Table Of Contentebook
THE GUILFORD PRESS
TREATING SOMATIC SYMPTOMS
IN CHILDREN AND ADOLESCENTS
The Guilford Child and Adolescent Practitioner Series
Editors: John Piacentini and John T. Walkup
This series offers effective, innovative intervention strategies for today’s child and adoles-
cent practitioners. Focusing on persistent clinical challenges that cut across diagnoses and
often come up in practice, books in the series present evidence-based tools for conceptu-
alizing and addressing clients’ individualized needs. These concise volumes provide what
is missing from many evaluation and treatment manuals: the nuts-and-bolts techniques
required for everyday clinical work. Each accessible guidebook includes a treasure trove
of suggested interventions, complete with case examples, practical tips, sample dialogues,
and practitioner-friendly resources, such as reproducible handouts and forms.
Teen Suicide Risk:
A Practitioner Guide to Screening, Assessment, and Management
Cheryl A. King, Cynthia Ewell Foster, and Kelly M. Rogalski
Psychological Interventions for Children with Sensory Dysregulation
Ruth Goldfinger Golomb and Suzanne Mouton-Odum
Treating Somatic Symptoms in Children and Adolescents
Sara E. Williams and Nicole E. Zahka
Treating
Somatic Symptoms
in Children and
Adolescents
SARA E. WILLIAMS
NICOLE E. ZAHKA
Series Editors’ Note by
John Piacentini and John T. Walkup
The Guilford Press
New York London
Copyright © 2017 The Guilford Press
A Division of Guilford Publications, Inc.
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Except as indicated, no part of this book may be reproduced, translated,
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Printed in the United States of America
This book is printed on acid-free paper.
Last digit is print number: 9 8 7 6 5 4 3 2 1
LIMITED DUPLICATION LICENSE
These materials are intended for use only by qualified mental health professionals.
The publisher grants to individual purchasers of this book nonassignable permission to reproduce all materi-
als for which permission is specifically granted in a footnote. This license is limited to you, the individual
purchaser, for personal use or use with individual clients. This license does not grant the right to reproduce
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The authors have checked with sources believed to be reliable in their efforts to provide information that is
complete and generally in accord with the standards of practice that are accepted at the time of publication.
However, in view of the possibility of human error or changes in behavioral, mental health, or medical sciences,
neither the authors, nor the editor and publisher, nor any other party who has been involved in the preparation or
publication of this work warrants that the information contained herein is in every respect accurate or complete,
and they are not responsible for any errors or omissions or the results obtained from the use of such information.
Readers are encouraged to confirm the information contained in this book with other sources.
Library of Congress Cataloging-in-Publication Data
Names: Williams, Sara Elizabeth, 1976– author. | Zahka, Nicole E., author.
Title: Treating somatic symptoms in children and adolescents / Sara E. Williams and Nicole E.
Zahka.
Other titles: The Guilford child and adolescent practitioner series.
Description: New York, NY : The Guilford Press, 2017. | Series: The Guilford child and
adolescent practitioner series | Includes bibliographical references and index.
Identifiers: LCCN 2016049135 | ISBN 9781462529520 (hardcover : alk. paper)
Subjects: | MESH: Somatoform Disorders—therapy | Cognitive Therapy |
Signs and Symptoms | Child | Adolescent
Classification: LCC RC552.S66 | NLM WM 170 | DDC 616.85/24—dc23
LC record available at https://lccn.loc.gov/2016049135
Illustrations by Scott Stoll.
About the Authors
Sara E. Williams, PhD, is a pediatric psychologist at Cincinnati Children’s Hospital
Medical Center, where she is Clinical Director of the Functional Independence Resto-
ration (FIRST) program for inpatient pediatric chronic pain rehabilitation. She is also
Associate Professor of Pediatrics at the University of Cincinnati College of Medicine.
Dr. Williams specializes in assessing, treating, and researching pediatric chronic pain
conditions.
