Our Treatment Approach:
The Pediatric Pain Rehabilitation Program at Kennedy Krieger offers a treatment approach with novel and emerging treatment modalities that focus on narcotic-free pain management for children and adolescents. Treatment integrates medical, physical and cognitive behavioral approaches to managing chronic pain. Most patients referred to the program are seen in our outpatient clinic for an initial evaluation by an experienced, interdisciplinary team that includes a pain medicine specialist, a physical therapist, a psychiatrist, a cognitive behavioral therapist, a pain clinic nurse and a clinic coordinator. The team then develops a treatment plan that targets the patient’s individual needs and specifies the most appropriate treatment approach, which could include outpatient, day hospital or, for some individuals, inpatient care at either Kennedy Krieger or another appropriate inpatient setting. Some patients may be referred for additional evaluation by specialists in neurology, genetics, gastroenterology, psychiatry, or physical medicine and rehabilitation.
Outpatient Care
If outpatient treatment is recommended by the team, we will use a variety of treatment options focused on restoring function through medical rehabilitation, physical therapy, cognitive behavioral therapy, coping strategies and, when indicated, interventional pain procedures performed under sedation. Individuals may be referred for additional outpatient services at Kennedy Krieger. Family participation is encouraged to ensure successful, long-term outcomes.
Day Hospital Care
For patients who require short-term intensive therapy and do not need hospitalization, we may recommend our comprehensive rehabilitation day hospital program. This program fills a unique niche by providing support for pain management through a rehabilitative approach in a more natural, school-like environment that prepares children to return to school. Every weekday, patients participate in therapy sessions addressing physical, medical, psychological, educational and daily living goals. To maximize success, attainable daily goals are set, and the level of difficulty is gradually increased. Parents participate in several weekly sessions to receive training and support in caring for their child with chronic pain.
Inpatient Care
Inpatient treatment is appropriate for patients who need intense, full-time care and daily therapy that addresses physical, medical, psychological, educational and daily living goals. To maximize success, attainable goals are set for each day. As patients become better able to manage and cope with their pain, we gradually increase physical demands. This increase helps patients learn to pace their daily tasks and activities, and learn when and how to relax. Caregivers of children receiving inpatient care are encouraged to be present for the initial evaluation period (approximately the first three days of admission) and may spend the night during the evaluation process, if they choose. After the evaluation period, caregivers are strongly discouraged from rooming-in, so patients can focus on their rehabilitation goals and adjusting to the hospital setting. Additionally, some restrictions may be set for visitors during daytime hours. These restrictions are discussed during the family meeting at the start of inpatient admission. Family and caregiver training occurs throughout the stay.
Please note: Inpatient or day treatment care may not be appropriate for patients who require intensive psychiatric services. Each patient is evaluated to determine their fit for the program and best level of care.
Follow-Up Care
In preparation for a child’s discharge from the Pediatric Pain Rehabilitation Program, our social worker assists the child’s family in developing a plan for referrals for outpatient physical therapy, occupational therapy and/or mental health services. This will ensure the child continues to make improvements in well-being, and succeeds in the transition to home, school and community life.