Psychosocial interventions for Siblings of Pediatric Cancer

Patients
Jerold L. Garrett OTS & Mariana E. Hall OTS
Touro University, Nevada
Design

Introduction
Introduction

Families
Families of
of children
children diagnosed
diagnosed with
with cancer
cancer may
may overlook
overlook the
the needs
needs of
of
the
the healthy
healthy sibling.
sibling. As
As many
many as
as 63%
63% of
of siblings
siblings experience
experience
psychological
psychological problems.
problems. Prompt
Prompt psychological
psychological interventions
interventions reduce
reduce
distress,
distress, prevent
prevent more
more severe
severe difficulties,
difficulties, and
and reduce
reduce the
the familys
familys
burden.
burden. This
This project
project aimed
aimed at
at finding
finding psychosocial
psychosocial intervention
intervention
strategies
strategies that
that promote
promote psychological
psychological well-being
well-being and
and improve
improve quality
quality of
of
life
life in
in siblings
siblings of
of pediatric
pediatric cancer
cancer patients.
patients. Educational
Educational components
components
reduced
reduced uncertainty,
uncertainty, thus
thus relieving
relieving anxiety,
anxiety, sleep
sleep problems,
problems, physical
physical
complaints,
complaints, and
and psychological
psychological distress.
distress. Psychosocial
Psychosocial components
components were
were
helpful
helpful in
in improving
improving symptoms
symptoms of
of post
post traumatic
traumatic stress
stress symptoms
symptoms
(PTSS),
(PTSS), anxiety,
anxiety, depression,
depression, as
as well
well as
as increasing
increasing self-confidence
self-confidence and
and
reducing
reducing behavioral
behavioral problems.
problems.

Level of Evidence
I

Study Design/Methodology of Selected Articles

1
0

III

IV

Cohort Study with pretest-post-test design

V
Other

0
Qualitative Phenomenology with pretest posttest
design

TOTAL:

Camp Okizu 1: N. California, 77 subjects, 6-17 years

Camp Okizu 2: N. California, 73 subjects

Background
Background

Contact Information:

Number of Articles
Selected

II

Group
Intervention
s

Research
Research studies
studies included
included in
in this
this project
project spanned
spanned the
the following
following types
types of
of
interventions:
interventions:
Individual
Individual Counseling:
Counseling:
2-session
2-session psychological
psychological intervention
intervention provided
provided at
at the
the hospital.
hospital.
E-Health:
E-Health:
See-Hear-Do
See-Hear-Do method:
method: individual
individual intervention
intervention with
with prompts
prompts to
to
facilitate
facilitate writing
writing of
of aa virtual
virtual reflection
reflection journal
journal sent
sent via
via e-mail
e-mail or
or cell
cell
phone
phone to
to one
one of
of the
the authors
authors who
who provided
provided feedback.
feedback.
Support
Support Groups:
Groups:
Weekly
Weekly sessions
sessions lasting
lasting 55 weeks,
weeks, conducted
conducted by
by 22 psychologists.
psychologists.
Weekly
Weekly sessions
sessions lasting
lasting 66 weeks
weeks that
that used
used art
art and
and crafts
crafts to
to address
address
goals.
goals.
22 hour
hour weekly
weekly sessions
sessions lasting
lasting 88 weeks
weeks with
with protocol
protocol manual
manual and
and
activities
activities to
to address
address goals.
goals.
.. Camp
Camp Interventions:
Interventions:
Camp
Camp Okizu:
Okizu: started
started with
with aa facilitated
facilitated group
group discussion
discussion about
about
coping
coping techniques.
techniques. Camping
Camping mentors
mentors who
who provided
provided positive
positive feedback
feedback
and
and ensured
ensured at
at least
least one
one experience
experience of
of success
success per
per week.
week.
4-day
4-day camp
camp providing
providing opportunities
opportunities to
to develop
develop peer
peer support
support
networks
networks and
and social
social competency.
competency. Age
Age appropriate
appropriate information
information about
about
cancer,
cancer, treatment,
treatment, and
and impact
impact on
on the
the family.
family.
Camp
Camp Ronal
Ronal McDonald:
McDonald: one
one week
week therapeutic
therapeutic summer
summer session
session

