Training in problem solving helps mothers cope with child's cancer diagnosis

The benefits of training in problem-solving skills goes beyond teaching parents to navigate the complex medical, educational, and other systems that accompany a child's diagnosis of cancer. The training also leads to a durable reduction in mothers' levels of anxiety and symptoms of posttraumatic stress, and improves overall coping with a child's illness.

“Earlier research shows that a mom is the keystone of a family. After a child's cancer diagnosis, if mom is stressed and not coping, you see the effects on the marriage and on siblings as well,” said author Diane Fairclough, DrPH, MSPH, with the University of Colorado Cancer Center.

This multisite study of 309 mothers found that immediately after Bright IDEAS training, the mothers show the same gains as with another intervention called nondirective support, which is effectively compassionate listening. But 3 months later, the gains from Bright IDEAS remained, while the gains from an understanding ear evaporated. In fact, at the 3-month mark, the benefits from problem-solving skills training were growing—the mothers were more adept problem-solvers, and this increased ability transferred to sustained gains in mood, decreased anxiety, and fewer symptoms of posttraumatic stress. This study was published in the Journal of Clinical Oncology (2013; doi:10.1200/JCO.2011.39.1870).

“I've been a cancer patient myself,” Fairclough said, “and I think the most stressing thing is that there's a sense that the disease has taken over your life. It defines your schedule, your family vacations; you can't change employers because of insurance concerns. I think problem-solving skills training helps mothers pull back some control after their child's diagnosis. It makes things seem manageable and gives parents a sense they're not just helpless observers.”

To date, the training has required 8 weekly individual meetings between a mother and her trainer. While this approach is successful, it is resource intensive. This past summer, the multi-institutional research group received funding from the National Cancer Institute to develop a web-based version to make Bright IDEAS available anytime, wherever a parent or other caregiver has access to the internet. Free downloads of the eight-session training can be found at the Research-Tested Intervention Programs page hosted by the National Cancer Institute.

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