Book Review

Helping parents and pediatric providers understand and support children experiencing acute and chronic pain

Practical treatment options for chronic pain in children and adolescents: an interdisciplinary therapy manual (2nd edition)

Peachman RR, Wilson, AC (2022). Cambridge, MA: Harvard University Press, 317 pp. ISBN 978-0674185029 (Hardcover: $27.95 USD). Link

Reviewed by Mimi Stotsky

printable version (PDF)

As established early on in When children feel pain, childhood pain is an overwhelmingly common experience that has historically been overlooked, misunderstood, and undertreated. When children feel pain aims to provide parents and professionals who work with youth with the tools to understand and help youth cope with pain in a manner that can promote both short- and long-term adjustment. Authors Rachel Rabkin Peachman, a health and parenting journalist, and Anna C. Wilson, Ph.D., a pediatric psychologist and associate professor of pediatrics at Oregon Health & Science University, approach this book from the nuanced perspectives of their own professional and personal experiences. Their combined expertise results in a 317 page book covering a wide range of acute and chronic pain presentations and offering recommendations for coping with pain that are easy for parents and pediatric providers to understand and implement.

Importantly, within the Introduction and Chapters 1 and 2 of When children feel pain, the authors provide a thorough yet succinct overview of the historical context for the study and treatment of pediatric pain. These chapters also lay the foundation for understanding pediatric pain. For instance, topics include the difference between acute and chronic pain, how pain is measured, and how infants and youth exhibit pain. By beginning with this scaffolding, Ms. Peachman and Dr. Wilson do an excellent job of priming readers with an understanding of the multifaceted biopsychosocial model of pain and pain treatment.

Chapters 3 through 5 focus on a variety of acute pain experiences common in infancy and childhood, such as routine vaccinations and injections, treatment in the neonatal intensive care unit (NICU), surgeries, minor medical procedures, and hospital stays. Along with information about what parents can expect and do in these situations to help children cope, these chapters also discuss how infants and children are likely to remember and process these pain experiences. These chapters highlight both the powerful role that parents play as advocates during their child’s medical care and the ways they can frame the child’s pain experience to promote coping and adjustment during future painful medical experiences. These chapters also validate and normalize the stress and helplessness that parents often feel when a child is hurting.

The next few chapters of When children feel pain focus on several common forms of chronic pain. Chapter 6 covers abdominal pain and functional gastrointestinal disorders while Chapter 7 discusses chronic headaches and migraines. Both of these chapters highlight the bidirectional relationship between these forms of chronic pain and internalizing psychological symptoms. Chapter 8 focuses on sports injuries and concussions. A notable strength within this chapter is a particularly thorough section with recommendations for injury prevention and treatment. Chapter 9 reviews chronic pain conditions that arise due to nervous system sensitization to pain, such as complex regional pain syndrome.

The final few chapters tackle complex topics with a deeper focus on chronic pain and long-term adjustment following pain experiences. Chapter 10 presents the importance of a multidisciplinary approach to chronic pain and the role of psychology in pediatric pain treatment. While this chapter does not go into full details of cognitive behavioral therapy (CBT), mindfulness and relaxation, biofeedback training, and parent coaching strategies, it introduces the reader to the research behind these approaches and directs readers to evidence-based programs and resources, such as the Comfort Ability Program and Web-Based Management of Adolescent Pain (WebMAP). The authors quite sensitively discuss how parents often respond to a child’s chronic pain in ways that may unintentionally increase distress and functional impairment and normalize the need for parents to learn new strategies to support their child. This topic is further expanded upon in Chapter 11 with discussions of how the family context influences how children understand, perceive, and respond to pain, as well as suggestions for parents who experience chronic pain themselves. Lastly, Chapter 12 deftly reviews how chronic pain is often an invisible burden associated with stigma and intersects with issues related to gender and race-based biases. This chapter also provides important recommendations surrounding recognizing and addressing the ways in which chronic pain impacts academic, social, and psychological functioning.

One of the most notable strengths throughout this book is the skillful manner in which Ms. Peachman and Dr. Wilson blend didactic knowledge, personal experiences with pediatric pain, parenting, and patient care, cutting-edge research, patient perspectives, and real-world examples to help readers easily access the information regardless of the extent of their experience parenting children in pain or working with youth in general. In addition, this information is made even more accessible due to brief sections near the end of most chapters that succinctly outline the recommendations, strategies, and tips for managing acute or chronic pain. Furthermore, the chapters often incorporate advice or examples related to advocating for the use of these strategies in the real world. The authors go a step further by providing an additional list of resources at the end of the book that range from websites to book recommendations, particularly for chronic pain. While this book offers an unflinching description of the not-so-distant past limits in pain management in pediatric populations, it leaves readers with a realistic optimism regarding the advances in modern pediatric pain treatment and a varied tool kit for supporting a child’s adjustment during acute or chronic pain experiences with the goal of helping decrease, as opposed to entirely eliminate, pain.

When children feel pain adds to the existing literature by covering material on acute pain and everyday aches in addition to chronic pain. This book also differs by providing information in a manner that is more educational than directive. In taking this approach, When children feel pain will be an excellent resource for helping families understand what acute and chronic pain is and the rationale behind common treatment recommendations. Finally, When children feel pain is likely to be a valuable text for practitioners, particularly emerging pediatric pain specialists, when framing psychoeducational discussions regarding acute and chronic pain to patients and parents in a way that families can understand and implement in their daily lives.

Overall, this thoughtfully and sensitively written book does a wonderful job of covering a wide range of pain experiences that parents may find themselves navigating throughout their children’s lives. By providing targeted, practical recommendations backed by relevant scientific evidence and evidence-based practice and framed with recognizable, validating examples, When children feel pain can help parents, as well as the myriad professionals who work with children, feel better prepared to support children when they experience pain and pain-associated medical, functional, and psychological challenges.

Cite as: Stotsky M. Helping parents and pediatric providers understand and support children experiencing acute and chronic pain. Book review: When children feel pain: from everyday aches to chronic conditions. Pediatric Pain Letter 2022;24(3):21-23. ppl.childpain.org