Do Mothers Benefit from a Child-Focused Cognitive Behavioral Treatment (CBT) for Childhood Functional Abdominal Pain? A Randomized Controlled Pilot Trial.

Claudia Calvano,Petra Warschburger,Martina Groß

doi:10.3390/children4020013

Abstract

While the efficacy of cognitive-behavioral treatment (CBT) approaches for childhood functional abdominal pain (FAP) is well-established for child outcomes, only a few studies have reported on parent-specific outcomes. This randomized controlled pilot trial analyzed effects of a group CBT on maternal variables (i.e., pain-related behavior, worries and self-efficacy, as well as general psychosocial strain). Methods: The sample constituted of 15 mothers in the intervention group (IG) and 14 mothers in the waitlist control group (WLC). Outcome measures were assessed pre-treatment, post-treatment and at three months follow-up. Results: Analyses revealed significant, large changes in maladaptive maternal reactions related to the child’s abdominal pain in the IG compared to the WLC—i.e., reduced attention (d = 0.95), medical help-seeking (d = 0.92), worries (d = 1.03), as well as a significant increase in behaviors that encourage the child’s self-management (d = 1.03). In addition, maternal self-efficacy in dealing with a child’s pain significantly increased in the IG as well (d = 0.92). Treatment effects emerged post-treatment and could be maintained until three months follow-up. There were no effects on general self-efficacy and maternal quality of life. Conclusion: While these results are promising, and underline the efficacy of the CBT approach for both the child and mothers, further studies, including long-term follow-ups, are warranted.

Highlights

Functional abdominal pain (FAP) is very prevalent in childhood [1], highly impairing [2]and persistent when untreated [3]
There were no missing data, except for the one dropout, and 14/15 randomized mothers in the intervention group (IG) participated in the parent session
This paper aimed to analyze whether any effects on the mothers of children suffering from FAP were noticeable, after participation in a group cognitive-behavioral treatment (CBT) focusing on their child’s self-management

Summary

Introduction

Functional abdominal pain (FAP) is very prevalent in childhood [1], highly impairing [2]and persistent when untreated [3]. Literature suggests that parents often influence a child’s coping and course of abdominal pain [8,9] a parent‘s reaction when the child experiences pain can be pivotal. This is especially true for parental protective behaviors, such as excusing the child from school or household chores and increased attention when their child is in pain—which are often seen as maladaptive behaviors—and can be associated with a child’s impairment [10,11,12] and increased healthcare use due to abdominal pain [13].

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Conclusion