Mentally Managing a Child's Illness

Children with chronic illnesses benefited emotionally from cognitive behavioral therapy

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) A child with a chronic illness can present a variety of hardships in a family. However, seeking therapy can reduce the mental health challenges these families face.

A recent study looked at whether a cognitive behavioral therapy program benefited children with chronic illnesses and their parents.

The researchers found that the program did help improve the mental health of the kids and their parents.

The children tended to act out less, and the parents had improvements in their symptoms related to depression and anxiety.

"Seek therapy in difficult times."

The study, led by Linde Scholten, MSc, of the Psychosocial Department at Emma Children’s Hospital Academic Medical Center in Amsterdam, the Netherlands, tested whether a therapy program could help children suffering from chronic illnesses such as asthma, diabetes, or arthritis.

The researchers included 194 children and their parents in a clinical trial at multiple centers to test the cognitive behavioral therapy program.

Cognitive behavioral therapy is a type of treatment where a person is taught to recognize their feelings and thought patterns and then retrain themselves to have healthier thought patterns and behaviors.

The researchers split the families randomly into three groups. One group only included therapy for the children. Another group included therapy for the parents and the child.

The third group was placed on a waiting list to receive therapy later and did not receive any therapy during the course of the study. Most of these families (74 percent) sought out their own forms of psychological support during the course of the trial.

The researchers were specifically investigating the effects of the therapy programs on the children's and adult's internalizing and externalizing problems.

Externalizing problems refer to behavior issues like acting out, aggression, rule-breaking and hyperactivity. Internalizing refer to issues like depression, anxiety and antisocial behavior.

The researchers also looked at the coping skills of the children in terms of how they dealt with their disease. These kinds of coping skills include seeking out information about their condition, relaxation, positive social interactions, complying with medical treatments and positive thinking.

The researchers evaluated all these emotional, social and psychological areas in the families at the start of the trial and then at 6 months and 12 months later.

The children in all three groups improved their coping skills in general during the trial as time went by.

In the group where the children alone received cognitive behavioral therapy, the researchers saw an improvement in the depression, anxiety and other internalizing symptoms reported by the parents.

The children also had decreases in their internalizing issues during the trial, but as time went by after the therapy, these children's internalizing issues tended to increase again whereas the children in the parent-involved group and in the wait-list group continued to see decreases in their internalizing problems.

The group with children only receiving therapy did, however, see lasting improvements on their externalizing problems (acting out, etc.) and on their desire to seek out information on their condition, their social skills and their positive thinking.

These positive effects of therapy were also seen in the group where the child received therapy with a parents' involvement in the treatment. The decrease in externalizing problems was also seen in the wait-list group.

The therapy in either group did not seem to have an effect on the child's internalizing issues, such as anxiety or depression symptoms. It also did not have an impact on the parents' externalizing issues, their ability to find relaxation or their willingness to follow medical treatment instructions.

When the researchers took into account the different types of illnesses the children had and the severity of the illnesses, these differences did not appear to matter in terms of how effective the therapy was.

The researchers concluded that the cognitive behavioral therapy program does appear to have positive effects for children with chronic illnesses and their parents.

"Adding a parental component to the intervention contributed to the persistence of the effects," the researchers wrote. This means the positive effects of the therapy lasted a bit longer when a parent was involved.

The study was published March 11 in the journal Pediatrics. The research was funded by a grant from The Netherlands Organization for Health Research and Development. The authors declared no conflicts of interest.

Reviewed by: 
Review Date: 
March 10, 2013
Last Updated:
March 11, 2013