Wonders & Worries Research

Research shows that strong psycho-social support of a family improves their ability to cope during a parent’s illness. Our work is based on, and contributes to, this body of evidence.

Clinical Research Study

Wonders & Worries has partnered with The University of Texas at Austin for a randomized controlled clinical trial of our six-session illness education program for children with a parent with stages 1-3 cancer.

This research evaluation is needed to show the effectiveness of the Wonders & Worries program, so that it can be disseminated to other cities and cancer centers. If you know a parent with early stage cancer and a child 5-14 years, please share our research recruitment flier.

Sorry, no current or previous Wonders & Worries families are eligible for the study.

We Need Your Help

Even if you’re not eligible, here are five ways you can help us fill the research study:

  1. If you know a parent with early stage cancer and a child who is 5-14 years, share the research study flyer.
  2. Post a research flyer up at the coffeeshops, libraries, places of worship and medical offices you frequent.
  3. Share the flyer and a blurb on your social media and neighborhood boards. Use this sample language or craft your own: “Wonders & Worries is an Austin-based nonprofit that ensures children and teens can reach their full potential even though their parent is facing a serious illness. They’re looking for volunteers for a clinical research trial with UT. If you are – or if you know – a parent with early stage cancer and a child who is 5-14 years old, give them a call at 512-329-5757. (Don’t worry, there are no pills or shots, and every family receives support.)”
  4. Ask cancer organizations and support groups you’re connected to if they would share the flyer.
  5. Tell us if you want copies of the flyer, a presentation to a group or have other ideas on how to recruit. We’re all ears!


Wonders & Worries started using independent evaluators in 2007 to assess the effectiveness of our services. In 2016, an evaluation of 156 families who received support was published in the Journal of Psycho-Oncology.2

As a result of receiving services from Wonders & Worries, most parents experienced improvement in communication skills and confidence in parenting during illness. Children also directly benefited from Wonders & Worries, showing improved communication skills, reduced anxiety, increased feelings of security at home, and improved school performance.2

Supporting Evidence

Existing research has consistently shown that serious parental illness has a clear impact on children. For instance, children may react to parental cancer by internalizing problems, withdrawing or becoming depressed, and/or by developing post-traumatic stress symptoms.2

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 cancer.
  2. Children need 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.

Child Adjustment

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.