Psychological Perspectives in Chronic Childhood Illness

Abstract

Special perspectives in clinical work, consultation, and research with chronically ill children are elaborated. Clinical work with the chronically ill requires a focus on the impact of illness-related stress on the entire family, and a consideration of coping as a process which varies with the stage and severity of physical disease. Moreover, the comprehensive care of chronically ill, children takes place in a highly charged interpersonal context. This process can disrupt communication among staff, can raise difficult ethical questions and uncertainties, and should involve a close dialogue among various professional disciplines. Research in chronic illness has been dominated by a personality-focused paradigm associated with a counterproductive focus on differences between chronically ill and physically healthy children and a neglect of factors which contribute to successful coping in family, school, and social settings. Future research might profitably be directed toward a study of the chronically ill children's adjustment in various life contexts, the evaluation of the efficacy of psychosocial interventions, and exploration of how the survivors of childhood chronic illnesses negotiate key developmental transitions.

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