{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T16:51:05Z","timestamp":1782233465529,"version":"3.54.5"},"reference-count":47,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychother Psychosom"],"abstract":"<jats:p>Introduction: Many children and adolescents suffer from high-impact chronic pain. While preliminary evidence suggests that intensive interdisciplinary pain treatment is effective, there is limited post-treatment support. Individualized support through a pain management app may help close this gap. Methods: We conducted a multicenter randomized controlled trial with N = 453 youths with chronic pain aged 8\u201317 and their caregivers. Participants had access to the app MyBrainCity from admission until 6 months following discharge. Immediately after discharge, participants had access to either (1) app usage statistics (reference group), (2) plus push notifications and suggestions, (3) plus on-demand chat communication with a psychologist, or (4) plus psychologist-initiated chat communication. Data were collected up to 9 months after discharge. Outcomes included the functional disability inventory, the Revised Anxiety and Depression Scale, and numeric rating scales to assess pain intensity. Results: The primary analysis showed no significant differences in functional impairment between groups 9 months post-discharge (\u03c72(3) = 6.122, p = 0.106). Secondary analyses revealed that patients in Groups 3 and 4 showed significantly greater improvements in functional impairment compared to the reference group (\u22121.13 points, p &lt; 0.001). Only patients in Group 4 demonstrated additional improvements in emotional burden (anxiety: \u22120.91 points, p &lt; 0.001; depression: \u22120.72 points, p = 0.012). Patients in Group 2 had significantly greater reductions in both average (\u22120.24 points, p = 0.007) and maximum pain intensity (\u22120.33 points, p = 0.001) compared to the reference group. Conclusions: Pediatric pain management apps may be most effective when designed to include individualized, personal support. Patients especially benefit from clinician-delivered feedback following discharge.<\/jats:p>","DOI":"10.1159\/000551681","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T16:01:19Z","timestamp":1775664079000},"page":"1-18","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Effectiveness of Different Feedback Intensities in a Pain Management App: A Multicenter Randomized Controlled Trial with Youths with Chronic Pain and Their Caregivers"],"prefix":"10.1159","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-9167-647X","authenticated-orcid":false,"given":"Amelie 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