Skip to main content

Necessary Adaptations to CBT with Pediatric Patients

  • Chapter
  • First Online:
Handbook of Cognitive Behavioral Therapy for Pediatric Medical Conditions

Abstract

Within pediatric medical settings, cognitive behavioral therapy (CBT) shows promise for treatment targets such as anxiety, depression, pain, and somatic symptoms, as well as adherence to medical regimens and family challenges. This chapter will describe a CBT framework for understanding behavioral health symptoms and discuss the role of physical symptoms in this model. Guidance on tailoring CBT approaches for these medical targets and sensitively adapting core CBT principles and interventions to improve “goodness-of-fit” for medically compromised youth will be discussed. Limitations and common pitfalls in applying CBT with medical illness will also be highlighted.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 219.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 279.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 279.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Akre, C., & Suris, J. C. (2014). From controlling to letting go: What are the psychosocial needs of parents of adolescents with a chronic illness? Health Education Research, 29(5), 764–772.

    Article  Google Scholar 

  • Alderfer, M. A., Fiese, B. H., Gold, J. I., Cutuli, J. J., Holmbeck, G. N., Goldbeck, L., et al. (2008). Evidence-based assessment in pediatric psychology: Family measures. Journal of Pediatric Psychology, 33(9), 1046–1061.

    Article  Google Scholar 

  • Allen, L. A., Woolfolk, R. L., & Escobar, J. I. (2006). Cognitive-behavioral therapy for somatization disorder: A randomized controlled trial. Archives of Internal Medicine, 166(14), 1512–1518.

    Article  Google Scholar 

  • Asarnow, J. R., Kolko, D. J., Miranda, J., & Kazak, A. E. (2015). The pediatric patient-centered medical home: Innovative models for improving behavioral health. American Psychologist, 72(1), 13–27.

    Article  Google Scholar 

  • Bagner, D. M., Fernandez, M. A., & Eyberg, S. M. (2004). Parent-child interaction therapy and chronic illness: A case study. Journal of Clinical Psychology in Medical Settings, 11, 1–6.

    Article  Google Scholar 

  • Boerner, K. E., Gillespie, J. M., McLaughlin, E. N., Kuttner, L., & Chambers, C. T. (2014). Implementation of evidence-based psychological interventions for pediatric needle pain. Clinical Practice in Pediatric Psychology, 2, 224–235.

    Article  Google Scholar 

  • Carey, L. K., Nicholson, B. C., & Fox, R. A. (2002). Maternal factors related to parenting young children with congenital heart disease. Journal of Pediatric Nursing, 17, 174–183.

    Article  Google Scholar 

  • Carpenter, J. L., Price, J. E. W., Cohen, M. J., Shoe, K. M., & Pendley, J. S. (2014). Multifamily group problem-solving intervention for adherence challenges in pediatric insulin-dependent diabetes. Clinical Practice in Pediatric Psychology, 2, 101–115.

    Article  Google Scholar 

  • Carter, B. D., & Threlkeld, B. M. (2012). Psychosocial perspectives in the treatment of pediatric chronic pain. Pediatric Rheumatology, 10(1), 15.

    Article  Google Scholar 

  • Chahal, N., Jelen, A., Rush, J., Manlhiot, C., Boydell, K. M., Sananes, R., et al. (2017). Kawasaki disease with coronary artery aneurysms: Psychosocial impact on parents and children. Journal of Pediatric Health Care, 31(4), 459–469. https://doi.org/10.1016/j.pedhc.2016.11.007.

    Article  Google Scholar 

  • Cohen, L. L., Vowles, K. E., & Eccleston, C. (2010). The impact of adolescent chronic pain on functioning: Disentangling the complex role of anxiety. The Journal of Pain, 11(11), 1039–1046.

    Article  Google Scholar 

  • Compas, B. E., Jaser, S. S., Dunn, M., & Rodriguez, E. M. (2012). Coping with chronic illness in childhood and adolescence. Annual Review of Clinical Psychology, 8, 455–480. https://doi.org/10.1146/annurev-clinpsy-032511-143108.

