Abstracts

Rationale: Epilepsy can be a challenge for families as they learn to manage their child’s seizures and cope with condition-related stressors. Educational programs about epilepsy, currently available, have been found to be beneficial for parents. Yet, few studies have investigated the impact of epilepsy on parents or offered interventions to promote adaptive coping. Using prior work on experimental manipulation of self-concept and self-presentation, two interventions were designed. Strategic self-presentation was used to bolster parent’s confidence and image as one who successfully copes, while the intervention of emotional disclosure was utilized to promote a reduction in psychological distress. This study compares the two interventions of strategic self-presentation (SSP) and emotional disclosure (ED) with education as the control, and evaluates their impact on parental adaptive coping. Methods: Sixty-seven parents of children with epilepsy, ages 7 to 18 years, were recruited from Children's Hospital clinics and the epilepsy camp, Great Rock. The parents were randomly assigned to one of three groups including (SSP), (ED), and the control. In the SSP and the ED groups, parents were asked sixteen similar questions in a structured videotaped interview phrased to elicit different responses. In the SSP group parents were asked to share “what worked” with their child or effective coping strategies. In the ED group, parents were asked to discuss problems related to their child’s epilepsy. The control group watched a standard educational video about epilepsy and answered questions. Parents completed the Coping Health Inventory for Parents (CHIP), at baseline (n=67), post-intervention (n=57), and the 3 month follow-up (n=51). Parents also completed the Family Inventory for Resource Management (FIRM) as a confounding variable. A univariate analysis of Variance (ANOVA) was used to determine homogeneity across the three groups for demographic variables and baseline measures. A paired sample t-test was used to measure change from pre and post test interventions on the CHIP. A MANOVA was used to assess interactions of gender, severity, and perception of family resources, with the CHIP. Results: The Strategic Self Presentation group showed significant improvement (p<.05), in one domain of the CHIP, “understanding the medical situation through communication with other parents and medical staff”. The Emotional Disclosure group showed significant worsening (p<.05), in one domain of the CHIP, following the interview. There was no significant change in the control group. Effects of gender, severity and family resources were found within all groups. Three months later, without interventions or boosters, the two groups returned to their baseline. Conclusions: Strategic self-presentation appears to demonstrate some immediate beneficial effect for parents of children with epilepsy; however, further studies with larger numbers are needed to investigate the short and long-term benefit for clinical use. Additionally, the frequency of intervention and feasibility of use in healthcare settings must be determined.