SPACE for Youth With Chronic Pain

Development of a Parent Training Intervention for Pediatric Patients With Pain

The primary objective is to assess the feasibility and acceptability of a group-based parent training intervention for parents of youth with chronic pain. Secondary objectives include evaluating changes in child functional impairment, pain intensity, and parent accommodation.

Study Overview

• Status: Recruiting
• Conditions: Chronic Pain
• Intervention / Treatment: Behavioral: Supportive Parenting for Anxious Childhood Emotions - Pain

• Study Type: Observational
• Enrollment (Estimated): 48

Contacts and Locations

• Study Contact: Name: Christina Murphy, PhD; Phone Number: 215-590-6577; Email: murphyc11@chop.edu
• Study Contact Backup: Name: Julia Ney, MA; Phone Number: 215-590-6577; Email: neyjs@chop.edu

Study Locations

• United States
  • California
    • Palo Alto, California, United States, 94025
      • Not yet recruiting
      • Stanford Children's Health
      • Contact: Rashmi Bhandari, PhD; Phone Number: 650-724-5333; Email: rbhandar@stanford.edu
  • Pennsylvania
    • Philadelphia, Pennsylvania, United States, 19104
      • Recruiting
      • Children's Hospital of Philadelphia
      • Contact: Christina Murphy, PhD; Phone Number: 215-590-6577; Email: murphyc11@chop.edu

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: N/A

• Sampling Method: Non-Probability Sample

Study Population

Children ages 10-17 years old with a chronic pain condition.

Description

Inclusion Criteria:

• Children aged 10-17 with chronic pain (≥3 months) and associated functional impairment
• Parent/guardian living with the child ≥50% of the time
• Parent and child are fluent in English

Exclusion Criteria:

• Pain better explained by another medical condition
• History of psychosis, bipolar disorder, autism spectrum disorder, or intellectual disability (child)
• Current emotional, cognitive, or physical barrier to participation for caregiver, as determined by clinical judgment of study personnel
• Severe psychiatric symptoms requiring immediate intervention
• Ongoing individual Cognitive Behavioral Therapy (CBT) for pain

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Youth with chronic pain; Youth with chronic pain will complete questionnaires assessing secondary outcome measures prior to the start of the parent-only group intervention. The parent-only group intervention is 6 weekly, 90 minute sessions held over a secure virtual platform. Sessions will focus on orientation to the group, psychoeducation about pain neuroscience, and the role of parents in pain management, how parents can increase support for their child as well as decrease behaviors that may inadvertently maintain or reinforce pain and pain-related behaviors. Sessions will be recorded to ensure consistency in session content across groups. Homework will be assigned to parents after each session and will be reviewed the following week. Youth with chronic pain will then be asked to complete questionnaires at the end of the intervention, and at 1-month and 3-month follow up time points. Questionnaire completion is expected to take about 20 minutes at each time point.
Parents of youth with chronic pain; Parents of youth with chronic pain will complete questionnaires assessing secondary outcome measures prior to the start of the parent-only group intervention. The parent-only group intervention is 6 weekly, 90 minute sessions held over a secure virtual platform. Sessions will focus on orientation to the group, psychoeducation about pain neuroscience, and the role of parents in pain management, how parents can increase support for their child as well as decrease behaviors that may inadvertently maintain or reinforce pain and pain-related behaviors. Sessions will be recorded to ensure consistency in session content across groups. Homework will be assigned to parents after each session and will be reviewed the following week. Parents of youth with chronic pain will be asked to complete questionnaires at the end of the intervention (45 minutes), and repeat some of the questionnaires at follow up time points (35-40 minutes).	Behavioral: Supportive Parenting for Anxious Childhood Emotions - Pain; Originally developed for pediatric anxiety disorders, SPACE equips parents to reduce accommodation while maintaining a warm, empathic stance.; Other Names: SPACE

