The assessment of mental health needs and access to appropriate interventions for parents and caregivers is one of 15 evidence-based standards for the psychosocial care of children with cancer and their families. The objectives of this paper are to describe one program's approach to meeting this standard in oncologic, hematologic, and immunologic populations and outline key ethical, regulatory, and logistical considerations in providing mental health services to caregivers in a pediatric medical setting. A description of the Caregiver Mental Health Program (CMHP) is provided along with a case example to illustrate key considerations, including multiple family members needing care, access to psychiatric services, scope of treatment, confidentiality and privacy, and logistics. Challenges in the development of the CMHP as well as the program’s benefits are discussed. Implementation of this standard of care will vary across institutions depending on various factors, such as staffing and programmatic resources and institutional culture.
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American Psychological Association. (2017). Ethical principles of psychologists and code of conduct. Washington, DC: American Psychological Association.
Ashton, K. R., & Sullivan, A. B. (2018). Ethical issues when working in hospital settings. In M. M. Leach & E. R. Welfel (Eds.), The Cambridge handbook of applied psychological ethics (pp. 70–92). New York, NY: Cambridge University Press.
Gerhardt, C. A., Salley, C. G., & Lehmann, V. (2016). The impact of pediatric cancer on the family. In A. N. Abrams, A. C. Muriel, & L. Wiener (Eds.), Pediatric psychosocial oncology: Textbook for multidisciplinary care (pp. 143–155). Basel: Springer.
Karyotaki, E., Smit, Y., Henningsen, K. H., Huibers, M., Robays, J., De Beurs, D., et al. (2016). Combining pharmacotherapy and psychotherapy or monotherapy for major depression? A meta-analysis on the long-term effects. Journal of Affective Disorders, 194, 144–152.
Katz, L. F., Fladeboe, K., King, K., Gurtovenko, K., Kawamura, J., Friedman, D.,… Lengua, L. (2018). Trajectories of child and caregiver psychological adjustment in families of children with cancer. Health Psychology, 37(8), 725
Kazak, A. E., DiDonato, S., Schneider, S. J., & Pai, A. L. (2016). Assessing family psychosocial risks in pediatric cancer. In A. N. Abrams, A. C. Muriel, & L. Wiener (Eds.), Pediatric psychosocial oncology: Textbook for multidisciplinary care (pp. 51–65). Basel: Springer.
Kazak, A. E., Hwang, W.-T., Chen, F. F., Askins, M. A., Carlson, O., Argueta-Ortiz, F., et al. (2018). Screening for family psychosocial risk in pediatric cancer: Validation of the Psychosocial Assessment Tool (PAT) version 3. Journal of Pediatric Psychology, 43(7), 737–748.
Kearney, J. A., Salley, C. G., & Muriel, A. C. (2015). Standards of psychosocial care for parents of children with cancer. Pediatric Blood & Cancer, 62(S5), S632–S683.
Leach, M. M., & Welfel, E. R. (2018). The Cambridge handbook of applied psychological ethics. New York, NY: Cambridge University Press.
Molitor, S. J., & Dvorsky, M. R. (2019). Ethical considerations for assessing parent mental health during child assessment services. Ethics & Behavior, 29(2), 87–100.
Palermo, T. M., Janicke, D. M., McQuaid, E. L., Mullins, L. L., Robins, P. M., & Wu, Y. P. (2014). Recommendations for training in pediatric psychology: Defining core competencies across training levels. Journal of Pediatric Psychology, 39(9), 965–984.
Riva, R., Forinder, U., Arvidson, J., Mellgren, K., Toporski, J., Winiarski, J., et al. (2014). Patterns of psychological responses in parents of children that underwent stem cell transplantation. Psycho-Oncology, 23, 1307–1313.
Sands, S., Mee, L., Bartell, A., Manne, S., Devine, K., Savone, M., et al. (2017). Group-based trajectory modeling of distress and well-being among caregivers of children undergoing hematopoietic stem cell transplant. Journal of Pediatric Psychology, 42, 283–295.
Scialla, M. A., Canter, K. S., Chen, F. F., Kolb, E. A., Sandler, E., Wiener, L., et al. (2017). Implementing the psychosocial standards in pediatric cancer: Current staffing and services available. Pediatric Blood & Cancer, 64(11), e26634.
Scialla, M. A., Canter, K. S., Chen, F. F., Kolb, E. A., Sandler, E., Wiener, L., et al. (2018). Delivery of care consistent with the psychosocial standards in pediatric cancer: Current practices in the United States. Pediatric Blood & Cancer, 65(3), e26869.
Tolin, D. (2017). Can cognitive behavioral therapy for anxiety and depression be improved with pharmacotherapy? A Meta-analysis. Psychiatric Clinics of North America, 40(4), 715–738.
Van Liew, J. R. (2012). Balancing confidentiality and collaboration within multidisciplinary health care teams. Journal of Clinical Psychology in Medical Settings, 19(4), 411–417.
Vidair, H. B., Reyes, J. A., Shen, S., Parrilla-Escobar, M. A., Heleniak, C. M., Hollin, I. L.,…. Rynn, M. A. (2011). Screening parents during child evaluations: Exploring parent and child psychopathology in the same clinic. Journal of the American Academy of Child & Adolesent Psychiatry, 50, 441–450
Wiener, L. (2019). Psychosocial standards of care update: Evidence-based standards of care to be updated with implementation strategies. Pediatric Psycho-Oncology Professionals/Providers International, 3, 4.
Wiener, L., Kazak, A. E., Noll, R. B., Patenaude, A. F., & Kupst, M. J. (2015). Standards for the psychosocial care of children with cancer and their families: An introduction to the special issue. Pediatric Blood & Cancer, 62(S5), S419–S424.
Wijnberg-Williams, B. J., Kamps, W. A., Klip, E. C., & Hoekstra-Weebers, J. E. (2006). Psychological adjustment of parents of pediatric cancer patients revisited: Five years later. Psycho-Oncology, 15(1), 1–8.
Conflict of interest
Emily McTate, Lauren Szulczewski, Naomi E. Joffe, Sherilynn F. Chan, Ahna L. H. Pai declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
A retrospective chart review was approved by the Institutional Review Board at Cincinnati Children’s Hospital Medical Center. Due to the nature of the information being collected, an exception for obtaining informed consent was requested and granted.
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McTate, E., Szulczewski, L., Joffe, N.E. et al. Implementation of the Psychosocial Standards for Caregiver Mental Health Within a Pediatric Hematology/Oncology Program. J Clin Psychol Med Settings 28, 323–330 (2021). https://doi.org/10.1007/s10880-020-09719-3
- Standards for psychosocial care
- Program development
- Case example