Coping Strategies for Emotional Distress After Parental Separation/Divorce

Overseen By Sharlene A Wolchik, PhD

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Arizona State University

Disqualifiers: Active therapy, Suicidality, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores ways to help children cope with emotional distress after parental separation or divorce. It focuses on three digital techniques: reappraisal (changing thoughts about a situation), distraction (shifting attention away), and relaxation. The goal is to assess how these methods affect children's ability to handle conflict and improve mental health. The trial seeks children aged 9-12 experiencing high levels of conflict between separated or divorced parents. As an unphased trial, it offers a unique opportunity for children to benefit from innovative techniques that could enhance emotional resilience.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research shows that the coping strategies under study—distraction, reappraisal, and relaxation—are generally safe and well-tolerated. These strategies have been linked to positive outcomes in children, such as fewer mental health issues. Studies have found that these methods can boost emotional security and improve coping skills without major side effects.

Distraction coping, which involves helping children focus on something else, effectively helps them manage stress. Reports suggest this is a safe way to support children through difficult times.

Reappraisal coping teaches children to think differently about a situation, which can lower stress and anxiety. Research supports that this method is safe and can enhance children's emotional resilience.

Relaxation techniques, like deep breathing or visualization, are widely used to calm the mind. They are considered safe and can help reduce stress and anxiety.

Overall, these strategies aim to support children's mental health safely, without significant risk of negative effects. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about these methods because they focus on teaching coping strategies to manage emotional distress after parental separation or divorce. Unlike standard treatments that might involve therapy sessions or medications, these digital modules offer a convenient, self-guided approach. Participants learn different techniques like reappraisal, distraction, and relaxation, which can be personalized and practiced anytime, anywhere. This approach empowers individuals to actively manage their emotions and stress in a flexible manner, potentially improving their emotional resilience and overall well-being.

What evidence suggests that this trial's treatments could be effective for reducing mental health problems in children after parental separation/divorce?

Research has shown that certain coping strategies can help reduce mental health issues in children facing high conflict between parents after a divorce. In this trial, participants may receive different combinations of these strategies. Techniques like distraction, such as engaging in enjoyable activities, can lower anxiety and distress. Reappraisal, or changing how they think about a situation, can make stressful events feel less overwhelming. Relaxation methods, including mindfulness and stress reduction exercises, have effectively managed anxiety symptoms. Education programs for children also improve their understanding and coping skills. Together, these strategies provide a strong foundation for supporting children's mental health during challenging family changes. ^{1 2 3 6 7}

Who Is on the Research Team?

Karey L O'Hara, PhD

Principal Investigator

Arizona State University

Are You a Good Fit for This Trial?

This trial is for children aged 9-12 who are experiencing emotional challenges due to their parents' separation or divorce. They must have some signs of anxiety or depression, be fluent in English, and spend a significant amount of time with at least one parent willing to participate. Children already receiving therapy, those with extreme mental health issues, or expressing suicidal thoughts cannot join.

Inclusion Criteria

A parent with sufficient contact with the child who is willing to complete study assessments and has legal right to give permission for the child to participate in research

Child and one parent are fluent in English

Child-report of high exposure to IPC (mean Z score ≥ 40th percentile on the two child report measures of IPC; score standardization based on data from 559 youth whose parents participated in an experimental parenting program)

Exclusion Criteria

Score ≥ 99th percentile on either internalizing and externalizing problems subscale

I am currently receiving treatment for my condition.

Endorse suicidality (will be ineligible for the study and referred for treatment)

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants complete digital modules on reappraisal, distraction, and relaxation coping strategies

6 weeks

Daily digital module completion

Follow-up

Participants are monitored for coping efficacy, emotional security, and mental health problems

3 months

What Are the Treatments Tested in This Trial?

Interventions

• Distraction Coping
• Education
• Reappraisal Coping
• Relaxation Coping

Trial Overview The study tests three digital coping strategies: reappraisal (changing how to think about stressful events), distraction (shifting attention away from stress), and relaxation (reducing tension). It aims to see which combination best helps kids handle emotions and behaviors after parental separation/divorce.

How Is the Trial Designed?

Group I: Education + Relaxation Experimental Treatment 2 Interventions

Participants will complete an educational digital module and a skills-based digital module that teaches relaxation coping.

