Psychological staging of pediatric cancer patients and their families

Advances in the treatment of childhood cancer have required a shift in our approach to the patient and family. Previously parents were helped to cope with the inevitable decline of the child's health over a rather short period of time; the child was acutely ill and crisis-oriented intervention was utilized. Today, the family unit can be helped to maintain normal life amidst intensive medical treatment; the child is acutely ill at times, but also chronically ill, and even well. Crisis intervention is still appropriate, but so is education, ego-supportive counseling, and insight-oriented psychotherapy. Psychological staging of pediatrics cancer patients and their families is essential in order to properly anticipate psychological adjustment and plan appropriate interventions. Assessment and staging require a multi-dimensional perspective including stage of disease, socioeconomic vulnerability, degree of psychopathology, family cohesion, and personal/family history. This article discusses this multi-dimensional perspective and implications for intervention. Illustrative case material is utilized.