May 13, 2016
The number of children and adolescents hospitalized for chronic pain — defined as recurrent or continuous pain lasting more than three months — increased ninefold between 2004 and 2010. For these young patients, adjusting to and living with pain can be overwhelming.
At Mayo Clinic's campus in Rochester, Minnesota, a team of psychologists and pain and physical medicine specialists sees adolescents and young adults with chronic pain in the outpatient pediatric pain clinic. A three-week pediatric pain rehabilitation program serves those whose chronic pain and other symptoms negatively affect functioning or mood. A two-day program is a bridge between the longer rehabilitation program and clinic.
The goal in every case is to help teens learn how to relieve pain-related emotional distress and return to a normal, active life. But the strategies can be challenging for them to implement and may sometimes seem as unmanageable as pain itself. The process can be frustrating for providers, too, who may struggle to frame their recommendations so that teens can understand and relate to them.
"We wanted to provide patients with an individualized list of recommendations they could take with them. We have brochures, but that's not what kids respond to," explains Cynthia Harbeck-Weber, Ph.D., L.P., a pediatric psychologist at Mayo's Minnesota campus. "So we thought about designing an app they could use to individualize their pain rehabilitation goals."
That led to a collaboration with the Mayo Clinic Center for Innovation and the creation of the iBeatPain for Teens app, which has been available for download in the iTunes store for almost a year.
The app features five main goals:
- Practice relaxation
- Participate in school
- Get regular sleep
- Engage in self-care, such as basic hygiene and drinking enough water
"If kids want to practice relaxation techniques twice a day, they can click on that goal and set a reminder," Dr. Harbeck-Weber says. "This is not a medical assessment as to what's causing pain; it's a tool designed to help patients set well-defined goals that help them learn to function despite pain — and to see that chronic pain is a hurdle they can overcome."
She points out that although some teens with chronic pain do very well, others struggle.
"They're not in school, they're anxious, they can't do homework, and some are in bed most of the day. Our goal is to help them learn to relax their bodies to take the focus off pain and instead move forward with the lives they want to have. They don't have to participate in the pain rehabilitation program to use the app, but it's consistent with the goals and strategies we teach there," she says.
The app, which also has a discussion board and an inspiration box where users can add meaningful quotes, photos and videos, is not intended to be a stand-alone device. Dr. Harbeck-Weber says its success will depend on a strong collaboration among therapists, physicians, parents and patients.
"We see families from across the country and internationally, and many have tried every medication and had physical therapy and surgery and nothing has worked for them. We have a large medical team, including psychologists, physicians, and physical, occupational and recreational therapists, and have had great success with the patients who come to us. If you want to reach teenagers, you have to do it in a way they will respond to," she says.