The Intensive Pain Rehabilitation and Education Program (iPREP)

The Intensive Pain Rehabilitation and Education Program (iPREP) at Nationwide Children's Hospital is a multidisciplinary day-treatment program. It is designed for children 10-18 years of age who suffer from debilitating pain, are medically stable and who have had an inadequate response to an outpatient pain program. 

Nationwide Children’s iPREP is the only intensive outpatient pain rehabilitation program in Ohio. With a customized three-week plan including both individual and group treatment sessions for pain rehabilitation, it is one of the most comprehensive programs of its kind in the county.

Our interdisciplinary approach includes complementary alternative therapies, such as aromatherapy, music, nutrition and art therapy. Our unique facilities were designed in a way to provide real life integration of skills, such as a test kitchen, community reintegration activities and a patient academic and school success program.

Throughout participation in the program, our team will provide customized communication with both the family and the referring physician to allow for the most seamless transition home.

What to Expect

Children and teens will participate in the program from 8 a.m. to 4 p.m. daily, Monday through Friday, for an average of three weeks.  Services will focus on physical therapy, occupational therapy, therapeutic recreation, pain psychology, music therapy, massage, acupuncture, academic success program and medical supervision, as this model has proven effective in the treatment of pediatric chronic pain. 

Parents will receive extensive education regarding the causes and effective treatment of chronic pain to maximize the chance of continued success and improved overall daily functioning upon their child’s graduation from the program. 

While your child is the primary treatment target, we know family plays an important role in the management of pain and functioning. Family participation in daily afternoon educational groups is required. The family groups will:

  • Educate caregivers on the skills your child is learning
  • Provide support and instruction on how to successfully adapt and implement skills learned during the program into the home
  • Promote the overall coping and functioning of your child.

Individual and family sessions will be scheduled as needed to address family specific needs.

Our Therapies


The general theory of acupuncture is that proper physiological function and health depend on the circulation of nutrients, substances and energy called Qi (pronounced “chee”) through a network of “channels” or “meridians.” Pain and ill health result when the flow of Qi through the body is disrupted or blocked by many things, including disease, trauma/injuries and medication (side-effects) as well as lifestyle factors such as poor diet, emotions, lack of rest and stress.

Acupuncture involves the stimulation of specific body locations (acupuncture points) to improve the flow of Qi. Insertion of sterile thin needles, heat or finger-pressure achieves this stimulation. For many children and teens, acupuncture can improve pain and assist in helping their body regain a more natural balance.

Aromatherapy: Use of Essential Oils

Aromatherapy is the use of pure organic plant extracts called essential oils. Aromatherapy is used to create a healing environment for emotional, psychological and physical well-being. Only real essential oils are used for aromatherapy.


Biofeedback is a technology that allows your child to gain greater awareness and control over the body’s physiological stress response. Biofeedback uses sensors to monitor changes in how the body reacts to stress and/or pain, including heart rate, muscle tension, breathing rate, temperature, sweating and blood pressure.

Biofeedback helps your child immediately see the benefits of relaxation on the body. Relaxation can reduce the negative reactions of stress on the body by decreasing or regulating muscle tension, heart rate, breathing rate and blood pressure.

Massage Therapy

Massage Therapy (MT) is a form of therapy that uses the gentle application of systematic touch, focusing on specific areas of the body, or the whole body, for the purpose of promoting healing and relaxation.

Massage therapy reduces stress, relieves tension and pain and increases the circulation throughout the body.Patients may benefit from feelings of safety, comfort, well-being, enhanced self-esteem and reduced anxiety and depression. Massage services are delivered by licensed massage therapists, who provide children with many different types of touch therapy.

Occupational Therapy

Occupational therapists (OT) evaluate a child’s motor, social, mental and emotional skills as well as their ability to understand and appropriately react to information related to their five senses. They then examine how difficulties with these functional skills may impact the child’s participation in their daily activities in their homes and communities.

Occupational therapists support the child in developing new skills or making adjustments to their activities or environments to help them improve their performance and independence in daily activities. OTs may provide services individually, within a group setting or in family sessions.

Patient Academic and School Success (PASS)

School plays a critical role in every child’s life. Maintaining educational needs throughout a hospitalization is important and can provide structure, distraction and motivation for a future outside of the hospital.

The Patient Academic and School Success program, or PASS, provides educational instruction to students enrolled in kindergarten through 12th grade. The PASS teacher will communicate between families, schools, and medical teams to receive direct feedback on academic skills and progress. Developmentally appropriate educational activities will be implemented in a group setting that will allow students to continue to achieve their academic goals while interacting with peers. The teacher will share information on educational and community resources with caregivers and can help to facilitate the transition from hospital to home and/or school.

Physical Therapy

Research has shown exercise is an important part of managing chronic pain, yet fear of pain often keeps people from wanting to begin an exercise program. A physical therapist (PT) can help an individual learn to interpret pain signals and manage and decrease symptoms through exercise. 

The physical therapist’s role is one of assessment and treatment. The physical therapist performs an assessment on the patient’s initial intake and at interval times throughout the patient’s course of rehabilitation. Following the initial intake, a plan of care for future visits will be established. 

Treatment interventions will be activity based and will focus on restoring normal function and movement patterns. Treatment interventions utilized may include range of motion/flexibility, strengthening, core stabilization, functional progression, low-impact aerobic exercise and development of a home exercise program.

Consistent performance of a home exercise program will be an essential piece of your child’s rehabilitation program. Proper pacing will also play a key role in your child’s rehab process. 


A pediatric pain psychologist provides a range of assessment and treatment services to each child or teen and their family. Assessment occurs at the time of the initial appointment and at regular times to examine psychological issues related to coping and adjustment to chronic, acute and recurrent pain.

Individual sessions focus on teaching specific pain management strategies, such as muscle relaxation or visual imagery, distraction and meditation. Individual sessions allow your child to explore their personal pain experience and expression to then create targeted treatment strategies. In addition, stress management and emotion regulation training is provided to manage changes in daily functioning as a result of pain, including scholastic performance and peer relations.

Individual and family counseling may also be provided to address personal and family factors either contributing to or resulting from pain and/or medical procedures. Finally, the psychologist provides education to you, your child or teen and health care providers about the developmental and psychological factors related to pediatric pain in general.

Therapeutic Recreation

Therapeutic recreation (TR) specialists evaluate a child’s ability to participate in positive and healthy leisure activities within their homes and communities.

Therapeutic recreation supports children and families by helping them identify meaningful leisure and social activities, connect with resources to support access to leisure and reduce barriers to healthy leisure participation. Therapeutic recreation specialists also focus on teaching new skills to help the child be successful in leisure activities that support their health as well as their family and peer connections. TR may provide services individually, within a group setting or in family sessions.