Daily coping practice predicts treatment effects in children with sickle cell disease

Objective: To examine the 1-month effects of a pain coping skills intervention in children with sickle cell disease (SCD). Methods: Forty-six African American children (8-17 years old) were randomly assigned to either a coping skills condition or a standard care control condition. Children were asked to practice daily with audiotaped instructions of skills (e.g., relaxation, imagery). Results: Multivariate analyses of summary measures indicated that children in the coping intervention (versus control group) reported a significantly more active approach to managing pain. Multilevel random effects models applied to daily diary data indicated that on pain days when children practiced their strategies, they had fewer health care contacts, fewer school absences, and less interference with household activities than on days when they did not practice. Conclusions: Brief training in coping skills followed by minimal therapist contact may lead to a range of benefits when children practice with their skills on a consistent basis.