CONTRIBUTORS'
SECTION
EDUCATION
GROUP DISCUSSIONSWITH MOTHERS OF
HOSPITALIZEDCHILDREN
Kurt Glaser, M.D.
Departments of Pediatrics and Psychiatry, University of Maryland School of Medicine
M ANY articles have been written about the trauma of hospitalization to the child, but only little has been published about parents' reactions to the hospitaliza
tion of their 2
The following observations concerning
group discussions with parents of hospital
ized children may suggest a three-fold ap
proach to alleviate some of the trauma to
the parents : directly through the anxiety
relieving effect of the discussions and in
directly through the experience gained from these group sessions when applied to the training of staff as well as to the setting up
of administrative policies.
The present study was undertaken with five objectives in mind:
1) Imparting of information, correction of misinformation, ventilation and clarffication of feelings, and the supportive effect of group interaction are aimed at relieving
the anxiety of the parents and improving the
interrelationships between parents, chil
dren, the hospital and its personnel.
2) To gather information about the moth er's emotional reaction to the illness and hospitalization of her child, and about her understanding of the workings of the hos
pital, the role of the personnel and the pur
pose of procedures and rules.
3) The information gathered can be used as teaching material for nurses, medical stu dents and house staff. Their better under standing of the parents' thoughts and feel ings should influence their attitudes toward the parents.
4) Administratively, the information gath ered from the discussions could be helpful
in changing some of the hospital routines
and rules for a better service to patients and their families.
5) Information gathered and presented here may help the referring physician in
preparing parents and children for hospital ization and in assisting them upon the
child's return to his home.
SUBJECTS AND PROCEDURES
Nature of the Group
Open group meetings of 1 hour's duration with mothers, fathers or relatives of children hospitalized on the service ward of the Uni versity Hospital in Baltimore, Maryland, were
organized and timed to follow the afternoon visiting hours in the hospital. Mothers were encouraged to return and many of the mothers attended more than one meeting; others, be cause of lack of interest, short hospitalization of the child or heavy demands at home at tended only one session. Since invitation went only to parents of children on the service ward, the majority of the mothers were Negro women from the lower socioeconomic and educational
strata.
Usually the discussion was lively and the in terchange active. At times, however, the ses sion consisted more of questions and answers among the members of the group on one side and the leader on the other. The occasional participation of a person with higher education would facilitate the starting of the session and enliven the discussion, but it often had an in timidating effect upon the others.
A public health nurse was present at all
Pxiwrsucs, July 1960
ADDRESS: Mental Hygiene Clinic, University Hospital, Lombard and Greene Streets, Baltimore 1,
Maryland.
meetings. Occasional meetings were observed by a pediatric resident, a psychologist or a nurse.
A total of 33 sessions were held in the pe nod from March, 1956 through March, 1957, with a total of 263 participants.
Number of meetings attended by 2-4
parents 5
Number of meetings attended by 5-10
parents 19
Number of meetings attended by 11-15
parents 9
Total number of meetings Average attendance
Function
of thePublicHealthNurse
A public health nurse assigned part-time to the project invited the mothers at the time of their visits with their children to attend the meetings. She also recorded the discussions
during on after the meetings. This material
was discussed between the author and the pub lic health nurse to evaluate the group processes. The group discussions and their evaluation were found helpful to the nurse in her con tacts with individual parents of ill children.
The public health nurse participated little in the discussions but served as a resource per son when the occasion arose. She also served as liaison to ward nurses and reported and in terpreted some of the proceedings to them. She also communicated with other public health nurses working in the community when follow up or referral was indicated after the child's discharge from the hospital.
Function of the Group Leader
The sessions were usually started in the form of a 1- to 2-minute introduction by the author who led the discussions. He briefly explained that the purpose of the sessions was to discuss with parents problems arising out of the hospi talization of their children, and that by dis cussing the problems it may be possible to clarify some of the questions and worries the mothers may have. It was also stated that these meetings might be helpful to the staff in necog
nizing the thoughts of mothers with regard to
the kind of service offered by the hospital, thus helping the hospital staff to introduce changes which may benefit children in the future.
