Back to top

Fostering Resilience in Adolescents with Chronic Musculoskeletal Pain

Statement of Problem

Pediatric chronic musculoskeletal pain (CMP)—chronic pain affecting the bones, joints, muscles or connective tissues for three months or longer—is extremely prevalent, affecting up to 40% of children, primarily adolescents. Despite current treatment practices, long-term outcomes for youth with CMP remain poor, with affected teens experiencing greater anxiety, depression, and overutilization of health care and a greater risk of opioid misuse as adults. While cognitive behavioral therapy (CBT) can effectively treat adolescent CMP, access to a psychologist can be challenging for some families, and CBT alone does not result in improved physical activity among affected teens.

Resilience-training interventions serve as potential alternative psychosocial skills-based interventions for the treatment of adolescent CMP. While routed in traditional CBT, resilience-training interventions are distinct in that they are brief and target specific stress management skills. More youth can access these interventions since providers, including bachelors-level, non-clinical personnel, can deliver them remotely via telephone or telehealth.

Our long-term goal is to test the efficacy of a resilience-training intervention (Promoting Resilience in Stress Management [PRISM])—which researchers in the Palliative Care and Resilience Research Program at Seattle Children’s Hospital originally designed for adolescents and young adults with serious illness—among a population of youth with CMP. However, prior to doing so, we need more research to understand the role of patient and parental resilience in disease management among youth with CMP.


Fostering Resilience in Adolescents with Chronic Musculoskeletal Pain


Findings from this study will support future studies evaluating the efficacy of resilience training interventions for adolescents with chronic musculoskeletal pain.

Next Steps

Understanding how resilience relates to symptom severity and treatment adherence among youth with CMP as well as further determining the efficacy and applicability of PRISM in clinical care for youth with CMP will help ensure successful treatment outcomes for this vulnerable patient population. Long-term, we hope this research will result in improved access to and efficacy of non-pharmacologic psychosocial interventions for adolescent CMP.

In our Research in Motion video series, Dr. Sabrina Gmuca explains more about her work in fostering resilience in youth with chronic, including her aims to utilize PRISM to help reduce suicidal thoughts among these youth. 

This project page was last updated in May 2023.

Suggested Citation

Children's Hospital of Philadelphia, PolicyLab. Fostering Resilience in Adolescents with Chronic Musculoskeletal Pain [online]. Available at: [Accessed: plug in date accessed here].