Integrative Coping Group for Children
Condition: Childhood Depression; Childhood Anxiety; Pediatric Pain; Migraines; ADHD; Pediatric Stomach Pain; Musculoskeletal Pain
MeSH terms: Musculoskeletal Pain
Study type: Interventional

Summary: 
      The purpose of this study is to examine whether an integrative group-based intervention will
      help children experiencing psychological and physical distress. Children, ages 10 to 12, will
      be recruited for participation in this therapeutic group. Eligible and consenting
      participants will be randomized to a wait-list control group or the group intervention. The
      group intervention will take place over a 12-week period, during which participants will
      attend a weekly coping skills group that integrates yoga-based practices (such as yoga poses,
      mindfulness, self-acceptance, breath work) with cognitive-behavioral principles (such as
      increasing awareness of thoughts and emotions).
    

Detailed description: 
      Psychosomatic symptoms are physical complaints in the absence of an organic cause. For
      children and adolescents, psychosomatic symptoms often manifest as headaches,
      gastrointestinal (GI) discomfort, non-specific musculoskeletal pain, and fatigue. These
      symptoms are strongly associated with the presence of an internalizing disorder-namely,
      anxiety or depression-in youth. Thus, treatment of these symptoms has often been cached
      within a broader intervention protocol, the overarching goal of which is to address the
      global internalizing disorder. For children who experience intense and persistent
      psychosomatic discomfort, however, it can be critical to specifically target these symptoms
      through intensive intervention. Otherwise, psychosomatic complaints can be extremely
      impairing, impeding children's attendance in school, participation in extracurricular
      activities, and disrupting family activities. At present, there are few systematic that can
      target a range of psychosomatic problems.

      Yoga-based interventions may be a particularly valuable treatment for children with
      psychosomatic complaints. Such interventions have been studied empirically in adults with a
      number of psychosomatic conditions, and more recently in children with a variety of
      psychological conditions. Indeed, there have been a small number of studies targeting
      psychosomatic complaints in children via yogic practices. Although there is emerging interest
      in yoga-based interventions for youth, and slowly growing evidence their efficacy, at present
      there are no known structured interventions for youth with psychosomatic complaints in the
      context of an internalizing disorder. Thus, the goal of the present proposal is to develop a
      semi-structured, manualized intervention that targets impairing psychosomatic symptoms in
      youth with a comorbid internalizing disorders. The specific aims are as follows:

      Specific Aim 1 Treatment Feasibility: Assess the feasibility of a novel integrative coping
      intervention for children with somatic symptoms and anxiety.

      Hypothesis: The yoga-based intervention will be acceptable and feasible for children.
      Acceptability will be defined as a 50% consent rate among participants approached for the
      study; Feasibility will be defined by 75% of children completing 80% of intervention
      sessions.

      Secondary Aim 1 Treatment Efficacy: Assess the preliminary efficacy of a 12-week integrative
      coping intervention on both somatic and psychological (e.g., anxiety, mood) symptoms compared
      to a wait-list control condition.

      Hypothesis: Children in the active intervention condition will have a significant reduction
      in somatic and anxiety symptoms following the 12-week intervention compared to a wait-list
      control.
    

Intervention name(s): Integrative Coping Group
Intervention type(s): Behavioral
Intervention description(s): The proposed 12-week intervention will integrate yoga-based skills with cognitive-behavioral principles. The development of this program was based on existing and empirically-validated cognitive-behavioral interventions for youth (i.e., Coping Cat and Cat Project; Kendall et al.) and therapeutic yoga interventions (e.g., Galantino et al., 2008 for review). The intervention will be broken down into four three-week modules, which address the following:
Module 1: Introduction to group and awareness of body Module 2: Awareness of emotion and developing an understanding of the mind-body connection Module 3: Focus on cognitive process Module 4: Experiential practice and therapeutic discussions
Allocation: Randomized
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Childhood anxiety; Pediatric Pain; Yoga; Cognitive behavioral therapy