Dataset Information

Animal-Assisted Psychotherapy for Pediatric Chronic Pain: Case Series of an Open Pilot Study to Test Initial Feasibility and Potential Efficacy.

ABSTRACT:

Objective

Chronic pain is a common complaint in children and adolescents, placing an enormous burden on individuals, their families, and the healthcare system. New innovative approaches for the treatment of pediatric chronic pain (PCP) are clearly warranted, as drop-out rates in intervention studies are high and it can be difficult to engage patients with PCP in therapy. Here, animal-assisted interventions (AAIs) might be promising, since there is preliminary evidence for the approach in adults with chronic pain, and AAIs are generally known to foster the therapeutic motivation of patients. To date, however, AAIs have not been examined in pediatric chronic pain.

Methods

The aim of this open pilot study was to examine the initial feasibility of recruitment and potential efficacy of an animal-assisted group psychotherapy (including horses, rabbits, chickens, goats, and a dog), providing case reports of three children with chronic pain. We applied a mixed-methods approach, including the conductance of semi-structured interviews and assessment of quantitative pre-post data with a focus on pain severity, avoidance behavior, pain acceptance, and ability to defocus from the pain.

Results

The three participating girls (age: 9-12 years) reported chronic pain in the head and abdomen. The process of recruitment turned out to be challenging. All three children reported reduced pain-related disability and pain-related distress, as well as an increased ability to accept pain and to defocus from the pain. The qualitative data revealed that patients and their parents had a positive attitude towards AAIs.

Conclusion

Our initial open pilot study is the first to investigate AAIs in the context of pediatric chronic pain. Notably, we had difficulties in the recruitment procedure, mostly due to the Covid-19 situation. Based on three case reports, we found some first indication that AAI approaches might be associated with symptom changes. Future randomized-control studies with larger sample sizes are clearly warranted.

Clinicaltrialsgov identifier

NCT04171336.

SUBMITTER: Locher C

PROVIDER: S-EPMC10237188 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Animal-Assisted Psychotherapy for Pediatric Chronic Pain: Case Series of an Open Pilot Study to Test Initial Feasibility and Potential Efficacy.

Locher Cosima C Petignat Milena M Wagner Cora C Hediger Karin K Roth Binia B Gaab Jens J Koechlin Helen H

Journal of pain research 20230529

<h4>Objective</h4>Chronic pain is a common complaint in children and adolescents, placing an enormous burden on individuals, their families, and the healthcare system. New innovative approaches for the treatment of pediatric chronic pain (PCP) are clearly warranted, as drop-out rates in intervention studies are high and it can be difficult to engage patients with PCP in therapy. Here, animal-assisted interventions (AAIs) might be promising, since there is preliminary evidence for the approach in ...[more]

PMID: 37273273

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Project description:IntroductionAs interest in Animal-Assisted Interventions (AAI) grows, there is increasing need to differentiate informal activities from formal and professionally directed therapies, including mental health focussed Canine-Assisted Psychotherapy (CAP). There have been no reviews focusing exclusively on CAP and the distinct developmental period of adolescence. The aims of this study were to identify the characteristics of CAP interventions, their impacts and their acceptability, tolerability and feasibility for adolescents with mental health disorders.MethodA systematic review identified studies incorporating canines into mental health treatments for adolescents aged 10-19 years. Studies reporting qualitative or quantitative psychological or psychosocial outcomes were included.ResultsSeven studies were scrutinised. Intervention characteristics varied, including a range of formats, settings, locations, doses, and facilitators. Information on the role of the canines in sessions was sparse. CAP had a positive impact on primary diagnoses and symptomatology, conferring additional benefits to standard treatments for internalising disorders, post-traumatic stress disorder, and equivalent effects for anxiety, anger and externalising disorders. CAP was associated with positive impacts on secondary factors including increased engagement and socialisation behaviours, and reductions in disruptive behaviours within treatment sessions. Global functioning also improved. There was insufficient evidence that CAP improved factors associated with self-esteem, subjective wellbeing, or coping. Good attendance and retention rates indicated high levels of acceptability. Moderate to high tolerability was also indicated. Feasibility may be limited by additional training and logistical requirements.RecommendationsWe recommend the development of theoretically informed, standardised (manualised) intervention protocols that may subsequently form the basis of efficacy and effectiveness testing. Such protocols should clearly describe canine-participant-facilitator interactions via a formalised nomenclature; spontaneous (animal-led), adjunctive (facilitator-led), and experiential (participant-led).ConclusionsThere is emerging evidence to suggest that CAP improves the efficacy of mental health treatments in self-selected adolescent populations via reductions in primary symptomatology, and via secondary factors that improve therapeutic processes and quality, such as engagement and retention.

Project description:BackgroundPsilocybin therapy has shown promise as a rapid-acting treatment for depression, anxiety, and demoralization in patients with serious medical illness (e.g., cancer) when paired with individual psychotherapy. This study assessed the safety and feasibility of psilocybin-assisted group therapy for demoralization in older long-term AIDS survivor (OLTAS) men, a population with a high degree of demoralization and traumatic loss.MethodsSelf-identified gay men OLTAS with moderate-to-severe demoralization (Demoralization Scale-II ≥8) were recruited from the community of a major US city for a single-site open-label study of psilocybin-assisted group therapy comprising 8-10 group therapy visits and one psilocybin administration visit (0·3-0·36 mg/kg po). Primary outcomes were rate and severity of adverse events, and participant recruitment and retention. The primary clinical outcome was change in mean demoralization from baseline to end-of-treatment and to 3-month follow-up assessed with a two-way repeated measures ANOVA. Trial registration: Clinicaltrials.gov (NCT02950467).FindingsFrom 17 July 2017 to 16 January 2019, 18 participants (mean age 59·2 years (SD 4·4)) were enrolled, administered group therapy and psilocybin, and included in intent-to-treat analyses. We detected zero serious adverse reactions and two unexpected adverse reactions to psilocybin; seven participants experienced self-limited, severe expected adverse reactions. We detected a clinically meaningful change in demoralization from baseline to 3-month follow-up (mean difference -5·78 [SD 6·01], ηp 2 = 0·47, 90% CI 0·21-0·60).InterpretationWe demonstrated the feasibility, relative safety, and potential efficacy of psilocybin-assisted group therapy for demoralization in OLTAS. Groups may be an effective and efficient means of delivering psychotherapy pre- and post-psilocybin to patients with complex medical and psychiatric needs.FundingCarey Turnbull, Heffter Research Institute, NIMH R25 MH060482, NIH UL1 TR001872, River Styx Foundation, Saisei Foundation, Sarlo Foundation, Stupski Foundation, Usona Institute, US Department of Veterans Affairs (Advanced Neurosciences Fellowship and IK2CX001495).

Dataset Information

Animal-Assisted Psychotherapy for Pediatric Chronic Pain: Case Series of an Open Pilot Study to Test Initial Feasibility and Potential Efficacy.

Objective

Methods

Results

Conclusion

Clinicaltrialsgov identifier

Publications

Animal-Assisted Psychotherapy for Pediatric Chronic Pain: Case Series of an Open Pilot Study to Test Initial Feasibility and Potential Efficacy.

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