IIPT Treatment Components

IIPT treatment components for all treatment sites identified through our systematic review.

Below are the treatment components for all 13 treatment sites we were able to identify. For information where these treatment sites are located and which articles were referenced for a respective site, see below.

Components per Site

Component AU
1		 UK
2		 DE
3		 US
4		 US
5		 UK
6		 US
7		 US
8		 US
9		 US
10		 US
11		 CA
12		 DE
13
Treatment Inclusion Criteria
Pain for more than 3 months ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓
High pain-related disability ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓
Patient and parent motivation ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓
Failure of outpatient treatment ✓ ✓ ✓ ✓ ✓
Structure
Inpatient ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓
Day-hospital ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓
Interdisciplinary team ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓
Psychotherapy Approach
CBT and operant ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓
ACT ✓ ✓ ✓ ✓ ✓
Medical Interventions
Medication ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓
Medical examination ✓ ✓ ✓ ✓ ✓ ✓ ✓
Physical therapy ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓
Biofeedback ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓
Psychological Interventions
Education ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓
Relaxation techniques ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓
Attention defocusing ✓ ✓ ✓ ✓ ✓
Imagery ✓ ✓ ✓ ✓ ✓ ✓ ✓
Active daily structure ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓
Stress management ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓
Problem-solving ✓ ✓ ✓ ✓
Addressing psychological comorbidities ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓
Exposure ✓ ✓ ✓ ✓
Social Interventions
Family sessions ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓
Parent-only sessions ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓
School reintegration ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓
Patient group sessions ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓
Other
Occupational therapy ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓
Recreational therapy ✓ ✓ ✓ ✓ ✓ ✓ ✓
Hospital school program ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓
Acupressure/acupuncture ✓ ✓ ✓
Diet ✓ ✓ ✓
Sleep hygiene ✓ ✓ ✓ ✓ ✓ ✓
Music therapy ✓ ✓ ✓ ✓ ✓ ✓ ✓
Art therapy ✓ ✓ ✓ ✓ ✓
Therapeutic homework and practice ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓
Relapse prevention ✓ ✓ ✓ ✓
Follow-up care ✓ ✓ ✓ ✓ ✓
Massage ✓ ✓ ✓
Yoga ✓ ✓ ✓
Aquatic therapy ✓ ✓ ✓ ✓

Considered Articles

AU (1)

Melbourne, Australia

UK (2)

Bath, UK

DE (3)

Datteln, Germany

, , , , , , , , , , , , , ,

US (4)

Baltimore, USA

,

US (5)

Boston, USA

, , , , , , , , , , ,

UK (6)

Bath, UK

,

US (7)

Kansas City, USA

, ,

US (8)

Cleveland, USA

, , , , ,

US (9)

Philadelphia, USA

,

US (10)

Cincinnati, USA

, , ,

US (11)

Rochester, USA

, ,

CA (12)

Calgary, Canada

,

DE (13)

