.

Research suggests that many children are exposed to adverse experiences in childhood. Such adverse childhood exposures may result in stress and trauma, which are associated with increased morbidity and mortality into adulthood. In general populations and trauma-exposed adults, mindfulness interventions have demonstrated reduced depression and anxiety, reduced trauma-related symptoms, enhanced coping and mood, and improved quality of life. Studies in children and youth also demonstrate that mindfulness interventions improve mental, behavioral, and physical outcomes. Taken together, this research suggests that high-quality, structured mindfulness instruction may mitigate the negative effects of stress and trauma related to adverse childhood exposures, improving short- and long-term outcomes, and potentially reducing poor health outcomes in adulthood. Future work is needed to optimize implementation of youth-based mindfulness programs and to study long-term outcomes into adulthood. Full article

(This article belongs to the Special Issue Mind-Body Medicine in Children and Adolescents)

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258 KiB

Open AccessReview

Medical Yoga Therapy

by Ina Stephens

Children 2017, 4(2), 12; https://doi.org/10.3390/children4020012 - 10 Feb 2017

Cited by 58 | Viewed by 33900

Abstract

Medical yoga is defined as the use of yoga practices for the prevention and treatment of medical conditions. Beyond the physical elements of yoga, which are important and effective for strengthening the body, medical yoga also incorporates appropriate breathing techniques, mindfulness, and meditation [...] Read more.

Medical yoga is defined as the use of yoga practices for the prevention and treatment of medical conditions. Beyond the physical elements of yoga, which are important and effective for strengthening the body, medical yoga also incorporates appropriate breathing techniques, mindfulness, and meditation in order to achieve the maximum benefits. Multiple studies have shown that yoga can positively impact the body in many ways, including helping to regulate blood glucose levels, improve musculoskeletal ailments and keeping the cardiovascular system in tune. It also has been shown to have important psychological benefits, as the practice of yoga can help to increase mental energy and positive feelings, and decrease negative feelings of aggressiveness, depression and anxiety. Full article

(This article belongs to the Special Issue Mind-Body Medicine in Children and Adolescents)

Other

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209 KiB

Open AccessCommentary

Perspectives on Technology-Assisted Relaxation Approaches to Support Mind-Body Skills Practice in Children and Teens: Clinical Experience and Commentary

by Timothy Culbert

Children 2017, 4(4), 20; https://doi.org/10.3390/children4040020 - 04 Apr 2017

Cited by 10 | Viewed by 9671

Abstract

It has been well-established that a variety of mind-body (MB) techniques, including yoga, mental imagery, hypnosis, biofeedback, and meditation, are effective at addressing symptoms such as pain, anxiety, nausea, and insomnia, as well as helping with a wide variety of medical, emotional, and [...] Read more.

It has been well-established that a variety of mind-body (MB) techniques, including yoga, mental imagery, hypnosis, biofeedback, and meditation, are effective at addressing symptoms such as pain, anxiety, nausea, and insomnia, as well as helping with a wide variety of medical, emotional, and behavioral issues in pediatric populations. In addition, MB skills can also be health promoting in the long-term, and with regular practice, could potentially contribute to longer attention spans, social skills, emotional regulation, and enhanced immune system functioning. Importantly, the benefits accrued from MB skills are largely dose dependent, meaning that individuals who practice with some consistency tend to benefit the most, both in the short- and long-term. However, clinical experience suggests that for busy patients, the regular practice of MB skills can be challenging and treatment adherence commonly becomes an issue. This commentary reviews the concept of technology assisted relaxation as an engaging and effective option to enhance treatment adherence (i.e., daily practice) for pediatric patients, for whom MB skills have been recommended to address physical and mental health challenges. Full article

(This article belongs to the Special Issue Mind-Body Medicine in Children and Adolescents)

186 KiB

Open AccessEssay

Incorporating Hypnosis into Pediatric Clinical Encounters

by Robert A. Pendergrast

Children 2017, 4(3), 18; https://doi.org/10.3390/children4030018 - 16 Mar 2017

Cited by 6 | Viewed by 7465

Abstract

Increasing numbers of licensed health professionals who care for children have been trained in clinical hypnosis. The evidence base for the safety and efficacy of this therapeutic approach in a wide variety of conditions is also growing. Pediatricians and other health professionals who [...] Read more.

Increasing numbers of licensed health professionals who care for children have been trained in clinical hypnosis. The evidence base for the safety and efficacy of this therapeutic approach in a wide variety of conditions is also growing. Pediatricians and other health professionals who have received training may wish to apply these skills in appropriate clinical scenarios but still may be unsure of the practical matters of how to incorporate this skill-set into day to day practice. Moreover, the practical application of such skills will take very different forms depending on the practice setting, types of acute or chronic conditions, patient and family preferences, and the developmental stages of the child or teen. This article reviews the application of pediatric clinical hypnosis skills by describing the use of hypnotic language outside of formal trance induction, by describing natural trance states that occur in children and teens in healthcare settings, and by describing the process of planning a clinical hypnosis encounter. It is assumed that this article does not constitute training in hypnosis or qualify its readers for the application of such skills; rather, it may serve as a practical guide for those professionals who have been so trained, and may serve to inform other professionals what to expect when referring a patient for hypnotherapy. The reader is referred to specific training opportunities and organizations. Full article

(This article belongs to the Special Issue Mind-Body Medicine in Children and Adolescents)

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