    Article  Google Scholar 

  • Connor-Smith, J. K., Compas, B. E., Wadsworth, M. E., Thomsen, A. H., & Saltzman, H. (2000). Responses to stress in adolescence: Measurement of coping and involuntary stress responses. Journal of Consulting and Clinical Psychology, 68(6), 976–992.

    Article  Google Scholar 

  • Cousino, M. K., & Hazen, R. A. (2013). Parenting stress among caregivers of children with chronic illness: A systematic review. Journal of Pediatric Psychology, 38(8), 809–828.

    Article  Google Scholar 

  • Dehghani-Arani, F., Besharat, M. A., Fitton, V. A., & Aghamohammadi, A. (2018). Efficacy of an attachment-based intervention model on health indices in children with chronic disease and their mothers. Administration and Policy in Mental Health and Mental Health Services Research, 45, 900–910.

    Article  Google Scholar 

  • Distelberg, B., Tapanes, D., Emerson, N. D., Brown, W. N., Vaswani, D., Williams-Reade, J., et al. (2018). Prospective pilot study of the mastering each new direction psychosocial family systems program for pediatric chronic illness. Family Process, 57(1), 83–99.

    Article  Google Scholar 

  • Eichner, J. M., & Johnson, B. H. (2018). Patient and family centered care and the pediatrician’s role: American Academy of Pediatrics policy statement. Pediatrics, 129(2), 394–404.

    Google Scholar 

  • Ernst, M. (2011). The Coping Club: A new user-generated resource for children with pain and other medical conditions [website review]. Pediatric Pain Letter, 13(2), 1–4.

    Google Scholar 

  • Golfenshtein, N., Srulovici, E., & Deatrick, J. (2016). Interventions for reducing parenting stress in families with pediatric conditions: An integrative review. Journal of Family Nursing, 22(4), 460–492.

    Article  Google Scholar 

  • Hilliard, M. E., Harris, M. A., & Weissberg-Benchell, J. (2012). Diabetes resilience: A model of risk and protection in type 1 diabetes. Current Diabetes Reports, 12(6), 739–748.

    Article  Google Scholar 

  • Holmbeck, G. N., Johnson, S. Z., Wills, K. E., McKernon, W., Rose, B., Erklin, S., et al. (2002). Observed and perceived parental overprotection in relation to psychosocial adjustment in preadolescents with a physical disability: The mediational role of behavioral autonomy. Journal of Consulting and Clinical Psychology, 70, 96–110.

    Article  Google Scholar 

  • Jamieson, N., Fitzgerald, D., Singh-Grewal, D., Hanson, C., Craig, J. C., & Tong, A. (2014). Children’s experiences of cystic fibrosis: A systematic review of qualitative studies. Pediatrics, 133(6), e1683–e1697.

    Article  Google Scholar 

  • Jensen, T. K., Holt, T., Ormhaug, S. M., Egeland, K., Granly, L., Hoaas, L. C., et al. (2014). A randomized effectiveness study comparing trauma-focused cognitive behavioral therapy with therapy as usual for youth. Journal of Clinical Child & Adolescent Psychology, 43(3), 356–369.

    Article  Google Scholar 

  • Karst, P., & Lew-Vriethoff, J. (2018). The invisible string. New York: Little, Brown.

    Google Scholar 

  • Kazak, A. E., Kassam-Adams, N., Schneider, S., Zelikovsky, N., Alderfer, M. A., & Rourke, M. (2006). An integrative model of pediatric medical traumatic stress. Journal of Pediatric Psychology, 31(4), 343–355.

    Article  Google Scholar 

  • Kazdin, A. E., Marciano, P. L., & Whitley, M. K. (2005). The therapeutic alliance in cognitive- behavioral treatment of children referred for oppositional, aggressive, and antisocial behavior. Journal of Consulting and Clinical Psychology, 73(4), 726.

