Bouncing Back Better: development of a family intervention program after young child burn injury

Burn injuries are a common form of unintentional childhood injury. The psychological sequelae of pediatric burn injury on the injured child and caregivers can be significant, including traumatic stress, anxiety, and depression. Factors such as parent capacity for monitoring and child ADHD (attention-deficit/hyperactivity disorder) symptoms can significantly increase the risk of injury in early childhood. A dual-foci intervention was created to improve family functioning and coping after a burn injury. The current proof-of-concept study examines the Bouncing Back Better (BBB) intervention, which targets parent mood and child externalizing behaviors after unintentional burn injury.

BBB intervention was completed by 10 parent-child dyads (12 enrolled). Inclusion comprised children (2-5 years) who sustained an unintentional burn injury and demonstrated hyperactivity symptoms upon standard clinical care psychosocial screening. BBB included four (30-45 min) sessions that involve CBT-focused behavioral intervention skills. Feasibility was assessed through recruitment, enrollment, and retention rates. Acceptability was assessed through satisfaction questionnaires and qualitative interviews. Proof-of-concept was demonstrated through analyses of findings from validated measures of depression, distress, and ADHD symptoms.

Findings support acceptability and feasibility of the intervention and provide evidence of a successful proof-of-concept by demonstrating significant decreases in reported parental depression symptoms and improvements in child inattentive and hyperactive behaviors.

An intervention focused on both caregiver well-being and child behaviors improves overall family functioning. Future research aims to expand the BBB intervention to a larger sample and examine initial efficacy through pilot testing using a randomized design and a larger team of treatment providers.