Table 2 Cascade intervention content

Module 1

‘What just happened to us?!’

Peer discussion to normalise range of typical parent experiences.

Processing the cancer experience and getting back to some form of ‘normal’.

Behavioural activation to improve mood, fatigue, and activity levels.

Module 2

‘How has cancer changed the way I think?’

Peer discussion to normalise increase in frequency and intensity of worries after cancer.

Managing upsetting thoughts and worries about cancer and everything else.

Psycho-education about common unhelpful thinking styles

Cognitive challenging.

Module 3

‘Out of your head and back into life’

Peer discussion to normalise existential concerns and highly distressing worries (for example, about child’s possible death).

Mindfulness and acceptance-based strategies for easing the struggle with ‘bigger’ existential concerns and emotional pain.

Practical problem solving strategies for problems with logical solution(s).

Cognitive strategies for disengaging from patterns of unhelpful thinking (for example, attention training, mindfulness exercises).

Module 4

‘Looking forward’

Peer discussion to normalise changes to relationships and feelings of isolation after the cancer experience.

Skills for fostering meaningful relationships, accessing social support and living a rich and fulfilling life after cancer.

Supportive discussion and problem-solving strategies to stimulate support seeking from family and network.

Assertive, effective communication skills strategies.

Booster

Individual ‘catch-up’ session with each parent one month after the end of the group.

Assist participant to identify challenging situations in the past month according to cognitive-behavioural model, and review helpful coping skills.

Review goal from the start of the program - discuss what has helped and what remains challenging in this area.