CHIRP is a structured multidisciplinary treatment program, based on research and clinical experience with pediatric patients with chronic painful and fatiguing illnesses. The program is specifically designed for adolescents (12 to 18) experiencing difficulty maintaining a more active lifestyle while coping with and recovering from their illness.


Adolescents with chronic, debilitating, fatiguing and/or painful illnesses face challenges that may prove disruptive to their normal physical, psychological and social developmental trajectories. CHIRP, the Children’s Health and Illness Recovery Program, is a multidisciplinary family-based treatment program designed to maximize the functioning of teens with chronic illness. It was developed from both a careful review of the evidence-based literature on treatment programs for adolescents with chronic physical illness and the authors’ (BC & WK) more than three decades of combined experience in helping children and families improve their quality of life while coping with pediatric illness.

The CHIRP treatment program has been developed to expose the patient and their parents to a series of exercises and activities that improve awareness of the interaction between illness and symptoms, enhance stress awareness and coping skills, and facilitate increased patient functional independence in both management of recovery, problem-solving and decision making. The session format is based upon our extensive clinical experience and research in working with pediatric patients with fatiguing and painful illnesses.

Who will benefit?

Teens who have benefited from this program have been diagnosed with such conditions as Chronic Fatigue Syndrome (CFS), Juvenile Fibromyalgia Syndrome (JFMS), Dysautonomia or Postural Orthostatic Tachycardia Syndrome (POTS), Complex Regional Pain Syndrome (CRPS), Irritable Bowel Syndrome (IBS), chronic headaches, recovery from Transverse Myelitis, to mention a few, and those with functional decline associated with other chronic illnesses.

Difficulties experienced by teens dealing with these conditions typically include the following:

  • Excessive fatigue
  • Low energy, stamina & endurance
  • Widespread pain in more than one area of the body
  • Frequent headaches
  • Light-headedness, dizziness, fainting
  • Non-refreshing and poorly regulated sleep
  • Frequent school absences
  • Difficulty with concentration, short-term memory, planning or organizing (not due to ADHD)
  • Decline or difficulty with academic and/or social functioning
  • Associated decreased self-confidence and motivation

Evidence-Based Treatment

CBT is perhaps the most studied and well-validated non-medication treatment for conditions involving pain and fatigue in children and adolescents. CBT approaches have been shown to improve patient coping and functioning with pain and fatigue, including more rapid return to school and other “normal” social and recreational activities. In addition, CBT can reduce associated symptoms of anxiety, depression and physical discomfort. In particular, CBT targets problems with beliefs and attitudes that often accompany dealing with a chronic illness. Patient and families are taught to examine the relationship between their thoughts, feelings and behaviors as they influence the recovery process. In CHIRP, key target areas might include:  


  • Self-image and confidence
  • Assertive communication skills
  • Dealing with peer issues
  • Setting realistic standards for success
  • Dealing with dependence on others in order to recover from illness
  • Overcoming feelings of invalidation
  • Pessimism regarding future health outcome and personal success


  • Struggles in promoting increased patient activity and independence
  • Overcoming fear of worsening teen symptoms by encouraging increased activity
  • Worries and fears of teen future success being affected by illness
  • Developing an accurate view of the patient’s symptoms and abilities

Making a referral to CHIRP

CHIRP has been developed from years of clinical experience and research conducted by numerous professionals who work with children and adolescents with chronic illness. We employ a treatment manual approach that helps patients (and parents, teachers, etc.) develop specific skills in identifying and managing the multitude of stresses and challenges that come with chronic illness. The program places a strong emphasis on a team approach. This involves collaboration with the patient’s primary care physician, specialists (e.g., Cardiology, Neurology, Adolescent Psychiatry, Rehab Medicine, Rheumatology, Physical and Occupational Therapy, etc.) and school/academic personnel to enhance and facilitate the teen’s rehabilitation and increase their independence in managing symptoms and returning to more normal functioning.


Ordering CHIRP Materials

Any pediatrician, family practitioner or pediatric specialist may refer a patient to CHIRP by calling the phone number below or completing a referral form (see the Forms link on this website) and mailing/faxing it, with appropriate releases. It is helpful for the referring professional to also send along recent clinical summaries detailing the patient’s diagnosis and treatment information. Upon receipt of the referral we will contact you to gather more relevant clinical information before scheduling an evaluation.

Phone:(502) 852-1030
Fax: (502) 852-1055


Bryan D. Carter, Ph.D.
Email Dr. Carter
CHIRP Program Director
U of L Medical School
Division of Child, Adolescent & Family Psychiatry
200 East Chestnut Street
Louisville, KY 40202


We would like to express our appreciation for the contributions of numerous colleagues, patients and their families who have helped us develop and refine this program. In particular, we would like to thank the Barbara Blair Foundation, the Barr Foundation and the Norton HealthCare Community Trust Foundation for their generous funding of various stages of research and program development.

Program Director

Bryan Carter, PhD

Portrait of Dr. Bryan CarterDr. Carter received his Ph.D. in Clinical Child Psychology from the University of Virginia, completed his predoctoral residency in Clinical Psychology at Wilford Hall USAF Medical Center in San Antonio, and a postdoctoral fellowship in Pediatric Psychology at the University of Oklahoma School of Medicine. He has been with the University of Louisville School of Medicine and the Bingham Clinic since 1985, and is a Professor of Child, Adolescent & Family Psychiatry and an Associate in Pediatrics. He is Director of the Pediatric Consultation-Liaison Service to Kosair Children’s Hospital and other hospitals in the U of L HSC system, Director of Postdoctoral Fellowship Training, and Chief Psychologist for the Division of Child, Adolescent & Family Psychiatry and Bingham Clinic. His research focus has been primarily on the psychological impact of chronic illness, somatization and somatoform disorders in children, traumatic injury and hospitalization on the child and family and the development of interventions and coping resources to facilitate child and family adaptation to pediatric illness. He has served as a consultant to the National Institutes of Health and the Centers for Disease Control and Prevention associated with his research on chronic fatigue syndrome in children and adolescents. His is the Director of CHIRP, the Children’s Health and Illness Recovery Program, a manualized treatment program for adolescents recovering from chronic fatiguing and painful pediatric illnesse

Giving to CHIRP

Making a tax-deductible gift to University of Louisville Children's Health & Injury Recovery Program (CHIRP) is easy. You may give online, by phone or by mail.

Many companies offer the benefit of Matching Gifts programs. An employee's charitable gift may be matched by his or her company 1:1 or even 3:1.

Visit louisville.edu/giving to make an online gift. You may also check to see if your company offers Matching Gifts.

For mor information or to make a gift over the phone, please contact:
Theresa Raidy
Phone: 502-852-2793
Email Theresa

or visit louisville.edu/giving to make an online gift.

Ordering CHIRP materials

Fill out our online form to order materials