How do parents perceive high-dose chemotherapy and autologous stem cell transplantation for their children.

Our objective was to understand the parents' perception of children treated in an ASCT unit. Parents (40) of children and adolescents were interviewed by the department psychiatrist-psychoanalyst, over 9 months. They expressed great distress (22), considerable difficulty in assuming their parental role (with feelings of helplessness and guilt), and had distorted relations with the child whose behavior was unusual and incomprehensible (22). The relation with care providers, who should be 'all-powerful' and harmless, was ambivalent (15). They found it difficult to think or refused to do so, because their 'thoughts are terrifying', and they wanted to forget everything (11). The couple was going through a crisis (9). Temporal landmarks were disturbed (8); ASCT was experienced as a threatening discontinuity in the course of treatment (parents were unable to think of the past, the future, or the present); social landmarks were disturbed (6) with loss of social and professional relations. We concluded that parents may experience intense distress and disorientation. Trained to understand the parents' and their children's thoughts and behavior, the medical team, which includes a psycho-oncologist, can better help them to understand and support the children, to strike a balance between their parental role and other responsibilities, and prevent conflicts.