Garmisch-Partenkirchen, Germany

Footnotes

    References

    Banez, Gerard A., Thomas W. Frazier, Andrea A. Wojtowicz, Kristen Buchannan, Douglas E. Henry, and Ethan Benore. 2014. “Chronic pain in children and adolescents: 24-42 month outcomes of an inpatient/day hospital interdisciplinary pain rehabilitation program.” Journal of Pediatric Rehabilitation Medicine 7 (3): 197–206. https://doi.org/10.3233/PRM-140289.
    Benore, Ethan, Alexandra D’Auria, Gerard A. Banez, Sarah Worley, and Anne Tang. 2015. “The influence of anxiety reduction on clinical response to pediatric chronic pain rehabilitation.” The Clinical Journal of Pain 31 (5): 375–83. https://doi.org/10.1097/AJP.0000000000000127.
    Boggero, Ian A., Kendra N. Krietsch, Hannah M. Pickerill, Kelly C. Byars, Kendra J. Homan, Sara E. Williams, and Christopher D. King. 2021. “Improvements in Sleep Correlate With Improvements in Clinical Outcomes Among Adolescents Undergoing Intensive Interdisciplinary Pain Treatment.” The Clinical Journal of Pain 37 (6): 443–53. https://doi.org/10.1097/AJP.0000000000000936.
    Bruce, Barbara K., Chelsea M. Ale, Tracy E. Harrison, Susan M. Bee, Connie A. Luedtke, Jennifer Geske, and Karen E. Weiss. 2017. “Getting Back to Living: Further Evidence for the Efficacy of an Interdisciplinary Pediatric Pain Treatment Program.” The Clinical Journal of Pain 33 (6): 535–42. https://doi.org/10.1097/AJP.0000000000000433.
    Buchannan, Kristen, Gerard A. Banez, Ethan Benore, Pam Senders, and Clarence Coker. 2018. “An initial examination of parent satisfaction following intensive rehabilitation for pediatric chronic pain.” Clinical Practice in Pediatric Psychology 6 (3): 238–47. https://doi.org/10.1037/cpp0000236.
    Chalkiadis, George A. 2001. “Management of chronic pain in children.” Medical Journal of Australia 175 (9): 476–79. https://doi.org/10.5694/j.1326-5377.2001.tb143680.x.
    Dobe, Michael, Uta Damschen, B. Reiffer-Wiesel, Claudia Sauer, and Boris Zernikow. 2006. “Dreiwöchige stationäre multimodale Schmerztherapie bei Kindern und Jugendlichen mit chronischen Schmerzen. Erste Ergebnisse in der Langzeitwirkung.” Der Schmerz 20 (1): 51–60. https://doi.org/10.1007/s00482-005-0457-0.
    Dobe, Michael, Tanja Hechler, J. Behlert, Joachim Kosfelder, and Boris Zernikow. 2011. “Schmerztherapie bei Chronisch Schmerzkranken, Schwer Beeinträchtigten Kindern und Jugendlichen: Langzeiterfolge einer 3-Wöchigen Stationären Schmerztherapie.” Der Schmerz 25 (4): 411–22. https://doi.org/10.1007/s00482-011-1051-2.
    Dogan, Meltem, Boris Zernikow, and Julia Wager. 2021. “Short-Term and Long-Term Effectiveness of Intensive Interdisciplinary Pain Treatment for Children and Adolescents with Chronic Headache: A Longitudinal Observation Study.” Children 8 (3). https://doi.org/10.3390/children8030220.
    Eccleston, Christopher, P. N. Malleson, Jacqui Clinch, Hannah Connell, and C. Sourbut. 2003. “Chronic pain in adolescents: evaluation of a programme of interdisciplinary cognitive behaviour therapy.” Archives of Disease in Childhood 88 (10): 881–85. https://doi.org/10.1136/adc.88.10.881.
    Erpelding, Nathalie, Laura E. Simons, Alyssa Lebel, Paul Serrano, Melissa Pielech, Sanjay Prabhu, Lino Becerra, and David Borsook. 2016. “Rapid treatment-induced brain changes in pediatric CRPS.” Brain Structure & Function 221 (2): 1095–1111. https://doi.org/10.1007/s00429-014-0957-8.