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Feasibility - Acceptance	Feasibility of intervention as measured by the mean of number of sessions attended. Local session documents will track each session.	From enrollment through the end of the treatment (6-8 weeks)
Acceptability - Client Satisfaction	Client satisfaction with the intervention will be measured by the patient-reported Client Satisfaction Questionnaire. The Client Satisfaction Questionnaire is an 8-item, widely used, self-report measure for assessing general client satisfaction with mental health services. It uses a 4-point Likert scale for each question. This will be administered to parents, who received the intervention. Total scores range from 8 to 32, with higher scores indicating greater satisfaction. Parents of youth with chronic pain will be asked to complete this measure at the end of the intervention.	Post-treatment (6-8 weeks)
Acceptability - Provider	Provider will assess the acceptability of the measure by the Acceptability of Intervention Measure. This 4-item measure is measured on a 5-point Likert scale (1 = completely disagree; 5 = completely agree). Scoring involves calculating the mean of the 4 items (range 1-5), with higher scores indicating higher acceptability. Providers will be asked to complete this measure at the end of the intervention.	Post-treatment (6-8 weeks)
Provider Intervention Appropriateness	Provider will assess the appropriateness of the measure by the Intervention Appropriateness Measure. This 4-item measure is measured on a 5-point Likert scale (1 = completely disagree; 5 = completely agree). Scoring involves calculating the mean of the 4 items (range 1-5), with higher scores indicating higher degree of appropriateness. Providers will be asked to complete this measure at the end of the intervention	Post-treatment (6-8 weeks)
Feasibility - Provider	Provider will assess the feasibility of the measure by the Feasibility of Intervention Measure. This 4-item measure is measured on a 5-point Likert scale (1 = completely disagree; 5 = completely agree). Scoring involves calculating the mean of the 4 items (range 1-5), with higher scores indicating higher degree of feasibility. Providers will be asked to complete this measure at the end of the intervention	Post-treatment (6-8 weeks)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Anxiety - Child	This 8-item Patient-Reported Outcomes Measurement Information System (PROMIS) - Anxiety scale measures the frequency and intensity of anxiety symptoms in children and adolescents per self- and parent-report. Responses are measured on a 5 point likert scale (1, "never" to 5, "almost always"). It is part of the PROMIS pediatric system and allows for reliable, standardized comparisons across studies. Total scores are calculated by summing each item response. Total scores are then translated into a T-score for each participant. The T-score rescales the raw score into a standardized T-score with a mean of 50 and a standard deviation (SD) of 10. Therefore, a person with a T-score of 40 is one SD below the mean. Youth will complete this questionnaire at baseline, post-treatment, as well as one- and three-month follow up time points.	Baseline
Anxiety - Child	This 8-item PROMIS Anxiety scale measures the frequency and intensity of anxiety symptoms in children and adolescents per self- and parent-report. Responses are measured on a 5 point likert scale (1, "never" to 5, "almost always"). It is part of the PROMIS pediatric system and allows for reliable, standardized comparisons across studies. Total scores are calculated by summing each item response. Total scores are then translated into a T-score for each participant. The T-score rescales the raw score into a standardized T-score with a mean of 50 and a standard deviation (SD) of 10. Therefore, a person with a T-score of 40 is one SD below the mean. Youth will complete this questionnaire at baseline, post-treatment, as well as one- and three-month follow up time points.	Post-Treatment (6-8 weeks)
Anxiety - Child	This 8-item PROMIS Anxiety scale measures the frequency and intensity of anxiety symptoms in children and adolescents per self- and parent-report. Responses are measured on a 5 point likert scale (1, "never" to 5, "almost always"). It is part of the PROMIS pediatric system and allows for reliable, standardized comparisons across studies. Total scores are calculated by summing each item response. Total scores are then translated into a T-score for each participant. The T-score rescales the raw score into a standardized T-score with a mean of 50 and a standard deviation (SD) of 10. Therefore, a person with a T-score of 40 is one SD below the mean. Youth will complete this questionnaire at baseline, post-treatment, as well as one- and three-month follow up time points.	1 month Post-Treatment
Anxiety - Child	This 8-item PROMIS Anxiety scale measures the frequency and intensity of anxiety symptoms in children and adolescents per self- and parent-report. Responses are measured on a 5 point likert scale (1, "never" to 5, "almost always"). It is part of the PROMIS pediatric system and allows for reliable, standardized comparisons across studies. Total scores are calculated by summing each item response. Total scores are then translated into a T-score for each participant. The T-score rescales the raw score into a standardized T-score with a mean of 50 and a standard deviation (SD) of 10. Therefore, a person with a T-score of 40 is one SD below the mean. Youth will complete this questionnaire at baseline, post-treatment, as well as one- and three-month follow up time points.	3 months Post-Treatment
