The National Palliative Care Research Center

Curing suffering through palliative care research.


Abby Rosenberg, MD, MS

Assistant Professor

Seattle Children’s Hospital

Grant Year
Grant Term
Grant Type
Pilot & Exploratory Project Support Grant

Project Description
Promoting Resilience in Stress Management (PRISM): A Novel Supportive Intervention for Parents of Children with Cancer

Parenting a child with cancer is highly distressing.  Both during and after cancer therapy, parents may suffer from poor mental health, risky health behaviors, and financial hardship, all of which may impact patients, siblings, and the family unit.   Positive psychological resources can mitigate negative outcomes.  In this regard, resilience is particularly important, describing an individual’s ability to maintain psychological and/or physical well-being in the face of stress. 

We have previously described the “Promoting Resilience in Stress Management” (PRISM) intervention for adolescent and young adult patients with cancer.  This brief, 1:1 intervention targets four “resilience resources” over approximately 3 months: skills in stress-management/mindfulness, goal-setting, cognitive restructuring, and meaning-making.  Notably, every parent whose child received the PRISM requested a similar intervention for him- or herself.  Hence, we adapted two versions of the intervention for parents (the “PRISM-P”).  First, using the same 1:1 format, we piloted the PRISM-P amongst 12 parents of children with cancer.  Feedback was highly positive; however, many parents requested additional group-based social support.  Second, we conducted a half-day symposium and administered small-group adaptations of the PRISM-P to 70 parents of children with serious illness.  Feedback was again positive; however, the opportunity to develop individual skills was limited.

This application proposes a pilot Randomized Clinical Trial (RCT) to evaluate and compare 3 formats of the PRISM-P in order to determine optimal methodologies and preferences for future, larger studies: Individual (1:1) vs. group-based vs. combined.  We hypothesize that the combined-format will be associated with higher parent-reported resilience 6 months following enrollment.  Consecutive eligible parents of children with newly diagnosed cancer will be randomly assigned to one of the 3 formats (N=75 total, n=25 per arm).  Secondary aims will assess parent-reported stress, burden of care, hope, goals, optimism, benefit-finding, psychological distress, and health behaviors, and ongoing perceptions of usefulness, feasibility, and preference.    


Abby R. Rosenberg, MD, MS, is an Assistant Professor of Pediatrics in the Division of Hematology/Oncology at the University of Washington and Seattle Children’s Hospital.  She is the director of the “Palliative Care and Resilience” research program at Seattle Children’s Research Institute and the chair of the Palliative Care subcommittee of the Children’s Oncology Group.   Dr. Rosenberg’s clinical and investigative work has focused primarily on the intersection of the medical, psychosocial, and bioethical issues involved in the care of adolescents and young adults (AYAs) with advanced cancer.  Specifically, she and her team have developed a platform for studying and promoting resilience in this patient population.  Ongoing projects include a randomized trial to test a novel, resilience-promoting intervention, as well as evaluations of end-of-life communication practices among AYAs with cancer.  Dr. Rosenberg is honored to be a recipient of the 2016 Pilot/Exploratory Support Award where she will expand the application of her resilience intervention to parents of children with cancer.