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Not enough participants were recruited to conduct a randomized controlled trial.
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Investigators are building a program that uses improvisation to teach kids and teens with medical issues healthy ways to cope. Medical issues have been linked to anxiety and depression. Doing theatre can prevent these complications. Participants will meet in groups of about ten for ten weeks to do improvisation that is fun and supportive. Participants will meet with a study team member before the program starts, after the program ends, six months after the program ends, and twelve months after the program ends. At these visits, participants will be screened for anxiety, depression, quality of life, and will be given a short interview.
Adolescents with chronic medical conditions are at increased risk for anxiety and depression compared to other people their age. Therapies that use role-play prevent anxiety and depression. However, often these studies do not have an underlying psychological framework, or there is not enough information to replicate the program. Investigators designed an intervention using role-play based on Integrative Community Therapy, developed in the 1980s by Dr. Adalberto Barreto. This program will help adolescents with chronic medical conditions explore their feelings about issues related to having a chronic condition, learn new coping strategies, and help one another find support among peers.
This treatment will take place once a week for 10 weeks and investigators will compare the effects to those derived from improvisational theatre alone. To evaluate this new treatment, the study team will screen participants for anxiety, depression, quality of life, and will give a short qualitative interview. This will occur before and after the intervention, 6 months after the intervention, and 1 year after the intervention.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Integrative Community Therapy (ICT) Intervention Arm | Experimental | Participants will perform scenes related to having a chronic medical condition and they will be guided through conversations about their feelings and coping methods. |
|
| Improvisational Theatre Arm | Sham Comparator | Participants will perform generic improvisational theatre with no instruction on feelings or coping methods. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Intervention: Integrative Community Therapy-based Psychodrama | Behavioral | Participants produce theatre scenes depicting issues that they have experienced. Group leaders then use a guide to facilitate a discussion of participants' feelings, coping strategies, and sharing of local knowledge. |
| Measure | Description | Time Frame |
|---|---|---|
| Anxiety and Depression | Anxiety and Depression as evaluated by the Revised Children's Anxiety and Depression Scale; Scored 0-30; higher score indicates worse outcome | Baseline to 10 weeks |
| Anxiety and Depression | Anxiety and Depression as evaluated by the Revised Children's Anxiety and Depression Scale; Scored 0-30; higher score indicates worse outcome | Baseline to 6 months |
| Anxiety and Depression | Anxiety and Depression as evaluated by the Revised Children's Anxiety and Depression Scale; Scored 0-30; higher score indicates worse outcome | Baseline to 12 months |
| Disease-Related Quality of Life | Disease-Related Quality of Life as evaluated by Qualitative Interview | Baseline to 10 weeks |
| Disease-Related Quality of Life | Disease-Related Quality of Life as evaluated by Qualitative Interview | Baseline to 6 months |
| Disease-Related Quality of Life | Disease-Related Quality of Life as evaluated by Qualitative Interview | Baseline to 12 months |
| Disease-Related Quality of Life | Disease-Related Quality of Life as evaluated by Pediatric Quality of Life Inventory; Scored 0-100; higher score indicates better outcome | Baseline to 10 weeks |
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Inclusion Criteria:
Identify as having a CMC
In grades kindergarten to 12th grade during the year recruited for the study
Able and willing to participate in improvisational theatre in spoken English
Able to understand and answer standard questionnaires used for evaluation in English (with or without accommodation)
