(496) Problem-solving therapy for parents of children receiving intensive pain rehabilitation

Abstract

Chronic pain is stressful for children and families. Intensive pediatric pain rehabilitation programs require a several week hospital stay, which can increase family burden. Parents may benefit from their own intervention to decrease distress. We adapted problem-solving therapy (PST) to reduce distress in parents of children receiving intensive pain rehabilitation, and evaluated its feasibility, acceptability, and preliminary efficacy. Parents (n=26, Mage=46 years, 85% female) of children (10-17 years, 70% female) enrolled at one of three intensive pain rehabilitation programs participated. Feasibility and acceptability were assessed by session and homework completion, therapist ratings, and parent ratings (Treatment Evaluation Inventory). A subset of parents (n=9) completed semi-structured treatment satisfaction interviews. All parents completed outcome measures of general mental health (Profile of Mood States) and pain-related impact (Bath Adolescent Pain-Parent Impact Questionnaire) at pre-treatment, post-treatment, and three-month follow-up. Parents received 1-6 intervention sessions (M=4.5); 88% completed treatment (>4 sessions). Therapists reported high parental engagement as evidenced by homework completion (M=8.16/10) and motivation (M=8.49/10), receptivity to learning (M=8.43/10), understanding PST (M=8.38/10), and having strong rapport (M=8.49/10). Parents rated the intervention as highly acceptable (M=32.60/45). In qualitative interviews, parents reported PST was validating and beneficial to their daily lives. Parents desired booster sessions and more advanced skills training. Linear growth models demonstrated improvements in parents' general mental health at post-treatment and follow-up (b=6.97, p=0.001; b=-7.37, p=0.001). Benefits were also found on parent pain-related impact, including reductions in depression and anxiety at post-treatment (b=-4.31, p=0.001; b=-4.65, p<0.001) and follow-up (b=-4.07, p=0.003; b=-4.06, p<0.001). This study suggests that PST may be an acceptable and helpful intervention for parents during intensive pediatric pain rehabilitation. Further research is needed to understand the unique benefits of PST in the context of intensive pain rehabilitation.