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Details of the Guided Imagery Audio Program for Functional Abdominal Pain

All the equipment needed to use

the audio program is an Internet-connected computer and a pair of headphones.

Origins and development of this audio program

 

The audio program available through this web site is a structured eight week program developed specifically to help children to improve their own functional abdominal pain, defined as "long lasting intermittent or constant abdominal pain without evidence of a organic cause". The program was created in collaboration by us, the three individuals behind Child Pain Solutions, based on our experience in research on abdominal pain and psychological treatment of gastrointestinal disorders. Our idea was to create an effective home-based program that enabled children to use their own minds to improve their abdominal pain in a fun and easy way without having to work with therapists or get a lot of help from adults. We decided that Guided Imagery was best suited for this purpose, because it is a technique that has been demonstrated to be helpful for a variety of other health problems such as headaches and cancer pain, and it is a method that children find easy and enjoyable to use.

 

The program we created was tested at the University of North Carolina at Chapel Hill and found to be highly effective. The main findings were published in the journal Pediatrics in 2009. You can access the full paper here, by clicking the button:

 

 

 

In this study, 34 children were randomly assigned to receiving either just standard medical care or use the guided imagery program as well. The results showed that using the home-based guided imagery program resulted in better outcomes compared to medical care alone, and decreased pain frequency.

 

      The children who used the guided imagery program:

 

• Were much more likely to have improvement in their abdominal pain after two months (73.3% vs. 28.6%)

 

• Were five times more likely to be pain free at the end of the two-month period (35% vs. 7%)

 

• Were far less likely to have pain every day after two months (3.5% vs. 28%)

 

Additionally, use of the guided imagery program was associated with shorter pain episodes, decreased school absences, increased quality of life and better sleep.

 

The audio program was found to be well liked and easy to use by children as young as age 6. No negative side effects were detected, with the exception of benign mild headaches in one child.

 

Finally, the improvements seen in abdominal pain were well maintained at six-month follow-up, indicating that the beneficial effects last long after the use of the program is finished.

 

The version of the audio program that was tested in the research study was delivered on compact discs via CD players that the children used at home. However, for easier access to this program and to lower costs, the same audio program has now been adapted for delivery entirely through the Internet, with minor improvements in content based on the experience from our research and to facilitate this different delivery mechanism.

 

The online Guided Imagery audio program

 

The audio program available through a user account on this web site can be used by practically anybody who has an Internet-connected computer and a pair of headphones. The program consists of:

 

• An introduction video to be watched before the first use of the audio sessions
• A two-month structured series of audio listening sessions delivered through an online flash audio player (a total of seven different audio sessions)

The audio program is designed to be easy for children to use on their own. Children use their own password-protected web page.  Parents or adult caretakers only need to be involved to help the children get set up initially and then as problem solvers and supporters to encourage frequent enough and proper use of the program.

 

 

How the audio program  process works

 

1. After signing up and paying the user account fee, you receive your user account number via e-mail.

 

2. You log into  the audio program access page with your account number to activate your account. You will be asked to create two passwords, one for yourself and one for your child. It is recommended that you let your child choose his/her own password.

 

3. You then watch the introductory video presentation with the child.

 

4. After watching the introductory video, your child is ready to begin the 8-week audio program. You should choose the start time, though, when conditions are favorable for regular practice.

 

5. To start the eight-week program period, you simply log in with your password and press the START PROGRAM button.

 

6. Your child then uses his/her own personal password to log into the audio program page regularly to listen to an audio session. Each time, the web page will first ask the child about abdominal pain that day on a simple to understand scale, so that the system can help you evaluate progress over time.

 

7. After the abdominal pain rating is completed, the audio player appears on the child’s web page. The web page will present the right audio sessions each time, according to the structured sequence of the program (on most days, there will be a selection of different sessions to choose from). The child simply puts on his/her headphones, presses the audio player start button on the computer, and listens to the whole session while sitting comfortably with the eyes closed. The sessions are generally  about 15-20 minutes in length.

 

8. As the child proceeds through the eight week program, your role is (a) to help encourage the child to listen to the audio recordings at least 5 days a week for the whole eight-week period (b) helping to ensure that the child uses the sessions correctly  (for example, that the child is not interrupted, does not engage in multi-tasking and is not practicing when he/she is too tired); and (c) to help problem-solve if the child has any difficulties in completing the sessions or using the program web site.

