Moderators of the Efficacy of a Psychosocial Group Intervention for Children with Chronic Illness and their Parents: For Whom

Background: The objective of this study was to investigate psychosocial characteristics of children and parents as well as parent-child relationships as moderators of the effect of a cognitive behavioral group intervention for children with chronic illness and their parents. Methods: Data from a randomized controlled trial were used, including 194 children (8-18 years) who were assigned to a child-only intervention, a parent-child intervention or a waitlist control group. Moderator variables included age, gender, baseline behavior problems, coping style, self-worth, the security of the parent-child relationship and parenting stress. Longitudinal multilevel regression analyses were performed to test twoand three-way interaction effects between the moderator variables, study-group, and time on parent and child reported internalizing and externalizing behavior problems. Results: Analyses revealed that for children with a more disengaged coping style, with lower self-worth, and for children who experienced a more secure parent-child relationship, the parent-child intervention was more effective than the child-only intervention in reducing behavior problems. Conclusions: Children who are more ‘at risk’ appear to gain more from participating in the intervention, especially if their parents are involved as well. However, benefit of parents’ involvement may depend on the quality of the parent-child relationship.