Approaching Chronic Conditions in Childhood

As unaccustomed as I am to blogging (this is my first ever blog), I feel compelled to do so by the article I read in this month’s Psychologist – ‘Coping and acceptance in chronic childhood conditions’, by Jeremy Gauntlett-Gilbert and Hannah Connell, pp. 198-201. As someone working in the field of ‘pain management’ – in my opinion a totally inappropriate phrase to describe the actual focus of what I do – I found the article reinforcing, elaborative and thought provoking. I want to use my first blog to explain why – though blogging about this feels rather egocentric to me in my blog-novice status! Any way….

Reinforcing, in that as I have read a lot of the literature and evidence base as to the relevance of mindfulness  / Acceptance and Commitment Therapy (ACT) based approaches to chronic conditions, and applied their modalities and their spirit first hand to therapeutic benefit, I am pleased more air time is being given to the application of such approaches in direct clinical settings – for it is only in the context of the setting that they start to make sense, it is a lived approach.

Elaborative, in that the article as well written as it is, with its humility to other more dominant approaches acknowledged, offers a more dynamic, yes I mean dynamic , elaboration of human experience through the conceptualisations of ACT it outlines, than those often offered by straight Cognitive Behavioural Therapy (CBT) conceptualisations themselves. Though I feel it is important to recognise that CBT has gone a long way in our socio-political context to revitalise and ask questions of the profession of Psychology as a whole – you can’t have a third wave without a second!

Thought provoking, in that with my social constructionist hat on, ACT like CBT seems to be trying to encounter truth’s in experience, something I find hard to engage with given my lived therapeutic experience of exploring macro and micro co-constructed relational meanings with others – in relation to the article one might ask why is being anxious, resisting or indeed ‘suffering in the rain’ bad? Could this be a construction of experience rather than the experience itself – in the moment! I wonder then if given that younger people (children) may have taken on less of the social constructed prescriptions through which to interpret their own experience, they might actually be better placed to manage chronic conditions than adults – not because they are naïve as to the ‘true’ meaning of illness as often proposed, but rather because they are open to more fluid meanings – psychological flexibility in the terminology of ACT – they may thus be more resilient than we give them credit for, reflecting our own ‘psychological stuckness’ in the construction of childhood .


Dr. Terry Boucher

Counselling Psychologist