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Evidence-based therapeutic interventions
Evidence-based therapeutic interventions
|Depending on your assessment and formulation, there are a number of evidence-based interventions that are useful. This section outlines a number of these interventions, their applications and further reading. |
|Family therapy works to address the relationships within families to help them better deal with a wide range of problems. A cancer diagnosis puts strain on a family and consequently in poorer functioning families this may highlight pre-existing family issues.|
The articles below provide more insight into family relationships:
- Machado da Silva, F., Jacob, E. & Castanheira Nascimento, L., (2010). Impact of Childhood Cancer on Parents’ Relationships: An integrative review. Journal of Nursing Scholarship, 42 (3), 250-261.
- Alderfer, M.A., Long, K.A., Lown, E.A., Marsland, A.L., Ostrowski, N.L., Hock, J.M. & Ewing, L.J. (2010). Psychosocial adjustment of siblings of children with cancer: a systematic review. Psycho-Oncology, 19, 789-805.
Cognitive Behavioural Therapy (CBT)
|Within a paediatric oncology population, CBT can be used to treat a number of emotional or behavioural disorders including anxiety, depression and post traumatic stress disorder.|
The articles below provide more information on cognitive behavioural therapy:
- Friedberg, R.D. & Brelsford, G.M. (2011). Core Principles in Cognitive Therapy in Youth. Child and Adolescent Psychiatric Clinics of North America, 20, 369-378.
- Thompson, R.D., Delaney, P., Flores, I. & Szigethy, E. (2011). Cognitive Behavioural Therapy for Children with Comorbid Physical Illness. Child and Adolescent Psychiatric Clinics of North America, 20, 329-348.
- Dorsey, S., Briggs, E.C. & Woods, B.A. (2011). Cognitive Behavioural Treatment for Posttraumatic stress disorder in children and adolescents. Child and Adolescent Psychiatric Clinics of North America, 20, 255-269.
- Kowalik, J., Weller, J., Venter, J. & Drachman, D. (2011). Cognitive behavioural therapy for the treatment of pediatric posttraumatic stress disorder: A review and meta-analysis. Journal of Behavior Therapy & Experimental Psychiatry, 42 (3), 405-413.
- Hirschfeld-Becker, D.R., Micco, J.A., Mazursky, H., Bruett, L. & Henin, A. (2011). Applying Cognitive Behavioural Therapy for anxiety to the younger child. Child and Adolescent Psychiatric Clinics of North America, 20, 349-368.
- Cohen, J., Mannarino, A., Berliner, L. & Deblinger, E. (2000). Trauma-focused cognitive behavioral therapy for children and adolescents: An empirical update.Journal of Interpersonal Violence, 15(11), 1202-1223.
Acceptance and Commitment Therapy (ACT)
|A mindfulness based behavioural therapy that uses metaphor, paradox, mindfulness skills, experiential exercises and values-guided behavioural interventions. The aim of Acceptance and Commitment Therapy is to accept problematic thoughts or emotions rather than trying to change or eliminate them. There is a role for using ACT in treatment of depression, anxiety and pain etc. This type of therapeutic approach can be beneficial in both individual work or as a parenting intervention.|
|The articles below provide more information about ACT:|
- Coyne, LW. McHugh, L. Martinez, E.R. (2011). Acceptance and Commitment Therapy (ACT): Advances and Applications with children, adolescents and families. Child and Adolescent Psychiatric Clinics of North America, 20, 379-399.
- Masuda, A., Cohen, L.L., Wicksell, R.K., Kemani, M.K., Johnson, A., (2011). A Case Study: Acceptance and Commitment Therapy for Pediatric Sickle Cell Disease. Journal of Pediatric Psychology, 36(4), 398-408.
Social Skills Training (SST)
|SST is a form of behaviour therapy that focuses on teaching the verbal and nonverbal behaviors involved in social interactions. SST helps individuals learn to interpret social signals, so that they can determine how to act appropriately in the company of other people in a variety of different situations. |
Social Skills Training in a paediatric oncology environment: As indicated previously, prolonged hospitalisation may impact a child’s development, specifically their social development, therefore social skills training may help aid children in acquiring developmental skills missed due to lack of socialisation as a result of hospitalisation.
