Special Issue "Mind-Body Medicine in Children and Adolescents"

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Integrative Pediatrics".

Deadline for manuscript submissions: closed (31 December 2016)

Printed Edition Available!
A printed edition of this Special Issue is available here.

Special Issue Editor

Guest Editor
Dr. Hilary McClafferty

Co-Director, Fellowship in Integrative Medicine; Director, Pediatric Integrative Medicine in Residency, University of Arizona Center for Integrative Medicine; Associate Professor, Department of Medicine University of Arizona College of Medicine, Tucson, AZ, USA
Website1 | Website2 | E-Mail
Interests: pediatric integrative medicine; mind-body medicine; medical acupuncture; education in integrative medicine; physician health and wellness; environmental health; children’s health

Special Issue Information

Dear Colleagues,

Mind–body therapies can be described as the deliberate harnessing of positive thought and emotion for use in health and healing. Some mind-body therapies with strongest evidence include biofeedback, clinical hypnosis, guided imagery, music therapy, mindfulness, yoga, and progressive muscle relaxation. In children, the mind-body therapies can expand the range of treatment options by introducing gentle, pharmaceutical –free and flexible complementary therapies in the treatment of common conditions such as acute and chronic pain, anxiety, migraine or tension headache, recurrent abdominal pain, chemotherapy associated side effects, and a range of behavioural and autoimmune-inflammatory driven illnesses. The mind-body therapies can also help address caretaker stress and fatigue. This Special Edition will explore a range of mind-body therapies in children and adolescents with the goal of updating the reader on evolving research in the field and familiarizing them with useful resources for further education and training programs for medical professionals.

Dr. Hilary McClafferty
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) is waived for well-prepared manuscripts submitted to this issue. Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Mind-body therapies
  • pain
  • headache
  • stress
  • biofeedback
  • hypnosis
  • guided imagery
  • mindfulness
  • yoga
  • caretaker stress

Published Papers (13 papers)

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Editorial

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Open AccessEditorial Mind-Body Medicine in Pediatrics
Children 2017, 4(9), 76; doi:10.3390/children4090076
Received: 22 August 2017 / Revised: 22 August 2017 / Accepted: 24 August 2017 / Published: 25 August 2017
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Abstract
The primary goals of this Special Issue are to encourage readers to become more familiar with the range of mind-body therapies and to explore their application in the pediatric clinical setting. The Special Issue includes a deliberate mix of case studies and practical
[...] Read more.
The primary goals of this Special Issue are to encourage readers to become more familiar with the range of mind-body therapies and to explore their application in the pediatric clinical setting. The Special Issue includes a deliberate mix of case studies and practical clinical guidance, with the dual goals of piquing curiosity and providing resources for clinicians interested in pursuing further training Full article

