Adolescents whose parents are living with AIDS face daily challenges and stressors related to the stage of their parent's illness and the adjustment following their parent's death. An intensive, cognitive-behavioral intervention is described that addresses coping at each phase of adjustment. Targeting long-term social, behavioral, and mental health outcomes of the adolescent, parents living with AIDS and their adolescent children participate in both joint and independent workshops in order to enhance their affective and behavioral skills to cope with the parent's illness. The intervention is delivered in three modules of 8 to 16 sessions each. In Module 1, parents are helped to recognize their emotional response to their own diagnosis; make decisions about illness status disclosure; and establish positive daily routines in their household. Module 2 focuses on parenting, custody and estate planning. Adolescents join their parents for the last 8 sessions, addressing their reactions to parental illness and daily routines. After the parent dies, adolescents and their new custodial parents address issues of bereavement and adjustment in Module 3. The efficacy of this intervention is currently being evaluated.
Balk, D.
(1983). Effects of sibling death on teenagers. Journal of School Health, 53, 14-18.
2.
Bifulco, A.
, Brown, G., & Harris, T. (1987). Childhood loss of parent, lack of adequate parental care and adult depression. Journal of Affective Discordance, 12(2), 15-128.
3.
Blumenthal, S.J.
(1990). Youth suicide: Risk factors, assessment, and treatment of adolescent and young adult suicidal patients. Pediatric Clinics of North America, 13(3), 511-556.
4.
Bowden, P.K.
, & Packham, D. (1992). Assessment of contact tracing procedures and policy for an Australian AIDS unit and STD clinic. Paper presented at the VIII International Conference on AIDS and HIV, Amsterdam.
5.
Cates, J.A.
, Graham, L.L., Boeglin, D., & Tielker, S. (1990). The effect of AIDS on the family system. Families in Society, 71(4), 195-201.
6.
Centers for Disease Control and Prevention (1995). HIV/AIDS surveillance report: U.S. HIV and AIDS cases reported through June 1995. 7(1).
7.
Chagoya, C.
, & Citron, K. (1992). The effect of an HIV positive diagnosis on the family life cycle: Therapeutic implications. Paper presented at the VIII National Conference on HIV and AIDS, Amsterdam.
8.
Chiefetz, P.
, Stavrakakis, G., & Lester, E. (1989). Studies of the affective state in bereaved children. Canadian Journal of Psychiatry, 34, 688-692.
9.
Choi, K.
, & Coates, T.J. (1994). Prevention of HIV infection. AIDS, 8, 1371-1389.
10.
Compas, B.E.
(1987). Coping with stress during childhood and adolescence. Psychological Bulletin, 101, 393-401.
11.
Compas, B.E.
, Phares, V., & Lordoux, N. (1989). Stress and coping preventive interventions for children and adolescents. In L. Bond & B. Compas (Eds.), Primary prevention and promotion in the schools (pp. 319-340). Newbury Park, CA: Sage Publications.
12.
Corby, N.H.
, & Wilson, G. (1989). Needs of family caregivers of persons with AIDS. Paper presented at the Vth International Conference on AIDS, Abstract No. T.E.P 28, p. 851. Ottawa, Ontario, Canada: International Development Research Centre.
13.
Draimin, B.H.
(1993). Adolescents in families with AIDS: Growing up with loss. In C. Levine (Ed.), A death in the family: Orphans of the HIV epidemic (pp. 13-23). New York: United Hospital Fund.
14.
Draimin, B.H.
, Hudis, J., & Segura, J. (1992). The mental health needs of well adolescents in families with AIDS. New York: City of New York Human Resources. Administration, Division of AIDS Services, 241 Church St., New York, NY, 10013, USA.
15.
Drucker, E.
, Rothschild, B., Poust, M., Pivnick, A., Dunsmoir, L., & Eric, K. (1988). IV drug users with AIDS in New York City: A study of dependent children, housing and drug addiction treatment. Unpublished manuscript. Montefiore Medical Center, Department of Epidemiology and Social Medicine, New York.
16.
Ensminger, M.E.
(1990). Sexual activity and problem behaviors among black, urban adolescents. Child Development, 61, 2032-2046.
17.
Fair, C.D.
, Spencer, E.D., Weiner, L., & Riekert, K. (1995). Healthy children in families affected by AIDS: Epidemiological and psychosocial considerations. Child and Adolescent Social Work Journal, 12(3), 165-181.
18.
Fanurik D.
