Promoting Psychological Flexibility in Parents of Adolescents With Chronic Pain: Pilot Study of an 8-Week Group Intervention

Parent responses to child pain affect children’s symptoms and functioning including school attendance, social functioning, and depression. In cross-sectional studies, parents’ pain-related psychological flexibility is associated with responses to child pain, but no intervention has yet specifically targeted psychological flexibility in parents of teens with chronic pain. Drawing on acceptance and commitment therapy (ACT), we created and piloted an 8-week group-based intervention for parents of teens with pain. Eight parents of teens with chronic pain enrolled, and 6 completed the study. Parents completed the Parent Psychological Flexibility Questionnaire, Adult Response to Child Symptoms, and PROMIS Pain Interference Proxy Questionnaire multiple times during the 8-week study and follow-up period (2-week, 3-month, and 6-month); teens also completed the PROMIS Pain Interference Questionnaire at these same time points. Questionnaire responses were evaluated with hierarchical linear modeling; separate slopes were calculated for intervention and follow-up. Results indicated that parent pain-related psychological flexibility increased during the intervention and through follow-up. Protective parenting responses decreased significantly during follow-up only, as did adolescent-rated pain interference. Parents indicated high satisfaction with the intervention. Results of this pilot study suggest that a group-based parent intervention is feasible and can lead to positive changes in parent psychological flexibility. The later improvement in parent responses to pain suggests psychological flexibility may be a mediator of these responses.