These children and families need psychological support to help them comply with doctors' orders and cope with issues such as restricted physical activity, frequent absences from school, and social problems.

Management of chronic illness in children and adolescents often is a multifaceted challenge that requires the attention and expertise of individuals from a variety of disciplines that include psychology, psychiatry, social work, and medicine. The aim of this book is to provide readers with a practical overview of the definitions, characteristics, theories and models, diagnostic and treatment indications, and relevant aspects and methods of evidence-based psychosocial treatments for chronic illness in children and adolescents. Although treatments and research for chronic conditions are reviewed in general, particular attention is directed at asthma, cancer, cystic fibrosis, diabetes mellitus, and sickle cell disease due to the high incidence of these chronic diseases among children and adolescents. Case vignettes and suggestions for further reading are provided for the interested reader.

The symposium "Family Dynamics, Family Therapy, and Pediatric Medical Illness," held at Downstate Medical Center on December 12 and 13, 1980, considered the impact of life-threatening illness in children and adolescents on intrafamilial dynamics. A group of experts addressed the practical and theoretical psychological and social issues facing pediatric patients and their families when con fronting chronic and severe childhood illnesses including brain damage, cancer, hemophilia, juvenile diabetes, and heart disease. The presentations and group discussions clearly revealed the complexity of physical and psychological problems posed by the seriously ill child with chronic disease for both the health care provider and the family. The conference proceedings confirm that quality care and treatment for the ill child requires the partici pation of a variety of health care disciplines representing diverse fields of knowledge. Pediatricians, family practitioners, child psychiatrists, nurses, social workers, psychologists, nutritionists and others all have important collaborative roles to play. The symposium participants wrestled with some of the basic developmental and clinical questions: How is the ongoing development of a family altered as a result of chronic incapacitating illness in a child member? How can principles of intensive family and individ ual psychotherapy be applied during the medical treatment of life threatening illness? What are the psychological stress points during the course of a chronic medical illness? These are but a few of the issues addressed in this publication.

Chronic childhood disease brings psychological challenges for families and carers as well as the children. Roger Bradford explores how they cope with these challenges, the psychological and social factors that influence outcomes and the ways in which the delivery of services can be improved to promote adjustment. Drawing on concepts from health psychology and family therapy, the author proposes a multi-level model of care which takes into account the child, the family and the wider care system and how they interrelate and influence each other.

The author draws extensively on the published research findings in child health psychology, and also on her own experience of working with pediatric medical and nursing staff. The emphasis throughout her book is on coping, and helping families to cope, with the stresses imposed by chronic childhood illness. Frequent hospital admissions, pain and its evaluation and control, adjustment and sources of support, communication, education and programs for intervention, all of these topics are discussed sensitively and with authority.

Based on a conference that assembled experts in the field of pediatric compliance in chronic illness, this book presents the latest data and conceptual models of adherence to treatment and recommendations for new directions in the field. Interdisciplinary in approach, the contributors represent a broad array of disciplines, including anthropology, pediatrics, psychology, and sociology. Designed to address critical gaps in the understanding of adherence/compliance to treatment regiments for children with chronic health conditions, this book reviews: *conceptual models used to define adherence treatment and conduct research; *the influences on treatment adherence to chronic illness in children; *the impact of adherence to treatment on children's health and psychological development; *strategies of interventions to promote adherence and reduce noncompliance rates; *methodological and measurement problems in the assessment of treatment adherence; and *recommended research priorities for the measurement of adherence and applications of interventions and training in the treatment of pediatric chronic illness.

The pattern of childhood illness has changed significantly during this century. Many frightening conditions such as polio and tuberculosis have essentially been eradicated. Other conditions that were once fatal have now achieved the status of chronic disorders, for example, leukemia, cancer, and cystic fibrosis. Technological advances which have resulted in the medical treatment of these conditions have, however, created a gamut of psychological problems for the children and their families. Recognition of these problems has lagged behind other advances in pediatric medicine. The emergence of a specialist area of pediatric psychology (Wright, 1975) has largely been responsible for the mushrooming of research in the area. In much early work, the emphasis was on the impact of chronic illness on children and their families. Reactions at times of greatest trauma, especially diagnosis or death, were particularly well documented. Issues relating to day-to-day aspects of child care, involving questions of discipline or protectiveness, have received much less attention. As far as the sick child is concerned, there has been much investigation of academic and intellectual development, as well as of personality changes that might accompany illness.

This book offers an overview of the critical issues in the assessment and treatment of children with chronic illnesses. Case vignettes, a literature review and the authors' clinical perspectives combine to inform about both the medical realities of chronic disease and the unique effects on psychological and developmental processes. There are sections on diabetes mellitus, asthma, cystic fibrosis, sickle-cell anemia, childhood cancers and paediatric AIDS. Developmental issues are considered, as are key issues of a case study approach.

In the United States, the lives of more than 10 million children are affected by chronic illnesses. In this book, the authors introduce a multidimensional framework for examining the development and adaptation of children with chronic illness. This framework encompasses biomedical, psychological and socio- ecological factors to be considered in developing intervention efforts to enhance adaptation in this population. Specific chronic illnesses discusses are asthma, cancer, cystic fibrosis, diabetes, sickle-cell disease and spina bifida. It is divided into four sections that cover the impact of chronic childhood illness, developmental changes, enhancement of adaptation and goals for public policy and research. This book is intended as more than a reference tool for those studying the process of adaptation; it can serve to influence the formulation of research questions, intervention programmes and public policy.

How can we measure the quality of life in children and adolescents with chronic disease? Major progress in the diagnosis and treatment of severe and chronic disease has led to an increased number of children and their families having to adapt and cope with the impact of disease, survival, and the cost of treatment. Health professionals have responded to this by developing a diversity of instruments for measuring quality of life for use in paediatrics, psychology and public health. This book introduces the reader to the emerging field of quality of life assessment and provides a comprehensive overview of the conceptual and methodological issues concerning quality of life in child and adolescent illness. Particular emphasis is provided on current efforts to measure the impact of specific chronic conditions on different domains of child functioning. Future directions are outlined for the development of appropriate instruments for measuring quality of life in children and adolescents. Quality of Life in Child and Adolescent Illness is intended for psychologists, paediatricians, paediatric nurses, child psychiatrists, public health professionals, researchers and other interested readers from the undergraduate to the working professional.