, & Zeltzer, L.K. (1991). Parenting the chronically ill adolescent. In G.D. Comerci & W.A. Daniel (Eds.), Adolescent medicine: State of the art reviews (pp. 1-7). Philadelphia, PA: Haney & Belfus.
19.
Frierson, R.L.
, Lippman, S.B., & Johnson, J. (1987). AIDS: Psychological stresses on the family. Psychosomatics, 28, 65-68.
20.
Garnier, H.
, & Weisner, T.S. (1994, February). A longitudinal study on the effects of family life style, values, and drug use on adolescents' achievement. Paper presented at the Society for Research on Adolescence, San Diego, CA.
21.
Gersten, J.C.
, Beals, J., & Kallgren, C. (1991). Epidemiology and prevention interventions: Parental death in childhood as a case example. American Journal of Community Psychology, 19(4), 481-500.
22.
Glyshaw, K.
, Cohen, L.H., & Towbes, L.C. (1989). Coping strategies and psychological distress: Prospective analysis of early and middle adolescence. American Journal of Community Psychology, 17, 607-623.
23.
Gonzalez, S.
, Steinglass, P., & Reiss, D. (1989). Putting the illness in its place: Discussion groups for families with chronic medical illnesses. Family Progress, 28, 69-87.
24.
Haverkos, H.W.
(1993). Reported cases of AIDS: An update. New England Journal of Medicine, 329, 511.
25.
Herek, G.M.
(1990). Illness, stigma, and AIDS. In P.T. Costa, Jr. & G.R. VandenBos (Eds.), Psychological aspects of serious illness: Chronic conditions, fatal diseases, and clinical care. Master lectures in psychology (pp. 107-150). Washington, DC: American Psychological Association.
26.
Holahan, C.
, & Moos, R. (1981). Social support and psychological distress: A longitudinal analysis. Journal of Abnormal Psychology, 90, 365-370.
27.
Irwin, C.E.
, & Millstein, S.G. (1991). Risk taking behaviors during adolescence. In R.M. Lerner, A.C. Peterson, & C.E. Millstein (Eds.), Encyclopedia of adolescence (Vol. II, pp. 934-943). New York: Garland.
28.
Jessor, S.
, & Jessor, R. (1977). Problem behavior and psychosexual development. New York: Academic.
29.
Kelly, J.
, St. Lawrence, J., Hood, H., & Brasfield, T. (1990). A skills-training group intervention model to assist persons in reducing risk behaviors for HIV infection. AIDS Education and Prevention, 2, 24-35.
30.
Kübler-Ross, E.
(1969). On death and dying. New York: Macmillan.
31.
Lamping, D.L.
, Gilmore, N., Ryan, B., Sewitch, M., Clark, E., Grover, S.A., Williams, J.L., Meister, C., Hamel, M., & Di Meco, P. (1991). HIV-related mental health distress in persons with HIV infection, caregivers, and family members/significant others: Results of a cross-Canada survey. Paper presented at the VII International Conference on AIDS, Vol. I, Abstract No. M.D.4050, (p. 402). Florence, Italy: Istituto Superiore Di Sanitá.
32.
Landsman, I.S.
, Baum, C.G., Arnkoff, D.B., Craig, M.J., Lynch, I., Copes, W.S., & Champion, H.R. (1990). The psychosocial consequences of traumatic injury. Journal of Behavioral Medicine, 13(6), 561-581.
33.
Lazarus, R.
(1991). Emotion and adaptation. New York: Oxford University Press.
34.
Maddison, D.
, & Raphael, B. (1972). The family of the dying patient. In B. Schoenberg, A.C. Carr, D. Peretz, & A.H. Dutscher (Eds.), Psychosocial aspects of terminal care. New York: Columbia University Press.
35.
Marcus, H.
, & Nurius, P. (1986). Possible selves. American Psychologist, 41(9), 954-969.
36.
McFarlane, W.R.
, Stastny, P., & Deakins, S. (1992). Family-aided assertive community treatment: A comprehensive rehabilitation and intensive case management approach for persons with schizophrenic disorders. In R.P. Liberman (Ed.), Effective psychiatric rehabilitation. New directions for mental health services (No. 53, pp. 43-54). San Francisco, CA: Jossey-Bass.
37.
McGrath, J.
, Ankrah, E., Schumann, D., Lubega, M., & Nkumbi, S. (1991). The psychosocial impact of AIDS in urban Ugandan families. Paper presented at the VII International Conference on AIDS, Vol. I, Abstract No. M.D. 4261, (p. 455). Florence, Italy: Istituto Superiore Di Sanitá.
