Parent training through the comfort ability program for pediatric chronic pain management: Self-reported expectations and outcomes.

Abstract

Objective: Targeted parent interventions are known to improve outcomes in pediatric pain, but systematic delivery of this type of training for parents is a challenge. The Comfort Ability Program (CAP) is a well-established, manualized intervention, delivered in a single-day intensive workshop format that includes 6 hr of parent training. The primary goal of this article is to systematically evaluate the impact of the parent training arm of this program on parent expectations and outcomes. Method: A sample of parents who attended CAP (n = 130) and a control sample (n = 74) completed self-report questionnaires at baseline, 30, and 90 days after baseline. Separately, a sample of parents attending CAP (n = 537) completed quality improvement (QI) assessments evaluating pretreatment expectations and posttreatment perceived benefits. Results: Preliminary linear mixed model analysis indicate parents who attended CAP demonstrated significant reductions in pain catastrophizing (PCS; b-estimate = -2.57, SE = 1.1, p , .05) and improvements in pain self-efficacy (PSES, b-estimate = À2.14, SE = .63; p , .01) as compared with controls. Parent over protectiveness (ARCS) and parent-report of child pain severity (PPST) did not differ between groups. Coding of parents' qualitative assessments suggest that parents who attend CAP are actively seeking skills-based training. Postintervention, parents report immediate benefit from an array of program-specific targets, including how to construct a plan for a child's return to function, social support, and pain neuroscience education. Conclusion: Parents who attend CAP demonstrate significant changes in research-identified parenting practices over time as compared to controls. Additionally, parent report of posttreatment benefit extends beyond pretreatment expectations (i.e., skills training) to include social support and pain education.

Learning, Hope, and Empowerment

“…The results of this thematic analysis indicated that there is a unique value of group programming for parents, which provides a benefit that may not be felt within individually delivered programming. Further, the benefits of a single-session parent group intervention have been reported, 7 and there have also been benefits of this 5-week group delivered to parents both in-person and virtually 9,16 . Thus, while the optimal “dose” of parent intervention is not yet clear, this decision may depend on the aim and purpose of the intervention.…”

“…Treatment satisfaction after a parent intervention has been commonly assessed, 6 although most of these outcomes were quantitatively measured (eg, via rating scales). A few studies have assessed parent feedback via questionnaires with open-ended questions for a self-guided intervention designed for youth and parents 10 and single session, in-person group interventions 7,11 . In a scoping review of the literature, only 1 study was found, which used semistructured interviews to assess parent treatment satisfaction 12 .…”

Evolution of parent-targeted interventions for pain-predominant disorders of gut–brain interactions: Research and clinical practice considerations.

“…Since the systematic review by Law et al (2019), two additional studies have been identified (Burns et al, 2023; Lee et al, 2021), which both evaluate a parent-targeted intervention that was implemented while children and adolescents were participating in a separate intervention. Lee et al (2021) described the development of a parent-targeted group intervention for parents of children being treated through an interdisciplinary pediatric chronic pain clinic.…”

“…Impact on child behaviors or symptoms was not measured. Burns et al (2023) evaluated the specific impact of the parent-targeted intervention delivered in a single-day intensive 6-hr format focusing on education, skills training, and social support. Treatment results demonstrated improvements in parents’ pain catastrophizing and child’s pain self-efficacy compared to controls.…”

“…Clinically, parent-targeted interventions may offer both practical and emotional benefits, particularly when offered separate from patient-targeted interventions. Parents have reported emotional benefits in working directly with a psychologist on their child’s functional pain, including validation, support, and emotional containment (Burns et al, 2023). The ability to speak openly about parenting-specific or adult-oriented material provides additional value to parent-only targeted interventions.…”