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Prospective Pilot Study of the Mastering Each New Direction Psychosocial Family Systems Program for Pediatric Chronic
Brian Distelberg1, Daniel Tapanes2, Natacha D Emerson3
1Loma Linda University Behavioral Medicine Center, Redlands, CA.
Insights
The MEND program, a family systems intervention, significantly improved health-related quality of life for children with chronic illnesses. It positively impacted stress, cognitive function, mental health, and family functioning.
Area of Science:
- Pediatric Psychology
- Family Systems Theory
- Health Services Research
Background:
- Psychosocial interventions are crucial for managing pediatric chronic illness (CI).
- Family systems approaches may enhance intervention effectiveness and sustainability.
- Existing interventions may not fully address the complex needs of families with pediatric CI.
Purpose of the Study:
- To evaluate the biopsychosocial benefits of a novel family systems psychosocial intervention, MEND (Mastering Each New Direction).
- To assess the impact of the MEND program on multiple domains of health-related quality of life in families with pediatric CI.
Main Methods:
- A single-arm study involving 45 families with pediatric CI participating in a 21-session intensive outpatient program.
- Measurement of five domains: Stress, Cognitive Functioning, Mental Health, Child Health-Related Quality of Life (HRQL), and Family Functioning using self-report surveys.
- Inclusion of biological measures, specifically catecholamines, to assess stress levels.
Main Results:
- Positive pre-, post-, and 3-month post-intervention effects were observed across all five measured domains.
- Program effects ranged from small to moderate (η² = .07–.64).
- Cognitive functioning (η² = .64) and stress (η² = .27) demonstrated the largest program effects.
Conclusions:
- The MEND program shows promise as an effective intervention for families managing pediatric chronic illnesses.
- Results support the integration of family systems principles in psychosocial interventions for pediatric CI.
- Further research and clinical practice should consider family systems-level interventions for improved outcomes.
Abstract:
Psychosocial interventions for pediatric chronic illness (CI) have been shown to support health management. Interventions that include a family systems approach offer potentially stronger and more sustainable improvements. This study explores the biopsychosocial benefits of a novel family systems psychosocial intervention (MEND: Mastering Each New Direction). Forty-five families participated in a 21-session intensive outpatient family systems-based program for pediatric CI. Within this single arm design, families were measured on five domains of Health-Related Quality of Life (HRQL) self-report measures; Stress, Cognitive Functioning, Mental Health, Child HRQL, Family Functioning. Both survey and biological measures (stress: catecholamine) were used in the study. Results from multivariate general linear models showed positive pre-, post-, and 3-month posteffects in all five domains. The program effects ranged from small to moderate (η2 = .07-.64). The largest program effects were seen in the domains of cognitive functioning (η2 = .64) and stress (η2 = .27). Also, between disease groups, differences are noted and future implications for research and clinical practice are discussed. Conclusions suggest that the MEND program may be useful in helping families manage pediatric chronic illnesses. Study results also add to the growing body of literature suggesting that psychosocial interventions for pediatric chronic illness benefit from a family systems level of intervention.
