Wonders & Worries Research

Studies show that a parent’s illness can have a negative effect on children. One in five people diagnosed with cancer have a child under the age of 18. Despite this, few resources exist that guide families through this challenging time. Wonders & Worries is committed to providing support to the children of parents diagnosed with serious illnesses, and continues to use therapies backed by research.

Wonders & Worries Research

Our Research

Wonders & Worries started using independent evaluators in 2007 to assess the effectiveness of our programs. We have achieved promising initial results in the success of our support programs through retrospective quantitative measurement.

In partnership with the University of Texas at Austin School of Social Work, we have launched the next stage of research to evaluate our six-session illness education and coping curriculum. If you know a parent diagnosed with early stage cancer who has a child 5-14 years, please share our research recruitment flier.

Wonders & Worries is grateful to the Rice Family Foundation for funding this rigorous evaluation.



Wonders & Worries is committed to evaluating the impact and benefits of our programs. Evaluation not only helps us attract funding, but it helps us to strengthen our programs so that we can support families to fully realize their potential and contribute to society.

Beginning in 2007, we worked with an independent consulting firm that specializes in program evaluation. Nybeck Analytics, who administered a survey for parents and caregivers whose families received services for at least three months. The surveys compared parenting skills and children’s behavior before and after program evaluation.

Evaluations show very high numbers of families indicate that Wonders & Worries helped improve their communication skills and/or increased their confidence in parenting during an illness. The first journal article detailing an evaluation of 156 families who responded to the Wonders & Worries survey between 2009 and 2014 was published in the Journal of Psychological Oncology.1

Most families described improvement in all five areas of parenting abilities assessed, including communication skills and confidence in parenting. Amelioration of multiple children’s issues was reported including improved communication skills (87%), reduced anxiety (84%), increased feeling of security at home (90%), and improved school performance (73%).

Additional Evidence

Existing research has consistently shown that serious parental illness has a clear impact on children.

Early research regarding the impact of a parent’s illness on children focuses on mothers with breast cancer. Results consistently showed that children may react to parental cancer by internalizing problems, withdrawing or becoming depressed, and/or by developing post-traumatic stress symptoms.2

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 suggestive evidence that children may also internalize their ill parent’s behavior as them not being lovable or valued.5

Review of studies regarding children’s psycho-social needs and existing interventions indicate three factors emerging as critical to future intervention development:

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


Cited Research

1 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

2 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.

3 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.

4 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.

5 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.