Parent Training Through the Comfort Ability Program for Pediatric Chronic Pain Management: Self-Reported Expectations and Outcomes

Abstract

Objective:

Targeted parent interventions are known to improve outcomes in pediatric pain, but systematic delivery of this type of training for parents is a challenge. The Comfort Ability Program (CAP) is a well-established, manualized intervention, delivered in a single-day intensive workshop format that includes 6 hr of parent training. The primary goal of this article is to systematically evaluate the impact of the parent training arm of this program on parent expectations and outcomes.

Method:

A sample of parents who attended CAP (n = 130) and a control sample (n = 74) completed self-report questionnaires at baseline, 30, and 90 days after baseline. Separately, a sample of parents attending CAP (n = 537) completed quality improvement (QI) assessments evaluating pretreatment expectations and posttreatment perceived benefits.

Results:

Preliminary linear mixed model analysis indicate parents who attended CAP demonstrated significant reductions in pain catastrophizing (PCS; β-estimate = -2.57, SE = 1.1, p < .05) and improvements in pain self-efficacy (PSES, β-estimate = −2.14, SE = .63; p < .01) as compared with controls. Parent over protectiveness (ARCS) and parent-report of child pain severity (PPST) did not differ between groups. Coding of parents’ qualitative assessments suggest that parents who attend CAP are actively seeking skills-based training. Postintervention, parents report immediate benefit from an array of program-specific targets, including how to construct a plan for a child’s return to function, social support, and pain neuroscience education.

Conclusion:

Parents who attend CAP demonstrate significant changes in research-identified parenting practices over time as compared to controls. Additionally, parent report of posttreatment benefit extends beyond pretreatment expectations (i.e., skills training) to include social support and pain education.

Implications for Impact Statement

Psychologically-based parent skills training and pain education are an essential part of a child’s recovery from chronic pain, but there are many system and patient-level barriers preventing access to such treatment. The Comfort Ability Program (CAP), a brief, manualized intervention for adolescents with chronic pain and their parents, was created specifically to address these barriers to care. This study, including quantitative and qualitative data, finds that parents who completed CAP make positive and lasting changes in how they think about their child’s chronic pain and report benefits from the specific research-supported targets of treatment including skills training, pain education, and social support.