Wonders & Worries Advanced Cancer: A Psychosocial Intervention for Families Coping with an Advanced Cancer Diagnosis

Purpose: Children of parents with advanced cancer have significantly elevated levels of distress compared to children in the general population. This level of distress is even greater during the terminal phase of the disease than after the parent dies. Over 73% of cancer patients with children desire information and services to support their children but only 9% receive this type of support. Although parent-child communication is an important factor to help children adjust to their parent’s prognosis, 33% of parents struggle to communicate advanced disease information to children. In response to this need, this study evaluated a psychosocial intervention for parents diagnosed with advanced cancer and their families called “Wonders & Worries Advanced Cancer” (WW-AC).

This pilot study sought to offer relief to families by providing them tools to communicate effectively about illness and to cope with advanced disease. Specific aims were to: 1) assess the acceptability of intervention materials, 2) evaluate the relevance of materials to families, and 3) assess the significance of baseline to post-intervention measures using non-parametric statistics.

Methods: Mixed method single group design was used to evaluate feasibility and short-term impact of the intervention. The fully manualized intervention involves 5 child sessions, 2 parent sessions, and one family session provided by masters’ level mental health professionals. Sessions focused on assessing child and family challenges and offering activities focused on influencing factors demonstrated to impact children’s’ adjustment to parental cancer. This included positively influencing the child’s appraisal of cancer by providing honest, accurate information, increasing parent-child relationship quality by facilitating open communication, and promoting positive strategies to influence the child’s coping style. The within-group analysis involved a pre-posttest design in which participants’ scores at baseline are compared to post-intervention scores on outcome measures. Twenty families that had a parent with any type of advanced cancer and their children (aged 5-15) were enrolled. Standardized measures with well-established reliability and validity and prior use in cancer populations were used to assess parent and child functioning and family communication.

Results: Preliminary results show the program improved parenting skills, confidence for ill and well parents, the family’s emotional well-being, and children’s behavioral-emotional adjustment while decreasing ill parents’ concerns about the impact of their illness on their child. Upon completion of the intervention parent’s reported satisfaction with intervention content and materials in addition to appreciation for the flexibility of session timing.

Conclusions: WW-AC is a critically needed intervention program that has the capacity to help families manage a significant threat to their wellbeing, a severely ill parent with a disease for which there is no known cure. Data obtained from the proposed study will be used to inform development of a larger randomized controlled trial with a diverse population evaluating the efficacy of the intervention.

Acknowledgement: Research reported in this abstract was supported by St. David’s Center for