Therapies to improve coping for children and adolescents with functional abdominal pain

Mind-body therapy	Instructions/example
Deep breathing	Place your hand over your belly Breathe deeply; feel your belly expand Breathe out through your mouth; allow your belly to deflate Repeat as necessary for up to 30 minutes
Progressive muscle relaxation	Lie down in a comfortable position Notice how the muscles feel in each part of your body Clench the muscles in your face for 5 seconds, take a deep breath, and release Repeat the sequence of clenching and releasing for other body areas (eg, shoulders, arms, hands, fingers, abdomen, thighs, lower legs, feet, toes) Clench all of your muscles for 5 seconds, take a deep breath, and release Focus on how your muscles feel after release
Guided imagery/self-hypnosis	Example 1: Relax and imagine a happy, comfortable place – A place you have been or a place you would like to go Pretend that you are there What do you see? Hear? Smell? Feel? Spend a few minutes enjoying everything about your special place
Guided imagery/self-hypnosis	Example 2: Imagine floating on a big puffy cloud Imagine butter melting onto your hand and making your hand shiny and warm Place this hand on your belly Imagine the butter melting through your belly and forming a coating that will protect it from irritation

References:

Gerik SM. Pain management in children: Developmental considerations and mind-body therapies. South Med J 2005; 98:295.
van Tilburg MA, Chitkara DK, Palsson OS, et al. Audio-recorded guided imagery treatment reduces functional abdominal pain in children: A pilot study. Pediatrics 2009; 124:e890.

Graphic 90731 Version 4.0