Psychosocial Intervention for Children with IBD

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DESCRIPTION (provided by applicant): Inflammatory Bowel Disease (Crohn's and ulcerative colitis; IBD), a serious medical condition that affects children and adolescents, is often associated with high rates of health care utilization and disability, including school absence. While psychosocial factors are not believed to cause IBD, research suggests they may increase illness-related dysfunction. Prior studies from our group suggest that response to chronic illness is, in part, acquired during childhood through social learning processes and may be modified with psychosocial interventions. Although encouraging results of such interventions have been seen in patients with less severe conditions, well-designed trials of such interventions for children with IBD are lacking. The aim of the proposed study is to conduct a randomized controlled trial comparing social learning and cognitive behavior therapy (SLCBT) to an education and support condition (ES). 180 children with IBD will be recruited and followed for 12 months. It is hypothesized that SLCBT participants, compared to those in the ES condition, will, at one-year follow-up 1) exhibit greater decreases in IBD symptoms, medical visits for IBD, and functional disability, and greater increases in quality of life; 2) demonstrate greater use of cognitive coping, relaxation and stress management skills, and their parents will demonstrate greater reductions in maladaptive responses to illness behavior; and 3) exhibit greater reductions in anxiety, depression, and somatization. Secondary objectives are to investigate whether other variables, e.g., child age, gender, medical care and psychosocial variables such as social and academic competence, moderate treatment effects, and explore differences between the two groups in hospitalizations and surgeries for IBD, as well as general illness behavior. Data on children's symptoms, illness behaviors, functional disability, health care utilization, parental responses to children's illness behavior, beliefs regarding pain, and life stressors will be collected at baseline, post-treatment, and 3, 6, and 12 months post-treatment from parents and children. Results may lead to innovative interventions for IBD and other chronic childhood medical conditions.