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Controlled trial of social work in childhood chronic illness
Insights
Social work support for chronically ill children did not reduce psychosocial maladjustment. This randomized controlled trial found no significant benefits for child behavior, self-esteem, or family impact, even in subgroups.
Area of Science:
- Pediatric Health
- Psychosocial Support
- Clinical Intervention Research
Background:
- Children with chronic illnesses face a higher risk of psychosocial maladjustment.
- Social work and counseling are common interventions to mitigate this secondary morbidity.
- Evidence for the effectiveness of social work in this population requires rigorous evaluation.
Purpose of the Study:
- To evaluate the effectiveness of social work services in reducing psychosocial maladjustment in children with chronic physical disorders.
- To assess the impact of social work intervention on child behavior, self-esteem, and family functioning.
- To identify any potential subgroups of children who might benefit from social work support.
Main Methods:
- A randomized controlled trial involving 345 children with chronic physical disorders across eleven specialty clinics.
- Intervention group received six months of social work services; control group did not.
- Outcomes assessed four months post-intervention using measures including the Child Behaviour Checklist, self-esteem scales, and family impact measures.
Main Results:
- No significant difference in overall psychosocial maladjustment prevalence between social work and control groups.
- The intervention showed no preventive or therapeutic effect on child behavior disorder or social dysfunction.
- No detectable effects were observed on child self-esteem, maternal psychological function, or family impact.
Conclusions:
- Social work services, as delivered in this trial, did not demonstrate a significant benefit in reducing psychosocial maladjustment in children with chronic illnesses.
- The findings do not support the use of this social work intervention for preventing or treating behavioral or social issues in this pediatric population.
- Further research may be needed to explore alternative or modified psychosocial interventions for chronically ill children and their families.
Abstract:
Children with chronic illnesses have a doubled risk of becoming psychosocially maladjusted, and social-work support and counselling are commonly used to reduce this secondary morbidity. A randomised controlled trial of this type of intervention was conducted in 345 children with chronic physical disorders cared for in eleven specialty clinics at a children's hospital. Four months after a six-month period of social-work services, no significant difference was found between social-work and control groups in overall prevalence of maladjustment. There was no evidence to support a preventive or therapeutic effect of social work on child behaviour disorder or social dysfunction on the principal outcome measure, the Child Behaviour Checklist. Nor was there any detectable effect on child self-esteem, on maternal psychological function, or on the impact of the child's illness on the family. Furthermore, no patient subgroup could be shown to benefit from the intervention, and restriction of the analysis to individuals who received the intervention did not alter the results.