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Background: Childhood cancer impacts the whole family system and has psychosocial consequences for all family members. Although many families adapt over time, a considerable proportion report unmet psychosocial needs and a lack of support. Despite recommendations for family-centred psychosocial interventions, few have been scientifically evaluated for families affected by childhood cancer. There is, therefore, an urgent need for evidence regarding the use of such interventions in paediatric oncology in order to understand what constitutes successful support.

Overall aim: To explore the potential effects and experiences of a psychosocial support intervention, the Family Talk Intervention (FTI), among families affected by childhood cancer, involving also the content and issues raised. 

Methods: This thesis comprises four papers (I-IV) using both qualitative and quantitative methods. Papers I-III are based on a pilot study of FTI, performed at one paediatric oncology centre in Sweden, using a mixed methods pretest/post-test design. In Paper I, parents’ perspectives regarding the potential effects of FTI were explored through web-based questionnaires and interviews. In Paper II, fieldnotes documented by hospital social workers were used to explore the content and issues raised during FTI. In Paper III, child interviews were conducted to explore how children with cancer and their sibling’s experienced participation in FTI. Paper IV applied a qualitative descriptive design to explore migrant families’ experiences of FTI, using interviews with all family members.

Results: The overall results showed that the use of FTI had the ability to improve family communication and relationships, thus strengthening family togetherness. FTI provided a space where all family members could raise their concerns and psychosocial needs in relation to their current life situation. It also promoted child participation by providing the children with a safe space where they could express themselves freely, allowing their voices to be heard and strengthening their involvement. Among the migrant families, the use of FTI was found to increase family stability by alleviating their urgent psychosocial burdens. 

Conclusions: This thesis strengthens the evidence for FTI as a promising psychosocial support intervention in paediatric oncology. The use of FTI provides a structured, yet flexible, way to support families in adjusting to the challenges related to the child’s illness and its impact on the family system. By supporting the family as a whole, FTI has the potential to improve family communication and relationships, and foster resilience. This represents an important step forward in promoting evidence-based psychosocial care in paediatric oncology.