This proposal develops a plan for the implementation and evaluation of a primary prevention program For children facing the imminent death of a parent. This short-term intervention program offers parental guidance to the well parent in order to enable his or her to better promote the maintenance of competence in his or her children following the death of an ill parent. The intervention is designed to achieve these goals by influencing the parent's relationship with the child and the family environment. Specifically, by intervening with parents through a strategy of parent guidance, we intend to provide them with the support, knowledge and insight necessary to maintain and enhance their ability to: meet their child's needs for care and support: provide an environment of open communication in which the child feels free to express his/her feelings, thoughts and fantasies; and maintain a relatively stable and consistent environment for the child. The intervention consists of both a pre-death and a post-death component. A social worker meets with the well parent five times before and five times after the death in sessions that focus on supporting parenting and imparting knowledge about the nature, course and meaning of children's grief reactions. Each child is seen twice before and twice after the death to determine the child's reactions to the illness and death and to assess his/her needs and concerns. The efficacy of the program will be evaluated using a pretest- posttest randomized control-group design with 110 children of terminally ill cancer patients per group. The children will range in age from 8 to 16. Intergroup comparisons will be made 6 and 13 months after the death to measure the program's impact on the child's adaptation to the loss. The child's competence will be measured by school performance, school adjustment, and the extent of psychological and somatic symptoms.

National Institute of Health (NIH)
Research Project (R01)
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Life Course and Prevention Research Review Committee (LCR)
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Memorial Hospital for Cancer & Allied Di
New York
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Christ, Grace H; Christ, Adolph E (2006) Current approaches to helping children cope with a parent's terminal illness. CA Cancer J Clin 56:197-212
Christ, Grace H; Raveis, Victoria H; Seigel, Karolynn et al. (2005) Evaluation of a preventive intervention for bereaved children. J Soc Work End Life Palliat Care 1:57-81
Christ, Grace H; Siegel, Karolynn; Christ, Adolph E (2002) Adolescent grief: "It never really hit me...until it actually happened". JAMA 288:1269-78
Pfeffer, C R; Karus, D; Siegel, K et al. (2000) Child survivors of parental death from cancer or suicide: depressive and behavioral outcomes. Psychooncology 9:10-Jan
Siegel, K; Karus, D; Raveis, V H (1996) Adjustment of children facing the death of a parent due to cancer. J Am Acad Child Adolesc Psychiatry 35:442-50
Siegel, K; Karus, D G; Raveis, V H et al. (1996) Depressive distress among the spouses of terminally ill cancer patients. Cancer Pract 4:25-30
Christ, G H; Siegel, K; Sperber, D (1994) Impact of parental terminal cancer on adolescents. Am J Orthopsychiatry 64:604-13
Siegel, K; Mesagno, F P; Karus, D et al. (1992) Psychosocial adjustment of children with a terminally ill parent. J Am Acad Child Adolesc Psychiatry 31:327-33
Christ, G H; Siegel, K; Mesagno, F P et al. (1991) A preventive intervention program for bereaved children: problems of implementation. Am J Orthopsychiatry 61:168-78
Siegel, K; Mesagno, F P; Christ, G (1990) A prevention program for bereaved children. Am J Orthopsychiatry 60:168-75

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