Quality of life in children with psychiatric disorders and parental well-being: Effects of group CBT

Health-related quality of life (HRQoL) is a multidimensional construct encompassing physical, psychological, and social functioning. It is increasingly used as a universal outcome in evaluating interventions for children with psychiatric disorders. This study examined the effects of group cognitive behavioral therapy (GCBT) on child HRQoL in naturalistic clinical settings and explored associations between child HRQoL and parental well-being dimensions using network analysis. The sample included 109 children with mixed psychiatric disorders. Of these, 56 were initially assigned to a waitlist condition receiving treatment as usual (TAU) before participating in GCBT. The final GCBT group comprised 99 children: 53 referred directly to GCBT and 46 who received it following TAU. Child HRQoL was assessed using child- and parent-rated KINDL-R, and parental well-being via the General Health Questionnaire and Jenkins Sleep Questionnaire. Assessments were conducted pre- and post-treatment, and at a 7-month follow-up. The parent-rated child HRQoL dimension Self-esteem showed significant improvement following GCBT, with gains maintained at follow-up. Although associations between child HRQoL and parental well-being dimensions were generally weak, both self- and parent-rated child HRQoL dimensions were interconnected. Notably, the parent-rated child HRQoL dimension Friends emerged as a central node in the network. GCBT may enhance self-esteem in children with mixed psychiatric disorders. The findings also highlight the potential value of targeting peer relationships in interventions in this population, given their central role in child HRQoL and parental well-being. • Group CBT may enhance parent-rated self-esteem in children with mixed psychiatric disorders. • Self- and parent-rated dimensions of child HRQoL were interrelated, while associations with parental well-being were weak. • Peer relationships may be important for both child HRQoL and parental well-being in children with mixed psychiatric disorder.