Introduction to the Special Issue: Time for Family-Based Interventions in Pediatric Psychology?

Abstract

From its very inception, pediatric psychology has been committed to involving the whole family in the service of treating children. Yet, in many respects family-based interventions are still in their infancy. Recently, Kazak and colleagues presented a model of family systems practice in pediatric psychology (Kazak, Simms, & Rourke, 2002). They introduce their article with the statement "We write this article reflecting on the lack of established family intervention approaches in pediatric psychology" (p. 133). In the same issue of the Journal of Pediatric Psychology, Brown's presidential address calls for greater attention to social ecologies and the reciprocal influence of children and families (Brown, 2002). Clearly, the need for family-based interventions in pediatric psychology has been endorsed. Why is it taking so long to heed the call from so many fine scholars? On the one hand, a marriage between family-based interventions and pediatric psychology makes sense. There are strong theoretical models suggesting that families affect children's well-being and that children's health affects family functioning (Fiese, 1997;Fiese & Wamboldt, 2001;Patterson & Garwick, 1994;Wood, Klebba, & Miller, 2000). There is a relatively large body of descriptive research linking family interaction styles, disease management practices, family belief systems, and communication patterns with children's health and well-being (Kazak, Rourke, & Crump, 2003). Like most marriages, the relationship between family-based interventions and pediatric psychology is a work in progress and the best of intentions take time to materialize.

The Interface of Child Mental Health and Juvenile Diabetes Mellitus

“…65 An understanding of illness-related behaviors in the child or adolescent and of the stress and emotional responses experienced by parents are critical if health care providers are to be effective in achieving helping the patients manage their illnesses effectively. In all serious illnesses in childhood and adolescence, parents can be expected to experience varying degrees of stress and frustration, which may lead to anxiety, depression, alterations in the marital relationship, and difficulties in the relationship with the child.…”

Parent perspectives on family-based psychosocial interventions in pediatric cancer: a mixed-methods approach

“…Parents face a number of demands including coping with the life-threatening nature of their child’s diagnosis, attending to their child’s physical status, and managing disruptions to existing family life [1]. Parents, however, are recognized as key to successful adaptation and coping [5, 6] and research supports family-based psychosocial interventions in the context of childhood illness [4, 7, 8]. Across pediatric cancer centers, evidence-based psychosocial assessments and interventions are inconsistently and infrequently delivered to families [9] due to limited institutional resources [9] and difficulty engaging families in psychosocial care during a period of heightened stress [10].…”

Broadening Parental Involvement in Family-based Interventions for Pediatric Overweight

“…7 Family systems frameworks share the common assertion that individuals are embedded in larger influential contexts including the family. 19 Minuchin 20 provided one of the earliest and most commonly held views of the family system as related to family functioning.…”

“…The promise of taking a broader family systems approach in treating pediatric illnesses is reflected by a special issue of Journal of Pediatric Psychology that examined the strengths of family-based interventions in treating pediatric illnesses, as well as obstacles faced by family-based approaches. 7 The issue recognized several needs for moving the field forward, such as a better understanding of how to contact families, examining costs versus benefits for including families, and determining whom to include, as well as how to include families based on diverse needs and availability of multifaceted approaches. Despite these challenges, Fiese states, "Clearly, the need for family-based interventions in pediatric psychology has been endorsed."…”

“…6 However, familybased interventions are still considered novel and in early development in the field of pediatric illnesses. 7 The current review examines relevant literature in family systems and child health to lay the groundwork for improving pediatric overweight treatment via parental involvement. First, we review relevant literature on families and child health.…”