Multi-Family Pediatric Pain Group Therapy: Capturing Acceptance and Cultivating Change.

Samantha Huestis,Austin Hilliard,Brenda Golianu,Grace Kao,Rashmi Bhandari,Isabel Yoon,Ashley Dunn

doi:10.3390/children4120106

Samantha Huestis, Austin Hilliard + Show 5 more

Open Access

https://doi.org/10.3390/children4120106

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Abstract

Behavioral health interventions for pediatric chronic pain include cognitive-behavioral (CBT), acceptance and commitment (ACT), and family-based therapies, though literature regarding multi-family therapy (MFT) is sparse. This investigation examined the utility and outcomes of the Courage to Act with Pain: Teens Identifying Values, Acceptance, and Treatment Effects (CAPTIVATE) program, which included all three modalities (CBT, ACT, MFT) for youth with chronic pain and their parents. Program utility, engagement, and satisfaction were evaluated via quantitative and qualitative feedback. Pain-specific psychological, behavioral, and interpersonal processes were examined along with outcomes related to disability, quality of life, pain interference, fatigue, anxiety, and depressive symptoms. Participants indicated that CAPTIVATE was constructive, engaging, and helpful for social and family systems. Clinical and statistical improvements with large effect sizes were captured for pain catastrophizing, acceptance, and protective parenting but not family functioning. Similar effects were found for functional disability, pain interference, fatigue, anxiety, and depression. Given the importance of targeting multiple systems in the management of pediatric chronic pain, preliminary findings suggest a potential new group-based treatment option for youth and families. Next steps involve evaluating the differential effect of the program over treatment as usual, as well as specific CBT, ACT, and MFT components and processes that may affect outcomes.

Highlights

Pediatric chronic pain is a multifactorial experience that impacts psychological, behavioral, and physical functioning and occurs within a larger ecological system [1]
The project was designed for youth 13–17 years old and their caregivers recently evaluated by or in treatment at the outpatient Pediatric Pain Management Clinic
A pain psychologist recruited twelve families (67%) after they reported a goal to connect with and learn from other youth and families living with chronic pain

Summary

Introduction

Pediatric chronic pain is a multifactorial experience that impacts psychological, behavioral, and physical functioning and occurs within a larger ecological system [1]. Chronic pain treatment may warrant attention to multiple systems—and perhaps, so, when youth are feeling isolated within the very systems meant to provide them with support. Introduced coping tools and strategies for managing feelings and discomfort. Introduced more adaptive ways of thinking about management of discomfort. Introduced ACT as an intervention that aims to increase psychological acceptance and flexibility, and its six core principles, including cognitive defusion. Reviewed mindfulness techniques emphasizing attention on an immediate experience and feelings of openness and acceptance. Discussed solely seeking to control and/or avoid pain versus choosing to pursue a valued, meaningful life

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