Nicole E. Zahka, PhD, is a pediatric psychologist at Cincinnati Children’s Hospital
Medical Center. Her practice includes children and adolescents with chronic medi-
cal conditions and anxiety disorders, with a specialty in assessment and treatment of
conversion and functional movement disorders, as well as syncope and gastrointesti-
nal disorders.
v
Series Editors’ Note
I
n The Guilford Child and Adolescent Practitioner Series, our goal is to provide
practitioners with a library of relatively short, practical, theory-driven books focused
on common clinical problems and key intervention techniques. The books in this
series differ from existing treatment manuals in that they do not focus on specific dis-
orders such as obsessive–compulsive disorder (OCD), major depression, or attention-
deficit/hyperactivity disorder (ADHD), but rather on clinical issues that cut across
specific disorders or fall between the so-called diagnostic “cracks.” These clinical
challenges—including the treatment of sleep and somatic problems, sensory intoler-
ance, unwanted habits, and adolescent noncompliance, among others—are common
in children and adolescents in therapy and can confound clinicians, many of whom
have not encountered them in training or in their clinical work.
By offering clearly and coherently organized titles that provide relentlessly practi-
cal, step-by-step guidance, we hope to help busy practitioners select and implement
the assessment and intervention strategies best suited to their needs. Common to
each of these titles is an emphasis on the functional understanding of the antecedents
(e.g., triggers) and consequent factors that serve to elicit and maintain the present-
ing problem. This theoretical framework provides a clear conceptual link between
the target psychopathology and specific assessment and treatment techniques. Ample
case examples illustrate case conceptualization and treatment selection and imple-
mentation. The technical aspects of the intervention are explained through clinical
illustrations, sample dialogue, and handouts, forms, and other practitioner-friendly
material.
Each book in the series provides relevant information about the topic problem,
including a description of how the behavior begins and is maintained, and how the
problem may manifest and change over development and across different settings
and contexts. The theoretical models underlying the problem behavior and interven-
tion strategies are presented along with existing research support for these strategies.
Guidelines for recognizing and addressing challenges that may arise during treat-
ment are also detailed. Finally, given the common occurrence of the target behaviors
vii
viii Series Editors’ Note
covered in this series with other clinical problems, strategies for integrating the
selected treatment into a more comprehensive treatment plan are provided.
In this book, Sara Williams and Nicole Zahka describe the evaluation and treat-
ment of children and adolescents with somatic symptoms, a challenging situation in
which kids experience real, physical symptoms without known medical cause or easy
explanation. As defined in this volume, somatic symptoms lasting for several months
or more and leading to significant impairment are common in youth with medical
and psychological disorders and can be highly perplexing, not only for the children
and their families, but also for the medical and therapeutic communities with whom
these individuals come into contact. As a result, affected youth can endure numerous
costly and invasive medical procedures that fail to yield causal information or relief.
Not surprisingly, high levels of frustration, distress, and disability are common.
Drs. Williams and Zahka, both expert pediatric psychologists with considerable
experience working with children and adolescents suffering from somatic symptoms
and with their families, present a comprehensive biopsychosocial model for evaluat-
ing and treating this often vexing problem. They expertly describe how the therapist
can bridge the gap between the medical and psychological aspects of the child’s expe-
rience and teach the child and family the connection between physical symptoms
and underlying psychosocial stressors. Once the child and family have developed a
reasonable understanding of these connections, cognitive-behavioral therapy is used
to teach children how to respond to their stressors in a more adaptive way. Of critical
importance, the authors also provide clear guidelines for therapists to use in navigat-
ing the larger treatment context, including step-by-step instruction in effective strate-
gies for collaborating with other family members, schools, and health care profes-
sionals necessary to ensure generalizable and durable treatment outcomes.
Highly detailed case material and sample treatment plans provide therapists with
the hands-on clinical material that is rarely available in treatment manuals. If you
need expert guidance in dealing with puzzling presentations of complex symptom
patterns, this is the right book for you. We are very familiar with the work of these
authors and know their treatment approach to be very helpful in improving the lives
of children and adolescents with somatic symptoms and those of their families. We
trust the highly valuable information in this book will be extremely useful to you in
your practice.
John Piacentini, PhD
John t. WalkuP, MD
Description:Persistent physical symptoms that may not be associated with a known medical disease can be perplexing and distressing for children and families. This book gives mental health professionals a complete understanding of somatic symptoms in 6- to 18-year-olds and presents an innovative treatment approa
