There is substantial evidence that a diagnosis of childhood cancer is a particularly potent stressor for the ill child and his or her family members, affecting quality of life in psychological, social and behavioral domains. Further, it is suggested that a parent's ability to cope with this stress is related to the psychological and physiological responses in themselves and their children. Although the benefit of interventions designed to reduce stress and to increase coping ability among adult cancer patients has been well documented, to date there are no equivalent studies with families experiencing childhood cancer that targets parents and children. This study represents an initial effort to develop and implement a multimodal, stress management and coping enhancement intervention tailored for children with cancer and their parents. Sixty children aged 8 to 17 who are within one month of diagnosis with any childhood cancer other than central nervous system cancer, and their parents, will be randomized to a multimodal stress management intervention. The proposed intervention includes traditional face-to-face sessions with a health psychologist supplemented by between session telephone contact and a web-based internet component designed to provide information and support in a more accessible and timely manner to all family members, including siblings, who often are difficult to access but are at significant risk for later adjustment difficulties. The primary aims of the study are to: (1) document the feasibility of a multimodal stress management intervention for families of children diagnosed with cancer; (2) determine whether participation in the intervention is associated with an increase in the use of active coping skills known to be associated with lower levels of distress. Secondary aims are to: (3) examine the potential utility of the intervention with respect to parent and child distress and health-related quality of life; and (4) examine potential predictors of treatment outcome. This project will provide the initial evidence and methodological foundation to support an application for a full-scale randomized, controlled clinical trial of the effectiveness of a stress management and coping enhancement intervention for families with a child newly diagnosed with cancer.
