The emotional adjustment of children has been linked to parental, especially maternal, reports of their own mental/physical health; health beliefs; coping styles; and perceptions of family and community social support. In a report on maternal well-being and the functioning of healthy siblings of pediatric cancer patients published in the late 1980s, Sahler et al found that lower levels of maternal well-being were correlated with poorer adaptation among healthy siblings. The study also found that mothers of poorly adjusted siblings coped by accessing more resources than did mothers of better adjusted siblings. Interestingly, however, these mothers' level of satisfaction with their resources was remarkably low. It is unknown whether their dissatisfaction was due to accessing the wrong resources; their inability to articulate their needs with sufficient clarity to obtain appropriate help; or their falure to effectively apply whatever advice was offered. These findings led us to hypothesize that a systematic method for teaching mothers of children with cancer ways to identify and solve problems to increase coping skills would reduce their perceived distress and increase their levels of self- satisfaction and well-being. The Bright IDEAS paradigm of Problem Solving Skills Training (PSST) has now been tested in > 830 mothers of recently diagnosed childhood cancer patients and found to be highly effective in reducing their levels of distress. It is also one of a very few programs to have been designated a Research- tested Therapy and Intervention Program (RTIP) by the NCI and given a Dissemination Capability score of 5.0/5.0. Using the principles of Diffusion of Innovation Theory, this proposal is designed to build capacity by training 200 professionals in partnership with the Children's Oncology Group (COG), the Association of Pediatric Oncology Social Workers (APOSW), the Association of Pediatric Hematology/Oncology Nurses (APHON), and the Society of Pediatric Psychologists (SPP) special interest group in hematology/oncology how to provide PSST to mothers, fathers, and other primary caregivers at child cancer centers throughout the US. Website-based materials developed for this project will make PSST available world-wide.
The goal of this proposal is to develop, deliver, and evaluate (dissemination trial) a 1.5 day training and follow- up case supervision in Problem Solving Skills Training (PSST) for psychologists, social workers, and advanced practice nurses who work at childhood cancer centers throughout the US. PSST is one of a small group of NCI/NIH designated Research-based Therapies and Intervention Programs (RTIP). Although already tested on > 830 mothers of children recently diagnosed with cancer who showed dramatic improvement in well-being, the use of PSST has been limited to 7 research institutions. This project proposes to bring PSST from the laboratory to the bedside by training 200 cancer psychosocial care providers. Updated and enhanced materials developed to support this project will ultimately be housed on the RTIP and COG websites. We will also seek funding for broader ongoing dissemination efforts after this project is completed (private foundations: Mattie Miracle, CureSearch, St. Baldrick).
