A psychological intervention for pediatric chest pain: Development and open trial

OBJECTIVE: Noncardiac chest pain (NCCP) is a common and persistent problem for children and adolescents; typically there is no clear medical cause. To date, no psychological intervention has been studied for chest pain in a pediatric sample. METHODS: (a) We developed a brief psychological treatment for chest pain and associated worry in children and adolescents with NCCP. This program includes psychoeducation, breathing retraining, cognitive coping strategies, and 1 session of parent education and coaching regarding the impact of reinforcement on pain and coping behaviors. (b) We treated 9 youngsters with chronic NCCP, assessing pain, somatization, disability, anxiety and depressive symptoms, and coping. Assessments were conducted before, after, and 6 months following treatment. RESULTS: After treatment, there was a significant decrease in chest pain and somatization. Benefits were maintained at 6-month follow-up. There was no decrease in associated psychological symptoms. CONCLUSIONS: A brief psychological treatment for pediatric NCCP is feasible to administer and may help alleviate symptoms of pediatric NCCP. Further study in a randomized trial is needed.