Practice Innovations, Vol 11(2), Jun 2026, 109-123; doi:10.1037/pri0000335
Pediatric psychology is essential to improving outcomes for children with medical conditions, yet access to care remains profoundly limited due to workforce shortages, limited community distribution, and lack of scalable delivery models. Chronic headache illustrates this evidence-to-practice gap: cognitive-behavioral therapy for headache is a first-line intervention supported by robust evidence, yet few have access to trained providers. This review outlines strategies for expanding access, including community-based service delivery, task-shifting to less-specialized providers, integration with medical teams, and digital innovation. Each has demonstrated effectiveness in other areas of child and adolescent mental health but has been underutilized in pediatric psychology. We describe how these approaches can be adapted to pediatric headache care and their potential to reduce disparities and improve continuity. We then present a scalable clinical model (“Streamind Health”), a digital behavioral health program developed outside existing medical systems for youth with medical conditions. Advancing such models will require rigorous evaluation, interdisciplinary collaboration, and investment in digital and workforce infrastructure. Thus, we also outline practical steps for expanding access to cognitive-behavioral therapy for headache within our current systems, including expanding training to the broader workforce, implementing structured referral and communication pathways, leveraging existing digital tools, developing stepped-care pathways, and building cross-disciplinary partnerships. (PsycInfo Database Record (c) 2026 APA, all rights reserved)