After this introduction the mothers were in
vited to bring up problems. At some sessions no one volunteered the first question or comment; at times it seemed that the mothers did not know just what kind of problem to present. At such occasion the leader would ask one of the mothers how old her child was, why he had come to the hospital and how he had adjusted. This was usually sufficient to stimulate this mother, and then others, to comment on their child's reaction to hospitalization. Usually a lively discussion ensued among the participants who presented similar experiences and prob lems and how they were approached. The re lief and comfort to the mother who saw that her problem was not unique and that others had coped with it successfully was often quite apparent.
The activity of the leader was limited to serv ing as source of information, to guide the dis cussion into what he considered pertinent ma tenial, to steer away from matters of only in dividual importance and to protect the mdi vidual mother from excessively critical, aggres sive discussants, thus avoiding a content of discussion which might provoke anxiety and antagonism.
Material for Staff Teaching
The content of the meetings as recorded by the public health nurse was discussed with in dividual residents who could often recall a particular event and found it most helpful to learn the reaction of the parent to the physi cian's comments, as reflected in the group meetings. Selected material was presented to groups of student nurses, to medical students and postgraduate nurses. It was considered a useful tool in increasing their awareness of the psychologic processes taking place in parents during the hospitalization of their child.
Material as Guide for Administrative Changes
The comments by parents about the services of the hospital, such as admission procedures, visiting hours, handling of charts or contact with physicians, were indicators of the parent's reaction to current practices and could serve as guide for future improvements.
CONTENT OF THE DISCUSSIONS
In the following section some of the
topics discussed are described in the form of examples. It is hoped that this may be of 33
charge from the hospital, particularly in the age group from 1 to 6 years. Mother would repeatedly state, “¿Mychild is spoiled; the nurses spoiled him at the hospital because they gave him everything he wanted and picked him up whenever he cried.―
Such mothers reacted to this by an at tempt to correct the “¿spoiled―behavior of the child as early and as radically as possi ble, refusing to give in to his demands and depriving him of the attention he craved. They were greatly annoyed by his “¿clinging― to them day and night, by frequently not wanting to go to sleep in their absence, by wanting to be fed. For this regressive be havior the mother would blame the staff of the hospital and would show resentment toward the management of the hospital as well as toward the child. This misinterpre tation of the reasons for the child's behavior led to an almost rejecting attitude of some mothers toward the kind of child that was returned to them.
A number of mothers were able to in tenpret the behavior of the child in terms of a physiologic reaction to hospitalization, separation and fear. They agreed that the child had been frightened by the experience in the hospital and sometimes disappointed in the mother who had left him there and repeatedly abandoned him at the close of visiting hours; that after return from the hospital he wanted to be close to the mother to make sure he was not going to be sent away again, and to take in all the love and affection which he had missed. Those with greater insight and previous experiences with hospitalization came forth with the suggestion that if the child would be given the attention and affection that he needed he would give up his clinging behavior after a period of full and unqualified ac ceptance by the mother. One could notice the relief some mothers experienced as they realized that their child's behavior was not unique and that according to the experi ences of other mothers this change in be havion was temporary and could correct it self if the child was given the attention he needed.
some help in organizing similar discussions which will lead to a better understanding of the parent-child, parent-physician and parent-hospital relationship, and that the material may prove useful for teaching and administrative purposes.
The examples are arranged according to the similarity of content. In the actual ses sions there was a great deal of overlapping, with no attempt made on the part of the leader to focus or restrain, except if the con tent seemed to be of such a nature that it would tend to increase rather than decrease the apprehension of the mother, or if one mother attempted to dominate the discus sion or to concentrate on one topic in order to obtain specific information about her own child. If a change of topic by a member of the group was thought to be an escape from an anxiety-provoking subject the leader would try to direct the discussion back if he considered it helpful, or at times would al low the change of topic and arrange for an individual meeting between himself or the public health nurse and the mother.
