Table 2 Summary of adolescent and parent CBT intervention timing and content
Module | Adolescent content | Parent content |
|---|---|---|
Preoperative treatment phase (4 weeks duration, delivered 4–6 weeks prior to surgery) | ||
1 | Preparing for surgery -Introduction to relaxation strategies and training in deep breathing. -Information about the importance of good sleep for recovery from surgery and strategies to improve sleep habits (e.g., wind-down routine). | Preparing for surgery -Information about preparing for surgery and how to effectively gather information from the medical team. -Introduction to relaxation strategies and training in deep breathing. -Information about the importance of good sleep for recovery from surgery and strategies to support teen’s healthy sleep. |
2 | Coping with worry before surgery -Introduction to cognitive strategies. -Training in thought replacement and mindfulness. | Coping with worry before surgery -Introduction to cognitive strategies. -Training in thought replacement and mindfulness. -Strategies to enhance parent-teen communication. |
3 | Getting ready for the hospital and recovery -Information about preparing for the hospital and setting positive expectations. -Training in using imagery and distraction for managing anxiety or pain. | Getting ready for the hospital and recovery -Information about preparing for the hospital and setting positive expectations and social connections. -Training in using imagery for managing anxiety. |
Postoperative treatment phase (4 weeks duration, delivered 3–7 weeks post-surgery) | ||
1 | Coping at home -Information about the importance of adequate sleep and strategies to improve sleep habits (e.g., sleep schedule). -Information about the 4 P’s of pain management. -Training in music distraction and mindful breathing. | Recovery at home after surgery -Information about how to support healthy teen sleep habits and pain management. -Introduction to basic principles of self-care. -Training in mindful breathing. |
2 | Getting back to activities -Introduction to behavioral activation. -Training in strategies to gradually increase physical activities (e.g., activity pacing). | Getting back to normal life after surgery -Information about handling daily stress. -Information about how to support teen’s return to activities and school. -Training in progressive muscle relaxation to reduce distress. |
3 | Long-term recovery -Information about possible future challenges with recovery and education about chronic pain. -Training in progressive muscle relaxation. | Long-term recovery -Information about possible future challenges with recovery and education about chronic pain. -Training in using positive self-statements to reduce distress. |