Group Cognitive-Behavioral Therapy for Hopelessness and Parenting Stress Among Mothers of Children With Cancer: A Quasi-Experimental Study With Three-Month Follow-Up

When a child is diagnosed with cancer, the shock ripples through the entire family, but the burden often falls heaviest on the mother. She becomes the primary coordinator of medical treatments, the emotional anchor for her child, and the manager of a household that has been upended by hospital visits and uncertainty. This relentless pressure can erode a parent's sense of control and hope for the future, leading to a state where the road ahead feels dark and unchangeable. At the same time, the daily demands of caregiving can exceed a mother's internal resources, creating a specific kind of exhaustion known as parenting stress. While medical teams focus on curing the disease, the psychological toll on these mothers is a critical, yet often overlooked, part of the healing process. Researchers have long understood that how a person thinks about their situation shapes how they feel; if a mother believes her efforts are futile or that the future holds only more pain, her distress deepens. The question facing psychologists is whether teaching these women new ways to think and cope can actually lighten that heavy load.

In a study conducted in 2025 at a charity cancer hospital in Dezful, Iran, a researcher named Maral Salemi set out to test a specific solution for this problem. She gathered forty mothers of children with cancer who were already struggling with high levels of hopelessness and parenting stress. These women were not just feeling sad; their scores on standard questionnaires indicated they were in significant distress. The researcher divided them into two groups. One group received a specialized psychological program, while the other group continued with their usual lives without any new therapy during the study period. The goal was to see if a structured approach to changing thoughts and behaviors could help these mothers feel more hopeful and less overwhelmed by the demands of parenting a sick child.

The program given to the first group was a form of group therapy called cognitive-behavioral therapy. Over the course of about one and a half months, the women met twice a week for twelve sessions, each lasting ninety minutes. The sessions were not just about talking; they were practical workshops designed to change how the mothers processed their experiences. In the beginning, the group learned to recognize how their thoughts influenced their feelings and physical reactions. They explored the specific stressors unique to their situation, such as the fear of relapse and the financial strain of treatment, and shared their experiences to realize they were not alone. As the weeks progressed, the focus shifted to skills. The women practiced identifying negative thoughts that made them feel helpless and learned to replace them with more balanced, realistic ones. They were taught techniques to relax their bodies when anxiety spiked, how to solve practical problems step-by-step, and how to schedule small, enjoyable activities to lift their moods. They also worked on building connections with others to reduce their sense of isolation.

The results of the study were clear and significant. When the researchers measured the mothers' levels of hopelessness and parenting stress before the program began, immediately after it ended, and again three months later, a distinct pattern emerged. The mothers who participated in the group therapy saw their scores drop dramatically. Their sense of hopelessness decreased, and the crushing weight of parenting stress lessened. In contrast, the mothers in the control group, who did not receive the therapy, showed no such improvement; their levels of distress remained high and unchanged throughout the same period. The difference between the two groups was so pronounced that it could not be attributed to chance. Furthermore, the benefits did not fade away. Three months after the final session, the mothers who had learned these new skills still maintained their lower levels of stress and hopelessness, suggesting that they had internalized the tools they needed to cope.

This study provides strong evidence that a structured, group-based approach can effectively help mothers of children with cancer manage their emotional well-being. By teaching these women to reframe their thoughts and develop practical coping strategies, the therapy offered a way to navigate the intense uncertainty of pediatric oncology. The findings suggest that psychological support is not just a luxury but a vital component of care that can restore a sense of agency and reduce the strain on the family unit. While the study was conducted with a specific group of women in one location, the success of this method offers a promising path forward for supporting the invisible caregivers who stand by their children during the most difficult times of their lives.