| The overwhelmingly detrimental sequelae of ill-managed pediatric pain, including physiological, psychological, behavioral, and societal costs demands highly effective treatment protocols. Cognitive and behavioral treatments designed to ameliorate pain, distress and disability were first introduced with adults over 40 years ago and are well established. Pediatric patients' sense of helplessness renders cognitive behavioral therapy (CBT), which aims to restore control, a particularly appropriate option for this population. Moreover, CBT treatment packages typically include a range of techniques that capitalize on children's inherent suggestibility, imagination, and play preferences. However, due to the complex, multifaceted nature of the pain experience, neither pharmacology nor psychology can independently solve the problems of procedural pain, anxiety, and behavioral distress in children. Integration of empirically validated procedures from both fields holds tremendous promise for significantly reducing pediatric procedural pain and distress.;In addition, parents possess unique qualifications to detect subtle changes in their children's behaviors, to discriminate pain-related behaviors from other stress responses, and to help their children cope. If CBT can alleviate the pain and distress of children undergoing extremely painful procedures, it may be quite effective in the management of less acute daily pain experienced outside the medical facility. Successful implementation of non-pharmacologic pain management in the comfort of home will likely enhance families' sense of mastery, strengthen their ability and confidence in home pain management, and reduce dependence on acute-care facilities.;The parent manual created for this dissertation includes sections on the types of pain, the impact of anxiety and emotional distress on pain, cultural differences in pain perception and management, the importance of parental involvement, resources for parent advocacy, caregiver stress reduction techniques, and descriptions of available multidisciplinary professionals who treat pain holistically. Most importantly, the manual delineates a range of non-pharmacologic procedures for alleviating pain and distress that emphasize cognitive-behavioral approaches, as well as sample exercises for acute and chronic pain intended for parents to implement with their children within the comfort of home or in procedure locations for acute and chronic pain. The techniques hold the potential to reduce pain and improve quality of life, provided that they are consistently practiced and incorporated into a comprehensive pain management protocol. |