    Evans, Jenny R., Ethan Benore, and Gerard A. Banez. 2016. “The Cost-Effectiveness of Intensive Interdisciplinary Pediatric Chronic Pain Rehabilitation.” Journal of Pediatric Psychology 41 (8): 849–56. https://doi.org/10.1093/jpepsy/jsv100.
    Fahrenkamp, Amy, Leslie Sim, Lisbeth Roers, Mark Canny, Tracy Harrison, and Cynthia Harbeck-Weber. 2020. “An Innovative and Accessible Biofeedback Intervention for Improving Self-Regulatory Skills in Pediatric Chronic Pain: A Pilot Study.” Journal of Alternative and Complementary Medicine (New York, N.Y.) 26 (3): 212–18. https://doi.org/10.1089/acm.2019.0297.
    Flack, Florentina, Lorin Stahlschmidt, Michael Dobe, Gerrit Hirschfeld, Alexa Strasser, Johannes Michalak, Julia Wager, and Boris Zernikow. 2018. “Efficacy of adding interoceptive exposure to intensive interdisciplinary treatment for adolescents with chronic pain: a randomized controlled trial.” Pain 159 (11): 2223–33. https://doi.org/10.1097/j.pain.0000000000001321.
    Gauntlett-Gilbert, Jeremy, Hannah Connell, Jacqui Clinch, and Lance M. McCracken. 2013. “Acceptance and values-based treatment of adolescents with chronic pain: outcomes and their relationship to acceptance.” Journal of Pediatric Psychology 38 (1): 72–81. https://doi.org/10.1093/jpepsy/jss098.
    Gmuca, Sabrina. 13.06.2022. “Personal communication on treatment components. https://www.chop.edu/services/therapeutic-hospital-treatment-program-amps.”
    Hechler, Tanja, Markus Blankenburg, Michael Dobe, Joachim Kosfelder, Bettina Hübner, and Boris Zernikow. 2010. “Effectiveness of a multimodal inpatient treatment for pediatric chronic pain: a comparison between children and adolescents.” European Journal of Pain 14 (1): 97.e1–9. https://doi.org/10.1016/j.ejpain.2009.03.002.
    Hechler, Tanja, Michael Dobe, Uta Damschen, Markus Blankenburg, Sandra Schroeder, Joachim Kosfelder, and Boris Zernikow. 2010. “The pain provocation technique for adolescents with chronic pain: preliminary evidence for its effectiveness.” Pain Medicine 11 (6): 897–910. https://doi.org/10.1111/j.1526-4637.2010.00839.x.
    Hechler, Tanja, Michael Dobe, Joachim Kosfelder, Uta Damschen, Bettina Hübner, Markus Blankenburg, Claudia Sauer, and Boris Zernikow. 2009. “Effectiveness of a 3-week multimodal inpatient pain treatment for adolescents suffering from chronic pain: statistical and clinical significance.” The Clinical Journal of Pain 25 (2): 156–66. https://doi.org/10.1097/ajp.0b013e318185c1c9.
    Hechler, Tanja, Ann-Kristin Ruhe, Pia Schmidt, Jessica Hirsch, Julia Wager, Michael Dobe, Frank Krummenauer, and Boris Zernikow. 2014. “Inpatient-based intensive interdisciplinary pain treatment for highly impaired children with severe chronic pain: randomized controlled trial of efficacy and economic effects.” Pain 155 (1): 118–28. https://doi.org/10.1016/j.pain.2013.09.015.
    Hechler, Tanja, Julia Wager, and Boris Zernikow. 2014. “Chronic pain treatment in children and adolescents: less is good, more is sometimes better.” BMC Pediatrics 14: 262. https://doi.org/10.1186/1471-2431-14-262.
    Hirschfeld, Gerrit, Tanja Hechler, Michael Dobe, Julia Wager, Pia von Lützau, Markus Blankenburg, Joachim Kosfelder, and Boris Zernikow. 2013. “Maintaining lasting improvements: one-year follow-up of children with severe chronic pain undergoing multimodal inpatient treatment.” Journal of Pediatric Psychology 38 (2): 224–36. https://doi.org/10.1093/jpepsy/jss115.
