title: Efficacy of psychosocial group intervention for children with chronic illness and their parents.
abstract: OBJECTIVE
  To investigate the efficacy of a cognitive-behavioral group intervention for children with chronic illnesses and to test the effect of an added parent component.
  
  
  METHODS
  Children (n = 194) and their parents participated in a multicenter randomized clinical trial comparing a child-only intervention and a parent-child intervention to a wait-list control group. Primary outcomes were parent- and self-reported internalizing and externalizing problems; secondary outcomes were child disease-related coping skills (information seeking, relaxation, social competence, medical compliance, and positive thinking). Assessments took place at baseline and at 6- and 12-month follow-ups. Intention-to-treat mixed-model analyses were performed to test the difference in change in outcomes.
  
  
  RESULTS
  The intervention had a positive effect on changes in parent-reported internalizing problems, child-reported externalizing problems, information seeking, social competence, and positive thinking. The additional effect of parental involvement was observed on parent-reported internalizing problems, child-reported externalizing problems, information seeking, and social competence. Illness severity and illness type did not moderate the effects. There were no intervention effects on child-reported internalizing problems, parent-reported externalizing problems, relaxation, or medical compliance. Of the families in the wait-list control group, 74% sought alternative psychological support during the intervention period.
  
  
  CONCLUSIONS
  This RCT supports the efficacy of a protocol-based group intervention for children with chronic illnesses and their parents. Adding a parental component to the intervention contributed to the persistence of the effects. Future research should focus on moderating and mediating effects of the intervention.
authors.affiliation: Psychosocial Department, Emma Children's Hospital Academic Medical Center, Meibergdreef 9, Room A3-241, 1105 AZ Amsterdam, Netherlands. linde.scholten@amc.nl
authors.forename: Linde
authors.initials: L
authors.lastname: Scholten
authors.forename: Agnes M
authors.initials: AM
authors.lastname: Willemen
authors.forename: Bob F
authors.initials: BF
authors.lastname: Last
authors.forename: Heleen
authors.initials: H
authors.lastname: Maurice-Stam
authors.forename: Elisabeth M
authors.initials: EM
authors.lastname: van Dijk
authors.forename: Elske
authors.initials: E
authors.lastname: Ensink
authors.forename: Noortje
authors.initials: N
authors.lastname: Zandbelt
authors.forename: Aafke
authors.initials: A
authors.lastname: van der Hoop-Mooij
authors.forename: Carlo
authors.initials: C
authors.lastname: Schuengel
authors.forename: Martha A
authors.initials: MA
authors.lastname: Grootenhuis
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D002648:Child; D002653:Child Behavior Disorders / Q000209:etiology / Q000628:therapy*; D002908:Chronic Disease / Q000523:psychology*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D057194:Intention to Treat Analysis; D008297:Male; D015233:Models, Statistical; D010287:Parent-Child Relations; D011615:Psychotherapy, Group / Q000379:methods*; D057566:Self Report; D016896:Treatment Outcome