Research

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Open AccessArticle A Pilot Study of Mindfulness Meditation for Pediatric Chronic Pain
Children 2017, 4(5), 32; doi:10.3390/children4050032
Received: 28 February 2017 / Accepted: 18 April 2017 / Published: 26 April 2017
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Abstract
Despite advances in psychological interventions for pediatric chronic pain, there has been little research examining mindfulness meditation for these conditions. This study presents data from a pilot clinical trial of a six-week manualized mindfulness meditation intervention offered to 20 adolescents aged 13–17 years.
[...] Read more.
Despite advances in psychological interventions for pediatric chronic pain, there has been little research examining mindfulness meditation for these conditions. This study presents data from a pilot clinical trial of a six-week manualized mindfulness meditation intervention offered to 20 adolescents aged 13–17 years. Measures of pain intensity, functional disability, depression and parent worry about their child’s pain were obtained at baseline and post-treatment. Results indicated no significant changes in pain or depression, however functional disability and frequency of pain functioning complaints improved with small effect sizes. Parents’ worry about child’s pain significantly decreased with a large effect size. Participants rated intervention components positively and most teens suggested that the number of sessions be increased. Three case examples illustrate mindfulness meditation effects and precautions. Mindfulness meditation shows promise as a feasible and acceptable intervention for youth with chronic pain. Future research should optimize intervention components and determine treatment efficacy. Full article
Open AccessArticle Do Mothers Benefit from a Child-Focused Cognitive Behavioral Treatment (CBT) for Childhood Functional Abdominal Pain? A Randomized Controlled Pilot Trial
Children 2017, 4(2), 13; doi:10.3390/children4020013
Received: 13 December 2016 / Revised: 3 February 2017 / Accepted: 6 February 2017 / Published: 15 February 2017
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Abstract
While the efficacy of cognitive-behavioral treatment (CBT) approaches for childhood functional abdominal pain (FAP) is well-established for child outcomes, only a few studies have reported on parent-specific outcomes. This randomized controlled pilot trial analyzed effects of a group CBT on maternal variables (i.e.,
[...] Read more.
While the efficacy of cognitive-behavioral treatment (CBT) approaches for childhood functional abdominal pain (FAP) is well-established for child outcomes, only a few studies have reported on parent-specific outcomes. This randomized controlled pilot trial analyzed effects of a group CBT on maternal variables (i.e., pain-related behavior, worries and self-efficacy, as well as general psychosocial strain). Methods: The sample constituted of 15 mothers in the intervention group (IG) and 14 mothers in the waitlist control group (WLC). Outcome measures were assessed pre-treatment, post-treatment and at three months follow-up. Results: Analyses revealed significant, large changes in maladaptive maternal reactions related to the child’s abdominal pain in the IG compared to the WLC—i.e., reduced attention (d = 0.95), medical help-seeking (d = 0.92), worries (d = 1.03), as well as a significant increase in behaviors that encourage the child’s self-management (d = 1.03). In addition, maternal self-efficacy in dealing with a child’s pain significantly increased in the IG as well (d = 0.92). Treatment effects emerged post-treatment and could be maintained until three months follow-up. There were no effects on general self-efficacy and maternal quality of life. Conclusion: While these results are promising, and underline the efficacy of the CBT approach for both the child and mothers, further studies, including long-term follow-ups, are warranted. Full article
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Review

