Wonders & Worries Research

Without support, children may experience post-traumatic stress symptoms, distance themselves emotionally, feel unloved, or worry that they caused a parent’s illness. Preventative programming such as ours is necessary. 


Wonders & Worries is committed to evaluating the impact of our programs and sharing the results of our work. In 2016, we published a study of the impact of our programming in the Journal of Psychological Oncology.2 The study found that among 156 families we served, most of them experienced amelioration of multiple children’s issues including improved communication skills (87%), reduced anxiety (84%), increased feeling of security at home (90%), and improved school performance (73%).  

Clinical Research Study

In June 2018, we completed data collected for a research study conducted in conjunction with the Steve Hicks School of Social Work at the University of Texas Austin focused on shedding light on the efficacy of our copyrighted, six-session curriculum. Data analysis has been completed and the results of the study have been submitted for journal publication. The results of the study will be presented at several conferences in 2019-2020.

Supporting Evidence

A serious parental illness affects families by producing emotions of confusion, anger, and fears of abandonment in children, and produce radical changes in their daily lives, which creates a disorienting home environment. Children may react to parental cancer by internalizing problems, withdrawing or becoming depressed, anxious and/or by developing post-traumatic stress symptoms.2

Successful Child Adjustment

Review of studies regarding children’s psycho-social needs and existing interventions indicate three elements as critical to successful interventions. Wonders & Worries’ services address all three of these needs:

  1. Children need age-appropriate information about their parent’s illness.
  2. Children need support in communicating with parents, family members and health professionals.
  3. Children need an environment where they feel comfortable sharing positive and negative emotions, and where they can have their experiences normalized among peers.

Comparative analysis studies show that cancer impacts a child’s adjustment, especially during the early period of diagnosis, treatment, and recovery.3 An interview study of 8- to 12-year-olds reveals that 81 percent of the children believed their mother would die from breast cancer, even though it was diagnosed as early stage.4

We also know that stress within families is even higher prior to a parent’s death than following death.5 When a parent has cancer, a child’s earlier ways of thinking–including poor hypothesis-testing and magical thinking–may reappear.4 This means that we cannot assume an adolescent will be able to reason or problem-solve when a parent is diagnosed with cancer.

Because strong emotional states may make it more difficult for a child to sort out what is happening, the upset child may perceive a greater threat than he or she might otherwise. There is evidence that children may also internalize their ill parent’s behavior as them not being lovable or valued.6


Yung-Chi C., Marian C.F. (2012) “Parental Involvement of Mothers With Chronic Illness and Children’s Academic Achievement.” Journal of Family Issues, 34(5) 583–606.
Phillips F., Prezio E.A. (2016) “Wonders & Worries: evaluation of a child centered psychosocial intervention for families who have a parent/primary caregiver with cancer.” Psycho-Oncology.
Huizinga G.A., Visser A., van der Graaf W.T.A., Hoekstra H.J., and Hoekstra-Weebers J.E.H.M. (2005) “The quality of communication between parents and adolescent children in the case of parental cancer.” Annals of Oncology, 16: 1956-1961.
Lewis, F. M. (2011) “Therapy for Parental Cancer and Dependent Children.” In Handbook of Psychotherapy in Cancer Care. Edited by Watson, M. and Kissane, D. W.
Fann, J.R., Thomas-Rich, A.M., Katon, W.J. et al. (2008) “Major depression after breast cancer: a review of epidemiology and treatment.” General Hospital Psychiatry, 30, 112–126.
6 Siegel K, Karus D, Raveis VH. (1996) “Adjustment of children facing the death of a parent due to cancer.” J Am Acad Child Adolesc Psychiatr; 35(4):442–450.

Further Reading

Ellis, S.J., Wakefield, C.E., et.al. (2016) “Supporting children facing a parent’s cancer diagnosis: a systematic review of children’s psychosocial needs and existing interventions.” European Journal of Cancer Care, 1-22.

Fallowfield, L.J., Hall, A., Maguire, G.P. et al. (1990) “Psychological outcomes of different treatment policies in women with early breast cancer outside a clinical trial.” British Medical Journal, 301, 575–580.

Grace Hyslop Christ. (2000) Healing Children’s Grief.

Huang X., O’Connor M., Lee, S. (2013). “School-aged and adolescent children’s experience when a parent has non-terminal cancer: a systematic review and meta-synthesis of qualitative studies.” Psycho-Oncology, 23: 493–506.