Evaluation of a Family Systems Intervention for Managing Pediatric Chronic Illness: Mastering Each New Direction (MEND)

Abstract

Family systems play a crucial, albeit complex, role in pediatric chronic illness. Unfortunately, very few psychosocial interventions are available to help these stressed families navigate the developmental steps of chronic illness. A new intervention (MEND) addresses the needs of these families and applies to a broad range of chronic illnesses. This article presents this family systems intervention as well as includes preliminary program evaluation data on 22 families that graduated from the program. Results show consistently strong effects across an array of psychosocial measures. Conclusions from this preliminary study suggest that families entering MEND present with high levels of stress due to the child's chronic illness, but after MEND, the level of stress and other functioning measures are comparable to those seen in healthy families, suggesting that the program offers a significant benefit to families with pediatric chronic illness.

Quality of Life and School Absenteeism in Children With Chronic Illness

“…As opposed to psychosocial interventions that focus on one disease type alone, this intervention and study are inclusive of many CIs. Not only does the inclusion of a variety of conditions improve generalizability of our findings, it underscores the commonalities shared by children with CI in terms of both issues and clinical solutions, a key assumption of the MEND intervention (Distelberg et al, 2014). Although we believe this is a significant strength of the MEND program, given the small sample size of this study, we are cautious about the generalizability of results across all disease types.…”

“…Mastering Each New Direction (MEND; Distelberg, Williams-Reade, Tapanes, Montgomery, & Pandit, 2014) is a 21-session/7-week intensive outpatient family therapy-based treatment protocol designed to improve adherence to medical regimens. MEND works to improve functioning across family, social, and health-care systems to positively influence self-management behavior through cognitive, emotional, familial, and social processes.…”

Longitudinal Model Predicting Self‐Concept in Pediatric Chronic Illness

“…If these pathways are supported empirically, this will support prior work that suggests that to meaningfully impact HRQOL, treatments must incorporate the family system (Distelberg, Williams-Reade, Tapanes, Montgomery, & Pandit, 2014;Drotar, 2013;Wood et al, 2000). Given that depression often exacerbates issues related to both identity formation and adjustment to CI, we anticipated that changes in depression would inversely predict changes in self-concept.…”

“…By contrast, teens with avoidant attachment styles have been shown to delay seeking treatment even when symptoms warrant it (Maunder & Hunter, 2001). This study is not focused on the overall effectiveness of MEND, as such studies can be found greater detail in other publications (Distelberg et al, 2014(Distelberg et al, , 2017. To evaluate these relationships over time, we analyzed participant data from the Mastering Each New Direction (MEND) program, a 3-month psychosocial, family based intensive outpatient program for adolescents with CI.…”

“…Please see Distelberg et al (2014) andMontgomery (2015) for the prescribed curriculum and underlying conceptual framework. MEND combines family and peer-based therapy to target and repair maladaptive patterns that contribute to disease activity and nonadherence behaviors.…”