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Open AccessReview Immersive Virtual Reality for Pediatric Pain
Children 2017, 4(7), 52; doi:10.3390/children4070052
Received: 12 March 2017 / Revised: 24 May 2017 / Accepted: 16 June 2017 / Published: 23 June 2017
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Abstract
Children must often endure painful procedures as part of their treatment for various medical conditions. Those with chronic pain endure frequent or constant discomfort in their daily lives, sometimes severely limiting their physical capacities. With the advent of affordable consumer-grade equipment, clinicians have
[...] Read more.
Children must often endure painful procedures as part of their treatment for various medical conditions. Those with chronic pain endure frequent or constant discomfort in their daily lives, sometimes severely limiting their physical capacities. With the advent of affordable consumer-grade equipment, clinicians have access to a promising and engaging intervention for pediatric pain, both acute and chronic. In addition to providing relief from acute and procedural pain, virtual reality (VR) may also help to provide a corrective psychological and physiological environment to facilitate rehabilitation for pediatric patients suffering from chronic pain. The special qualities of VR such as presence, interactivity, customization, social interaction, and embodiment allow it to be accepted by children and adolescents and incorporated successfully into their existing medical therapies. However, the powerful and transformative nature of many VR experiences may also pose some risks and should be utilized with caution. In this paper, we review recent literature in pediatric virtual reality for procedural pain and anxiety, acute and chronic pain, and some rehabilitation applications. We also discuss the practical considerations of using VR in pediatric care, and offer specific suggestions and information for clinicians wishing to adopt these engaging therapies into their daily clinical practice. Full article
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Open AccessReview A Mind–Body Approach to Pediatric Pain Management
Children 2017, 4(6), 50; doi:10.3390/children4060050
Received: 1 March 2017 / Revised: 11 May 2017 / Accepted: 13 June 2017 / Published: 20 June 2017
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Abstract
Pain is a significant public health problem that affects all populations and has significant financial, physical and psychological impact. Opioid medications, once the mainstay of pain therapy across the spectrum, can be associated with significant morbidity and mortality. Centers for Disease and Control
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Pain is a significant public health problem that affects all populations and has significant financial, physical and psychological impact. Opioid medications, once the mainstay of pain therapy across the spectrum, can be associated with significant morbidity and mortality. Centers for Disease and Control (CDC) guidelines recommend that non-opioid pain medications are preferred for chronic pain outside of certain indications (cancer, palliative and end of life care). Mindfulness, hypnosis, acupuncture and yoga are four examples of mind–body techniques that are often used in the adult population for pain and symptom management. In addition to providing significant pain relief, several studies have reported reduced use of opioid medications when mind–body therapies are implemented. Mind–body medicine is another approach that can be used in children with both acute and chronic pain to improve pain management and quality of life. Full article
Open AccessReview Mind–Body Therapy for Children with Attention-Deficit/Hyperactivity Disorder
Children 2017, 4(5), 31; doi:10.3390/children4050031
Received: 30 November 2016 / Revised: 3 April 2017 / Accepted: 18 April 2017 / Published: 25 April 2017
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Abstract
Attention-deficit/hyperactivity disorder (ADHD) is pervasive among the pediatric population and new treatments with minimal adverse effects are necessary to be studied. The purpose of this article is to review current research studying mind–body therapies for treatment of children diagnosed with ADHD. Literature was
[...] Read more.
Attention-deficit/hyperactivity disorder (ADHD) is pervasive among the pediatric population and new treatments with minimal adverse effects are necessary to be studied. The purpose of this article is to review current research studying mind–body therapies for treatment of children diagnosed with ADHD. Literature was reviewed pertaining to the effectiveness of movement-based therapies and mindfulness/meditation-based therapies for ADHD. Many positive effects of yoga, Tai Chi, physical activity, and meditation may significantly improve symptoms of ADHD among children. Full article
Open AccessReview Mind–Body Interventions for Pediatric Inflammatory Bowel Disease
Children 2017, 4(4), 22; doi:10.3390/children4040022
Received: 15 February 2017 / Revised: 17 March 2017 / Accepted: 28 March 2017 / Published: 3 April 2017
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Abstract
Pediatric inflammatory bowel disease is an autoimmune disease that causes chronic inflammation of the gastrointestinal mucosa. There is emerging evidence that the brain–gut connection affects inflammatory bowel disease (IBD) patients more than previously thought. This is evidenced by comorbid mood disorders, irritable bowel
[...] Read more.
Pediatric inflammatory bowel disease is an autoimmune disease that causes chronic inflammation of the gastrointestinal mucosa. There is emerging evidence that the brain–gut connection affects inflammatory bowel disease (IBD) patients more than previously thought. This is evidenced by comorbid mood disorders, irritable bowel symptoms concurrent with quiescent IBD, and the potential of psychosocial stressors to trigger IBD flares. Mind–body interventions such as psychotherapy, relaxation, mindfulness, biofeedback, yoga, and clinical hypnosis offer an adjunct to standard medical treatment for IBD. We will review the current evidence base for these mind– body interventions in the treatment of pediatric IBD, illustrate a case study, and offer suggestions for future research for this promising field. Full article
Open AccessReview Review of Randomized Controlled Trials of Massage in Preterm Infants
Children 2017, 4(4), 21; doi:10.3390/children4040021
Received: 1 February 2017 / Revised: 14 March 2017 / Accepted: 27 March 2017 / Published: 3 April 2017
