Treatments for Somatic Symptom and Related Disorders

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How Boston Children’s Hospital approaches SSDs

Having a condition that is “invisible” or being told your symptoms are “just in your mind” only adds to the stress of having an SSD. Our specialists understand this and will pull together a diverse team to address the mind and the body at the same time. For many families, it’s a relief to get validation that the symptoms are real and to know that others are going/have gone through the same thing.

SSDs are often temporary, and many children and adolescents fully recover. The most effective treatment involves a team of different specialists—medical doctors, psychologists, psychiatrists, physical therapists and nurses—working together to address the mind and the body at the same time.

Types of treatment for SSDs

These are the approaches that research has shown to be most helpful:

Cognitive-behavioral therapy

Cognitive behavioral therapy (CBT) helps patients redirect themselves away from negative thoughts and beliefs that make SSDs harder to cope with and can even worsen symptoms.

Imagine the nervous system as a dimmer switch. When the setting is low, the nervous system is calm and symptoms are few and mild; when the setting is high, the nervous system is more activated and symptoms escalate. The setting can be influenced by many factors, including:

  • how much the child thinks about their symptoms
  • how people around the child react to their symptoms
  • the child’s past experiences with the symptoms
  • the child’s worry about what is wrong
  • the child’s ability to distract themselves from the symptoms.

Through CBT techniques like relaxation training and biofeedback, children and adolescents get psychological support and learn strategies to gain more control over their stressful emotions and body sensations, keeping the dimmer switch on a “low” setting.

Families often participate in CBT as well, to help reinforce their child’s new coping strategies and support their recovery.

Exercise and physical rehabilitation

Many youth with SSD experience a deterioration of their physical fitness. Some have previously been very active, and it may be hard to accept that their abilities have changed. Along with the psychological support of CBT, physical rehabilitation gets youth moving, an essential part of their “toolbox” of wellness strategies. Working with a physical therapist or occupational therapist will gradually increase their energy, endurance and ability, one step at a time.

Medication

As physicians continue to monitor the child’s health, they might suggest medications to help with the SSD. Medication can be used to reduce the physical symptoms and discomfort, as well as to treat anxiety, sleep problems or mood disorders like depression that can make the physical symptoms worse.

CBT and physical rehabilitation—the two mainstays of treatment—require hard work. The more motivated youth and families are to engage in these forms of treatment, the more they will benefit from them.

In some instances SSDs can become chronic and disabling, particularly when they are unrecognized for a long time. When an SSD is severe and debilitating, a more intensive multidisciplinary treatment program like a partial hospitalization or inpatient care may be recommended to support the child’s physical and psychological recovery.

Prognosis

Most children and adolescents with SSDs benefit from this multi-team treatment. Studies show that some are cured and many will feel significantly better. Follow-up care can generally be handled by their pediatrician.

Symptoms may wax and wane in times of change or stress, but being aware of this possibility can help prevent new episodes or help with quick recovery if they occur again.

We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”
- Sandra L. Fenwick, President and CEO

Boston Children's Hospital 300 Longwood Avenue, Boston, MA 02115 617-355-6000 | 800-355-7944

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