Table 2.

Description of Program Modules

Module	Description	Goals	Materials
Module 1: Pain Journey	Participants are asked to create a visual timeline of their journey since the onset of their child's pain which includes elements of past, present, and future. Emphasis is placed on reflecting, expressing, and validating the parent's experience and the effect that their child's pain has had on their life (e.g. relationships, career, burdens, and loss). Participants are also challenged to look towards the future and envision wellness for themselves and their child despite current struggles.	1. To identify personal struggles, fears, and barriers present when caring for a child with chronic pain. 2. To acknowledge and validate the difficulty of the healing journey for parent as well as child. 3. To encourage parents to look towards the future with hope and positivity.	Landscape paper Pre-cut collage images Markers Oil pastels Chalk pastels Glue Scissors
Key themes: Self-reflection Validation Burden Loss Hope & Acceptance
Module 2: Social Atom	Adapted from Joseph Moreno's social atom inventory (Buchanan, 1984) ,this module asks participants to utilize symbols and shapes to create a “map” of social supports and important people in their life. Next they are encouraged to reflect and notate if each relationship is stimulating, energizing, and supportive (positive) or draining and conflict-ridden (negative). Participants are also asked to identify different people in their life who serve a specific purpose (e.g. a person you would call if you had a difficult day) and commit to contacting one person from their social atom in the coming week.	1. To explore, identify, and reflect on interpersonal relationships. 2. To identify positive and negative relationships/ support systems. 3. To reflect on the importance of maintaining personal relationships. 4. To reconnect with friends, family	Paper Markers Pens
Key themes: Support Healthy Relationships
Module 3: Invisible Support	From a group of 18 descriptive phrases and values written on button pins (e.g., “be confident,” “be admirable”) participants are asked to choose a value that is important to them as a parent or a value that they are working on strengthening. 10 minutes are given for free writing about the personal meaning and importance of this value. Next, they are guided to write this word on a large piece of paper in permanent marker and embellish it as they feel inspired. The individual papers are then passed around the circle whereupon each participant writes a supportive/ inspirational word, quote, phrase, or draws a symbol on their peer's paper in white crayon. The messages written in white crayon on white paper are invisible until the participant paints over his paper with watercolors to make the messages appear. Activity concludes with discussion about the metaphor of how those who support us may sometimes feel invisible.	1. To identify important values. 2. To cultivate support for peers and share positive self-statements with others. 3. To receive support from peers. 4. To create something that is tangible and reflective of the support which they receive in group. 6. To increase relaxation through the use of watercolors. 7. To increase imagination and artistic self-expression.	Landscape & lined paper Pens White crayons Permanent markers Watercolors Brushes Water Value statements
Key themes: Support Values identification
Module 4: Letter to Future Self	Participants are asked to envision themselves in the future, after their child has graduated from the program. Participants are encouraged to identify potential difficulties that could arise during this transitory time period. Participants are then asked to write a letter to their future self and to the other parents- as a way to affirm, validate, and support themself in the future. These letters are mailed out 2 weeks after their child's graduation to support participants post-discharge.	1. To increase parent's ability to self- validate 2. To cultivate support, empathy, and encouragement for one self and other. 3. To identify potential barriers for when their child is back home and preemptively use positive self- statements to manage distress.	Blank cardstock Colored pens Markers Oil Pastels Index cards
Key themes: Fear Validation Future