    Article  Google Scholar 

  • Kendall, P. C., Robin, J. A., Hedtke, K. A., Suveg, C., Flannery-Schroeder, E., & Gosch, E. (2005). Considering CBT with anxious youth? Think exposures. Cognitive and Behavioral Practice, 12(1), 136–148.

    Article  Google Scholar 

  • Kibby, M. Y., Tyc, V. L., & Mulhern, R. K. (1998). Effectiveness of psychological intervention for children and adolescents with chronic medical illness: A meta-analysis. Clinical Psychology Review, 18(1), 103–117.

    Article  Google Scholar 

  • Kieckhefer, G. M., Trahms, C. M., Churchill, S., & Simpson, J. N. (2009). Measuring parent-child shared management of chronic illness. Pediatric Nursing, 35(2), 101–108.

    Google Scholar 

  • Maikranz, J. M., Steele, R. G., Dreyer, M. L., Stratman, A. C., & Bovaird, J. A. (2007). The relationship of hope and illness-related uncertainty to emotional adjustment and adherence among pediatric renal and liver transplant recipients. Journal of Pediatric Psychology, 32(5), 571–581.

    Article  Google Scholar 

  • Mannix, M. M., Feldman, J. M., & Moody, K. (2009). Optimism and health-related quality of life in adolescents with cancer. Child: Health, Care and Development, 35(4), 482–488. https://doi.org/10.1111/j.1365-2214.2008.00934.x.

    Article  Google Scholar 

  • McCann, D., Bull, R., & Winzenberg, T. (2015). Sleep deprivation in parents caring for children with complex needs at home: A mixed methods systematic review. Journal of Family Nursing, 21(1), 86–118.

    Article  Google Scholar 

  • McClellan, C. B., & Cohen, L. L. (2007). Family functioning in children with chronic illness compared with healthy controls: A critical review. The Journal of Pediatrics, 150(3), 221–223.

    Article  Google Scholar 

  • McGoldrick, M., Carter, B., & Garcia-Preto, N. (2011). The expanded family life cycle: Individual, family, and social perspectives. Boston: Allyn and Bacon. Google Scholar.

    Google Scholar 

  • McMahon, M. A., Noll, R. B., Michaud, L. J., & Johnson, J. C. (2001). Sibling adjustment to pediatric traumatic brain injury: A case-controlled pilot study. The Journal of Head Trauma Rehabilitation, 16(6), 587–594.

    Article  Google Scholar 

  • McNeil, C. B., & Hembree-Kigin, T. L. (2010). Parent-child interaction therapy. Berlin: Springer Science & Business Media.

    Book  Google Scholar 

  • Mellonie, B., & Ingpen, R. (1983). Lifetimes: A beautiful way to explain death to children. New York: Bantam Books.

    Google Scholar 

  • Moore, E. R., Bennett, K., Dietrich, M. S., & Wells, N. (2015). The effect of directed medical play on young children’s pain and distress during burn wound care. Journal of Pediatric Health Care, 29, 265–273.

    Article  Google Scholar 

  • Mullins, L. L., Wolfe-Christensen, C., Hoff Pai, A. L., Carpentier, M. Y., Gillaspy, S., Cheek, J., et al. (2007). The relationship of parental overprotection, perceived child vulnerability, and parenting stress to uncertainty in youth with chronic illness. Journal of Pediatric Psychology, 32(8), 973–982.

    Article  Google Scholar 

  • Pao, M., & Bosk, A. (2011). Anxiety in medically ill children/adolescents. Depression and Anxiety, 28(1), 40–49.

    Article  Google Scholar 

  • Picoraro, J. A., Womer, J. W., Kazak, A. E., & Feudtner, C. (2014). Posttraumatic growth in parents and pediatric patients. Journal of Palliative Medicine, 17(2), 209–218.

