Abstracts

Rationale: Youth with epilepsy are at increased risk for psychological and behavioral problems; however, access to and utilization of mental health services is poor. Youth may experience learned helplessness when seizure control is not contingent on attempts to manage epilepsy. Therefore, a brief pilot intervention for youth and their caregivers was designed to provide primary and secondary control enhancement training and self-management skills. Methods: Children and adolescents ages 10-15 diagnosed with epilepsy for at least 6 months, had at least average IQ, and had not been diagnosed with a serious mental illness. Youth and caregivers completed pre-assessment self-report surveys measuring self-efficacy for seizure management, coping skills, depressive symptoms, seizure severity, etc. The COPE program consisted of 8 modules delivered in a group format. Modules covered epilepsy education, self management skills, relaxation, cognitive restructuring, problem solving, etc. Vignettes, role-plays, and behavioral rehearsal were included to promote mastery of material. Homework assignments were distributed to promote treatment adherence. Participants then completed post assessment measures following completion of the COPE program. In addition, they completed anonymous measures of satisfaction, feasibility, and accuracy of the program. A booster session was held 2 months following the last COPE session. A follow up questionnaire was mailed one month after the booster session to assess use of the skills learned. Results: Nine youth completed the COPE program (5 Male, 4 Female). The average age was 12.89 years (SD=1.69). Five children had been diagnosed with frontal lobe, 3 with temporal lobe, and one with unspecified focal epilepsy. Two children endorsed suicidal ideation at pre-assessment. No children endorsed ideation at post-assessment. CDI scores did improve slightly; however, nonparametric tests revealed no significant differences between pre and post CDI scores (Sign Test p=.180). Eight of the 9 caregivers reported that the COPE program “very much” addressed needs, covered things they wanted to know, included helpful handouts, information was easy to follow. Seven of 9 reported that the program was “very much” easy to attend sessions and apply skills to life. All 9 youth reported that they learned from the program and that it helped them “a lot” learn to use skills on their own. Six of 9 reported that handouts and assignments helped them “a lot.” Conclusions: Results must be interpreted carefully given the small number of participants , and difficulties with recruitment for such an involved study is noted. Participants indicated strong satisfaction for the program. The program was feasible, and adjustments to the content of the program will be made based on participant feedback. Results will be utilized to revise the intervention for future examination.