their children before and during hospitalization (Campbell et al., 1995). Children in the treatment group had a higher level of well-being with a gradual increase over time. There were no significant treatment effects on medical outcome measures or on children’s or caregivers’ anxiety. However, treatment group caregivers perceived themselves as substantially more competent to care for the children, and the intervention favorably affected the children’s behavior in the hospital, at home, and at school.

Kaslow and colleagues (Collins et al., 1997; Kaslow and Brown, 1995; Kaslow et al., 1997) studied a family-focused intervention for sickle-cell disease. They developed a psychoeducational family intervention aimed at improving relationships in families of children and adolescents (aged 7–16 years) with sickle-cell disease. The intervention consisted of a culturally and developmentally sensitive manualized treatment in six sessions tailored to the needs and competencies of each child and family. It included education about the disease, provision of skills for enhancing stress management and coping, and methods to improve family and peer relationships. African American health-care counselors conducted all the interventions. Preliminary post-intervention results revealed that, compared with families randomly assigned to the usual control condition (n=20), youth and their caretakers assigned to the experimental condition (n=20) showed greater increases in knowledge about sickle cell disease. That change is important because treatment compliance has been found to be greater among patients who have a better understanding of the disease (Dunbar-Jacob et al., 2000). No reductions in psychological symptoms were noted for the children or caretakers at the end of the intervention. Six-month follow-up data were collected but have not been reported.

Interventions Affecting Family Relationship Quality and Functioning

This type of intervention focuses on family relationships and includes various methods to foster emotional expressiveness, reduce social isolation, prevent disease from dominating family life, help deal with loss, promote collaboration among family members, improve empathy, deal with stigma, reinforce developmental family roles, and resolve intrafamily conflict. Psychoeducation is often combined with family relationship interventions, which might be more effective than psychoeducation alone for secondary prevention. These interventions also appear to be helpful for tertiary prevention (reducing the duration and effects of established com-



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