A Special Kind of Family Medicine

Fifteen years ago, a close friend, a mother to children similar in age to my own, was diagnosed with breast cancer. She was seeking advice on how to be proactive and ensure that her children would continue to thrive despite her illness. She shared her concerns about how to differentiate between behaviors that reflect normal development and those that would signal reasons for worry.

As a psychiatrist practicing in Boston, I thought it would be easy to connect her with the appropriate expert. I was surprised to discover that none of my colleagues specialized in the challenges of parenting while seriously ill. However, since my career as a child psychiatrist had focused on working with seriously ill children and their families, I felt confident that together with my friend, a devoted and attuned parent, we could address her key questions and concerns. And we did.

Around the same time, many of the chronically ill children I had been working with at the Massachusetts General Hospital for Children were becoming young adults. I would often find myself the rare child psychiatrist on the adult medical wards.

Colleagues would frequently ask me how they could help an ill parent prepare for a visit from young children. What, for example, should a parent tell a child about a diagnosis or an unfolding medical situation?

Supported by the MGH Cancer Center, what began as a few hours of my time is now a six-person parent-guidance program—the Marjorie E. Korff Parenting at a Challenging Time Program (PACT). As I explain in our book, "Raising an Emotionally Healthy Child When a Parent Is Sick" (McGraw-Hill), a child's experience of a parent's illness is influenced by the parent's own experience of that illness, and her own degree of calm. When we help parents feel more confident in their ability to parent and more comfortable with their treatment, it will help their children.

Just as complex surgeries are best performed by experienced surgeons, complex parenting dilemmas are best addressed by experienced clinicians. Every parent deserves expert guidance from someone who understands the interplay of child development, mental health and the challenges of parenting when ill. (One place to start is at our Web site, www.mghpact.org.)