Group Counseling for Children with Chronic Illness Is Effective

. . . and the benefits are enhanced when parents participate.

Children with chronic illness often experience painful medical procedures, restriction of activities, and adverse effects on academic achievement and social competency. Treatments designed to help children cope with psychosocial stresses of specific chronic illnesses have been reported but with limited long-term outcomes. Researchers in the Netherlands tested the efficacy of group cognitive behavioral therapy (CBT) in 194 children (age range, 8–18 years) with type 1 diabetes (35%), kidney disease (16%), autoimmune disease (11%), asthma (7%), or other chronic illnesses. Study participants were randomized to receive a child-only CBT intervention (4–8 children/group), the child CBT intervention plus a parallel parent intervention, or a wait-list control. The intervention groups met for 6 weekly 90-minute sessions led by a psychologist who used CBT methods to teach coping strategies (seeking and giving information about the disease, using relaxation techniques, knowledge of complications and self-management, social competence skills, and positive thinking).

Based on standardized online questionnaires for behavior and disease-coping skills at 6 and 12 months, the CBT intervention had a significant and positive effect on parent-reported internalizing symptoms (e.g., anxiety and depression), child-reported externalizing problems (e.g., hyperactivity and aggression), information seeking, social competence, and positive thinking. The addition of the parent intervention was associated with greater improvements in most outcomes. Type and severity of illness did not modify these effects. The intervention did not change child-reported internalizing problems, parent-reported externalizing problems, relaxation, or medical compliance.

CITATION(S):

Scholten L et al. Efficacy of psychosocial group intervention for children with chronic illness and their parents. Pediatrics 2013 Apr; 131:e1196.