Anxiety - Parent	This 8-item PROMIS Anxiety scale measures the frequency and intensity of anxiety symptoms in children and adolescents per self- and parent-report. Responses are measured on a 5 point likert scale (1, "never" to 5, "almost always"). It is part of the PROMIS pediatric system and allows for reliable, standardized comparisons across studies. Total scores are calculated by summing each item response. Total scores are then translated into a T-score for each participant. The T-score rescales the raw score into a standardized T-score with a mean of 50 and a standard deviation (SD) of 10. Therefore, a person with a T-score of 40 is one SD below the mean. Parents will complete this questionnaire at baseline, post-treatment, as well as one- and three-month follow up time points.	Baseline
Anxiety - Parent	This 8-item PROMIS Anxiety scale measures the frequency and intensity of anxiety symptoms in children and adolescents per self- and parent-report. Responses are measured on a 5 point likert scale (1, "never" to 5, "almost always"). It is part of the PROMIS pediatric system and allows for reliable, standardized comparisons across studies. Total scores are calculated by summing each item response. Total scores are then translated into a T-score for each participant. The T-score rescales the raw score into a standardized T-score with a mean of 50 and a standard deviation (SD) of 10. Therefore, a person with a T-score of 40 is one SD below the mean. Parents will complete this questionnaire at baseline, post-treatment, as well as one- and three-month follow up time points.	Post-Treatment (6-8 weeks)
Anxiety - Parent	This 8-item PROMIS Anxiety scale measures the frequency and intensity of anxiety symptoms in children and adolescents per self- and parent-report. Responses are measured on a 5 point likert scale (1, "never" to 5, "almost always"). It is part of the PROMIS pediatric system and allows for reliable, standardized comparisons across studies. Total scores are calculated by summing each item response. Total scores are then translated into a T-score for each participant. The T-score rescales the raw score into a standardized T-score with a mean of 50 and a standard deviation (SD) of 10. Therefore, a person with a T-score of 40 is one SD below the mean. Parents will complete this questionnaire at baseline, post-treatment, as well as one- and three-month follow up time points.	1 month Post-Treatment
Anxiety - Parent	This 8-item PROMIS Anxiety scale measures the frequency and intensity of anxiety symptoms in children and adolescents per self- and parent-report. Responses are measured on a 5 point likert scale (1, "never" to 5, "almost always"). It is part of the PROMIS pediatric system and allows for reliable, standardized comparisons across studies. Total scores are calculated by summing each item response. Total scores are then translated into a T-score for each participant. The T-score rescales the raw score into a standardized T-score with a mean of 50 and a standard deviation (SD) of 10. Therefore, a person with a T-score of 40 is one SD below the mean. Parents will complete this questionnaire at baseline, post-treatment, as well as one- and three-month follow up time points.	3 months Post-Treatment
Depression - Child	The PROMIS Depression Short Form evaluates depressive symptoms, including sadness and unhappiness, in pediatric populations in the past 7 days. The Child report form is 8 items. Responses are measured on a 5 point likert scale (1 = never to 5 =almost always). It provides a standardized measure of affective functioning relevant to chronic pain and related conditions. Total scores are calculated by summing each item response. Total scores are then translated into a T-score for each participant. The T-score rescales the raw score into a standardized T-score with a mean of 50 and a standard deviation (SD) of 10. Therefore, a person with a T-score of 40 is one SD below the mean. Youth will complete this questionnaire at baseline, post-treatment, as well as one- and three-month follow up time points.	Baseline
Depression - Child	The PROMIS Depression Short Form evaluates depressive symptoms, including sadness and unhappiness, in pediatric populations in the past 7 days. The Child report form is 8 items. Responses are measured on a 5 point likert scale (1 = never to 5 =almost always). It provides a standardized measure of affective functioning relevant to chronic pain and related conditions. Total scores are calculated by summing each item response. Total scores are then translated into a T-score for each participant. The T-score rescales the raw score into a standardized T-score with a mean of 50 and a standard deviation (SD) of 10. Therefore, a person with a T-score of 40 is one SD below the mean. Youth will complete this questionnaire at baseline, post-treatment, as well as one- and three-month follow up time points.	Post-Treatment (6-8 weeks)