Group II: Education + Reappraisal + Relaxation Experimental Treatment 3 Interventions

Participants will complete an educational digital module and two skills-based digital modules, one that teaches reappraisal coping and one that teaches relaxation coping.

Group III: Education + Reappraisal + Distraction + Relaxation Experimental Treatment 4 Interventions

Participants will complete an educational digital module and three skills-based digital modules, one that teaches reappraisal coping, one that teaches distraction coping, and one that teaches relaxation coping.

Group IV: Education + Reappraisal + Distraction Experimental Treatment 3 Interventions

Participants will complete an educational digital module and two skills-based digital modules, one that teaches reappraisal coping and one that teaches distraction coping.

Group V: Education + Reappraisal Experimental Treatment 2 Interventions

Participants will complete an educational digital module and a skills-based digital module that teaches reappraisal coping.

Group VI: Education + Distraction + Relaxation Experimental Treatment 3 Interventions

Participants will complete an educational digital module and two skills-based digital modules, one that teaches distraction coping and one that teaches relaxation coping.

Group VII: Education + Distraction Experimental Treatment 2 Interventions

Participants will complete an educational digital module and a skills-based digital module that teaches distraction coping.

Group VIII: Education Experimental Treatment 1 Intervention

Participants will complete an educational digital module and no skills-based digital modules.

Who Is Running the Clinical Trial?

Arizona State University

Lead Sponsor

Trials

311

Recruited

109,000+

National Institute of Mental Health (NIMH)

Collaborator

Trials

3,007

Recruited

2,852,000+

Published Research Related to This Trial

Divorce and parental separations in the U.S. affect over 1 million children annually, leading to potential emotional trauma for both children and parents.

Pediatricians can play a crucial role in identifying family dysfunction and providing age-appropriate counseling and resources to help mitigate the negative effects of divorce on children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Helping Children and Families Deal With Divorce and Separation. Cohen, GJ., Weitzman, CC.[2018]

In a study of 42 hospitalized acute burn patients, those using music distraction during dressing changes reported significantly fewer intrusive thoughts compared to those focusing on procedural sensations.

Training in distraction techniques, like music, can effectively reduce procedure-related distress, while focusing on sensations may increase feelings of intrusion and tension during medical procedures.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Coping with the stress of a painful medical procedure. Fauerbach, JA., Lawrence, JW., Haythornthwaite, JA., et al.[2022]

The development of a parent education booklet encourages the use of distraction and relaxation techniques during painful procedures in children with cancer, aiming to reduce anxiety and pain.

Implementing these nonpharmacologic strategies can enhance coping skills for both parents and children, potentially decreasing the need for general anesthesia and improving overall patient care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Promoting parental use of distraction and relaxation in pediatric oncology patients during invasive procedures. Christensen, J., Fatchett, D.[2022]

Coping is a circular process involving perception of change, cognitive processing, and active coping strategies, with active behaviors being more beneficial for patient well-being than passive ones.

Structured coping-based interventions, which include establishing a therapeutic relationship and problem analysis, have been shown to significantly enhance the healing process across various medical fields.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Coping-based intervention strategies. Heim, E.[2019]

In a study of 100 children aged 3 to 10 years undergoing ambulatory surgery, higher levels of engagement (or 'flow') in distracting activities were linked to lower preoperative anxiety during critical waiting periods.

The findings suggest that the effectiveness of distraction as an anxiety management strategy in children is influenced by how absorbed they are in the task, which could inform better clinical practices for reducing anxiety before surgery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The benefits of experiencing flow through distracting activities: flow reduces preoperative anxiety in children before surgery, but not postoperative difficulties. Tordet, C., Erhel, S., Dodeler, V., et al.[2023]

Positive distraction, which involves engaging in activities that induce positive emotions, can be an adaptive coping strategy for managing chronic stress, as shown in a study with 1,152 participants across multiple samples.

Unlike traditional avoidance strategies, positive distraction is associated with better well-being, increased positive emotions, and fewer depressive symptoms, suggesting it should be included in future coping interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Not all disengagement coping strategies are created equal: positive distraction, but not avoidance, can be an adaptive coping strategy for chronic life stressors. Waugh, CE., Shing, EZ., Furr, RM.[2021]

In a study of 351 children whose parents recently divorced, stress from divorce-related events and how children perceive these threats were found to increase their ruminations about the divorce.

