ABSTRACT
Given the increase in the provision of telehealth services during the COVID-19 pandemic, it is important for medical and psychology providers to promote evidence-based treatments that can also demonstrate clinical utility through telehealth (1). This proof-of-concept study provides preliminary support for the clinical utility of the Williams and Zahka Cognitive Behavioral Therapy (CBT, 2) approach in reducing functional impairment and pain for pediatric patients with a Disorder of Gut-Brain Interaction (DGBI) when delivered through telehealth. A retrospective chart review was completed to examine psychological treatment duration and response among pediatric patients with DGBIs including functional abdominal pain and irritable bowel syndrome. CBT was delivered via telehealth with a licensed psychologist or supervised psychology trainee embedded in a pediatric gastroenterology clinic. Participants were 24 youth who completed initial evaluations between February and July of 2021 during the COVID-19 pandemic. Demographics, treatment characteristics, and statistical analyses are presented in Tables 1 and 2 (3,4). The Williams and Zahka CBT (2) approach utilizes a biopsychosocial framework that includes an initial focus on psychoeducation and function. Consistent with study hypotheses, non-parametric statistical analyses demonstrated statistically significant reductions in functional disability and pain with large effect sizes following treatment via telehealth. On average, patients attended approximately five sessions, including one initial evaluation and four treatment sessions, and this was not substantially different depending upon initial severity of impairment. These findings are in line with average treatment duration reported as 3 to 5 sessions in prior studies (5,6). Given the average length of treatment, patient care involved predominately psychoeducation on somatic symptoms and DGBIs along with a strong focus on functional restoration through behavioral activation, including a daily schedule and gradual return to routines and meaningful activities independent of school term status. Findings are similar to prior studies reporting reductions in functional impairment and pain following evidence-based treatment through a biopsychosocial framework for pediatric patients with DGBIs delivered in-person (5). (Table Presented).