Miller Alaina K, Ely Samantha L, Barber Garcia Brittany N, Richardson Patricia, Cunningham Natoshia R
Department of Psychology, Wright State University, Dayton, OH 45435, USA.
Department of Family Medicine, Michigan State University, Grand Rapids, MI 49503, USA.
Children (Basel). 2021 Sep 2;8(9):775. doi: 10.3390/children8090775.
Functional abdominal pain disorders (FAPD) are common disabling pain conditions frequently associated with co-occurring mental health problems such as anxiety. Psychological therapies such as cognitive behavioral therapy (CBT) have been shown to be effective. Therefore, it is important to understand participant engagement (i.e., use of intervention tools) to such approaches, and if engagement impacts treatment response. The Aim to Decrease Anxiety and Pain Treatment (ADAPT) is an effective psychological treatment approach using a blend of in-person sessions and interventionist phone support with self-paced web modules to manage pain and anxiety. The current study used a mixed-methods approach to investigate micro-level and macro-level participant engagement during the ADAPT program. In-person/phone session attendance was high (>95%) although scheduling adjustments were common (25.5%). Varied levels of engagement with web tools were observed. Thematic analysis also revealed variability in patterns of use. Additionally, while participants indicated they generally understood how to use certain skills (e.g., problem solving, detective thinking), and these skills were effective in managing symptoms during treatment, these activities were generally underutilized. Further, participant engagement did not predict response to the ADAPT intervention. These findings are important as the demand for accessible psychotherapeutic tools to manage pain and anxiety is likely to remain high.
功能性腹痛障碍（FAPD）是常见的致残性疼痛病症，常与焦虑等同时出现的心理健康问题相关。认知行为疗法（CBT）等心理疗法已被证明是有效的。因此，了解参与者对这类方法的参与情况（即干预工具的使用）以及参与是否会影响治疗反应很重要。降低焦虑与疼痛治疗（ADAPT）是一种有效的心理治疗方法，它结合了面对面治疗、干预人员电话支持以及自主学习的网络模块来管理疼痛和焦虑。本研究采用混合方法来调查ADAPT项目中微观层面和宏观层面的参与者参与情况。尽管常见日程安排调整（25.5%），但面对面/电话治疗的出勤率很高（>95%）。观察到参与者对网络工具的参与程度各不相同。主题分析还揭示了使用模式的差异。此外，虽然参与者表示他们通常理解如何使用某些技能（如解决问题、侦探式思维），并且这些技能在治疗期间对管理症状有效，但这些活动总体上未得到充分利用。此外，参与者的参与情况并不能预测对ADAPT干预的反应。这些发现很重要，因为对可及的心理治疗工具来管理疼痛和焦虑的需求可能仍然很高。
