Efficacy of psychosocial group intervention for children with chronic illness and their parents: a multicentre randomized controlled trial

Abstract

s ingediend voor het Amsterdam Kindersymposium 2013 105 Efficacy of psychosocial group intervention for children with chronic illness and their parents: a multicentre randomized controlled trial L Scholten, MSc (1), AM Willemen, PhD (2), BF Last, PhD (1,2), H Maurice-Stam, PhD (1), EM van Dijk, MSc (3), E Ensink, MSc (4), N Zandbelt, MSc (5), A.van der Hoop-Mooij,MSc (6), C Schuengel, PhD (2), MA Grootenhuis, PhD (1) (1) Emma Children’s Hospital Academic Medical Center Amsterdam, Psychosocial Department (2) VU University Amsterdam, Department of Clinical Child and Family Studies, and EMGO Institute for Health and Care Research (3) VU Medical Center, Department of Medical Psychology, Section of Pediatric Psychology, Amsterdam (4) Radboud University Medical Center, Nijmegen (5) Children’s Clinic/De Kinderkliniek, Almere 6 Admiraal de Ruijter Hospital, Goes INTRODUCTION To adequately prevent children with a chronic illness from developing psychosocial problems, evidenced based intervention programs are needed. The objective of this study is to investigate the effi cacy of a preventive cognitive-behavioral group intervention for children with chronic illnesses, and to test the eff ect of an added parent component. METHODS Children (n = 194) and their parents participated in a multicenter randomized clinical trial comparing a child-only intervention and a parent-child intervention to a wait-list control group. Primary outcomes were parentand self-reported internalizing and externalizing problems; secondary outcomes were child disease-related coping skills (information seeking, relaxation, social competence, medical compliance, and positive thinking). Assessments took place at baseline, and at 6-month and 12-month follow-ups. Intention-to-treat mixed-model analyses were performed to test the diff erence in change in outcomes. RESULTS The intervention had a positive eff ect on changes in parent-reported internalizing problems, child-reported externalizing problems, information seeking, social competence, and positive thinking. The additional eff ect of parental involvement was observed on parent-reported internalizing problems, child-reported externalizing problems, information seeking, and social competence. Illness severity and illness type did not moderate the eff ects. Of the families in the wait-list control group, 74% sought alternative psychological support during the intervention period. CONCLUSION This RCT supports the effi cacy of a protocol-based group intervention for children with chronic illnesses and their parents. Adding a parental component to the intervention contributed to the persistence of the eff ects. Future research should focus on moderating and mediating eff ects of the intervention.