Conclusions
Conclusions

Support
Groups

5 weekly sessions, Netherlands, 24 subjects, 718

Summary:
Summary: Articles
Articles examined
examined interventions
interventions for
for non-bereaved
non-bereaved siblings
siblings of
of
pediatric
pediatric cancer
cancer patients.
patients. Interventions
Interventions included
included individualized
individualized
interventions
interventions such
such as
as counseling
counseling and
and e-health,
e-health, as
as well
well as
as group
group
interventions
interventions such
such as
as therapeutic
therapeutic camps
camps and
and support
support groups
groups
Significance
Significance and
and relevance:
relevance: E-health
E-health is
is an
an effective
effective modality
modality to
to deliver
deliver
therapeutic
therapeutic education
education and
and emotional
emotional support
support to
to siblings
siblings of
of pediatric
pediatric cancer
cancer
patients.
patients. Even
Even aa brief
brief individual
individual 2-session
2-session intervention
intervention can
can be
be beneficial.
beneficial.
Camps
Camps are
are useful
useful to
to normalize
normalize the
the life
life experience
experience of
of siblings.
siblings. Group
Group
programs
programs can
can be
be useful
useful in
in reducing
reducing anxiety
anxiety and
and depression
depression
Key
Key conclusions:
conclusions: Group
Group interventions
interventions were
were more
more effective
effective to
to alleviate
alleviate PTSS,
PTSS,
anxiety,
anxiety, depression,
depression, and
and social
social functioning.
functioning. Individual
Individual interventions
interventions were
were
more
more effective
effective in
in increasing
increasing psychological
psychological well-being
well-being and
and quality
quality of
of life.
life.
Implications:
Implications: OTs
OTs working
working with
with pediatric
pediatric cancer
cancer patients
patients should
should be
be mindful
mindful
of
of and
and address
address siblings'
siblings' needs.
needs. An
An intervention
intervention approach
approach that
that includes
includes the
the
family
family as
as aa whole
whole should
should be
be utilized.
utilized. OTs
OTs should
should pay
pay particular
particular attention
attention to
to
PTSD
PTSD symptoms
symptoms and
and address
address them
them utilizing
utilizing effective
effective interventions
interventions such
such as
as
cognitive
cognitive behavioral
behavioral therapy
therapy (CBT).
(CBT). In
In siblings
siblings with
with high
high levels
levels of
of anxiety
anxiety
the
the OT
OT should
should implement
implement and
and recommend
recommend psychosocial
psychosocial therapeutic
therapeutic camps
camps
and
and support
support groups.
groups.
Possible
Possible future
future research:
research: should
should include
include randomly
randomly selected
selected larger
larger
samples,
samples, control
control comparison
comparison groups,
groups, and
and double
double blind
blind designs.
designs. Research
Research on
on
bereaved
bereaved siblings
siblings is
is needed.
needed.

Results

Outcomes:
Outcomes:
CBT Session Switzerland, 30 participants, 6-17 years old
Anxiety,
Post
Stress
Symptoms
(PTSS),
behavioral
problems,
Anxiety,
Post Traumatic
Traumatic
Stress
Symptoms
(PTSS),
behavioral
problems,
Individual
E-Health
Sweden, 14 siblings, 11 families, 9-22 years old
Intervention
quality
qualitys of
of life,
life, medical
medical knowledge,
knowledge, physical
physical health.
health.
Findings
Findings
Individual
Individual Counseling:
Counseling: improvements
improvements in
in psychological
psychological well-being,
well-being,
medical
medical knowledge,
knowledge, social
social support,
support, and
and quality
quality of
of life.
life. No
No effect
effect on
on
anxiety
anxiety or
or PTSS.
PTSS.
E-Health:
E-Health: Increased
Increased knowledge
knowledge about
about cancer
cancer treatment
treatment and
and side
side effects.
effects.
Improved
Improved sleep.
sleep. Decrease
Decrease in
in bodily
bodily pain
pain and
and emotional
emotional regulation
regulation
problems
problems
Support
Support Groups:
Groups: Decreased
Decreased anxiety,
anxiety, depression,
depression, fear
fear of
of the
the illness,
illness,
behavior
behavior problems,
problems, and
and family
family distress.
distress. Improvements
Improvements in
in knowledge
knowledge of
of
cancer,
cancer, expressing
expressing feelings,
feelings, and
and interpersonal
interpersonal relationships.
relationships. Younger
Younger boys
boys
had
had the
the highest
highest decrease
decrease in
in depression.
depression.
Camps:
Camps: Statistically
Statistically significant
significant decrease
decrease in
in PTSS,
PTSS, anxiety,
anxiety, and
and emotional
emotional
problems.
problems. Improvements
Improvements in
in emotional
emotional health,
health, social
social functioning,
functioning, school
school
functioning,
functioning, and
and self-esteem.
self-esteem.

References
References

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children with
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cancer
Their
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experiences of
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intervention
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Health
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Jerold Garrett OTS, [email protected]. Mariana E. Hall OTS, [email protected]. Touro University Nevada,
874 American
Pacific
Drive, Henderson,
NV 89014,
(702)Health
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