Childhood-onset Systemic Lupus Erythematosus (cSLE) is a complex autoimmune disease. Patients with cSLE often experience debilitating symptoms of fatigue, depression, and pain, even when medical aspects of disease activity are well-controlled. Cognitive behavioral therapy (CBT) can be effective in managing fatigue, pain and depression. Unfortunately, patients often experience barriers to receiving CBT in person, such as long distance to treatment facilities. In partnership with cSLE patients and caregivers, our research team proposes to test a remotely delivered CBT intervention compared to medical treatment as usual. It is expected that the remotely delivered CBT intervention will reduce symptoms of fatigue, depression, and pain over and above standard medical care. The results of this project will provide data to support a future study focused on improving health outcomes for individuals affected with cSLE and other rheumatic conditions.