    Hoefel, L., M. Spamer, R. Haefner, N. Draheim, E. Schnoebel-Mueller, and J.-P. Haas. 2016. “Multimodale Schmerztherapie bei Kindern und Jugendlichen mit chronischen muskuloskelettalen Schmerzen.” Aktuelle Rheumatologie 41 (04): 326–33. https://doi.org/10.1055/s-0042-105741.
    Hurtubise, Karen, Samuel Blais, Melanie Noel, Astrid Brousselle, Frederic Dallaire, Nivez Rasic, and Chantal Camden. 2020. “Is It Worth It? A Comparison of an Intensive Interdisciplinary Pain Treatment and a Multimodal Treatment for Youths With Pain-related Disability.” The Clinical Journal of Pain 36 (11): 833–44. https://doi.org/10.1097/AJP.0000000000000869.
    Junghans-Rutelonis, Ashley N., Julia R. Craner, Chelsea M. Ale, Cynthia Harbeck-Weber, Philip R. Fischer, and Karen E. Weiss. 2018. “Youth with Chronic Pain and Postural Orthostatic Tachycardia Syndrome (POTS): Treatment Mediators of Improvement in Functional Disability.” Journal of Clinical Psychology in Medical Settings 25 (4): 471–84. https://doi.org/10.1007/s10880-018-9558-7.
    Kemani, Mike K., Marie Kanstrup, Abbie Jordan, Line Caes, and Jeremy Gauntlett-Gilbert. 2018. “Evaluation of an Intensive Interdisciplinary Pain Treatment Based on Acceptance and Commitment Therapy for Adolescents With Chronic Pain and Their Parents: A Nonrandomized Clinical Trial.” Journal of Pediatric Psychology 43 (9): 981–94. https://doi.org/10.1093/jpepsy/jsy031.
    Kempert, Heidi. 2020. “The use of yoga as a group intervention for pediatric chronic pain rehabilitation: Exploring qualitative and quantitative outcomes.” International Journal of Yoga 13 (1): 55–61. https://doi.org/10.4103/ijoy.IJOY$\backslash${\textunderscore }13$\backslash${\textunderscore }19.
    Kempert, Heidi, Ethan Benore, and Rachel Heines. 2017. “Easily Administered Patient-Reported Outcome Measures: Adolescents’ Perceived Functional Changes After Completing an Intensive Chronic Pain Rehabilitation Program.” Archives of Physical Medicine and Rehabilitation 98 (1): 58–63. https://doi.org/10.1016/j.apmr.2016.08.471.
    Krietsch, Kendra N., Dean W. Beebe, Christopher King, Kendra J. Homan, and Sara E. Williams. 2021. “Sleep among Youth with Severely Disabling Chronic Pain: Before, during, and after Inpatient Intensive Interdisciplinary Pain Treatment.” Children 8 (1). https://doi.org/10.3390/children8010042.
    Logan, Deirdre E., Elizabeth A. Carpino, Gloria Chiang, Marianne Condon, Emily Firn, Veronica J. Gaughan, Melinda Hogan, et al. 2012. “A day-hospital approach to treatment of pediatric complex regional pain syndrome: initial functional outcomes.” The Clinical Journal of Pain 28 (9): 766–74. https://doi.org/10.1097/AJP.0b013e3182457619.
    Logan, Deirdre E., Christine B. Sieberg, Caitlin Conroy, Kelly R. Smith, Shannon Odell, and Navil F. Sethna. 2015. “Changes in sleep habits in adolescents during intensive interdisciplinary pediatric pain rehabilitation.” Journal of Youth and Adolescence 44 (2): 543–55. https://doi.org/10.1007/s10964-014-0155-2.
    Lopez Lumbi, Susanne, Ann-Kristin Ruhe, Ingo Pfenning, Wager Julia, and Boris Zernikow. 2021. “Economic long-term effects of intensive interdisciplinary pain treatment in pediatric patients with severe chronic pain: Analysis of claims data.” European Journal of Pain. https://doi.org/10.1002/ejp.1825.
