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Family rituals serve important functions for families, especially at times of change and stress, such having a child diagnosed with cancer. No studies have investigated how family rituals may be impacted during pediatric cancer treatment. This qualitative study explored the impact of pediatric cancer and its treatment on family rituals. Semistructured interviews with 19 mothers of children with cancer, ages 8-17 years old, were conducted and analyzed using grounded theory strategies. The interviews revealed two main types of changes in rituals: Loss; and Transformation. The Loss of Family Rituals included two subcategories (Nonattendance at Ongoing Family Rituals, Disruption of Family Rituals). The Transformation of Family Rituals included three subcategories (Readjustment of Family Rituals, Creation of New Family Rituals, Reestablishing Old Family Rituals). Seven general functions of family rituals were identified (Celebrating, Family Cohesion, Family Communication, Respite, Sense of Predictability, Sense of Security, Rhythm of Life) and five illness-related functions (Grounding in Life, Hope, Marking the Course of Treatment, Sense of Normalcy, Treatment Adherence). Although pediatric cancer may compromise family rituals (nonattendance and/or disruption) and their functions, families develop adaptive strategies (readjustment, creation, and/or reestablish) to transform rituals and facilitate their potentially protective functions. Discussion of rituals can be integrated into interventions to optimize family interactions in the adverse context of pediatric cancer, via the readjustment of existing rituals, the creation of new ones and the reestablishing of old rituals. (PsycINFO Database Record, ((c) 2018 APA, all rights reserved).)

Background: Although families of children with cancer and other serious medical conditions have documented psychosocial needs, the systematic identification of needs and delivery of evidence-based care remain challenges. Screening for multifaceted family psychosocial risk is a means by which psychosocial treatment needs for pediatric patients and their families can be identified in an effective and inclusive manner., Material and Methods: The Pediatric Psychosocial Preventative Health Model (PPPHM) is a model that can guide systematic assessment of family psychosocial risk. The Psychosocial Assessment Tool (PAT) is a brief parent report screener of psychosocial risk based on the PPPHM that can be used for families of infants through adolescents. The PPPHM and the PAT are described in this paper, along with a summary of data supporting systematic risk assessment., Results: The PPPHM outlines three tiers of family psychosocial risk - Universal (low), Targeted (medium), and Clinical (high). The PAT is a validated measure of psychosocial risk. Scores on the PAT, derived from multiple sites and disease conditions, map on to the PPPHM with indications that one-half to two-thirds of families score at the Universal level of risk based on the PAT., Conclusion: The PAT is a unique screener of psychosocial risk, both in terms of its breadth and underlying model (PPPHM), and its length and format. As an example of a means by which families can be screened early in the treatment process, PAT scores and corresponding PPPHM levels can provide direction for the delivery of evidence-based psychosocial care.

Purpose of Review: Traumatic stress offers a helpful framework by which the ongoing reactions of children with cancer and their families can be understood. Family systems interventions in pediatric oncology are reviewed, with a focus on reducing pediatric medical traumatic stress (PMTS) across members of the family., Recent Findings: A recently developed model of PMTS is presented and applied to the pediatric cancer population. Two family interventions to decrease traumatic stress systems are reviewed. Reductions in traumatic stress symptoms were observed at postintervention follow-ups for family members in both studies., Summary: The pediatric medical traumatic stress model provides a useful heuristic for understanding the psychological consequences of pediatric cancer on the child and their family over the course of treatment and beyond. Two family systems interventions show promise in improving outcomes for childhood cancer survivors and their parents. Although interventions are promising, future development of these interventions to modify them for dissemination is needed.

Objective: The Pediatric Psychosocial Preventative Health Model (PPPHM) is a three-tier model of family psychosocial risk used to guide intervention approaches in pediatric healthcare settings. Screening all families to determine levels of risk supports equitable care. We review evidence from papers using the Psychosocial Assessment Tool (PAT), a brief caregiver-report measure of family psychosocial risk with scores that map to the PPPHM, to characterize the distribution of risk. We predict that across study samples the distribution of risk on the PPPHM will be approximately 60% universal (low), 30% targeted (moderate), and 10% clinical (high). Method: We conducted a scoping review searching PubMed, MEDLINE, Emcare, and PsycInfo for articles that reported PPPHM data using the PAT. Results: Forty-seven samples from 43 papers were included, reporting on patients with 17 conditions. PPPHM scores were highly consistent with median percentages of 55% universal, 34% targeted, and 11% clinical. There is evidence of higher levels of risk for samples using the Spanish version of the PAT, from weight management programs and with families who have children with autism spectrum disorder. Conclusions: The data demonstrate consistent patterns of psychosocial risk distributions on the PPPHM and support implementation of universal family psychosocial risk screening, followed by delivery of personalized care based on level of risk. Screening all families promotes health equity in pediatric health care settings by normalizing the importance of understanding psychosocial risk and resiliencies and assuring family input in the delivery of integrated psychosocial care. Public Significance Statement: When inclusive of all families, family psychosocial risk assessment promotes health equity and highlights the range of risk, supporting universal, preventative psychosocial care matched to specific risks. [ABSTRACT FROM AUTHOR]

Focuses on the challenges in family health intervention research in the U.S. Types of services representing standards of care and families in healthcare settings; General goals for family-focused interventions for chronic disease; Outline on issues related to family and disease characteristics.

Objective: To present a pediatric psychology consultation treatment framework based on family systems and developmental theories.Methods: After reviewing background relevant to family systems interventions, a five-step protocol (referral, assessment, collaboration, outcome) for consultation is presented, using case examples from our pediatric oncology service, to illustrate joining, focusing, promoting competence and collaboration with patients, families, and staff.Results: Using protocols based on family systems frameworks, pediatric psychologists can offer systems-oriented consultation to patients, families, and healthcare teams.Conclusions: Further development and evaluation of family systems protocols are necessary to understand the efficacy of these approaches and their role in training and practice. [ABSTRACT FROM AUTHOR]