Cognitive-Behavioral Therapy for Functional Abdominal Pain in Kids

“My Stomach Hurts!”

For those of you with children that complain of their stomach hurting often, it can feel like a hard place to be. The complaining of stomach pain and then not knowing what to do to help relieve the pain is challenging. 

Even after all the doctor’s visits to figure out the cause of the stomach pain, it still comes down to no relief and the recurrent stomach pain, although doctors say, “Everything is fine; it must just be functional abdominal pain.”

Functional abdominal pain (FAP) can be described as basically recurrent stomach pain that is not relieved with usual treatment methods.

Did you know that it is pretty standard? About 10-15% of school-aged children experience FAP at some point.

Have you ever noticed that when your child is complaining of something hurting, the more attention you give them, the more they complain? Or maybe they complain, you ignore them because this happens so frequently, and then you feel like a horrible parent?

I have always wondered how a parent’s intervention may control the child’s stomach pain narrative. I have also asked if cognitive-behavioral therapy may benefit a child with FAP to help ease their pain. 

So, I looked at a study by Levy et al. on cognitive-behavioral therapy for children with FAP.

The study's main goal was to test the efficacy of an intervention that taught children/parents strategies for managing symptoms. They also taught parents how to model and reinforce healthier responses to GI discomfort.

The study included 200 children and teens aged 7-17. Participants were assessed at baseline, one week after treatment, three months after treatment, and six months after treatment. Participants were excluded if they had physical/laboratory findings to explain abdominal pain, any chronic disease (Crohn’s, ulcerative colitis, diabetes, etc.), diagnosed lactose intolerance, major surgery within one year, and developmental disabilities.

All participants met with trained therapists for three in-person sessions one week apart. Treatment consisted of three major components: relaxation training, working with parents and children to modify family responses to illness and wellness behaviors, and cognitive restructuring to address and alter dysfunctional cognitions regarding symptoms and their implications for functioning through cognitive therapy techniques.

What were the results?

Children who met with therapists for social learning and cognitive-behavioral therapy (SLCBT) improved significantly more than the non-SLCBT group on abdominal pain-related symptoms, desirable beliefs and pain coping strategies, and parental attentiveness in response to pain behaviors. They also found that children with SLCBT had greater confidence in finding ways to feel better. 

This study is essential information for parents whose children suffer from FAP. Parents' responses to children are vital in how children view their symptoms. Parents can learn the skills and techniques to help children cope with lessening the disease burden's severity and helping get them back to their regular routines without missing activities/events due to FAP.

 Learn more about Diet Changes for Functional Abdominal Pain in Children.

1. _{What is functional abdominal pain?. Functional abdominal pain | Boston Children's Hospital. (n.d.). Retrieved January 15, 2023.}
2. _{Levy, R. L., Langer, S. L., Walker, L. S., Romano, J. M., Christie, D. L., Youssef, N., DuPen, M. M., Feld, A. D., Ballard, S. A., Welsh, E. M., Jeffery, R. W., Young, M., Coffey, M. J., & Whitehead, W. E. (2010). Cognitive-behavioral therapy for children with functional abdominal pain and their parents decreases pain and other symptoms. The American journal of gastroenterology, 105(4), 946–956.}