Development and pilot testing of the treatment and education approach for childhood-onset lupus (TEACH): a cognitive behavioral treatment

• Published in: Pediatric Rheumatology 2019-02, Vol.17 (1), p.9-9, Article 9
• Main Authors: Cunningham, Natoshia R, Fussner, Lauren M, Moorman, Erin, Avar Aydin, Pinar O, Brunner, Hermine I, Kashikar-Zuck, Susmita
• Format: Article
• Language: English
• Subjects: Adolescent; Anxiety; Anxiety - etiology; Arthritis; Behavior modification; Behavioral medicine; Care and treatment; Child development; Childhood; Childhood-onset; Children; Children & youth; Chronic illnesses; Clinical trials; Cognitive behavioral therapy; Cognitive behavioral therapy (CBT); Cognitive Behavioral Therapy - methods; Depression - etiology; Depressive symptoms; Education; Fatigue; Fatigue - etiology; Feasibility Studies; Female; Fibromyalgia; Humans; Intervention; Lupus; Lupus erythematosus; Lupus Erythematosus, Systemic - therapy; Mental depression; Methods; Pain; Pain - etiology; Pain management; Pain Measurement; Patient education; Pediatric research; Pediatrics; Quantitative psychology; Rheumatology; Sickle cell disease; Stress (Psychology); Stress, Psychological - etiology; Systematic review; Systemic lupus erythematosus; Teenagers; Testing; Treatment Outcome; United States; Young Adult; Young adults; Youth
• ISSN: 1546-0096; 1546-0096
• DOI: 10.1186/s12969-019-0307-8

To develop and test the feasibility and initial effectiveness of the Treatment and Education Approach for Childhood-onset Lupus (TEACH) protocol, a 6-session cognitive behavioral therapy (CBT) intervention for adolescents and young adults (AYA) with childhood-onset systemic lupus erythematosus (cSLE). Females with cSLE (n = 14; ages 13-19 years, M = 16.21 years) presenting to a pediatric rheumatology clinic subsequently completed the protocol, which was iteratively modified based on participant/interventionist feedback. Upon intervention completion, participants provided qualitative data on feasibility, acceptability, potential modifications, and perceived effectiveness of the program via a semi-structured interview, which was analyzed for shared themes. Participants also completed measures of fatigue, psychological distress, and pain intensity before and after the intervention. Nonparametric statistics were conducted to examine changes in outcome measures following the intervention. During the study, several protocol modifications were employed to better address the unique needs of individuals with cSLE (e.g., separate content for adolescents versus young adults). Results suggest that TEACH is feasible, acceptable, and potentially effective in the management of cSLE symptoms. Following the intervention, there was a statistically significant reduction in fatigue (Z = - 2.81, p