Child's Reaction to Hospitalization
Children in different age groups may re act to hospitalization by behavior changes which produce a great deal of anxiety in the parents. The withdrawal of the 2-year-old child, the infantilization of a 5- to 7-year old, and the independence and impertur bability of a 9- to 11-year-old are difficult to understand and accept. However, when the experience is shared by several mothers and the frequency of the reaction is pointed out by the discussion leader the mother is able to accept the phenomenon as common, and therefore normal. If she then hears that other children subsequently abandoned their unusual behavior and resumed their former attitudes, hen anxiety will be de creased because she may expect a similar recovery for her own child.
INCREASED DEPENDENCY NEEDS AND Pinisi
OLOGIC REGRESSION IN BEHAVIORI These
were noted during and after hospitalization.
Mothers frequently commented on the
EDUCATION
The group discussion had a definite func tion in this situation which could hardly be replaced by an individual doctor-patient interview. It is unlikely that a similar dis cussion would come up in an individual interview between physician and patient, since the mother would be reluctant to dis cuss a topic which originally contained a criticism of the hospital staff with which the physician is identffied. If discussed, however, the physician's interpretation might well be construed as defense of the nurses, and his suggestion of management at home parried with, “¿Youmen don't have to put up with the child at home all day, you don't know what it is like.―Support or criti cism from mothers—fellow-sufferers “¿who have gone through it―—wasmore acceptable than from the theoretician, a male physician. In discussing the problem of regression with the staff, nurses could always cite ex amples of mothers whose anxiety over the “¿babyish,spoiled― behavior of their child surpassed even their worry about the ill ness itself. Teaching sessions were geared toward increasing the understanding on the part of students and staff of the child's be havior and the mother's reaction to it. Nurses were thus in a better position to help alleviate the anxiety of the mother by in terpreting the meaning and reason of the child's behavior and assuring her about the frequency and temporary nature of such be havior changes.
WITHDRAWAL FROM THE Mo@nnm: This
reaction, described by Bowlby and others,35 was a frightening experience to some moth ers and not known to some of the younger doctors and nurses. Mothers frequently thought their children, usually between 1 to 3 years of age, had forgotten their par ents. They made a variety of attempts to endear themselves or showed their dis appointment by such statements as “¿he doesn't want me anyhow so I won't come to visit.―Feeling rejected by him, the par ents themselves began to reject the child. Others felt jealous of the nursing staff to whom the child responded more positively, and accused the staff of spoiling their chil
dren and alienating their affections. One mother planned to buy a white uniform be fore taking the child home so that he would “¿likeher, too.―
Many mothers could recount similar re actions in their children after separation. Some children ignored their mothers upon the mother's return home after childbirth. One youngster shocked his mother by ask ing, “¿Whois this woman?― Being able to share this experience with other mothers and receiving their assurance, from personal experience, of the temporary nature of the behavior of the child, it became more ac ceptable to the mother and she was able to patiently await the time when the child would “¿forgivemother for having sent him away.― Mothers began to see the child's re action as a not uncommon sequence to the
trauma of separation rather than the result
of spoiling by nurses, or meanness and de liberate rebuff by the child.
Through group interchange it was hoped that instead of overconcern and/or angry rejection the mother would be able to give the child the attention and warmth which he needed after his traumatic experience. While the study was not designed to docu ment this improved maternal attitude, it was the author's subjective impression that the
anxiety of the mothers was relieved and
some stated so directly in casual encounters with the public health nurse after the group sessions or on the ward.
