Family-based cognitive-behavioral pain intervention involving guided imagery

The most common complication of sickle cell disease (SCD) is the acutepainful episode. The effectiveness of nonpharmacologic pain interventions indecreasing reports of pain has been documented in other pediatric populations. However, there is a paucity of intervention research conducted with SCD populations. Thus, the goal of the present study was to implement a standardized, family-based cognitive-behavioral pain intervention for children with SCD. A three-session intervention involving guided imagery was used with 16 (8 in the intervention group, 8 in the waitlist group) school-aged children (Mean age = 14.00, SD = 2.68) with SCD. It was hypothesized that the intervention group would exhibit decreased medical contacts and report of pain, and improved quality of life when compared to the waitlist group. A repeated measures analysis of variance, however, revealed no significance for between group differences. There was a significant reduction in medical contacts and report of pain over time, regardless of group (intervention or waitlist). Quality of life was average for both groups and was stable over time. In addition, it was hypothesized that utilization and engagement in the guided imagery would be related to the outcome of the intervention. However, correlations showed no significance for the relationship between utilization and engagement in the intervention and the outcome measures. Treatment adherence was variable ; the overall adherence rate for participation in the intervention was 56%. When participants did practice, they gave high ratings of enjoyment and helpfulness. They were also able to engage in the guided imagery, which increased over time. In addition, caregiver participation was inconsistent, which may have contributed to the adherence issues. Follow-up analyses of treatment fidelity and psychosocial functioning suggest that the delivery of the intervention and family functioning and coping may have impacted the outcome of the intervention. Limitations of the present study included small sample size, recruitment issues, high dropout rates, and other methodological issues (i.e. measures, design of intervention), which all played a part in the outcome of the intervention. Information gained from this study is beneficial in addressing and developing pain interventions for children with sickle cell disease.Ph.D., Clinical Psychology -- Drexel University, 200