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The psycho-social and medical care of families with a cancer sick child can be more effective if the team can identify those parents who need help most desperately from the very beginning. In a retrospective study of 20 patients and their families two groups of parents with different levels of stress could be seperated. Highly stressed parents demonstrated already at the time of diagnosis unfavorable coping strategies with the possibility of a cancer disease. They experience a high degree of guilt feelings and believe that they might be responsible for the occurrence of the disease. However they refuse more often than the other parents psycho-social help offered by the professionals. The results suggest to implement special kind of help for the more stressed families already in the early phase of diagnosis and treatment.

Concepts for counseling and long term support have been the major interest in the psychosocial care of pediatric oncology patients and their families. Similar methods for psychosocial care on the ward are still rare. This paper presents the psychological care of the oncology patients during their stay on the ward, complimentary to the medical treatment. The concept is based on the process of coping with the phases and specific situations (L.P.; B.M.A.; diagnosis; medication ect.) of the cancer therapy. This process contains on the part of the patients and their parents the need for information, active involvement in treatment regimes and relaxation (before, during and after the stressful situation). The concepts of informed consent, adherence and recovery-counseling are related to the coping methods of the patients and their parents. The aims of our concept are to create and utilize diagnostic tests and psychological methods to enable the families to help themselves. To reach this goal, the technique of semantic and pragmatic information is very important because this kind of social communication helps us to make the medical implications of the treatment understandable and suitable for the patients and families.

A concept based on empirical data is needed for psychological support of children with cancer and their families. A number of concepts are already available, but a psychological assessment is needed, which controls the feasibility of these concepts. The psychosocial questionnaire is such an assessment, which transforms individual data into the practical psychosocial work during the entire course of cancer treatment. The diagnostical procedure includes aspects of coping with cancer, such as stress, protective and risk factors and health behavior. Data are collected before, during and after the intensive cancer treatment and in a follow-up after 6 or 12 months respectively. The questionnaire has four parts. Each contains a "handbook for parents", which informs the parent in detail on each part. Thus, we enforce the potential of each parent to help him-/herself.