Researchers from the Netherlands reported that cognitive-behavioral therapy with a parental support component was successful in reducing internalizing and externalizing problems in children with chronic illnesses, and that the effects of this intervention persisted over time.
The new approach added parental support to a standardized, child-only intervention named Op Koers, or “On Track,” which was designed to teach cognitive-behavioral skills to heterogeneous groups of children with chronic illnesses ranging from asthma to diabetes.
Linde Scholten, MSc, of Emma Children’s Hospital Academic Center in Amsterdam, and colleagues compared the efficacy of the parent-involvement intervention with the child-only intervention and a wait-list control group. A total of 194 Dutch children aged 8 to 18 years and their parents participated in the study.
Both interventions consisted of six weekly 90-minute sessions, followed by a booster session 6 months later. The following coping strategies were taught to each intervention group:
- Seeking and giving information about the disease.
- Relaxation techniques.
- Knowledge of self-management and medical compliance.
- Social competence.
- Positive thinking.
For the parent-involvement intervention, parents were asked to attend to their child’s needs and encourage them to use the coping skills taught during the sessions.
The parent-involvement intervention was significantly associated with a reduction in parent-reported internalizing problems over time (P=.018). Internalizing problems in children assigned to the child-only intervention increased again between 6 and 12 months (P=.034), but the parent-involvement intervention and wait-list groups saw internalizing problems continue to decrease (P=.025). However, the parent-involvement intervention had no significant effect on parent-reported externalizing problems.
The parent-reported intervention also had no significant effect on child-reported internalizing problems, but the new approach did have a greater effect in reducing child-reported externalizing problems vs. the child-only intervention (P=.027).
In terms of coping skills, the parent-involvement intervention was associated with improvements in information seeking, social competence and positive thinking.
“Adjustment to chronic illness can be promoted by teaching disease-related coping skills in a group intervention using cognitive behavioral techniques,” Scholten told Psychiatric Annals. “Parental involvement in the intervention is necessary to achieve long term effects.”
Disclosure: Scholten reports no relevant financial disclosures.