Specificity of problem-solving skills training in mothers of children newly diagnosed with cancer: results of a multisite randomized clinical trial.
Open accessAbstract
PURPOSE: Diagnosis of cancer in a child can be extremely stressful for parents. Bright IDEAS, a problem-solving skills training (PSST) intervention, has been shown to decrease negative affectivity (anxiety, depression, post-traumatic stress symptoms) in mothers of newly diagnosed patients. This study was designed to determine the specificity of PSST by examining its direct and indirect (eg, social support) effects compared with a nondirective support (NDS) intervention. PATIENTS AND METHODS: This randomized clinical trial included 309 English- or Spanish-speaking mothers of children diagnosed 2 to 16 weeks before recruitment. Participants completed assessments prerandomization (T1), immediately postintervention (T2), and at 3-month follow-up (T3). Both PSST and NDS consisted of eight weekly 1-hour individual sessions. Outcomes included measures of problem-solving skill and negative affectivity. RESULTS: There were no significant between-group differences at baseline (T1). Except for level of problem-solving skill, which was directly taught in the PSST arm, outcome measures improved equally in both groups immediately postintervention (T2). However, at the 3-month follow-up (T3), mothers in the PSST group continued to show significant improvements in mood, anxiety, and post-traumatic stress; mothers in the NDS group showed no further significant gains. CONCLUSION: PSST is an effective and specific intervention whose beneficial effects continue to grow after the intervention ends. In contrast, NDS is an effective intervention while it is being administered, but its benefits plateau when active support is removed. Therefore, teaching coping skills at diagnosis has the potential to facilitate family resilience over the entire course of treatment.
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Barriers to attending face-to-face programs include recurrent illness and/or ongoing disability in the child, time, childcare and financial pressures, and a preference to spend time at home following family separations.
“Barriers to attending face-to-face programs include recurrent illness and/or ongoing disability in the child, time, childcare and financial pressures that have arisen from the child’s illness, and a preference to spend time at home following family separations associated with the child’s hospitalization [22–24].”
From Take A Breath: Study protocol for a randomized controlled trial of an online group intervention to reduce traumatic stress in parents of children with a life threatening illness or injury (2016) · cites this paper as [24]
The Results (page not specified) report withdrawals during a child’s medical crisis and difficulty scheduling sessions. The Discussion (page not specified) describes siblings’ care and wage-earning responsibilities as challenges to engaging fathers. The paper does not establish ongoing disability, financial pressures as a barrier to attendance, or a preference to stay home after hospitalization-related family separation. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe application of an ACT-based intervention is highly novel in this population, with past studies using traditional cognitive behavioral therapy or problem-solving therapy.
“The application of an ACT-based intervention is highly novel in this population, with past studies using traditional cognitive behavioral therapy18,19,43,44 or problem-solving therapy.18,24”
From Effect of a Videoconference-Based Online Group Intervention for Traumatic Stress in Parents of Children With Life-threatening Illness (2020) · cites this paper as [24]
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- Authors
- Sahler, O. J. Z., Dolgin, M. J., Phipps, S., Fairclough, D. L., Askins, M. A., Katz, E. R., Noll, R. B., & Butler, R. W.
- Affiliations
- St. Jude Children's Research Hospital (US)
- Venue
- Journal of Clinical Oncology
- Published
- 2013-04-01
- Volume
- 31
- Issue
- 10
- Pages
- 1329-1335
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- PMC
- PMC3607672
- OpenAlex
- W2133615396
- Cited by
- 195
- References
- 41
- Citations by year
- 2026: 7 · 2025: 13 · 2024: 14 · 2023: 12 · 2022: 18 · 2021: 24 · 2020: 15 · 2019: 18 · 2018: 22 · 2017: 15 · 2016: 11 · 2015: 14 · 2014: 6 · 2013: 4 · 2012: 1
- FWCI
- 10.89
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Oncology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Cancer Institute (R01CA098954)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Health Sciences › Health Professions › Speech and Hearing › Problem Solving Skills Development
- Social Sciences › Sociology and Political Science › Family Support in Illness
- Keywords
- problem-solving training, mothers of children with cancer, childhood cancer, parental stress, negative affectivity, anxiety, depression, post-traumatic stress, social support, coping strategies, family resilience
- MeSH terms
- Adaptation, Psychological, Adolescent, Adult, Anxiety Disorders, Child, Child, Preschool, Depressive Disorder, Female, Follow-Up Studies, Humans, Middle Aged, Mother-Child Relations, Mothers, Neoplasms, Problem Solving, Stress, Psychological, Treatment Outcome
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