Promoting Resilience in Stress Management: A Pilot Study of a Novel Resilience-Promoting Intervention for Adolescents and Young Adults With Serious Illness

Abstract

The PRISM intervention is feasible and well-accepted by AYAs with cancer or T1D. Differences in patient populations warrant differences in approach.

Stress and A1c Among People with Diabetes Across the Lifespan

“…Stressors related to limited financial resources or insurance coverage or exposure to serious psychosocial adversity (e.g., abuse, psychiatric disorders) may also be more appropriately treated by providers with expertise and resources in those specific domains (e.g., social work, case management, clinical psychology). Among youth with T1D, pilot data suggest that a more generalized approach to stress management focusing on general (not disease-specific) stress management skills (e.g., relaxation, goal-setting, cognitive restructuring) may have the potential to also impact clinical outcomes such as self-management behaviors and glycemic control [83]. More research is needed to determine whether general stress interventions are most effective prior to, in combination with, or in place of diabetes-specific interventions to target general and diabetes-related stress, for whom, and in what circumstances.…”

Promoting Resilience in Stress Management for Parents (PRISM-P): An intervention for caregivers of youth with serious illness.

“…The original development of the PRISM intervention for AYAs is described elsewhere (Rosenberg, et al, 2015). In short, four pillars of teachable skills linked with bolstering individual resilience resources emerged from a comprehensive review of theoretical models of resilience and direct stakeholder interviews (Bradshaw et al, 2007; Carver, 2005; Fjorback, Arendt, Ornbøl, Fink, & Walach, 2011; Lyon et al, 2009; McCarty, et al, 2011; Tan & Martin, 2012).…”

“…The “Promoting Resilience in Stress Management” (PRISM) intervention was originally developed by our team for adolescents and young adult (AYA) patients with serious illness (Rosenberg et al, 2015). Briefly, the intervention is based on established theories such as stress and coping theory which highlights maintenance of well-being during serious illness through building of resources (Folkman & Greer, 2000), and adapted from successful interventions among cancer, and general adolescent and parent populations (Carver, 2005; Henry, Cohen, Lee, Sauthier, Provencher, Drouin et al, 2010; McCarty, Violette, & McCauley, 2011; Sahler, Dolgin, Phipps, Fairclough, Askins, Katz, et al, 2013).…”

“…PRISM’s feasibility and acceptability was first established among AYAs with cancer and T1D (Rosenberg et al, 2015). A primary request from both patients and their parents was a PRISM for parents.…”

Should Clinicians Intervene If They Suspect That a Caregiver Whose Child Has Cancer Is at Risk of Psychological Harm?

“…It is therefore even more difficult to intentionally promote [26]. However, some pediatric oncology researchers have begun to test interventions to encourage the development of resilience in parents and caregivers (as well as patients) and have suggested a role for health care professionals in promoting resilience by offering psychosocial supportive care and optimizing communication and decision-making support [27,28]. Resilience is associated with several positive psychosocial outcomes, including post-traumatic growth, benefit-finding, and lack of psychological distress [27].…”