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Recent health care legislation and shifting health care financing strategies are transforming health and behavioral health (a broad term referring to mental health, substance use, and health behavior) care in the United States. Advances in knowledge regarding effective treatment and services coupled with incentives for innovation in health and behavioral health care delivery systems make this a unique time for mobilizing our science to enhance the success of health and behavioral health care redesign. To optimize the potential of our current health care environment, a team was formed composed of leaders from the Societies of Clinical Child & Adolescent Psychology, Pediatric Psychology, and Child and Family Policy and Practice (Divisions 53, 54, and 37 of the American Psychological Association). This team was charged with reviewing the scientific and policy literature with a focus on five major issues: (a) improving access to care and reducing health disparities, (b) integrating behavioral health care within primary care, (c) preventive services, (d) enhancing quality and outcomes of care, and (e) training and workforce development. The products of that work are summarized here, including recommendations for future research, clinical, training, and policy directions. We conclude that the current emphasis on accountable care and evaluation of the outcomes of care offer numerous opportunities for psychologists to integrate science and practice for the benefit of our children, families, and nation. The dramatic changes that are occurring in psychological and behavioral health care services and payment systems also require evolution in our practice and training models. [ABSTRACT FROM AUTHOR]

The association between pediatric parenting stress (i.e., parenting stress related to caring for a child with a medical illness) and family functioning outcomes was evaluated in 116 parents of children treated for cancer. Results indicated that pediatric parenting stress, as measured by the Pediatric Inventory for Parents (PIP), was significantly correlated with family functioning, using the McMaster Family Assessment Device (FAD). After controlling for child treatment status (on vs. off treatment), several independent associations among PIP and FAD scores emerged, indicating that increased pediatric parenting stress is associated with poorer family functioning outcomes. Findings, within the limitations of the study, suggest that pediatric parenting stress and family functioning are important constructs to assess when working with children who are being treated for cancer, and family-based interventions targeting the needs of this population may be warranted. [ABSTRACT FROM AUTHOR]

Comprehensive care for children with cancer is complex, multisystemic, and dynamic. At its optimum, it includes an organizing model or framework, effective and cost efficient clinical services for children and their families, and a close feedback link between clinical research and practice. Treatment teams for children with cancer at most children's hospitals in the United States include psychosocial professionals. Using a social ecological perspective, we illustrate multiple opportunities and challenges related to the sustenance of a comprehensive care program for children with cancer and their families program over time, and across systems. The interplay between clinical practice and research is emphasized, along with examples of interdisciplinary family-centered collaboration related to procedural pain, psychological sequelae of childhood cancer survival, and assessment of risk for ongoing psychological distress. [ABSTRACT FROM AUTHOR]

Child and parental distress related to lumbar punctures and bone marrow aspirates and general family adaptation are evaluated in a cross-sectional study of children currently in treatment with leukemia in first remission (N = 70). A parental self-report measure developed for this study--the Perception of Procedures Questionnaire (PPQ)--yielded three factors: (a) parental satisfaction, (b) parental distress or involvement, and (c) child distress. Data from the PPQ showed high levels of both satisfaction and distress in the context of invasive procedures. Data from standardized measures of family adaptation demonstrated a range of functioning. Analyses by length of time since diagnosis indicated that parental distress remains stable over the course of treatment. The data are discussed with respect to the newly developed measure of parental procedures (the PPQ) and the need for research in this field that provides an integration of procedural distress with parent and family perceptions and adjustment. [ABSTRACT FROM AUTHOR]

Assessed 25 preschool siblings and families of children with cancer and 25 preschool siblings and families of healthy children, using standardized measures of child adjustment and family adaptability and cohesion. Prosocial behavior and perceptions of similarity/difference in sibling pairs were also measured. Siblings' behavior, social competence, and self-perceptions in the oncology group were consistent with published norms and did not differ significantly from the comparison group. Rates of some prosocial behaviors were higher. The oncology group had more extreme levels of adaptability, and mothers were more likely to describe sibling pairs as "alike." There was a negative correlation between behavior problems and adaptability and cohesion in the oncology group. The results highlight potential competencies of young siblings o fill children and ways in which families of children with cancer adapt to the demands of illness and treatment. [ABSTRACT FROM AUTHOR]

No abstract available for this article. [ABSTRACT FROM PUBLISHER]

The American Psychological Association Task Force on Evidence-Based Practice for Children and Adolescents (2008) recommended a systems approach to enhancing care in order to improve outcomes for children and adolescents with mental health needs and redress persistent systemic problems with the structure of services. Recommendations for enhancing an ecological approach to the adoption and implementation of evidence-based practices are offered through increased attention to practice-based research frameworks for adoption and dissemination. Five criteria are discussed for providing acceptable evidence, including (a) systematic evidence searching and adoption of evidence-based prevention and intervention practices, (b) implementation and adherence to intervention integrity, (c) invoking standards for drawing inferences from interventions, (d) using quality assessments to measure outcomes, and (e) adopting formal data analysis procedures to assess intervention outcomes. Each criterion is illustrated with an example. Future research and policy agendas are outlined. [ABSTRACT FROM AUTHOR]