Case formulation in persistent pain in children and adolescents: The application of the nonlinear dynamic systems perspective

Abstract

Statement of context: Recent empirical evidence demonstrates both insecure attachment and atypical sensory modulation patterns are associated with impaired function for children/adolescents with persistent pain. An integrating framework is required to translate this knowledge into clinical practice. Critical reflection on practice: Case studies demonstrate how the nonlinear dynamic systems perspective can assist occupational therapists to (1) understand how sensory modulation and attachment systems contribute to pain, distress, and functioning for children/adolescents with persistent pain, and (2) identify processes supporting adaptive occupational patterns. Implications for practice: Application of nonlinear dynamic systems theory can inform clinical formulation for children/adolescents with persistent pain.