Beyond traditional cognitive-behavioral therapy: Novel psychological and alternative approaches to pediatric pain

This article highlights recent studies on novel psychological and complementary and alternative medicine (CAM) approaches for acute/procedural and chronic/recurrent pediatric pain. Computerized databases were searched from 1996-2006 to identify controlled trials on CAM therapies and psychological interventions that extended beyond traditional cognitivebehavioral therapy (CBT), defined as clinic-based individual (therapist-child) psychotherapy. Existing data supports the efficacy of novel psychological therapies for both acute and chronic pain reduction. Computer-based and distance (e.g., Internet/phone) interventions have emerged as inexpensive new modes of treatment delivery. Well-conducted studies on CAM approaches are limited. Evidence supporting biofeedback for recurrent headaches and hypnosis for acute/procedural pain is the most robust. Compared to the literature on novel psychological interventions, there are relatively few rigorously conducted CAM investigations and thus further well-designed trials are warranted. For novel psychological approaches, additional large-scale studies are needed to replicate initial positive findings.