Treatment of Posttraumatic Stress Symptoms in Adolescent Survivors of Childhood Cancer and Their Families: A Randomized Clinical Trial.

Department of Pediatrics, The Children's Hospital of Philadelphia, The University of Pennsylvania, Philadelphia, PA 19104-4399, USA.
Journal of Family Psychology (Impact Factor: 1.89). 10/2004; 18(3):493-504. DOI: 10.1037/0893-3200.18.3.493
Source: PubMed


Posttraumatic stress symptoms (PTSS), particularly intrusive thoughts, avoidance, and arousal, are among the most common psychological aftereffects of childhood cancer for survivors and their mothers and fathers. We conducted a randomized wait-list control trial of a newly developed 4-session, 1-day intervention aimed at reducing PTSS that integrates cognitive-behavioral and family therapy approaches--the Surviving Cancer Competently Intervention Program (SCCIP). Participants were 150 adolescent survivors and their mothers, fathers, and adolescent siblings. Significant reductions in intrusive thoughts among fathers and in arousal among survivors were found in the treatment group. A multiple imputations approach was used to address nonrandom missing data and indicated that treatment effects would likely have been stronger had more distressed families been retained. The data are supportive of brief interventions to reduce PTSS in this population and provide additional support for the importance of intervention for multiple members of the family.

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    • "Family problem-solving interventions in pediatric diabetes (Wysocki et al., 2006), childhood traumatic brain injury (Wade, Walz, Carey, & Williams, 2009), asthma (Seid, Varni, Gidwani, Gelhard, & Slymen, 2010), and pediatric pain (Palermo, Law, Essner, Jessen-Fiddick, & Eccleston, 2014) have found significant improvements in psychosocial functioning (adherence , self-management, and HRQL, respectively). The pediatric literature also reports the potential efficacy of brief, family problemsolving methods (Kaslow et al., 2000; Kazak et al., 2004; Sahler et al., 2005). Although mechanisms of change have not been formally explored in prior studies, we hypothesized that by improving family problem-solving skills to address school-related challenges that child HRQL and academic outcomes may improve. "
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    ABSTRACT: Objective: Tested a family-based group problem-solving intervention, "Families Taking Control," (FTC) to improve school functioning and health-related quality of life (HRQL) for children with sickle cell disease. METHOD: Children and caregivers completed questionnaires assessing HRQL and school functioning and children completed performance-based measures of IQ and achievement at baseline and 6 months later. Families were randomized to the intervention (FTC, n = 42) or delayed intervention control (DIC, n = 41) group. FTC involved a full-day workshop followed by 3 booster calls. RESULTS: There were no differences between FTC completers (n = 24) and noncompleters (n = 18). FTC group (n = 24) and DIC group (n = 38) did not differ significantly on primary outcomes at follow-up: number of formal academic and disease-related accommodations, individualized education plan/504 service plan, school absences, school HRQL, or academic skills. CONCLUSIONS: Although families found FTC to be acceptable, there were no intervention effects. Challenges of the trial and implications for future research are discussed.
    Journal of Pediatric Psychology 06/2015; DOI:10.1093/jpepsy/jsv063 · 2.91 Impact Factor
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    • "Reported reasons for parents to decline their AYA's involvement in studies have included: (a) risk of randomization to an undesired treatment group (Bleyer et al., 2006; Hinds et al., 2000); (b) inconvenience of participation (Harth, 1995; Hayman, Taylor, Peart, Galland, & Sayers, 2001; Hinds et al., 2002; Kazak et al., 2004); (c) safety concerns (Caldwell, Butow, & Craig, 2003; Harth, 1995; Hayman et al., 2001); and (d) potential adverse effects of proposed treatments (Bowman, Vidsten, Kogner, & Samuelsson, 2004; Hendricks-Ferguson, 2006). Also, AYA decline participation because of: (a) lack of interest or perceived benefit (Gattuso et al., 2006; Hinds et al., 2002; Ruffin & Baron, 2000); (b) symptom distress (Crowley & Casarett, 2003; Gattuso et al., 2006; Hendricks- Ferguson, 2006; Hinds et al., 2000; Kyngas et al., 2001); (c) engagement in other activities, such as homework or video games (Ward-Smith, Hamlin, Bartholomew, & Stegenga, 2007); and (d) not wanting to revisit their cancer experience (Kazak et al., 2004). "
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    • "22.22% obtained mixed results (significant changes in some adjustment measures, but not in others) (Kazak et al., 2004; Svavardottir & Sigurdardortti, 2005) and 33.33% produced no effects (Hoekstra-Weebers et al. 1998; Drotar & Schwartz, 2004; Streisand et al., 2000). Unlike the results with children's interventions, 33.33% of parents´RCTs (6 studies) showed that these treatments were effective in achieving their objectives (Kazak et al., 2005; Sahler et al., 2005), while 16.7% produced mixed results (Kazak et al. 2004) and 50% did not yield any therapeutic benefits (Hoekstra-Weebers et al., 1998, Schwartz & Drotar, 2004; Streisand et al., 2000). The two " effective " treatments had the intention of reducing posttraumatic stress and emotional symptoms on parents of newly diagnosed children. "
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    ABSTRACT: This article aims at providing a general overview of psychological interventions intended to promote psychological adjustment of children with cancer and their parents. To achieve this goal, we reviewed published articles between 1998-2010, using a combination of the following keywords: psychosocial intervention, psychotherapy, trial, treatment, adjustment, well-being, adaptation, cancer, childhood cancer, pediatric cancer, anxiety and depression in the electronic databases: Psycinfo, Medline, Scielo, Lilacs, Psicodoc and Psyarticles. Fourteen articles were found and analyses show that most interventions had some efficacy in the psychological adjustment of children and their parents; nevertheless, there is a limited number of treatments that can in fact be considered effective. The convenience of psychological interventions is discussed and how they must comprehend strengths and the promotion of psychological health and should not be based solely on deficits and psychopathological models. Possibly, this re-orientation will help fostering significant clinic changes regarding the stress associated to cancer and its treatment.
    Anales de Psicología 01/2014; 30(1):93-103. DOI:10.6018/analesps.30.1.149161 · 0.50 Impact Factor
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