Preliminary Feasibility and Efficacy of The Balance Program to Reduce the Impact of Pain on Daily Functioning in Pediatric Sickle Cell Disease

About the study

Pain is the primary complication of sickle cell disease (SCD), including vaso-occlusive
crises and more persistent, chronic pain. SCD-related pain is associated with significant
functional impairment, spanning poor school attendance, decreased quality of life, and stress
and mood difficulties. Pharmacological approaches are the first-line treatment for
SCD-related pain, but these can be costly and have unwanted side effects. Given limitations
from pharmacological approaches and the influence that poor behavioral responses have on
disease management and health outcomes suggest a critical need for alternative and adjunctive
treatments. Due to gaps in available behavioral treatments specifically designed for
addressing common challenges associated with pain management in pediatric SCD, the
investigators developed a manualized behavioral therapy protocol by tailoring existing
evidence-based treatments. The overall goal of the intervention is to reduce the impact of
pain on daily functioning in pediatric SCD. This study will empirically test the feasibility
and preliminary efficacy of this intervention for youth with SCD. Children and adolescents
with SCD between the ages of 8 and 17 years old (n=20) will be recruited to complete the
treatment protocol. Feasibility will be assessed by examining participation and program
completion rates, as well as feedback from a treatment acceptability questionnaire and
qualitative interview. Participants will complete baseline assessments, weekly
questionnaires, and post-treatment assessments (post-intervention assessment, follow-up time
points: 1-month following the intervention, and 3-months following the intervention).

Study point of contact

Megan Connolly, PhD
[email protected]


1 United States site


8 to 17 Years





Study type








participation requirements

– Children and adolescents with SCD (HbSS, HbSC, HbS-beta0 thalassemia, or HbS-beta+
thalassemia) between the ages of 8 and 17 years old with pain-related disability and
who are currently prescribed short- or long-acting opioid medications.

1. Participants will meet at least one of the following criteria for pain-related
disability: 1) Have had at least 3 pain crises in the last year, 2) Have had at
least one admission for pain in the last year, or 3) Have missed at least one
week of school (5 days) in the last year

2. Current prescription of opioids will be confirmed by participants’ primary
hematologist, review of the electronic medical record, and discussion with the

participation restrictions

– Patients and caregivers with limited English proficiency, a neurodevelopmental delay,
or a visual or motor impairment that would interfere with their ability to complete
the assessments and intervention.

– Documented history of major depressive disorder in medical record and/or through
discussion with their primary hematology suggesting that patients may need a specific
and higher level of therapeutic care.

– Patients have regularly scheduled outpatient therapy sessions outside of the study.


  • Washington, District of Columbia, United States, Children's National Hospital, 20010 [Recruiting]
Last updated 2021-01-25