    Article  Google Scholar 

  • Pinquart, M. (2013). Do the parent–child relationship and parenting behaviors differ between families with a child with and without chronic illness? A meta-analysis. Journal of Pediatric Psychology, 38, 708–721.

    Article  Google Scholar 

  • Powers, S. W., Jones, J. S., & Jones, B. A. (2005). Behavioral and cognitive-behavioral interventions with pediatric populations. Clinical Child Psychology and Psychiatry, 10(1), 65–77.

    Article  Google Scholar 

  • Price, J., Kassam-Adams, N., Alderfer, M. A., Christofferson, J., & Kazak, A. E. (2016). Systematic review: A reevaluation and update of the integrative (trajectory) model of pediatric medical traumatic stress. Journal of Pediatric Psychology, 41(1), 86–97.

    Article  Google Scholar 

  • Santos, S., Crespo, C., Canavarro, C., & Kazak, A. E. (2015). Family rituals and quality of life in children with cancer and their parents: The role of family cohesion and hope. Journal of Pediatric Psychology, 40(7), 664–671.

    Article  Google Scholar 

  • Selhub, E. (2007). Mind-body medicine for treating depression. Alternative & Complementary Therapies, 2, 4–9.

    Article  Google Scholar 

  • Stanger, C., Ryan, S. R., Delhey, L. M., Thrailkill, K., Zhongze, L., Zhigang, L., et al. (2013). A multicomponent motivational intervention to improve adherence among adolescents with poorly controlled type 1 diabetes: A pilot study. Journal of Pediatric Psychology, 38(6), 629–637.

    Article  Google Scholar 

  • Swallow, V., Lambert, H., Santacroce, S., & MacFadyen, A. (2011). Fathers and mothers developing skills in managing children’s long-term medical conditions: How do their qualitative accounts compare? Child: Care, Health and Development, 37(4), 512–523.

    Article  Google Scholar 

  • U.S. Department of Health and Human Services. (2013). Health resources and services administration, Maternal and Child Health Bureau (The National Survey of Children with Special Health Care Needs Chartbook 2009–2010). Rockville, MD: U.S. Department of Health and Human Services.

    Google Scholar 

  • Van Allen, J., Steele, R. G., Nelson, M. B., Peugh, J., Egan, A., Clements, M., et al. (2016). A longitudinal examination of hope and optimism and their role in type 1 diabetes in youths. Journal of Pediatric Psychology, 41(7), 741–749.

    Article  Google Scholar 

  • Van Slyke, D. A., & Walker, L. S. (2006). Mothers’ responses to children’s pain. The Clinical Journal of Pain, 22(4), 387–391.

    Article  Google Scholar 

  • Vermaes, I. P., van Susante, A. M., & van Bakel, H. J. (2012). Psychological functioning of siblings in families of children with chronic health conditions: A meta-analysis. Journal of Pediatric Psychology, 37(2), 166–184.

    Article  Google Scholar 

  • Walker, L. S., Smith, C. A., Garber, J., & Van Slyke, D. A. (1997). Development and validation of the pain response inventory for children. Psychological Assessment, 9(4), 392–405.

    Article  Google Scholar 

  • Wysocki, T., Harris, M. A., Buckloh, L. M., Mertlich, D., Lochrie, A. S., Taylor, A., et al. (2006). Effects of behavioral family systems therapy for diabetes on adolescents’ family relationships, treatment adherence, and metabolic control. Journal of Pediatric Psychology, 31, 928–938.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Corinne Catarozoli .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Catarozoli, C., Brodzinsky, L., Salley, C.G., Miller, S.P., Lois, B.H., Carpenter, J.L. (2019). Necessary Adaptations to CBT with Pediatric Patients. In: Friedberg, R.D., Paternostro, J.K. (eds) Handbook of Cognitive Behavioral Therapy for Pediatric Medical Conditions. Autism and Child Psychopathology Series. Springer, Cham. https://doi.org/10.1007/978-3-030-21683-2_8

Download citation

Publish with us

Policies and ethics