Abstract
Background: Adolescents with chronic medical conditions have higher rates of anxiety and depression than their peers, possibly due to maladaptive coping strategies. We have developed a role-play intervention based on Integrative Community Therapy that uses improvisational theatre to teach healthy coping strategies to adolescents with chronic medical conditions. To assess the appropriateness of this intervention for this population, we conducted a pre-intervention assessment of participants’ quality of life and knowledge and utilization of coping strategies. Methods: Participants were recruited from pediatric subspecialty offices, electronic medical records, and local high schools and middle schools. Pre-intervention variables were measured using both quantitative and qualitative methods. Participants were screened for major depressive disorder and generalized anxiety disorder using the Revised Children’s Anxiety Depression Scale. Quality of life was assessed by the Pediatric Quality of Life Inventory. Knowledge and utilization of coping strategies were assessed using the KidCOPE questionnaire. Qualitative interviews were also conducted and coded using modified grounded theory. Results: This pilot study consists of 3 participants between the ages of 15 and 17. No participant had a clinically significant score for either major depressive disorder or generalized anxiety disorder. On the Pediatric Quality of Life Inventory, emotional and school functioning were the most significantly affected categories, with median scores of 45/100 and 50/100 respectively. On the KidCOPE checklist, 2 out of the 3 participants scored less than 1, meaning they endorsed using more negative coping strategies than positive ones. In qualitative interviews, most participants endorsed significant emotional and functional effects of their illnesses on their everyday lives, corresponding with the domains indicated in the Pediatric Quality of Life Inventory. When presented with standard scenarios, most participants were more likely to use positive problem-based coping strategies when standing up for a friend to another peer. Additionally, participants were more likely to use maladaptive, avoidant behaviors when confronted with an authority figure. Conclusion: This intervention is inexpensive and easy to administer. It uses improvisational theatre to teach healthy coping strategies to adolescents with chronic medical conditions. The pre-intervention assessment of participants in this pilot study indicates that this population is ideal for this intervention given the impact of their medical conditions on their everyday lives and their lack of utilization of positive coping strategies.