(541) Guiding parent responses to their child’s pain during intensive interdisciplinary pediatric pain rehabilitation

Abstract

Parental responses to their child's pain, particularly protective responses, are associated with the young person’s pain-related impairment, pain complaints, mood, and engagement in social activities. Research suggests these responses may be affected by the parent’s feelings of distress and helplessness, parent catastrophizing, and parent attributions about the cause of symptoms. However, few studies have investigated the effect of pediatric pain rehabilitation on parental responses or directly targeted these potential contributors to parent responses. While their adolescent children (ages 11-18) participated in a 3-6 week intensive interdisciplinary pediatric pain rehabilitation program, all 22 parents (primarily mothers) consistently attended two 60-90 minute parent groups per week led by a psychologist or social worker. Groups maintained a supportive and educational format, and parents were encouraged to share challenges of parenting a teen with pain, while also being prompted to interact with a specific topic each session (e.g. coping with own emotions, responding to teen pain, promoting appropriate teen independence, behavior management, and education about chronic pain). One parent from each family completed measures at baseline, the end of each week of treatment, and one-month follow-up, including the Adult Responses to Children’s Symptoms (ARCS) and the parent Functional Disability Inventory (FDI-parent). Teens reported their pain on a 100mm visual analog scale. Results indicate, on average, both parent protective and monitoring responses declined throughout the program (t=5.37; p<.001; t=6.18; p<.001, respectively) and these effects were maintained at follow-up. FDI-parent was somewhat associated with protective and monitoring parent responses at baseline (p’s<.05), but only with protective responses at program end (p<.05). Child pain was not associated with parent responses. In conclusion, parent groups during intensive interdisciplinary pediatric pain rehabilitation may be an effective format to target parent responses to their child’s pain, and these effects are not solely explained by improvements in child disability or pain. Parental responses to their child's pain, particularly protective responses, are associated with the young person’s pain-related impairment, pain complaints, mood, and engagement in social activities. Research suggests these responses may be affected by the parent’s feelings of distress and helplessness, parent catastrophizing, and parent attributions about the cause of symptoms. However, few studies have investigated the effect of pediatric pain rehabilitation on parental responses or directly targeted these potential contributors to parent responses. While their adolescent children (ages 11-18) participated in a 3-6 week intensive interdisciplinary pediatric pain rehabilitation program, all 22 parents (primarily mothers) consistently attended two 60-90 minute parent groups per week led by a psychologist or social worker. Groups maintained a supportive and educational format, and parents were encouraged to share challenges of parenting a teen with pain, while also being prompted to interact with a specific topic each session (e.g. coping with own emotions, responding to teen pain, promoting appropriate teen independence, behavior management, and education about chronic pain). One parent from each family completed measures at baseline, the end of each week of treatment, and one-month follow-up, including the Adult Responses to Children’s Symptoms (ARCS) and the parent Functional Disability Inventory (FDI-parent). Teens reported their pain on a 100mm visual analog scale. Results indicate, on average, both parent protective and monitoring responses declined throughout the program (t=5.37; p<.001; t=6.18; p<.001, respectively) and these effects were maintained at follow-up. FDI-parent was somewhat associated with protective and monitoring parent responses at baseline (p’s<.05), but only with protective responses at program end (p<.05). Child pain was not associated with parent responses. In conclusion, parent groups during intensive interdisciplinary pediatric pain rehabilitation may be an effective format to target parent responses to their child’s pain, and these effects are not solely explained by improvements in child disability or pain.