During rounds the attention of the house staff, nurses and medical students was drawn to the child who was “¿bestbehaved on the ward,― the one who “¿doesn'tcause any trouble.― It was pointed out that he was not necessarily the one who was best ad justed but who, although easily manage able because of his quiet, withdrawn, unde manding attitude, might be one who needed help in order to be able to relate to the people around him, including his own mother during her visits.
staff were able to change their attitude of “¿abad mother, she doesn't like her kid― or “¿anover-critical mother who finds fault with nurses and doctors,― to a more sympa thetic and helpful approach. Some, rather than trying to avoid these mothers, sought them out during visiting hours and engaged them in individual discussions about their child's adjustment to the hospital. At times, after rounds, a medical student began to give special attention to such a “¿verygood― child, with the result that this child would begin to cheer up and act much more like a “¿realboy.― His previous “¿good―behavior was then readily accepted by the staff as depressed withdrawal.
NEED FOR CONTINUED CONTACT WITH THE
OUTSIDE Woiu.i. Some mothers were under
the impression that they could prevent homesickness by avoiding all mention of family members, pets, friends, school, etc. Other mothers told how their child reacted to this approach by complaining, often only later and after much heartache, that he had been forgotten, that no one loved him, that he had no friends, that his teacher was glad to be rid of him.
Comments by mothers after sessions on this topic showed their relief of anxiety about facing their children on visiting day. Instead of carefully avoiding all refer ence to anything which may remind the child of home and artificially looking for “¿somethingto do with the child,―they were now able to share freely their thoughts with the child, extend greetings, bring little ne membrances from home, friends and school; in other words, intensify the contact with the outside world nather than reduce it.
When the staff became aware of the pre valence of this misconception in parents they began to include a comment on the subject when preparing the family for hos pitalization, thus hopefully reducing the trauma of separation.
The Mother-child Relationship
Mom@R's APPROACH TO Cmu?s PROB
LEMS: The topic of visiting hours offered
an opportunity to clarify and possibly in
fluence some aspects of the mother-child relationship.
Most parents wanted more and longer visiting hours but some, by implication or direct statement, indicated their discomfort if “¿outsideobligations forced them―to leave before visiting time was oven or prevented them from coming. Some recognized their own guilt feelings over leaving the child and indicated that limitations by hospital negu lations (rather than their own needs or de sires) would make them feel more comfort able. With some mothers the “¿outsideob ligations― constituted a realistic problem such as small unattended children at home; for others it was a defense to reduce guilt. A few frankly indicated that they did not know how to occupy themselves with their child during visits.
One mother expressed concern about her child not eating when not fed by her, and that visiting limitations prevented her from doing so. Other mothers were quick to correct this misinformation. The author noticed the anxious expression of this mother's face and her with drawal from further conversation, and changed the topic of the discussion. At the end of the session the mother headed straight for the ele vator, neither returning to the child like most other parents, nor asking for extended visiting privileges.
When approached by the public health nurse this mother expressed in tears her conflict of having four small children locked in the apart ment while visiting at the hospital, thus neglect ing either them or her sick child. She had
sought partial relief from her guilt feelings by
the hospital's restrictions of visiting hours and her guilt was greatly increased by the “¿informa tion― of other mothers. A further conference with this mother revealed her immaturity and inability to cope with the large family and her rejection of the sick child. It was suggested that she seek assistance and counseling from a social agency since her problem extended be yond the acute condition created by the hos pitalization of the sick child.
EDUCATION 137
child. Other mothers felt that visits should be reduced in order to lessen the repeated
trauma of separation.
A number of mothers deceived their chil dren about the time of their return, saying that they would be “¿nightback.―The nurses then found a disappointed, angry and cry ing child. In most instances the mothers agreed, after some discussion, upon the need for a healthier approach than deceit or in definiteness. It became clear that mothers who deceived their children regarding visit ing hours handled other life situations in a similar unhealthy fashion. It was the aim of the discussion leader to help them gain in sight into the reason for their attitude: their feelings of guilt about the child's illness and their inability to cope with the difficult sit uation of separation. They began to recog
nize their approach as an escape on their part rather than a protection for the child
as first stated. Care was necessary in the guidance of these discussions in order to spare these mothers from the overly severe criticism and blame by others. Such embar
rassment, aside from increasing the
mother's guilt, may also prevent her return to future meetings.
