David J. Bearison – författare

As the practice of paediatric oncology continues to advance and prognoses continue to improve, the course of treatment for children with poor prognoses becomes more biologically aggressive, more stressful, and more uncertain. Even for children who cannot be cured, new treatments have prolonged the survival of those with active disease and, consequently, medical interventions have complicated the dying process. For those who are cured, there are the lingering uncertainties of having undergone medical regimens whose adverse late effects are not yet fully understood. Consequently the field of paediatric oncology now encompasses more than strictly medical concerns. The conditions of treatment, survival, and dying have become the concerns of all health-care practitioners, including psychiatrists.This volume addresses a range of psychological issues - coping with paediatric cancer, pain and symptom management, medication compliance, sibling and family relations, care of the dying child, among others - pertaining to the practice of paediatric oncology. Each topic encompasses a substantial body of research that not only has theoretical but applied significance. Each chapter is written by a nationally recognized investigator in his or her respective area of inquiry and (1) contextually defines the research area, (2) discusses theoretical and methodological concerns of the area, (3) critically reviews and integrates research findings in the area, and (4) discusses unresolved research issues and suggests future research. The topics included are currently supported by sufficient empirical research to allow useful generalization of findings in the clinical setting.

Over 50,000 children die of medical causes each year in the U.S. and 85 percent of them do so in hospitals. While great strides have been made in palliative care, many of these children still suffer considerably in the last months of life. Studies have found that pediatricians, who often do not expect to confront death on a frequent basis, and other hospital staff typically feel inadequately trained to manage the situation and are emotionally unprepared for the death. All of the feelings associated with caring for a chronically ill child, guilt, anger, frustration, ambivalence, exhaustion, are magnified when a child's life can no longer be prolonged. When Treatment Fails will be based directly on the voices of those who care for children at the end of their lives, the doctors, nurses, social workers, pastoral counselors, and psychologists. Centered around seven cases, Bearison will elicit and record the stories of these professionals about their experiences caring for a patient. The narratives will illustrate how clinicians coming from different professional roles speak about the biological, psychological, spiritual, and social dimensions of caring for terminally ill patients. Bearison will analyze their ways of making sense and giving meaning to their difficult experiences, unearthing common and distinct themes and issues across disciplines. The book will also identify the ways their interdisciplinary teams facilitate or hinder each others work, and to what extent greater reciprocity can be achieved in providing the highest quality palliative care.

Twenty to thirty years ago, the prognosis for children with cancer was dismal. Since then, remarkable advances in the treatment of childhood cancers have resulted in overall cure rates of 60 percent. In response to these improved prognoses, psychological frontiers of patient care and clinical research have evolved. Psychologists as well as mental health professionals from other disciplines are now routinely included in medical treatment planning and patient care. Psychosocial interventions with pediatric cancer patients and their families are guided by an increasingly sophisticated body of research findings that enhance their quality of life. With contributions from nationally recognized clinicians and researchers, this volume addresses the wide range of psychological issues inherent in pediatric oncology, including coping with pediatric cancer, pain and symptom management, medication compliance, neuropsychological effects of disease and therapy, sibling and family relations, bereavement, and care of the dying child. Each author carefully defines his or her research area, discusses theoretical and methodological concerns, critically reviews and integrates research findings, and discusses unresolved issues as well as future directions for research. This balanced and comprehensive overview of pediatric psychooncology is essential reading for all those interested in the treatment of children diagnosed with cancer.

IThe Edge of Medicine/I tells the stories of dying children and their families, capturing the full range of uncertainties, hopes and disappointments, and ups and downs of children near the end of life. Dr. Bearison relies on narrative to bridge the disconnect among abstract theories, medical technologies, and clinical realities.

Human cognition increasingly is coming to be understood and studied as something that does not necessarily reside within individuals, but rather as something that evolves through interpersonal communication. Using the interpersonal event as the unit of analysis, the authors of Collaborative Cognition examine how children interactively co-construct knowledge and ways of knowing in social contexts. In an illustration of the idea that thinking is as much interactive as self-reflective--one that supports the cognitive developmental theories of Jean Piaget and Lev Vygotsky--this important new study examines the social origins of thought, and the inherently discursive nature of thinking itself.The social context in question was created by the authors, who showed to pairs of children a variety of game materials and asked them to collaborate on creating a board game. Negotiating the co-construction of a game, back and forth, turn by turn, enabled the children to construct jointly a series of mutually obligatory goals and rules that sequentially defined the evolution of increasingly more complex modes of play. This innovative use of sequential analyses to study evolving streams of conversation discourse represents a fully process-oriented, rather than outcome-oriented, approach to studying cognitive development.