    Maynard, Cynthia S., Adrianna Amari, Beth Wieczorek, James R. Christensen, and Keith J. Slifer. 2010. “Interdisciplinary behavioral rehabilitation of pediatric pain-associated disability: retrospective review of an inpatient treatment protocol.” Journal of Pediatric Psychology 35 (2): 128–37. https://doi.org/10.1093/jpepsy/jsp038.
    Mirek, Elizabeth, Deirdre Logan, Kimberly Boullard, Amber M. Hall, Steven J. Staffa, and Navil Sethna. 2019. “Physical Therapy Outcome Measures for Assessment of Lower Extremity Chronic Pain-Related Function in Pediatrics.” Pediatric Physical Therapy 31 (2): 200–207. https://doi.org/10.1097/PEP.0000000000000587.
    Nelson, Sarah, Kelly R. Smith, Navil F. Sethna, and Deirdre E. Logan. 2019. “Youth With Chronic Pain and a History of Adverse Childhood Experiences in the Context of Multidisciplinary Pain Rehabilitation.” The Clinical Journal of Pain 35 (5): 420–27. https://doi.org/10.1097/AJP.0000000000000686.
    Pielech, Melissa, Dustin P. Wallace, Megan Fitzgerald, and Cara M. Hoffart. 2018. “Parent Responses to Child Pain During Intensive Interdisciplinary Pain Treatment and 1-Year Follow-Up.” The Journal of Pain 19 (11): 1275–84. https://doi.org/10.1016/j.jpain.2018.05.002.
    Randall, Edin T., Yasmin C. Cole-Lewis, Carter R. Petty, and Kelsey N. Jervis. 2021. “Understanding How Perfectionism Impacts Intensive Interdisciplinary Pain Treatment Outcomes: A Nonrandomized Trial.” Journal of Pediatric Psychology 46 (3): 351–62. https://doi.org/10.1093/jpepsy/jsaa111.
    Randall, Edin T., Kelly R. Smith, Caitlin Conroy, Allison M. Smith, Navil F. Sethna, and Deirdre E. Logan. 2018. “Back to Living: Long-term Functional Status of Pediatric Patients Who Completed Intensive Interdisciplinary Pain Treatment.” The Clinical Journal of Pain 34 (10): 890–99. https://doi.org/10.1097/AJP.0000000000000616.
    Rayner, Laura. 11.10.2022. “Personal communication on treatment components.”
    Robinson, Merideth, Cynthia M. Ward, Beverly S. Shieh, Bridget Armstrong, Marissa A. Docimo, Ximena Celedon, Suzanne Rybczynski, Eric Levey, and Keith J. Slifer. 2019. “Assessment of functional outcomes of an interdisciplinary inpatient pediatric pain rehabilitation program.” Clinical Practice in Pediatric Psychology 7 (2): 116–26. https://doi.org/10.1037/cpp0000253.
    Ruhe, Ann-Kristin, Michael Frosch, Julia Wager, Roland Linder, Ingo Pfenning, Dirk Sauerland, and Boris Zernikow. 2017. “Health Care Utilization and Cost in Children and Adolescents With Chronic Pain: Analysis of Health Care Claims Data 1 Year Before and After Intensive Interdisciplinary Pain Treatment.” The Clinical Journal of Pain 33 (9): 767–76. https://doi.org/10.1097/AJP.0000000000000460.
    Scheufler, Ashley, Dustin P. Wallace, and Emily Fox. 2021. “Comparing Three Music Therapy Interventions for Anxiety and Relaxation in Youth With Amplified Pain.” Journal of Music Therapy 58 (2): 177–200. https://doi.org/10.1093/jmt/thaa021.
    Sherry, David D., Lori Brake, Jenna L. Tress, Jennifer Sherker, Katherine Fash, Kelly Ferry, and Pamela F. Weiss. 2015. “The Treatment of Juvenile Fibromyalgia with an Intensive Physical and Psychosocial Program.” The Journal of Pediatrics 167 (3): 731–37. https://doi.org/10.1016/j.jpeds.2015.06.036.