Moni@'s ANXIETYOVER SEPARATION:
Some mothers expressed surprise and ap peared somewhat disturbed because their children comforted them and did not seem upset when mother left the hospital. One mother was obviously concerned about the child's independent behavior on the wand and his “¿feelingat home―with staff, fellow patients, and eating and sleeping arrange ments. The other participants were quick to pick up this mother's overprotectiveness and interpreted her concern over the child's easy separation and excellent adjustment on the ward as her own fear of losing her baby.
Moui@ii's UNDERSTANDINGOFTHEIMPACT
OF ILLNESSUPON THE CHILD: This aspect of the mother-child relationship could fre quently be improved by information given during the group discussions.
Some mothers felt they had to bring ex pensive toys to their children “¿tocheer them up.―Loss, breakage or exchange often led
to very unpleasant scenes; these were usu ally instigated by the mother who would blame the loss on careless nurses, bad chil dren on the wand on her own child's destruc tiveness and carelessness.
This topic would lend itself to much deeper exploration of the dynamics of each case, but the open group was, in the author's mind, not the forum for working through such anxiety-producing, soul-searching problems. However, unpleasant scenes could be avoided and the atmosphere improved by explaining the advantage of small, inex pensive toys, brought at each visit, which could be broken, exchanged, destroyed or disposed of without resentment on the mother's pant. Thus the child, in an outburst of anger, could break such toys, or could give them to another child as a token of friendship. The toy could serve as emotional outlet without retribution. Mothers looked for and obtained information and sugges tions as to the selection of toys for an ill child. Consideration was given to the age level, the emotional regression, the activity level as dictated by illness and age, and the interest and intellectual level of the child.
Changes in food requirements during ill ness were a frequent source of confusion. Mothers felt that their children had to eat extra large amounts while in the hospital “¿toget strong and well,―and failure to do so caused a great deal of anxiety. Most mothers were reassured when they were told about the lesser caloric requirements because of reduced activity and the innocu ousness of losing some weight during illness.
The mother's anxiety about “¿spoiling―was relieved when she understood about the
greater need for affection during stressful
situations. Restrictions imposed by hospital regulations were more readily accepted
after informative explanations by more ex
penienced mothers, with supplementation by the group leader.
MoTH@s USINGHOSPITALANDDOCTORAS
Tm@&T: Preparation for hospitalization or
GROUP DISCUSSIONS
embarrassed smile to having at some time made statements to their children such as, “¿Ifyou don't behave I will take you to the doctor and he will give you a shot,―or, “¿If you don't eat you will have to go to the hos pital.―Although the recognition of the map propniateness of these threats caused embar nassment and increased the guilt feelings, the widespread use of such statements some what relieved the tension since “¿everybody makes such remarks.― However, it was hoped that the thorough discussion of the inadvisability of such threats would influ@ ence parents to avoid them in the future.
On the basis of the experience gained from this material physicians and nurses recognized the importance of the preventive aspects in pointing out the inappropriate ness of this approach and in guiding parents in the psychologic management of illness and preparation for hospitalization.
Interrelationship Between Mother and Hospital Staff
The following episodes demonstrate the influence which our discussions had on the mother-nurse-doctor relationship.
A mother was refused permission by a nurse to bring food from home to her child. Later the physician gave her the permission. From this she concluded that doctors and nurses did not work together and that the inconsistency in this instance might well carry into areas of treatment and general management of the child.
The other mothers in the group explained to her the rules of the hospital with regard to bringing food and the limitations of the nurses' authority, while the doctor was in a position to allow exceptions depending on the patient's condition. Here again the mother seemed to accept the explanations from the other mothers readily, regarding them as allies in their mutual concern for their children. A similar interpretation by staff members on the patient's physician might have been seen as defensive and may not have altered her attitude toward the hospital staff.
The incident was taken up in discussions
with nurses as well as house staff. It was suggested that the nurse, instead of nefus ing the mother's request, could have ex plained the limitations of her authority and suggested the mother contact the doctor di nectly.
