Despite growing awareness, research on how to treat rumination syndrome (RS) remains scarce. Despite mixed results, diaphragmatic breathing (DB) is a cornerstone of current therapy recommendations. The strongest evidence comes from inpatient treatment settings. In this study, researchers presented the outpatient protocol for Comprehensive Behavioral Treatment for Rumination Syndrome (CBT-R) and initial analysis of its efficacy. The CBT-R protocol is laid out in full with its roots in behavioral theory and its progressive approach to relieving symptoms. Children and adolescents (8-18 years old) with a main diagnosis of RS who a pediatric psychologist treated in an outpatient environment were the subjects of a retrospective case series design used to assess the efficacy of the therapy. About 28 patients were enrolled because they met the inclusion criteria; 23 patients were assessed for outcomes (47.8% female; Mage=14.3; SD=2.8). 17.4 percent of the sample had a psychiatric diagnosis, and 43.5 percent had a comorbid medical condition. Most individuals show improvement in their symptoms (87.0%), with the majority showing complete elimination of symptoms (73.9%). The average number of clinic visits per patient was 4.8 (standard deviation: 5.4). However, this ranged from 1-22 in some cases, and in 21.7% of patients, complications such as hospitalization or nutritional support extended treatment duration. Negative treatment outcomes and increased treatment time were both associated with psychological variables. Positive treatment outcomes were shown with CBT-R, with most patients showing complete remission of symptoms, making it a preferable outpatient treatment option for some pediatric patients. Previous conceptions of RS as a predominantly female disorder with severe mental comorbidity were challenged by the features of the current sample.

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