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Survivors of childhood cancer whose malignancy and/or treatment involved the central nervous system may demonstrate a consistent pattern of neurocognitive deficits. The present study evaluated a randomized clinical trial of the Cognitive Remediation Program (CRP). Participants were 6- to 17-year-old survivors of childhood cancer (N = 161; 35% female, 18% Hispanic, 10% African American, 64% Caucasian, 8% other) who were at least 1 year off treatment and who manifested an attentional deficit. They were enrolled at 7 sites nationwide. Two thirds of the participants were randomly assigned to cognitive remediation. All participants were assessed using a battery of academic achievement/neurocognitive tests and parent/teacher measures of attention. The CRP resulted in parent report of improved attention and statistically significant increases in academic achievement. Effect sizes were modest but were comparable with those for other clinical trials of brain injury rehabilitation and for psychological interventions in general. The CRP is presented as a potentially beneficial treatment for many survivors of pediatric cancer. Long-term clinical significance remains unproven. Further work is needed to improve effect sizes and treatment compliance and to address the needs of other populations with pediatric brain injury. (Contains 1 figure and 4 tables.)

Mothers of children with cancer experience significant distress associated with their children's diagnosis and treatment. The efficacy of problem-solving skills training (PSST), a cognitive-behavioral intervention based on problem-solving therapy, was assessed among 430 English- and Spanish-speaking mothers of recently diagnosed patients. Participants were randomized to usual psychosocial care (UPC; n = 213) or UPC plus 8 sessions of PSST (PSST; n = 217). Compared with UPC mothers, PSST mothers reported significantly enhanced problem-solving skills and significantly decreased negative affectivity. Although effects were largest immediately after PSST, several differences in problem-solving skills and distress levels persisted to the 3-month follow-up. In general, efficacy for Spanish-speaking mothers exceeded that for English-speaking mothers. Findings also suggest young, single mothers profit most from PSST.

Abstract. In order to assess the effects of various cancer treatments on neuropsychological functioning, 74 long-term survivors of childhood cancer were examined. A comprehensive battery of tests was administered to two CNS treatment groups (irradiated and nonirradiated leukemia and lymphoma patients) and a control group (solid tumor and Hodgkin disease patients receiving no CNS treatment). The CNS-irradiated group obtained lower scores than the other two groups, with significant differences in visual-motor and fine motor skills, spatial memory, and arithmetic achievement resulting in significant differences in IQ scores (VIQ, PIQ, FSIQ). The results are discussed in relation to: (1) the effects of CNS irradiation on cognitive development; (2) the specificity of these effects; and (3) the relationship of age at diagnosis to treatment effects. It is concluded that although there is a general lowering of scores after CNS irradiation, the effect is most pronounced for nonlanguage skills. Age at diagnosis was less important than the type of treatment, with CNS irradiation reducing performance regardless of when cancer was diagnosed. There were indications that children with any type of cancer diagnosed before age 5 years are more likely to have some cognitive difficulties. [ABSTRACT FROM AUTHOR]

The present paper reviews the literature on object relations theory with respect to the borderline patient and, within this perspective, discusses its application to hypnotherapy. Emphasis is placed on developmental aspects of the attachment-separation-individuation process that relate to certain characteristics of the hypnotic experience and the therapeutic relationship, including transference, regression, and the internalization of positive aspects of the therapeutic alliance. The therapeutic process as described parallels normal developmental phases. Specific techniques to facilitate therapeutic integration are outlined and illustrated with case examples. These help to structure the internalization of the therapeutic relationship as a foundation to restructuralization of the patient's representational world. [ABSTRACT FROM PUBLISHER]

The development of two brief self-report measures for assessing parent-child communication specific to pediatric cancer is reported The instruments assess the quality of parent-child communication with their ill child and the sibling of the ill child The measures have good internal consistency and are significantly related to the overall level of healthy sibling adjustment. [ABSTRACT FROM AUTHOR]

This study examined the predicted utility of the Nonverbal LearningDisabilities syndrome (NLD) (Rourke, 1995) for characterizing neurocognitiveand psychosocial outcomes in 123 children with brain tumors. Children withbrain tumors were found to be at high risk of having a specific academic deficit,particularly in arithmetic. Children with arithmetic deficit evidenced a higherrate of impairment on nonverbal tasks than on verbal tasks, whereas childrenwith reading deficit evidenced a higher rate of impairment on verbal tasksthan on nonverbal tasks. However, significant differences between childrenwith arithmetic and reading deficits were not found for all of the componentfeatures of the NLD syndrome, and arithmetic deficit was not related to treatmentwith irradiation. [ABSTRACT FROM AUTHOR]