Handbook of Psychology

Basic Assumptions 443

TABLE 19.1 Summary of Special Series on Empirically Supported Treatments in the Journal of Pediatric Psychology

Well-Established Probably Ef“cacious

Pediatric Health Condition Treatments Treatments Promising Interventions Citation and Notes

Headache Relaxation. Thermal biofeedback. Relaxation
Biofeedback. Holden, Delchmann, and Levy, 1999
Self-hypnosis. Integration of CBT. N13 studies
Recurrent abdominal pain CBT. Fiber (constipation Janicke and Finney, 1999
present). N9 studies
Operant procedures did not
meet minimal EST criteria.
Procedural pain Cognitive-behavioral Powers, 1999
therapy, encompassing N13 studies
different speci“c
techniques.
Disease-related pain Cognitive-behavioral Walco, Sterling, Conte, and
therapy. Engel, 1999
Reviewed pediatric chronic illness
literature.
Nocturnal enuresis Urine alarm. Hypnosis. Mellon and M. McGrath, 2000

• Dry-Bed Training.Ž Cognitive-behavioral N39 studies
  therapy, contingency
  management.
  Constipation and encopresis Medical intervention Medical intervention plus M. McGrath, Mellon, and Murphy,
  (with and without “ber) positive reinforcement in 2000
  
  positive reinforcement. small group format. N20 studies
  Biofeedback
  medical
  intervention.
  Relaxation
  reinforcers.
  Severe feeding problems Contingency Extinction. Kerwin, 1999
  management (positive Swallow induction. N32 studies
  reinforcement, ignoring).
  Obesity Multicomponent For adolescents, Jelalian and Saelens, 1999
  behavioral intervention behavioral diet regulation. N42 studies
  (for 8...12 year olds).
  Disease-related symptoms EMG biofeedback for Relaxation for asthma. McQuaid and Nassau, 1999
  in asthma, cancer, diabetes emotionally triggered Distraction with
  asthma. relaxation for
  Imagery for children chemotherapy.
  receiving chemotherapy.
  Bedtime refusals Extinction. Graduated extinction. Positive routines. Mindell, 1999
  Night wakings Parent education. Scheduled awakenings. N41 studies

Source: Journal of Pediatric Psychology: Special Series on Empirically Supported Treatments in Pediatric Psychology, 24(2, 3, 4, 6), 25 (4), 26 (5).

is expanding. In pediatric psychology, interventions typically
target small samples with low base-rate occurrences of spe-
ci“c health conditions. In addition, pediatric intervention re-
search is often conducted in health care settings as a primary
site. That is, rather than move intervention studies from
effectiveness trials (in the laboratory) to ef“cacy studies (in
actual clinical settings), as in psychotherapy outcome re-
search, pediatric psychologists are conducting all phases of
intervention research in the •real worldŽ of the pediatric in-
patient or outpatient setting. This is inevitable and consistent
with other medical/pediatric clinical trials, albeit different
from psychotherapy outcome trials that formed the basis of
the Division 12 guidelines. In an effort to acknowledge these
differences, the criteria for effective treatments in pediatric
psychology were modi“ed (Spirito, 1999). Rather than a

treatment manual, treatments may rely on a speci“c protocol.

In cases of relatively rare chronic illnesses, the sample size

criteria were relaxed. Finally, a category called promising

interventionswas established, requiring at least one well-

controlled group design and an additional less rigorous study

with positive “ndings.

The “ndings extracted from the review papers published

in the Journal of Pediatric Psychologyare presented in

Table 19.1. These papers address the following diseases

and conditions: procedure-related pain; disease-related pain;

recurrent headache; recurrent abdominal pain (RAP); dis-

ease-related symptoms in asthma, diabetes, and cancer; feed-

ing problems; obesity; nighttime enuresis; encopresis and

constipation; and sleep dif“culties. A general conclusion is

that many scienti“cally supported treatment approaches are