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Karen A Ephlin, MD | Geisinger Clinic | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Geisinger Primary Care South Wilkes-Barre | Wilkes-Barre | Pennsylvania | 18702 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30934877 | Background | Young KS, Sandman CF, Craske MG. Positive and Negative Emotion Regulation in Adolescence: Links to Anxiety and Depression. Brain Sci. 2019 Mar 29;9(4):76. doi: 10.3390/brainsci9040076. | |
| 28215656 | Background | Jones LC, Mrug S, Elliott MN, Toomey SL, Tortolero S, Schuster MA. Chronic Physical Health Conditions and Emotional Problems From Early Adolescence Through Midadolescence. Acad Pediatr. 2017 Aug;17(6):649-655. doi: 10.1016/j.acap.2017.02.002. Epub 2017 Feb 12. |
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| ID | Term |
|---|---|
| D002908 | Chronic Disease |
| ID | Term |
|---|---|
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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One group will receive a new behavioral intervention; the other group will receive improvisational theatre alone
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The participants will not know which group they are in, as they will not be familiar with the particular procedure of the intervention being studied
|
|
| Control: Improvisational Theatre | Behavioral | Participants play improvisational theatre games. |
|
| Disease-Related Quality of Life | Disease-Related Quality of Life as evaluated by Pediatric Quality of Life Inventory; Scored 0-100; higher score indicates better outcome | Baseline to 6 months |
| Disease-Related Quality of Life | Disease-Related Quality of Life as evaluated by Pediatric Quality of Life Inventory; Scored 0-100; higher score indicates better outcome | Baseline to 12 months |
| Knowledge and Utilization of Coping Strategies | Knowledge and Utilization of Coping Strategies as evaluated by Qualitative Interview | Baseline to 10 weeks |
| Knowledge and Utilization of Coping Strategies | Knowledge and Utilization of Coping Strategies as evaluated by Qualitative Interview | Baseline to 6 months |
| Knowledge and Utilization of Coping Strategies | Knowledge and Utilization of Coping Strategies as evaluated by Qualitative Interview | Baseline to 12 months |
| Knowledge and Utilization of Coping Strategies | Knowledge and Utilization of Coping Strategies as evaluated by KidCope Checklist; Scored 0-120; higher score indicates better outcome | Baseline to 10 weeks |
| Knowledge and Utilization of Coping Strategies | Knowledge and Utilization of Coping Strategies as evaluated by KidCope Checklist; Scored 0-120; higher score indicates better outcome | Baseline to 6 months |
| Knowledge and Utilization of Coping Strategies | Knowledge and Utilization of Coping Strategies as evaluated by KidCope Checklist; Scored 0-120; higher score indicates better outcome | Baseline to 12 months |
| Empathy | Empathy as evaluated by Qualitative Interview | Baseline to 10 weeks |
| Empathy | Empathy as evaluated by Qualitative Interview | Baseline to 6 months |
| Empathy | Empathy as evaluated by Qualitative Interview | Baseline to 12 months |
| 31676391 | Background | Cobham VE, Hickling A, Kimball H, Thomas HJ, Scott JG, Middeldorp CM. Systematic Review: Anxiety in Children and Adolescents With Chronic Medical Conditions. J Am Acad Child Adolesc Psychiatry. 2020 May;59(5):595-618. doi: 10.1016/j.jaac.2019.10.010. Epub 2019 Oct 30. |
| 22224836 | Background | Compas BE, Jaser SS, Dunn MJ, Rodriguez EM. Coping with chronic illness in childhood and adolescence. Annu Rev Clin Psychol. 2012;8:455-80. doi: 10.1146/annurev-clinpsy-032511-143108. Epub 2011 Dec 20. |
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| 32811094 | Background | Hersov L. Psychotherapy for Children and Adolescents. Evidence-based Treatments and Case Examples. Child Adolesc Ment Health. 2006 May;11(2):124-125. doi: 10.1111/j.1475-3588.2006.00399_5.x. No abstract available. |
| 33551907 | Background | Feniger-Schaal R, Koren-Karie N. Using Drama Therapy to Enhance Maternal Insightfulness and Reduce Children's Behavior Problems. Front Psychol. 2021 Jan 20;11:586630. doi: 10.3389/fpsyg.2020.586630. eCollection 2020. |
| 18383198 | Background | Blacker J, Watson A, Beech AR. A combined drama-based and CBT approach to working with self-reported anger aggression. Crim Behav Ment Health. 2008;18(2):129-37. doi: 10.1002/cbm.686. |
| 21362006 | Background | Joronen K, Hakamies A, Astedt-Kurki P. Children's experiences of a drama programme in social and emotional learning. Scand J Caring Sci. 2011 Dec;25(4):671-8. doi: 10.1111/j.1471-6712.2011.00877.x. Epub 2011 Mar 1. |
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