Depression - Child	The PROMIS Depression Short Form evaluates depressive symptoms, including sadness and unhappiness, in pediatric populations in the past 7 days. The Child report form is 8 items. Responses are measured on a 5 point likert scale (1 = never to 5 =almost always). It provides a standardized measure of affective functioning relevant to chronic pain and related conditions. Total scores are calculated by summing each item response. Total scores are then translated into a T-score for each participant. The T-score rescales the raw score into a standardized T-score with a mean of 50 and a standard deviation (SD) of 10. Therefore, a person with a T-score of 40 is one SD below the mean. Youth will complete this questionnaire at baseline, post-treatment, as well as one- and three-month follow up time points.	1 month Post-Treatment
Depression - Child	The PROMIS Depression Short Form evaluates depressive symptoms, including sadness and unhappiness, in pediatric populations in the past 7 days. The Child report form is 8 items. Responses are measured on a 5 point likert scale (1 = never to 5 =almost always). It provides a standardized measure of affective functioning relevant to chronic pain and related conditions. Total scores are calculated by summing each item response. Total scores are then translated into a T-score for each participant. The T-score rescales the raw score into a standardized T-score with a mean of 50 and a standard deviation (SD) of 10. Therefore, a person with a T-score of 40 is one SD below the mean. Youth will complete this questionnaire at baseline, post-treatment, as well as one- and three-month follow up time points.	3 months Post-Treatment
Depression - Parent	The PROMIS Depression Short Form evaluates depressive symptoms, including sadness and unhappiness, in pediatric populations in the past 7 days. The Parent report form is 6 items. Responses are measured on a 5 point likert scale (1 = never to 5 =almost always). It provides a standardized measure of affective functioning relevant to chronic pain and related conditions. Total scores are calculated by summing each item response. Total scores are then translated into a T-score for each participant. The T-score rescales the raw score into a standardized T-score with a mean of 50 and a standard deviation (SD) of 10. Therefore, a person with a T-score of 40 is one SD below the mean. Parents will complete this questionnaire at baseline, post-treatment, as well as one- and three-month follow up time points.	Baseline
Depression - Parent	The PROMIS Depression Short Form evaluates depressive symptoms, including sadness and unhappiness, in pediatric populations in the past 7 days. The Parent report form is 6 items. Responses are measured on a 5 point likert scale (1 = never to 5 =almost always). It provides a standardized measure of affective functioning relevant to chronic pain and related conditions. Total scores are calculated by summing each item response. Total scores are then translated into a T-score for each participant. The T-score rescales the raw score into a standardized T-score with a mean of 50 and a standard deviation (SD) of 10. Therefore, a person with a T-score of 40 is one SD below the mean. Parents will complete this questionnaire at baseline, post-treatment, as well as one- and three-month follow up time points.	Post-Treatment (6-8 weeks)
Depression - Parent	The PROMIS Depression Short Form evaluates depressive symptoms, including sadness and unhappiness, in pediatric populations in the past 7 days. The Parent report form is 6 items. Responses are measured on a 5 point likert scale (1 = never to 5 =almost always). It provides a standardized measure of affective functioning relevant to chronic pain and related conditions. Total scores are calculated by summing each item response. Total scores are then translated into a T-score for each participant. The T-score rescales the raw score into a standardized T-score with a mean of 50 and a standard deviation (SD) of 10. Therefore, a person with a T-score of 40 is one SD below the mean. Parents will complete this questionnaire at baseline, post-treatment, as well as one- and three-month follow up time points.	1 month Post-Treatment
Depression - Parent	The PROMIS Depression Short Form evaluates depressive symptoms, including sadness and unhappiness, in pediatric populations in the past 7 days. The Parent report form is 6 items. Responses are measured on a 5 point likert scale (1 = never to 5 =almost always). It provides a standardized measure of affective functioning relevant to chronic pain and related conditions. Total scores are calculated by summing each item response. Total scores are then translated into a T-score for each participant. The T-score rescales the raw score into a standardized T-score with a mean of 50 and a standard deviation (SD) of 10. Therefore, a person with a T-score of 40 is one SD below the mean. Parents will complete this questionnaire at baseline, post-treatment, as well as one- and three-month follow up time points.	3 months Post-Treatment
Parent Stress	The Parent Stress Scale is an 18-item self-report scale. Items represent positive (e.g., emotional benefits, personal development) and negative (e.g., demands on resources, restrictions) themes of parenthood. Respondents agree or disagree in terms of their typical relationship with their child. Responses are measured on a 5-point likert scale (1=strongly disagree to 5=strongly agree). A total score is calculated by summing each item score. Overall possible scores on the scale range from 18 - 90. The higher the score, the higher the measured level of Parental stress. Parents will complete this questionnaire at baseline, post-treatment, as well as one- and three-month follow up time points.	Baseline
