1*School of Social Work, University of Washington, Seattle, Washington; †Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina; ‡Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, Washington; §Department of Pediatrics, Vanderbilt University, Nashville, Tennessee; ‖Department of Oral Health Sciences, University of Washington, Seattle, Washington; ¶School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin; **Department of Gastroenterology, Seattle Children's Hospital, Seattle, Washington; ††Prime Health Clinic, Federal Way, Washington; ‡‡St. Charles Health System, Bend, Oregon; §§HealthPoint, Bothell, Washington; and ‖‖Alcohol and Drug Abuse Institute, University of Washington, Seattle, Washington.
Studies testing the efficacy of behavioral interventions to modify psychosocial sequelae of inflammatory bowel disease in children are limited. This report presents outcomes through a 6-month follow-up from a large randomized controlled trial testing the efficacy of a cognitive behavioral intervention for children with inflammatory bowel disease and their parents.
One hundred eighty-five children aged 8 to 17 years with a diagnosis of Crohn's disease or ulcerative colitis and their parents were randomized to one of two 3-session conditions: (1) a social learning and cognitive behavioral therapy condition or (2) an education support condition designed to control for time and attention.
There was a significant overall treatment effect for school absences due to Crohn's disease or ulcerative colitis (P < 0.05) at 6 months after treatment. There was also a significant overall effect after treatment for child-reported quality of life (P < 0.05), parent-reported increases in adaptive child coping (P < 0.001), and reductions in parents' maladaptive responses to children's symptoms (P < 0.05). Finally, exploratory analyses indicated that for children with a higher level of flares (2 or more) prebaseline, those in social learning and cognitive behavioral therapy condition experienced a greater reduction in flares after treatment.
This trial suggests that a brief cognitive behavioral intervention for children with inflammatory bowel disease and their parents can result in improved child functioning and quality of life, and for some children may decrease disease activity.