Psychosocial intervention in childhood renal disease

Treatment of children with end-stage renal disease (ESRD) involves extraordinary stresses for families and treatment staff. In many hospital settings, pediatric care is provided by an interdisciplinary team. However, the structure and functions of this comprehensive pediatric care may vary considerably from setting to setting and have not been sufficiently articulated in prior reports. Over the past five years, the authors have developed a model of comprehensive care that includes individual support of children's adjustment, facilitation of family decision-making, and collaborative planning of mental health interventions; these are described in the present report. Our observations have important implications for planning pediatric and mental health services for children with ESRD.