Any parent whose child has a chronic or life-threatening illness will attest to the fact that it can be a worrying, stressful and exhausting journey.
Parents can struggle to juggle caring for their child with work, social and other commitments. This can lead to parents suffering from mental health problems themselves, in addition to the pain and psychological distress that can accompany chronic childhood conditions such as cancer, diabetes, asthma, traumatic brain injury, inflammatory bowel diseases, skin diseases or gynaecological disorders.
A new systematic review from the Cochrane Pain, Palliative and Supportive Care Group looks at the effectiveness of psychological therapies that include coping strategies for parents of children/adolescents with chronic illnesses. The review looks at the impact that talking treatments can have on the child and the parents.
The reviewers conducted a systematic search and found 35 RCTs involving a total of 2,723 participants.
They analysed the data in two main ways:
- By medical condition (immediately post-treatment and the first available follow-up)
- By treatment class (cognitive behavioural therapy, family therapy, problem solving therapy and multi-systemic therapy) across all medical conditions at two time points (immediately post-treatment and the first available follow-up
The outcomes of interest were:
- Parent behaviour
- Parent mental health
- Child behaviour/disability
- Child mental health
- Child symptoms
- Family functioning
Here’s what they found:
- Children with painful conditions had fewer symptoms immediately post-treatment if they and their parents had been given a psychological therapy together
- Across all medical conditions:
- Cognitive behavioural therapy significantly improved child symptoms
- Problem solving therapy significantly improved parent behaviour and parent mental health immediately post-treatment
The overwhelming majority of evidence included in this review focuses on CBT (19 of the 35 trials found).
The reviewers described the quality of the evidence they found as ‘adequate’. They highlighted that many of the studies are short with small sample sizes, have limited description of the treatments delivered and suffer from poor reporting of results.
A decent systematic review with a familiar refrain: “more good quality RCTs needed!”
Eccleston C, Palermo TM, Fisher E, Law E. Psychological interventions for parents of children and adolescents with chronic illness. Cochrane Database of Systematic Reviews 2012, Issue 8. Art. No.: CD009660. DOI: 10.1002/14651858.CD009660.pub2.