Article

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

ABSTRACT 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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    • "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 · 0.55 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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    ABSTRACT: INTRODUCTION: To provide an overview of factors related to recruitment of adolescents and young adults (AYA) into research and recruitment rates and reasons for refusal from a multicenter study entitled "Stories and Music for Adolescent/Young Adult Resilience during Transplant" (SMART). METHODS: A randomized clinical trial study design was used. The settings included 9 hospitals. The sample included AYAs (aged 11-24 years) who were undergoing a stem cell transplant. Several instruments were used to measure symptom distress, coping, resilience, and quality of life in AYA with cancer. RESULTS: A total of 113 AYA were recruited (50%) for this study. Strategies were refined as the study continued to address challenges related to recruitment. We provide a description of recruitment strategies and an evaluation of our planning, implementing, and monitoring of recruitment rates for the SMART study. DISCUSSION: When designing a study, careful consideration must be given to factors influencing recruitment as well as special considerations for unique populations. Dissemination of strategies specific to unique populations will be helpful to the design of future research studies.
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