More information on SST is available in the articles below:
- Dieluweit, U., Debatin, K.M., Grabow, D., Kaatsch, P., Peter, R., Seitz, D.C.M. & Goldbeck, L. (2010). Social outcomes of long-term survivors of adolescent cancer. Psycho-Oncology, 19, 1277-1284.
Grief and Loss Counselling
|The grieving process has an enormous impact on children and families who have been affected by cancer. Grief is the normal and natural reaction to loss of any kind and does not necessarily refer exclusively to the process of death and dying. |
Children and families may grieve over the loss of:
- Independence - Due to hospitalisation or as a result of fatigue which may impact ability to independently self care.
- Self image - Physically as a side effect of treatment e.g. hair loss, weight loss, naso-gastric tubes
- Identity - Separation from school, friends, sporting or other extracurricular activities, home environment.
|Additional information on grief and loss counselling can be found in the below resources:|
- DeCinque, N., Monterosso, L., Dadd, G., Sidhu, R. & Lucas, R. (2004). Bereavement support for families following the death of a child from cancer: Practice characteristics of Australian and New Zealand pediatric oncology units. Journal of Pediatric Child Health, 40, 131-135.
- The Grief Recovery Handbook- 20th Anniversary Addition. James & Friedman (specifically the ‘Loss of Health’ section).
Problem Solving Skills Training
|Problem Solving Skills Training (PSST) is designed to teach the skills involved in effective problem-solving, including skills that address practical problems faced by caregivers.|
A cancer diagnosis requires an immediate reorganisation of life and relationships. Such reorganisation can lead to new roles being taken on by family members and new strains on resources. Problem Solving Skills Training aims to provide a preventative intervention by teaching practical skills for families to reduce the stress experienced.
The below resources offer more information on PSST:
|Outcomes Research References|
- Sahler, O., Fairclough, D., Phipps, S., Mulhern, R., Dolgin, M., Noll, R., Katz, E., Varni, J.W., Copeland, D., & Butler, D. (2005). Using problem-solving skills training to reduce negative affectivity in mothers of children with newly diagnosed cancer: report of a multisite randomized trial. Journal of Consulting and Clinical Psychology, 73, 272–283.
- Varni, J. W., Sahler, O. J., Katz, E. R., Mulhern, R. K., Copeland, D. R., Noll, R. B, et al. (1999). Maternal problem-solving therapy in pediatric cancer. Journal of Psychosocial Oncology, 16, 41–71.
|Clinical Approach References|
- Iobst, E.A., Alderfer, M.A., Sahler, O.J., Askins, M.A., Fairclough, D.L., Katz, E.R., Butler, R.W., Dolgin, M.J. & Noll R.B. (2009). Problem solving and maternal distress at the time of a child’s diagnosis of cancer in two-parent versus lone-parent households. Journal of Pediatric Psychology, 34, 817-821.
Symptom Management: Procedural Pain
|The articles below provide information on procedural pain:|
- Young, K.D. (2005). Pediatric Procedural Pain. Annals of Emergency Medicine. 45(2), 160-171.
- LaMontagne, L., Wells, N., Hepworth, J.T., Johnson, B.D. & Manes, R. (1999). Parent coping and child distress behaviours during invasive procedures for childhood cancer. Journal of Pediatric Oncology Nursing, 16 (1), 3-12.
- Uman, L.S., Chambers, C.T., McGrath, P.J., Kisley, S., Matthews, D. & Hayton, K. (2010). Assessing the quality of randomised controlled trials examining Psychological Interventions for Pediatric Procedural Pain: Recommendations for Quality Improvement. Journal of Pediatric Psychology, 35(7), 693-703.
|Expressive therapy is the use of the creative arts as a form of therapy. Unlike traditional art expression, the process of creation is emphasized rather than the final product. Some common types of expressive therapy include art therapy, dance therapy, drama therapy, music therapy and writing therapy.|
The articles below provide additional information on expressive therapies:
- Angstron-Brannstron, C., Norberg, A & Jansson, L. (2008). Narratives of Children with Chronic Illness about being comforted. Journal of Pediatric Nursing, 23(4), 310-316.
|In addition to the evidence based therapeutic treatments listed above, The National Child Traumatic Stress Network (US) suggests the following evidence based trauma treatment programs. |