Table 3 Representative Quotes from Qualitative Interviews

Domain 1: Feasibility

Theme: Practice/Usability of skills

I think [the skills] are pretty versatile. .. you can do them while you are in a room full of people and they might not necessarily know.

…before I knew about activity pacing I would just try to squeeze it in as much as I possible could without breaking and then I’d just wear myself out and that would lead to flares. But I feel better now that I’m taking breaks in between.

Out in the sun, I can’t go and do anything so when my friends are playing in the sun, so the [calming] statements come in handy.

Theme: Barriers to Feasibility

If I’m out with friend, I probably wouldn’t want to do [the coping skills] in front of them.

Domain 2: Tolerability/Acceptability

Theme: Program Format

There wasn’t too much information packed in one session, but it also wasn’t so short that there was no time to go over anything.

Personally, I liked six [sessions] because that still really kept me going and now, being the last session, I feel awesome. I feel like I can actually move on…

There could probably be a couple more sessions just to go over certain things and go over things that you think you need a little more help on.

Theme: Therapist Characteristics

Like when she did [the coping skills] with me. I liked that because I felt like… me trying to do it at home probably wouldn’t have worked so I liked how she did it with me here just so I could know what it feels like.

She focused more on what was specific for me. It wasn’t overall what was helpful for everybody- it was specific for me.

I felt like [the therapist] actually understood where I was coming from which was amazing. .. it’s so nice to have someone to listen to that

Theme: Suggested Modifications

Post-it notes to write out things and a specific time and place to do a certain activity [would be helpful].

…advocating for yourself should have been one of the first skills instead of the last skill because I think that’s something teens could use a little more practice on.

[More skills for] memory [which] is like a big issue for me and it gets me a lot, it gets frustrating.

Domain 3: Treatment Outcomes

Theme: Sleep/Fatigue

[Using the sleep skills] helps me take less medicine at nighttime. Instead of taking melatonin, I just used the relaxing muscles [progressive muscle relaxation].

So when I tried [charging my phone outside of my room]…I tried it for a full week and it actually worked. And I liked it so I want to continue with that because I actually slept better.

Theme: Mood

[The intervention] gave good things to do to keep stress levels down and to better take care of myself in the future.

Just like changing your perspective on things. .. she just said like if you have a negative thought then you can turn it into a positive like this and then she gave different ways.

And I feel like I’m more happy, a lot happier than what I was before I started.

Theme: Pain

I think [the intervention] is really helpful with pain and how to deal with that.

[Progressive muscle relaxation is helpful when] I have aches… or feel tight.

I definitely think [the content from the intervention is] going to help me a lot, especially when I am having a flare.

Theme: Self-Management

[The program provided] good ideas to calm down and take care of myself- not just laying around and feeling bad, but preventing feeling bad in the future.

Theme: Self-Efficacy

I’m actually very confident that this program will help me cope better.

…when I do feel sick I try to tell myself like oh everything’s going to be okay. You don’t have to be sad all the time. I actually really needed that.