Digital Acceptance and Commitment Therapy for pediatric chronic pain – a randomized controlled trial.

Research problem and specific questionsChronic primary pain is increasingly becoming a societal health problem also in children, and 5 % have a pain problem that affects their function and quality of life. Despite the high prevalence, access to evidence-based treatment is low.

Psychological treatment in the form of cognitive behavioral therapy (CBT) and Acceptance and Commitment Therapy (ACT) show promising effects and are the methods recommended for major functional limitations, but the state of evidence is of low to moderate reliability due to a lack of larger randomized studies.

To increase treatment accessibility and reach, we have developed a digital treatment.

In the development and pilot testing of this we have worked to increase treatment compliance and optimize the treatment´s effects, especially through an increased focus on exposure, which is a treatment intervention where the patient approaches situations that he or she previously avoided.

We want to evaluate the digital treatment in a larger randomized, controlled study where the results of digitally delivered ACT are evaluated in relation to an active control (that is also in accordance with the recommendation for the patient group; pain education) and a passive control (waiting list).

Data and method Patients are randomized to internet treatment, pain education only and waiting list (ratio 1:1:1). The main outcome is pain-related disability and is measured with the Pain Interference Index (PII).

Secondary outcomes are pain intensity, quality of life, self-rated health, depression and psychological flexibility.Treatment effects are analyzed using hierarchical linear modeling.

Social relevance and utilisationThe short term goal of the project is the successful implementation of a high-quality RCT that answers the research questions and improves the state of evidence for digital psychological treatment for pediatric chronic pain.

The goal of the project from a longer perspective is to implement high-quality and scientifically proven digital treatment interventions for children with chronic pain in clinical practice.

Plan for project realisation The project is well founded in the organisation (Behavioral Medicine, Medical Psychology, K) and recruitment, assessment and treatment will be conducted in our regular clinical practice. The study will continue with recruitment, data collection and writing of scientific manuscripts for 3-years.