Anxiety Clinical Trial
Official title:
Evaluation of a Group Therapy Intervention for Children and Adolescents With Injection-Related Anxiety and Their Caregivers
The specific aim of this project is to determine the impact of this group therapy
intervention on improving adherence, coping, and functioning among children and adolescents
with disease processes requiring injections who experience injection-related
anxiety.Hypotheses include:
1. General psychosocial (quality of life) improvements from beginning to post-treatment as
well as maintenance of these improvements 2-4 weeks following the termination of
treatment for both youth and parents.
2. Reduced injection-related anxiety from baseline to post-treatment as well as
maintenance of this improvement 2-4 weeks following the end of treatment for both youth
and parents.
3. Reduced anxiety immediately following exposure to feared injection- related stimuli.
4. For participants experiencing poor adherence to medical treatment, improvement in
adherence as reported by both parents and youth from baseline to post-treatment as well
as maintenance of these improvements 2-4 weeks following the end of treatment.
The proposed intervention protocol is a modification of an existing empirically developed
treatment (Self-Injection Anxiety Counseling) for adults with injection related anxiety who
rely on self-injection for illness management (Mohr, Cox, & Boudewyn, 2003). Self-Injection
Anxiety Counseling (SIAC) was developed to assist psychologists and medical staff in working
with patients individually to develop strategies to reduce anxiety and increase an
individual's ability to self-inject. This treatment protocol has been found to result in
increased self injection in patients who experienced injection anxiety prior to undergoing
this treatment (Mohr, Cox, & Merluzzi, 2005). Permission has been obtained from Dr. Mohr to
modify this treatment manual to be applied to youth in group setting.
This modified group protocol consists of five group sessions. The goals of the first session
include development of a group identity, psychoeducation, and physiological treatment of
anxiety though the instruction and practice of relaxation techniques. The second session
introduces a cognitive component to anxiety reduction and focuses on unhelpful thoughts and
strategies youth and caregivers can use to counteract these thoughts. The third session
implements the previously learned physiological and cognitive treatments through in vivo
injection practice. A registered nurse skilled in working with youth and caregivers on
self-injection will be present and active throughout this session and all infection control
procedures will be followed. Problem solving strategies are implemented in the fourth
session to reduce any difficulties encountered by participants as they practiced their
injection goal throughout the week. The fifth session will occur two weeks after the fourth
session. This extra week between sessions allows for additional practice and problem solving
related to injection goals. The last session reviews problem solving strategies and
celebrates the success of participants.
Relevant outcomes for hypotheses testing will be measured before treatment, after completion
of treatment, and at follow-up; one measure of injection-related anxiety will be utilized
more frequently throughout the treatment.
;
Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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