• Tanja Hechler, Michael Dobe, Uta Damschen, Markus Blankenburg, Sandra Schroeder, Joachim Kosfelder, and Boris Zernikow.
• Vodafone Foundation Institute and Children's Pain Therapy and Paediatric Palliative Care, Children's and Adolescents' Hospital, Datteln, Witten/Herdecke University, Datteln, Germany. jon.raphael@bcu.ac.uk
• Pain Med. 2010 Jun 1;11(6):897-910.

ObjectiveThis study aims to investigate the effectiveness of the "pain provocation technique" (PPT)--a focused treatment strategy incorporating interoceptive exposure (i.e., imagining increases in pain intensity), bilateral stimulation (tactile stimulation), and implementation of pain-related coping to decrease pain intensity--for adolescents suffering from chronic pain.DesignProspective observational comparative study.MethodsAdolescents utilizing PPT (19 boys and 21 girls) within multimodal inpatient treatment were compared with adolescents in standard multimodal inpatient treatment matched for age, gender, and diagnosis. Core outcome variables (pain intensity, disability, emotional distress) were assessed at admission and 3 months posttreatment.ResultsAdolescents in the PPT group demonstrated a sharper decrease in pain intensity and school aversion. Both groups demonstrated significant reductions in disability and emotional distress.ConclusionsResults are discussed in terms of the importance of focused treatment strategies such as interoceptive exposure for adolescents suffering from disabling chronic pain. Future studies are warranted to carefully investigate the effectiveness and possible process of change during the PPT such as sensory, cognitive, emotional, and memory aspects.

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