Why Therapists Need to Understand Pediatric Pain Psychology
Why Talking About Pediatric Pain Matters
When we think of kids and pain, most of us picture playground injuries—scraped knees, a broken arm, maybe a bee sting. But what about the kids experiencing chronic pain?
Chronic pain in children is more common than you might think. Depending on how it’s measured, research estimates that anywhere from 10% to 40% of children experience chronic pain. Yet, as therapists, we rarely talk about it.
To help bridge this gap, I sat down with pediatric pain psychologist Dr. Emily Foxen-Craft to explore what therapists need to know about chronic pain in children and adolescents.
Understanding Pediatric Chronic Pain
Pain isn’t always the result of an injury. It can also be a primary condition, meaning the pain itself is the diagnosis, not just a symptom of something else. The latest edition of the International Classification of Disorders (ICD-11) now recognizes primary pain conditions, which is a big step toward better treatment.
Chronic pain in children can range from frequent headaches and stomachaches to widespread pain with no clear medical explanation. Whether or not a specific diagnosis is attached, these kids are still struggling—and they need support.
How Chronic Pain Impacts Kids and Families
Pain is more than a physical experience. It’s a biopsychosocial phenomenon, meaning it involves the body, the mind, and the child’s environment.
For children with chronic pain, life can look very different:
- They may struggle to attend school regularly.
- They might miss out on activities they love.
- Their pain can affect family dynamics, particularly if a parent also has chronic pain and models certain coping mechanisms—whether helpful or not.
Because children are still developing, early intervention is crucial. Left untreated, chronic pain can lead to long-term mental health struggles, increased disability, and a reduced quality of life.
How Can Therapists Help?
If you’re a therapist working with children, chances are you’ll encounter a client dealing with chronic pain at some point. Even if pain isn’t the primary reason they’re coming to you, it can be a significant factor in their overall well-being. Here are some ways to help:
1. Validate Their Experience
Many kids with chronic pain are dismissed—told they’re exaggerating, that it’s just “growing pains,” or that their pain is purely anxiety-related. Instead of questioning the legitimacy of their pain, acknowledge what they’re experiencing and work from there.
2. Shift the Focus to Functioning
Pain treatment isn’t always about making the pain disappear—it’s about helping kids live full lives despite it. Encourage a balance of empathy and gradual re-engagement with daily activities, like school and social events.
3. Understand the Role of Psychology in Pain
Pain is deeply connected to emotions, thoughts, and behaviors. Therapists can help kids and families develop coping skills that improve their resilience. Techniques like Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), and positive psychology approaches can be incredibly effective.
4. Work With Families
Chronic pain doesn’t just affect the child—it impacts the entire family system. Helping parents understand their role in their child’s pain experience is key. Some parents may be overly dismissive, while others may inadvertently reinforce avoidance behaviors. Educating and supporting caregivers is just as important as working with the child.
5. Collaborate With Medical Providers
Chronic pain treatment is most effective when multiple professionals work together. If a child is seeing a pediatrician, pain specialist, or physical therapist, consider connecting with them to align treatment goals.
When to Refer to a Specialist
Not every therapist needs to specialize in pediatric pain psychology, but knowing when to refer is essential. If pain is severely limiting a child’s daily functioning or if you feel out of your depth, collaborating with or referring to a specialist in pediatric pain management is a great next step.
But don’t underestimate your ability to help. Many of the skills you already use—like supporting behavior change, managing anxiety, and setting goals—are highly relevant in chronic pain treatment.
Final Thoughts
Pediatric chronic pain is often misunderstood and overlooked, but as therapists, we have an opportunity to change that. By validating kids’ experiences, focusing on functioning, and integrating psychological tools into treatment, we can make a huge difference.
If you’re interested in learning more, check out our continuing education courses for therapists at Not Boring CEs. We cover a range of out-of-the-box topics to keep you engaged while growing your clinical skills.
Want more CEs for therapists? Stay tuned for upcoming episodes and trainings!
