Family therapy for asthma in children

Psychological factors may have an effect on asthma in children, or its severity. As some children with families who are having problems have severe asthma, family therapy has been tried. The aim is to resolve any problems there might be in a family, in case they are causing the child stress and then making asthma worse. The review found some evidence from two trials that family therapy (in addition to standard asthma treatments) might help reduce a child's asthma symptoms, but more research is needed to be certain.

Authors' conclusions: 

There is some indication that family therapy may be a useful adjunct to medication for children with asthma. This conclusion is limited by small study sizes and lack of standardisation in the choice of outcome measures.

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Background: 

Psychosocial and emotional factors are important in childhood asthma. Nevertheless, drug therapy alone continues to be the main treatment. Treatment programmes that include behavioural or psychological interventions have been developed to improve disturbed family relations in the families of children with severe asthma. These approaches have been extended to examine the efficacy of family therapy to treat childhood asthma in a wider group of patients. This review systematically examines these studies.

Objectives: 

Recognition that asthma can be associated with emotional disturbances has led to the investigation of the role of family therapy in reducing the symptoms and impact of asthma in children. The objective of this review was to assess the effects of family therapy as an adjunct to medication for the treatment of asthma in children.

Search strategy: 

We searched the Cochrane Airways Group Specialised Register of trials, and checked the reference lists in trial reports and review articles. The most recent search was carried out in January 2007.

Selection criteria: 

Randomised trials comparing children undergoing systematic therapy focusing on the family in conjunction with asthma medication, with children taking asthma medication only.

Data collection and analysis: 

Two reviwers (JY and CS) applied the study inclusion criteria.

Main results: 

Two trials with a total of 55 children were included. It was not possible to combine the findings of these two studies because of differences in outcome measures used. In one study, gas volume, peak expiratory flow rate and daytime wheeze showed improvement in family therapy patients compared to controls. In the other study, there was an improvement in overall clinical assessment and number of functionally impaired days in the patients receiving family therapy. There was no difference in forced expiratory volume or medication use in both studies.

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