38.
McKeever, P.
(1983). Siblings of chronically ill children: A literature review with implications for research and practice. American Journal of Orthopsychiatry, 53(2), 209-218.
39.
Michaels, D.
, & Levine, C. (1992). Estimates of the number of motherless youth orphaned by AIDS in the United States. Journal of the American Medical Association, 268(24), 3456-3461.
40.
Miller, S.
, & Rotheram-Borus, M.J. (1994). Project T.A.L.C.: Teens and parents learning to communicate. Department of Psychiatry, Division of Social and Community Psychiatry, University of California, Los Angeles.
41.
Moos, R.H.
(1984). Coping with physical illness, 2: New perspectives. New York: Plenum.
42.
Moreau, D.
, Piacentini, J., Dunne, E., Miller, S., & Follett, C. (1995, October). HIV prevention for Latina girls in therapy. Paper presented at the annual meeting of the American Academy of Child and Adolescent Psychiatry. New Orleans, LA.
43.
Neinstein, L.
, & Zeltzer, L.K. (1991). Chronic illness in the adolescent. In L. Neinstein (Ed.), Adolescent health care: A practical guide (2nd ed. pp. 985-1007). Baltimore, MD: Urban & Schwarzenberg.
44.
Osterweis, M.
, Solomon, F., & Green, M. (1984). Bereavement: reactions, consequences, and care. Washington, DC: National Academy Press.
45.
Patterson, J.M.
, & McCubbin, H.I. (1983). Chronic illness: Family stress and coping. In C.R. Figley & H.I. McCubbin (Eds.), Stress and the family II: Coping with catastrophe. New York: Brunner/Mazel.
46.
Patterson, J.M.
, & McCubbin, H.I. (1987). Adolescent coping style and behaviours: Conceptualization and measurement. Journal of Adolescence, 10, 163-186.
47.
Rabkin, J.
, & Remien, R. (1991). Depression, stress, and immune status in two HIV positive cohorts and psychological outlook and suicidality in AIDS long-term survivors. Paper presented at the HIV Center, Columbia University, New York.
48.
Raphael, B.
(1983). The anatomy of bereavement. New York: Basic Books.
49.
Raphael, B.
, Cubis, J., Dunne, M., Lewin, T., & Kelly, B. (1990). The impact of parental loss on adolescents' psychosocial characteristics. Adolescence, 25(99), 689-700.
50.
Rolland, J.S.
(1988). A conceptual model of chronic and life-threatening illness and its impact on families. In C.S. Chilman, E.W. Nunnally, & F.M. Cox (Eds.), Chronic illness and disability Families in trouble series (Vol. 2, pp. 17-68). Newbury Park, CA: Sage.
51.
Rosenheim, E.
, & Reicher, R. (1986). Children in anticipatory grief: The lonely predicament. Journal of Clinical Child Psychology, 15(2), 115-119.
52.
Rotheram-Borus, M.J.
, Draimin, B., Murphy, D.A., & Reid, H. (1997). Disclosure of illness and custody for children of parents. Manuscript submitted for publication.
53.
Rotheram-Borus, M.J.
, Gwadz, M., Reid, H., & Srinivasan, S. (1997). Timing of HIV interventions on reductions in sexual risk among adolescents. Manuscript submitted for publication.
54.
Rotheram-Borus, M.J.
, Koopman, C., Haignere, C., & Davies, M. (1991). Reducing HIV sexual risk behaviors among runaway adolescents. Journal of the American Medical Association, 266, 1237-1241.
55.
Rotheram-Borus, M.J.
, Murphy, D.A., & Coleman, C. (In press). Interventions for adolescents living with HIV: Routines, relationships, roles, and stages of adaptation. In M.A. Chesney & M.H. Antoni (Eds.), Health psychology and HIV disease: From transmission to treatment. Washington, DC: The American Psychological Association Division of Health Psychology.
56.
Rotheram-Borus, M.J.
, Murphy, D.A., Srinivasan, S., & Reid, H. (1997). Changing sexual risk acts among adolescents. Manuscript submitted for publication.
57.
Rotheram-Borus, M.J.
, Reid, H., Murphy, D.A., Draimin, B., & Rosen, L. (1997). Parents living with AIDS: Risk acts and medical adherence. Manuscript submitted for publication.
58.
Rotheram-Borus, M.J.
, Reid, H., & Rosario, M. (1994). Factors mediating changes in sexual HIV risk behaviors among gay and bisexual adolescents. American Journal of Public Health, 84(12), 1938-1946.