 

9. You should also log in with your own password once a week, and rate your child's symptoms and well-being for the past week, for each of the eight weeks. Within your own password-protected page, you will be able to see how frequently your child has been using the audio sessions, and you will be able to view graphs indicating how symptoms and well-being of your child is changing over time.

 

10. Once the eight-week program is completed, your child does not necessarily need to continue using the program. However, since you have full use of your account for six months, it is a good idea to encourage your child to continue to use the guided imagery exercises for a while if he/she enjoys doing it, to solidify benefits even further.

 

The content of the Guided Imagery sessions

 

So what exactly do these audio sessions contain? Each session is a mental adventure that is verbally described in great detail, and is to be experienced vividly. Therapeutic imagery and verbal suggestions for better health and reduced abdominal pain are woven into these imaginary experiences in many places, in a way that makes the mind more receptive to them. Each session has a different main theme or adventure scene. The themes of the seven different sessions in the program are as follows:

 

 

 

 

 

 

 

• A question-and-answer page where you can find answers to questions about using the program, or post your own questions for us to answer

 

• Prompt support through e-mail for any problems in use of the program

 

• Built-in symptom measurement and automatically generated graphs showing progress in symptoms and well-being

 

Each of this sessions begins by the child being instructed to close the eyes and sit as still as possible (those are conditions that make it easier to clearly imagine what is described). The child is then asked to vividly experience in all senses being in the scene that is the theme of the session. This is followed by a lot of imagined motion (such as flying or gliding on a slide) and having many interesting experiences - seeing, hearing, touching, and even tasting or smelling various things. All the sessions also include putting a hand on the stomach and shining imagined healing light into the stomach that soothes discomfort and restores health.

 

To get a better idea of how these sessions sound, you can press the button below and use the audio players in the pop-up window to listen to  a couple of 2-minute sample clips from the sessions.

 

 

 

 

 

 

The voices in the audio sessions in this program are those of Miranda van Tilburg and Marsha Turner -- the same as in our research study.

 

Is this program something for your child?

 

The Guided Imagery audio program for abdominal pain may be suitable for your child if:

 

1. Your child has recurrent or chronic abdominal pain with no identifiable organic cause. It is important that you have consulted a doctor and the doctor has confirmed that no organic cause can be found. Children with diagnosis of functional abdominal pain or irritable bowel syndrome are among those for whom this program is suitable. Please note that this program is not a healthcare intervention and should not be used instead of proper healthcare for abdominal pain. If you are uncertain whether this treatment is suitable for your child, please consult your child’s physician about this.

 

2. The age of your child is in the range between 6 and 15 years. Children at the lower end of this range may need more assistance and support in completing the program than the older ones.

 

3. Your child is able to sit reasonably still and focus his/her attention while listening to a story.

 

What to expect from the program

 

Based on the experience from our research, this guided imagery audio program is likely to substantially improve your child's chances of good improvement in abdominal pain and enhancement in well-being and life functioning. Not every child who uses this program will experience noticeable benefits. However, our study results indicate that the odds of good improvement are quite favorable. About 3 out of every 4 (or 73.3%) in our controlled research study had clear improvement - much higher percentage than in the comparison group that only received usual medical care. It should also be noted that not nearly all children who improve from this treatment will be completely free from abdominal pain after treatment, but in such cases, symptom improvement may nonetheless be sufficient to greatly reduce the suffering and impairment in life functioning due to the abdominal pain problem.

 

 

1. Boat: The child imagines being on a boat out on the ocean.

 

2. Cloud: The child imagines being safely carried high into the sky and far away on a soft bouncy cloud.

 

3. Flying blanket: The child imagines a flying adventure on a flying blanket

 

4. Moon walk: The child takes a trip to the moon and experiences fun bounces and jumps and somersaults  in the low-gravity environment in a space suit.

 

5. Slide: The child vividly experiences a thrilling ride on a huge amusement park slide.

 

6. Swing: The child imagines swinging on a swing.

 

7. Snow: The child imagines being on a sled gliding down a long snowy hill and experiences the snowy terrain and the feeling of snow.