Coping with pediatric chronic illness Efficacy of online group interventions for adolescents and parents

This thesis describes the development and efficacy of two online psychosocial group interventions Op Koers Online for adolescents (12-18 years) with a chronic illness and parents of children (0-18 years) with a chronic illness. The intervention aims to teach how to use adaptive coping skills and consists of eight (adolescents) or six (parents) online sessions guided by two trained course leaders, mostly psychologists. Cognitive behavioral therapry (CBT) and Acceptance and commitment (ACT) techniques are used. After a pilot study and parental support needs study, efficacy of the interventions was tested with two separate multicentre Randomized Controlled Trials with nine participating hospitals across the Netherlands. Assessments took place at baseline, post-intervention (six or eight weeks) and at six- and twelve months follow-up. The intervention for adolescents had a positive effect on adaptive coping skills and on quality of life . The intervention for parents was effective in decreasing symptoms of anxiety and depression and the use of adaptive coping skills. In both interventions, sharing experiences with others in a similar situation was important for participants. Op Koers Online for adolescents and parents are unique and innovative interventions given the illness-generic character, the option for parents to participate with a focus on themselves instead of their child and the possibility to participate from home. The last part of the thesis describes the development, evaluation and implementation of the Op Koers program over the past 25 years and presents the lessons learned.