Parent Stress	The Parent Stress Scale is an 18-item self-report scale. Items represent positive (e.g., emotional benefits, personal development) and negative (e.g., demands on resources, restrictions) themes of parenthood. Respondents agree or disagree in terms of their typical relationship with their child. Responses are measured on a 5-point likert scale (1=strongly disagree to 5=strongly agree). Overall possible scores on the scale range from 18 - 90. A total score is calculated by summing each item score. Overall possible scores on the scale range from 18 - 90. The higher the score, the higher the measured level of Parental stress. Parents will complete this questionnaire at baseline, post-treatment, as well as one- and three-month follow up time points.	Post-Treatment (6-8 weeks)
Parent Stress	The Parent Stress Scale is an 18-item self-report scale. Items represent positive (e.g., emotional benefits, personal development) and negative (e.g., demands on resources, restrictions) themes of parenthood. Respondents agree or disagree in terms of their typical relationship with their child. Responses are measured on a 5-point likert scale (1=strongly disagree to 5=strongly agree). A total score is calculated by summing each item score. Overall possible scores on the scale range from 18 - 90. The higher the score, the higher the measured level of Parental stress. Parents will complete this questionnaire at baseline, post-treatment, as well as one- and three-month follow up time points.	1 month Post-Treatment
Parent Stress	The Parent Stress Scale is an 18-item self-report scale. Items represent positive (e.g., emotional benefits, personal development) and negative (e.g., demands on resources, restrictions) themes of parenthood. Respondents agree or disagree in terms of their typical relationship with their child. Responses are measured on a 5-point likert scale (1=strongly disagree to 5=strongly agree). A total score is calculated by summing each item score. Overall possible scores on the scale range from 18 - 90. The higher the score, the higher the measured level of Parental stress. Parents will complete this questionnaire at baseline, post-treatment, as well as one- and three-month follow up time points.	3 months Post-Treatment
Parent Accommodation	The Inventory of Parent Accommodations to Children's Symptoms (IPACS) is an 11-item parent report form that assesses the degree to which parents accommodate their child's pain. Responses are captured on a 5-point likert scale (0, "never" to 4, "always"). A total score is calculated by summing each item score. Overall possible scores range from 0 to 44 with higher scores suggesting greater parental accommodation. Parents will complete this questionnaire at baseline, post-treatment, as well as one- and three-month follow up time points.	Baseline
Parent Accommodation	The Inventory of Parent Accommodations to Children's Symptoms (IPACS) is an 11-item parent report form that assesses the degree to which parents accommodate their child's pain. Responses are captured on a 5-point likert scale (0, "never" to 4, "always"). A total score is calculated by summing each item score. Overall possible scores range from 0 to 44 with higher scores suggesting greater parental accommodation. Parents will complete this questionnaire at baseline, post-treatment, as well as one- and three-month follow up time points.	Post-Treatment (6-8 weeks)
Parent Accommodation	The Inventory of Parent Accommodations to Children's Symptoms (IPACS) is an 11-item parent report form that assesses the degree to which parents accommodate their child's pain. Responses are captured on a 5-point likert scale (0, "never" to 4, "always"). A total score is calculated by summing each item score. Overall possible scores range from 0 to 44 with higher scores suggesting greater parental accommodation. Parents will complete this questionnaire at baseline, post-treatment, as well as one- and three-month follow up time points.	1 month Post-Treatment
Parent Accommodation	The Inventory of Parent Accommodations to Children's Symptoms (IPACS) is an 11-item parent report form that assesses the degree to which parents accommodate their child's pain. Responses are captured on a 5-point likert scale (0, "never" to 4, "always"). A total score is calculated by summing each item score. Overall possible scores range from 0 to 44 with higher scores suggesting greater parental accommodation. Parents will complete this questionnaire at baseline, post-treatment, as well as one- and three-month follow up time points.	3 months Post-Treatment

Collaborators and Investigators

• Sponsor: Children's Hospital of Philadelphia
• Collaborators: Stanford Children's Health
• Investigators: Principal Investigator: Christina Murphy, PhD, Children's Hospital of Philadelphia

Study record dates

Study Major Dates

• Study Start (Actual): March 13, 2026
• Primary Completion (Estimated): June 30, 2026
• Study Completion (Estimated): June 30, 2026

Study Registration Dates

• First Submitted: February 16, 2026
• First Submitted That Met QC Criteria: February 16, 2026
• First Posted (Actual): February 23, 2026

Study Record Updates

• Last Update Posted (Actual): April 15, 2026
• Last Update Submitted That Met QC Criteria: April 14, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Chronic Pain
• Other Study ID Numbers: 25-023906

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No