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Abstract
Preterm birth affects about 10% of infants born in the United States. Massage therapy is being used in some neonatal intensive care units for its potential beneficial effects on preterm infants. This article reviews published randomized controlled trials on the effects of massage
[...] Read more.
Preterm birth affects about 10% of infants born in the United States. Massage therapy is being used in some neonatal intensive care units for its potential beneficial effects on preterm infants. This article reviews published randomized controlled trials on the effects of massage in preterm infants. Most studies evaluating the effect of massage in weight gain in premature infants suggest a positive effect on weight gain. Increase in vagal tone has been reported in infants who receive massage and has been suggested as a possible mechanism for improved weight gain. More studies are needed on the underlying mechanisms of the effects of massage therapy on weight gain in preterm infants. While some trials suggest improvements in developmental scores, decreased stress behavior, positive effects on immune system, improved pain tolerance and earlier discharge from the hospital, the number of such studies is small and further evidence is needed. Further studies, including randomized controlled trials, are needed on the effects of massage in preterm infants. Full article
Open AccessReview Clinical Hypnosis, an Effective Mind–Body Modality for Adolescents with Behavioral and Physical Complaints
Children 2017, 4(4), 19; doi:10.3390/children4040019
Received: 2 February 2017 / Revised: 7 March 2017 / Accepted: 20 March 2017 / Published: 24 March 2017
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Abstract
Mind–body medicine is a system of health practices that includes meditation/relaxation training, guided imagery, hypnosis, biofeedback, yoga, art/music therapy, prayer, t’ai chi, and psychological therapies such as cognitive behavioral therapy. Clinical hypnosis is an important mind–body tool that serves as an adjunct to
[...] Read more.
Mind–body medicine is a system of health practices that includes meditation/relaxation training, guided imagery, hypnosis, biofeedback, yoga, art/music therapy, prayer, t’ai chi, and psychological therapies such as cognitive behavioral therapy. Clinical hypnosis is an important mind–body tool that serves as an adjunct to conventional medical care for the adolescent patient. Clinical hypnosis specifically uses self-directed therapeutic suggestions to cultivate the imagination and facilitate the mind–body connection, leading to positive emotional and physical well-being. There are many similarities between clinical hypnosis and other mind–body/self-regulatory modalities such as visual imagery, mindfulness meditation, yoga, and biofeedback that incorporate experiential learning and mechanisms for change. They may be viewed as subtypes of the hypnotic experience and share the common experience of trance as the entrée into self-empowered change in physiologic and psychological states. Clinical hypnosis can be used by health care providers to teach adolescents coping skills to deal with a wide variety of conditions such as chronic headaches, recurrent abdominal pain, anxiety, depression, grief and bereavement, phobias, anger, family stressors, sleep disorders, or enuresis. Clinical vignettes are given to help illustrate the effectiveness of hypnosis in adolescents. Full article
Open AccessReview The Role of Mindfulness in Reducing the Adverse Effects of Childhood Stress and Trauma
Children 2017, 4(3), 16; doi:10.3390/children4030016
Received: 26 January 2016 / Revised: 19 February 2017 / Accepted: 21 February 2017 / Published: 28 February 2017
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Abstract
Research suggests that many children are exposed to adverse experiences in childhood. Such adverse childhood exposures may result in stress and trauma, which are associated with increased morbidity and mortality into adulthood. In general populations and trauma-exposed adults, mindfulness interventions have demonstrated reduced
[...] Read more.
Research suggests that many children are exposed to adverse experiences in childhood. Such adverse childhood exposures may result in stress and trauma, which are associated with increased morbidity and mortality into adulthood. In general populations and trauma-exposed adults, mindfulness interventions have demonstrated reduced depression and anxiety, reduced trauma-related symptoms, enhanced coping and mood, and improved quality of life. Studies in children and youth also demonstrate that mindfulness interventions improve mental, behavioral, and physical outcomes. Taken together, this research suggests that high-quality, structured mindfulness instruction may mitigate the negative effects of stress and trauma related to adverse childhood exposures, improving short- and long-term outcomes, and potentially reducing poor health outcomes in adulthood. Future work is needed to optimize implementation of youth-based mindfulness programs and to study long-term outcomes into adulthood. Full article
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Open AccessReview Medical Yoga Therapy
Children 2017, 4(2), 12; doi:10.3390/children4020012
Received: 27 December 2016 / Accepted: 3 February 2017 / Published: 10 February 2017
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Abstract
Medical yoga is defined as the use of yoga practices for the prevention and treatment of medical conditions. Beyond the physical elements of yoga, which are important and effective for strengthening the body, medical yoga also incorporates appropriate breathing techniques, mindfulness, and meditation
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Medical yoga is defined as the use of yoga practices for the prevention and treatment of medical conditions. Beyond the physical elements of yoga, which are important and effective for strengthening the body, medical yoga also incorporates appropriate breathing techniques, mindfulness, and meditation in order to achieve the maximum benefits. Multiple studies have shown that yoga can positively impact the body in many ways, including helping to regulate blood glucose levels, improve musculoskeletal ailments and keeping the cardiovascular system in tune. It also has been shown to have important psychological benefits, as the practice of yoga can help to increase mental energy and positive feelings, and decrease negative feelings of aggressiveness, depression and anxiety. Full article

