Development and pilot testing of the treatment and education approach for childhood-onset lupus (TEACH): a cognitive behavioral treatment.
BACKGROUND
To develop and test the feasibility and initial effectiveness of the Treatment and Education Approach for Childhood-onset Lupus (TEACH) protocol, a 6-session cognitive behavioral therapy (CBT) intervention for adolescents and young adults (AYA) with childhood-onset systemic lupus erythematosus (cSLE).


METHODS
Females with cSLE (n = 14; ages 13-19 years, M = 16.21 years) presenting to a pediatric rheumatology clinic subsequently completed the protocol, which was iteratively modified based on participant/interventionist feedback. Upon intervention completion, participants provided qualitative data on feasibility, acceptability, potential modifications, and perceived effectiveness of the program via a semi-structured interview, which was analyzed for shared themes. Participants also completed measures of fatigue, psychological distress, and pain intensity before and after the intervention. Nonparametric statistics were conducted to examine changes in outcome measures following the intervention.


RESULTS
During the study, several protocol modifications were employed to better address the unique needs of individuals with cSLE (e.g., separate content for adolescents versus young adults). Results suggest that TEACH is feasible, acceptable, and potentially effective in the management of cSLE symptoms. Following the intervention, there was a statistically significant reduction in fatigue (Z = - 2.81, p < .01) and depressive symptoms (Z = - 2.69, p < .01). Reductions in pain and anxiety symptoms were marginal.


CONCLUSIONS
TEACH, a tailored CBT protocol for AYA with cSLE, is a feasible and potentially effective intervention for the management of fatigue and depressive symptoms. Future directions include testing the protocol in a larger controlled study.
['Cunningham|Natoshia R|NR|', 'Fussner|Lauren M|LM|', 'Moorman|Erin|E|', 'Avar Aydin|Pinar O|PO|', 'Brunner|Hermine I|HI|', 'Kashikar-Zuck|Susmita|S|']
D000293:Adolescent D001007:Anxiety D015928:Cognitive Behavioral Therapy D003863:Depression D005221:Fatigue D005240:Feasibility Studies D005260:Female D006801:Humans D008180:Lupus Erythematosus, Systemic D010146:Pain D010147:Pain Measurement D013315:Stress, Psychological D016896:Treatment Outcome D014481:United States D055815:Young Adult
Childhood-onset Lupus Cognitive behavioral therapy (CBT) Fatigue Pain Depressive symptoms