59.
Rutter, M.
(1966). Children of sick parents: An environmental and psychiatric study. London: Oxford University Press.
60.
Sandler, I.N.
, West, S.G., Baca, L., Pillow, D.R., Gersten, J.C., Rogosch, F., Virdin, L., Beals, J., Reynolds, K.D., Kallgren, C., Tein, J-Y., Kriege, G., Cole, E., & Ramirez, R. (1992). Linking empirically based theory and evaluation: The family bereavement program. American Journal of Community Psychology, 20(4), 491-521.
61.
Schilling, R.
, El-Bassel, N., Schinke, S., Gordon, K., & Nichols, S. (1991). Building skills of recovering women drug users to reduce heterosexual AIDS transmission. Public Health Reports, 106, 297-304.
62.
Schneider, M.
, Seidle, O., Ermann, M., Rommel, F., & Schramm, W. (1991). Use of social networks among HIV-infected and non-infected hemophiliacs. Paper presented at the VII International Conference on AIDS, Vol. II, Abstract No. W.B. 2399, p. 281. Florence, Italy: Istituto Superiore Di Sanitá.
63.
Sherr, L.
, Hedge, B., Petrak, J., Steinhardt, K., & Davey, T. (1992). Unique patterns of bereavement in HIV: Implications for counseling. Paper presented at the VIII International Conference on AIDS, Amsterdam.
64.
Siegel, K.
, Raveis, V.H., Bettes, B., Mesagno, F.P., Christ, G., & Weinstein, L. (1990). Perceptions of parental competence while facing the death of a spouse. American Journal of Orthopsychiatry, 60(4), 567-576.
65.
Siegel, K.
, & Krauss, B.J. (1991). Living with HIV infection: Adaptive tasks of seropositive gay men. Journal of Health and Social Behavior, 32, 17-32.
66.
Siegel, K.
, Mesagno, F., Karus, D., Christ, G., Banks, K., & Moynihan, R. (1992). Psychosocial adjustment of children with a terminally ill parent. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 327-333.
67.
Sinclair, R.
(1989). The impact on children whose parents or loved ones have HIV disease. Paper presented at the V International Conference on AIDS, Abstract No. E.504, p. 886. Ottawa, Ontario, Canada: International Development Research Centre.
68.
State of New York Department of Health
(1993). AIDS in New York State through 1993. Albany, NY: Author.
69.
Taylor, S.E.
(1983, November). Adjustment to threatening events. American Psychologist, pp. 1161-1173.
70.
Tweed, J.L.
, Schoenbach, V.J., George, L.K., & Blazer, D.G. (1989). The effects of childhood parental death and divorce on six-month history of anxiety disorders. British Journal of Psychiatry, 154, 823-828.
71.
Van den Boom, F.M.
, Mead, C., Gremmen, T., & Roozenburg, H. (1991). AIDS, euthanasia and grief. Paper presented at the VIIth International Conference on AIDS, Vol. I, Abstract No. M.D. 55, p. 36. Florence, Italy: Istituto Superiore Di Sanitá.
72.
Van Eerdewegh, M.M.
, Bieri, M.D., Parrilla, R.H., & Clayton, P.J. (1982). The bereaved child. British Journal of Psychiatry, 140, 23-29.
73.
Weiner, L.
, & Septimus, A. (1990). Psychological consideration and support for the child and family. In P. Pizzo (Ed.), Pediatric AIDS: The challenge of HIV infection in infants, children, and adolescents (pp. 577-594). New York: Williams & Wilkins.
74.
West, S.G.
, Sandler, I., Pillow, D.R., Baca, L., & Gersten, J.C. (1991). The use of structural equation modeling in generative research: Toward the design of a preventive intervention for bereaved children. American Journal of Community Psychology, 19, 459-480.
75.
Wooley, S.C.
, Blackwell, B., & Winget, C. (1978). A learning theory model of chronic illness behavior: Theory, treatment and research. Psychosomatic Medicine, 40(5), 379-401.
76.
Zayas, L.H.
, & Romano, K. (1994). Adolescents and parental death from AIDS. In B.O. Dane & C. Levine (Eds.), AIDS and the new orphans (pp. 59-76). Westport, CT: Auburn House.
77.
Zeltzer, L.K.
, Dolgin M.J., LeBaron S., & LeBaron, C. (1991). A randomized, controlled study of behavioral intervention for chemotherapy distress in children with cancer. Pediatrics, 88(1), 34-42.