Other

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Open AccessCommentary Perspectives on Technology-Assisted Relaxation Approaches to Support Mind-Body Skills Practice in Children and Teens: Clinical Experience and Commentary
Children 2017, 4(4), 20; doi:10.3390/children4040020
Received: 21 January 2017 / Revised: 13 March 2017 / Accepted: 19 March 2017 / Published: 4 April 2017
Cited by 1 | PDF Full-text (209 KB) | HTML Full-text | XML Full-text
Abstract
It has been well-established that a variety of mind-body (MB) techniques, including yoga, mental imagery, hypnosis, biofeedback, and meditation, are effective at addressing symptoms such as pain, anxiety, nausea, and insomnia, as well as helping with a wide variety of medical, emotional, and
[...] Read more.
It has been well-established that a variety of mind-body (MB) techniques, including yoga, mental imagery, hypnosis, biofeedback, and meditation, are effective at addressing symptoms such as pain, anxiety, nausea, and insomnia, as well as helping with a wide variety of medical, emotional, and behavioral issues in pediatric populations. In addition, MB skills can also be health promoting in the long-term, and with regular practice, could potentially contribute to longer attention spans, social skills, emotional regulation, and enhanced immune system functioning. Importantly, the benefits accrued from MB skills are largely dose dependent, meaning that individuals who practice with some consistency tend to benefit the most, both in the short- and long-term. However, clinical experience suggests that for busy patients, the regular practice of MB skills can be challenging and treatment adherence commonly becomes an issue. This commentary reviews the concept of technology assisted relaxation as an engaging and effective option to enhance treatment adherence (i.e., daily practice) for pediatric patients, for whom MB skills have been recommended to address physical and mental health challenges. Full article
Open AccessEssay Incorporating Hypnosis into Pediatric Clinical Encounters
Children 2017, 4(3), 18; doi:10.3390/children4030018
Received: 31 December 2016 / Revised: 21 February 2017 / Accepted: 7 March 2017 / Published: 16 March 2017
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Abstract
Increasing numbers of licensed health professionals who care for children have been trained in clinical hypnosis. The evidence base for the safety and efficacy of this therapeutic approach in a wide variety of conditions is also growing. Pediatricians and other health professionals who
[...] Read more.
Increasing numbers of licensed health professionals who care for children have been trained in clinical hypnosis. The evidence base for the safety and efficacy of this therapeutic approach in a wide variety of conditions is also growing. Pediatricians and other health professionals who have received training may wish to apply these skills in appropriate clinical scenarios but still may be unsure of the practical matters of how to incorporate this skill-set into day to day practice. Moreover, the practical application of such skills will take very different forms depending on the practice setting, types of acute or chronic conditions, patient and family preferences, and the developmental stages of the child or teen. This article reviews the application of pediatric clinical hypnosis skills by describing the use of hypnotic language outside of formal trance induction, by describing natural trance states that occur in children and teens in healthcare settings, and by describing the process of planning a clinical hypnosis encounter. It is assumed that this article does not constitute training in hypnosis or qualify its readers for the application of such skills; rather, it may serve as a practical guide for those professionals who have been so trained, and may serve to inform other professionals what to expect when referring a patient for hypnotherapy. The reader is referred to specific training opportunities and organizations. Full article
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