Effective coping strategies were linked to lower levels of ruminations over time, suggesting that helping children develop better coping mechanisms could reduce their negative thoughts related to their parents' divorce.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Stress and coping as predictors of children's divorce-related ruminations. Weyer, M., Sandler, IN.[2007]

Support from family adults and nonfamily adults significantly helps children of divorce adjust better, especially under high stress, as seen in a study of 104 children.

Interestingly, at low stress levels, children with high support from nonfamily adults showed worse adjustment, suggesting that the type of support matters depending on the stress context.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Social support of children of divorce: direct and stress buffering effects. Wolchik, SA., Ruehlman, LS., Braver, SL., et al.[2023]

Divorce creates significant stress that can negatively affect parent-child relationships, which are crucial for helping children adjust during this challenging time.

Implementing early intervention strategies can lead to better outcomes for both parents and children, highlighting the importance of timely support.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Changes in parent-child relationships following divorce. Melnyk, BM.[2004]

In a study of 60 children and adolescents from a residential treatment facility, most of whom had experienced severe abuse and neglect, children reported low levels of depressive symptoms despite caregivers noting significant psychological issues.

The children predominantly used avoidant coping strategies, which were more common than emotion-focused and problem-focused strategies, highlighting a need for targeted interventions to help them cope with parental loss effectively.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Coping with parental loss because of termination of parental rights. Schneider, KM., Phares, V.[2014]

The Distraction in Action Tool© (DAT©) is a user-friendly intervention that helps parents assess their child's risk for distress during needle stick procedures and provides tailored distraction techniques, showing high usability among parents (84.2% found it easy to use) and clinicians (100% found it helpful).

The study involved 20 parents of children aged 4-10 years undergoing venipuncture, and results indicated that DAT did not disrupt clinical workflow, suggesting it can be effectively integrated into medical settings to reduce child distress during procedures.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Distraction in Action Tool©: Feasibility and Usability in Clinical Settings. Hanrahan, K., Kleiber, C., Miller, BJ., et al.[2021]

In a study involving 69 children undergoing dental treatment, watching television significantly reduced anxiety levels and improved cooperation compared to the traditional Tell-Show-Do method.

Television distraction led to a notable decrease in pulse rate and increased cooperation, especially during the administration of anesthetic injections, highlighting its effectiveness in pediatric dental care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effect of television distraction versus Tell-Show-Do as behavioral management techniques in children undergoing dental treatments. Kharouba, J., Peretz, B., Blumer, S.[2021]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6854280/

The long-term relations between interparental conflict and ... Previous evidence indicates that coping efficacy mediates exposure to interparental conflict and children's distress reactions (Camisasca et al., 2017) and ...

2. sciencedirect.com sciencedirect.com/science/article/abs/pii/S2212657023000430

Preventing mental health problems in children after high ... This intensive longitudinal intervention study examines the mechanisms through which coping intervention components impact children's responses to interactions.

3. withpower.com withpower.com/trial/phase-depression-1-2023-32de4

Coping Strategies for Emotional Distress After Parental ... Distraction coping techniques, such as using music or engaging in activities, are generally safe and have been shown to reduce anxiety and distress in various ...

4. tandfonline.com tandfonline.com/doi/full/10.1080/10502556.2023.2295060

Adolescent Adjustment to Parental Marital Transitions This study aimed to (1) identify the perceived helpfulness of relationships and resources adolescents relied on in their transition to their parents' divorce ...

5. midwifery.iocspublisher.org midwifery.iocspublisher.org/index.php/midwifery/article/download/460/401/

ADOLESCENT COPING STRATEGIES WITH PARENTAL ... The results of previous studies showed that the coping used in adolescents when facing parental divorce was focused on Emotion-focused coping (Lestari, 2013).

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10938851/

Preventing Mental Health Problems in Children After High ... Reappraisal, distraction, and relaxation coping strategies are related to fewer problems among children (Chorpita et al., 2005), making intervention components ...

7. researchgate.net researchgate.net/publication/369988089_The_Effects_of_Parental_Divorce_and_Separation_on_Children

The Effects of Parental Divorce and Separation on Children Parental separation and divorce places preschool aged children at risk for an array of immediate and longterm negative psychosocial outcomes including worse ...