Brief Cognitive Behavioral Therapy to Treat Itch Rumination "Itch CBT" in Eczema

Northwestern University

Status: Completed

Conditions: Atopic Dermatitis

Treatments: Behavioral: Itch CBT

Study type: Interventional

Funder types: Other

Identifiers

NCT04486742

IRB 2019-2560

Details and patient eligibility

About

The main purpose of this study is to adapt cognitive behavior therapy (CBT) to improve itch in children with eczema.

Full description

Eczema is characterized by chronic itch. Many children develop a chronic focus (rumination) on their itch. Rumination is a maladaptive method of responding to distress, in which the individual thinks obsessively about the source of distress. The rumination on chronic itch in eczema can have detrimental effects on one's quality of life, as well as induce significant anxiety about when itch will return, how long it will last, and how it will affect physical and social functioning.

Cognitive behavior therapy (CBT) is a frontline treatment for rumination, as it focuses on teaching strategies so that the individual can examine distressing thoughts objectively and determine their validity, replace negative thinking patterns with more adaptive thought patterns, and increase the individual's awareness to their problematic thought patterns. Additionally, CBT helps the individual to implement behavioral strategies to cope with possibly anxiety-inducing situations, such as scratching while trying to go to sleep.

The investigators hypothesize that an Itch CBT intervention is an effective, non-medication-based, easy to implement strategy to improve itch in children with eczema.

Enrollment: 20 patients

Sex: All

Ages: 8 to 17 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Moderate to severe atopic dermatitis [assessed by Patient Oriented Eczema Measure (POEM)score of >-8 OR NRS itch score of >= 4].
• English speaking.
• Currently receiving treatment at Lurie Children's Hospital for atopic dermatitis.
• Parent or guardian available to participate in protocol.
• Have sufficient technology (e.g., cell phone, computer, tablet, etc.) that can be used to access Zoom conference technology for telemedicine visits.

Exclusion criteria

• Inability to comprehend and complete questionnaires.
• History of intellectual disability or psychosis.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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20 participants in 2 patient groups

Itch CBT Arm

Experimental group

Description:

Participants randomized to the Itch CBT Arm will participate in 4 weekly telehealth sessions with a therapist to address common areas of anxiety related to atopic dermatitis.

Treatment:

Behavioral: Itch CBT

Usual Care Arm

No Intervention group

Description:

Participants randomized to the Usual Care Arm of the study will receive standard of care eczema educational materials that are typically provided by their health care provider after a clinic (or telehealth) visit.