Applicability of criteria for empirically validated treatments to family interventions for pediatric sickle cell disease

One in every 400-500 African American babies carries a diagnosis of sickle cell disease (SCD). SCD, a congenital, hereditary hematologic disorder places youth at risk for developing potentially serious and life threatening disease related medical problems. Many SCD youth manifest neurocognitive impairments and learning problems, externalizing and internalizing behavior problems, difficulties in interpersonal relationships, low self-esteem, and problematic disease coping. Compared to control families, families with an SCD child have more conflict and lower levels of family organization. In contrast to the burgeoning research on medical advances, few researchers have examined the psychological sequelae of SCD of effective psychosocial interventions. With America's changing health care climate, the need for psychologists to work with medically ill individuals in primary care settings is increasing. In response to this need and to the 1995 American Psychological Association's guidelines for-treatment efficacy studies, a manualized family-oriented treatment program for pediatric SCD patients was developed. This paper discusses the strengths and challenges associated with implementing a culturally and developmentally sensitive manual-based family intervention for a low SES African American chronically ill population. Possible solutions to the challenges of conducting family-oriented intervention efficacy studies with pediatric populations are presented.