Congruence between coaching interventions and children's coping style : effects on coping
Webb, Louise Anne
Some children with recurrent pain do not experience adjustment problems, whereas other children experience difficulties such as poor school attendance, a marked decrease in activities and high anxiety. In the psychological literature these children are often labelled 'copers' and 'non-copers,' respectively. Coping efforts are thought to be influenced both by individual coping styles and direct instruction from others. The coping style of catastrophizing is often found in individuals with recurrent pain. Catastrophizing is associated with greater distress and can interfere with the perceived effectiveness of children's coping. Some literature exists which examines the effect of matching pre-existing coping styles with interventions on subsequent coping. However, the findings from pain studies of the effects of the congruence or 'match' are equivocal. The purpose of this study was to examine the relationship between children's style of coping (high vs low catastrophizing) and the efficacy of coaching in style-consistent (matched) or style-in consistent (mismatched) coping techniques during a pain analogue task. The two types of coaching (positive and negative/catastrophizing) were based on a preliminary study in which parents' spontaneous coaching of their children in an exercise bike situation was observed. Participants included 68 children between 7 and 12 years of age (38 with recurrent pain; 26 girls, 12 boys and 30 healthy; 21 girls, 9 boys). The children completed two 10-minute exercise sessions (with a 20-minute break) while receiving the two different types of coaching from experimenters. Number of coping strategies, rated effectiveness of coping strategies, pain ratings and work output were measured. It was expected that significant interactions would occur between type of coaching and level of catastrophizing, specifically when the-match occurred (i.e., low catastrophizers-positive coaching, high catastrophizers-negative coaching). In addition, main effects for level of catastrophizing and for type of coaching were predicted. No support was found for the congruency hypothesis. Contrary to the hypotheses, high catastrophizers reported using more coping strategies and had higher rated effectiveness than low catastrophizers. Consistent with the hypotheses, positive coaching was associated with increased coping and rated effectiveness, as compared to the negative coaching. There were no differences between the pain and healthy group in terms of their coping, when matched for type of coaching and level of catastrophizing. The findings lend support to the use of distraction, imagery and encouragement when trying to help children cope with a painful situation. Also, the unexpected findings concerning level of catastrophizing challenges the existing literature that says high catastrophizers are poor copers, show more distress and have poorer outcomes.