Table 1.

Description of EC-T Intervention Sessions & Rationale

Session 1: Anchoring yourself to help your child: This session helps the diagnosed mother define the child’s experience with the cancer as distinct from the parent’s own experience and add to the parent’s ways to manage their own cancer-related emotions so that they do not emotionally flood the child. This session positions the mother to be a more attentive listener to the child as well as add to the parent’s self-care skills. Rationale: Diagnosed mothers can attentively listen to their child if they are able to emotionally control their own anxiety. An overly emotive mother is unable to fully attend to her child’s words, maintain healthy interpersonal boundaries, or be emotionally accessible to the child. Overly charged interactions between the mother and child can emotionally flood the child, risking further disconnection with the ill parent.

Session 2: Adding to your listening skills: This session assists the ill mother develop skills to deeply listen and attend to the child’s thoughts and feelings, complementing the parent’s tendency to be a teacher, not a deep listener, of the child’s concerns, worries or understandings. Rationale: In the absence of intervention, diagnosed mothers function like biology teachers, offering the child biomedical facts about the cancer using highly charged information that is not developmentally appropriate. By focusing on the child’s view of the cancer, the ill mother is more informed and able to strategically support the child in ways that articulate with the child’s views and concerns.

Session 3: Building on your listening skills: This session builds on Session 2 and adds to the mother’s abilities to elicit and assist the child elaborate the child’s concerns or feelings, even a reticent child. It is one thing to engage a talkative child; it is another to help a child talk who is withdrawn. Rationale: Session 2 equips the ill mother with additional communication and parenting skills that enable her initiate difficult cancer-related conversations and also interact with an upset child or one who is not forthcoming.

Session 4: Being a detective of your child’s coping: This session helps the diagnosed mother focus on and non-judgmentally interpret the child’s ways of coping with the cancer. It includes exercises that assist the mother to relinquish negative assumptions about the child’s behavior related to the mother’s cancer. By giving away negative assumptions, the session enables the ill parent to positively interpret, not negatively evaluate, her child’s behavior. Concurrently, the session offers the ill parent ways to elicit ways to assist the child cope with the cancer-related pressures. Rationale: Listening and drawing out the child’s concerns is one thing; engaging in interpersonal behavior that the child finds supportive is a different skill. Both skills are important for the parent to use to reduce the child’s cancer-related concerns and distress.

Session 5. Celebrating your success: This session focuses on the gains the ill mother made in prior sessions and what she accomplished, in her own words, in parenting their child about the cancer. Both self-monitoring and self-reflection are key elements to enhance the parent’s self- efficacy in supporting and communicating with her their child; this session structures specific self- reflective exercises to help the parent internalize their accomplishments into a new self-view as an efficacious parent. The session also assists the ill parent to identify available resources that can be used after program completion to maintain the parent’s newly acquired gains from the program. Rationale: This final session helps the parent internalize a new view of the self as a skilled and confident parent. Through the ill parent’s self-report of her own behavior and the gains she attributes to themselves, the session anchors the parent’s new identity as an efficacious parent, not just a parent with new skills.