    Shulman, Julie, Caitlin Conroy, Anna Cybulski, Kelly R. Smith, Kelsey Jervis, Hannah Johnson, David Zurakowski, and Navil F. Sethna. 2020. “Does intensive interdisciplinary pain treatment improve pediatric headache-related disability?” Disability and Rehabilitation, 1–8. https://doi.org/10.1080/09638288.2020.1762125.
    Shulman, Julie, Allison Smith, Julie Keysor, Anne Kenney, Brittany Damice, Roxanne DeFabio, Kelsey Jervis, David Zurakowski, and Navil Sethna. 2020. “Putting fitness to the test: clinical application of the Fitkids Treadmill Test in youth with chronic pain.” European Journal of Physiotherapy, 1–8. https://doi.org/10.1080/21679169.2020.1779343.
    Sieberg, Christine B., Allison M. Smith, Matthew White, Juliana Manganella, Navil F. Sethna, and Deirdre E. Logan. 2017. “Changes in Maternal and Paternal Pain-Related Attitudes, Behaviors, and Perceptions across Pediatric Pain Rehabilitation Treatment: A Multilevel Modeling Approach.” Journal of Pediatric Psychology 42 (1): 52–64. https://doi.org/10.1093/jpepsy/jsw046.
    Simons, Laura E., Karen J. Kaczynski, Caitlin Conroy, and Deirdre E. Logan. 2012. “Fear of pain in the context of intensive pain rehabilitation among children and adolescents with neuropathic pain: associations with treatment response.” Journal of Pain 13 (12): 1151–61. https://doi.org/10.1016/j.jpain.2012.08.007.
    Simons, Laura E., Christine B. Sieberg, Caitlin Conroy, Edin T. Randall, Julie Shulman, David Borsook, Charles B. Berde, Navil F. Sethna, and Deirdre E. Logan. 2018. “Children With Chronic Pain: Response Trajectories After Intensive Pain Rehabilitation Treatment.” The Journal of Pain 19 (2): 207–18. https://doi.org/10.1016/j.jpain.2017.10.005.
    Stahlschmidt, Lorin, F. Barth, Boris Zernikow, and Julia Wager. 2017. “Therapie-Outcome ein Jahr nach Erstvorstellung in einer pädiatrischen Schmerzambulanz: Das Chronic Pain Grading (CPG) für jugendliche Schmerzpatienten.” Der Schmerz 31 (6): 601–9. https://doi.org/10.1007/s00482-017-0215-0.
    Stahlschmidt, Lorin, Boris Zernikow, and Julia Wager. 2018. “Satisfaction With an Intensive Interdisciplinary Pain Treatment for Children and Adolescents: An Independent Outcome Measure?” The Clinical Journal of Pain 34 (9): 795–803. https://doi.org/10.1097/AJP.0000000000000600.
    Weiss, Karen E., Amy Hahn, Dustin P. Wallace, Bridget Biggs, Barbara K. Bruce, and Tracy E. Harrison. 2013. “Acceptance of pain: associations with depression, catastrophizing, and functional disability among children and adolescents in an interdisciplinary chronic pain rehabilitation program.” Journal of Pediatric Psychology 38 (7): 756–65. https://doi.org/10.1093/jpepsy/jst028.
    Williams, Sara E. 13.10.2022. “Personal communication on treatment components.”
    Williams, Sara E., Kendra J. Homan, Susan L. Crowley, David W. Pruitt, Andrew B. Collins, Emily T. Deet, Nicole D. Samuel, Abigail John, Katherine Banner, and John B. Rose. 2020. “The Impact of Spatial Distribution of Pain on Long-Term Trajectories for Chronic Pain Outcomes After Intensive Interdisciplinary Pain Treatment.” The Clinical Journal of Pain 36 (3): 181–88. https://doi.org/10.1097/AJP.0000000000000793.
    Zernikow, Boris, Ann-Kristin Ruhe, Lorin Stahlschmidt, Pia Schmidt, Tobias Staratzke, Michael Frosch, and Julia Wager. 2018. “Clinical and Economic Long-Term Treatment Outcome of Children and Adolescents with Disabling Chronic Pain.” Pain Medicine 19 (1): 16–28. https://doi.org/10.1093/pm/pnx067.