PARENT-DOCTOR CoMMuNICATIoN: Spe
cific questions about individual children were discouraged during the group meet ings and the mothers were referred to the child's physician. This led to comments by mothers about the difficulty in locating the doctor, the brevity of his explanations and his use of technical terms.
One of the parents expressed his anger about the doctor's failure to give him a pre cise diagnosis and prognosis for his child. He interpreted this as a sign of disinterest on the part of the doctor and disregard for the parent as an intelligent, thinking and responsible person.
Members of the group presented their ex peniences, some similar, some opposite, and discussed the doctor's hesitation to make diagnostic and prognostic statements before the completion of the work-up. They also were able to recognize and partially accept the doctor's own difficulty in presenting a grave prognosis to a parent and were be ginning to see the doctor as a person with human frailties rather than the undisputable and all-powerful authority on sickness and health, life and death.
In a staff discussion a junior member de scnibed his dilemma and expressed his anger about senior members delegating to him the job of informing parents of a fatal illness in their child. This then led to a study of the psychologic management of fatal illness, an important area in the doctor-patient rela tionship. Articles from the literature were reported and the subject was reviewed.
EDUCATION 139
was able to alter his approach to the par ents. Not all house officers accepted this kind of critical self-evaluation and further attempts had to be abandoned at this point in order to avoid the physician's alienation to the entire program. Deeper pursuit would have been most desirable, especially with the men who showed resistance, but a regu lan program of individual supervisory con ferences, as has been described by others,6 would have had to be set up for this pun pose.
PHYSICIANS' SENSITIVITY Tow@iw PARENTS'
QUESTIONS
A mother whose child was in the
hospital with erythnoblastosis was very upset about the diagnosis because it meant to her “¿badblood―and the doctor did not tell her whose blood was bad, hers or her husband's.
When excerpts of the discussion as re corded verbatim by the public health nurse were reread to the resident physician he at first expressed anger and despair about the stupidity of the parents with whom he had spent considerable time explaining the in tricacies of Rh incompatibility. However,
after some recall of their questions and his answers, he became aware of the discrep ancy between his desire to educate them in the disease of their child and the anxious parents' desire to obtain an answer to their one question : “¿Whois to blame?― “¿Bad blood―to them meant venereal disease, and they wanted to pinpoint the blame.
It was felt that such material based on the resident's personal contact with a family on a practical problem was more valuable to him than theoretic and abstract discussions.
COMMENTS AND SUMMARY
Parents of children hospitalized in the pediatric department of the University of Maryland Hospital attended group discus sions under the leadership of the author and the participation of a public health nurse. A total of 33 open group meetings were held, with 263 participants and an average attendance of 8 persons.
The usefulness of these meetings included the direct benefit to the parents attending the discussions, utilization of the material
for staff teaching, and suggestions for ad ministrative changes resulting from the in formation gathered at these meetings.
Limitation of the participants to parents
of chronically ill children, especially in se lected wards such as tuberculosis, rheumatic fever, congenital heart disease, diabetes, malignancies, orthopedic problems or mental retardation could have produced more stable groups, with topics focused to the specific needs of parents of children af flicted with one particular ailment. Such arrangements make it possible to work through the psychodynamics of families with similar problems and serve as educa tional means. Reports on studies of such groups have been published.7'° The project described here dealt with parents of chil dren in a general pediatric ward, most of them suffering from acute illnesses.
The selection of participants from similar educational and intellectual levels is advati tageous. The homogenicity of the group re duced the chance of domination by more verbal participants with resulting suppres sion of the others. Probably a group com posed of participants with a higher educa tional background would have produced livelier discussions on a higher intellectual level. When mixture did occur, silent with dnawal of the participants with less educa tion or boredom by the others was observed. The teaching value for hospital staff (resi dents and nurses) could potentially be en hanced even further by recording the meet ings and discussing the recordings with groups of staff members. The direct partici pation of staff members in the group dis cussions was considered inadvisable because it might have suppressed the expression of critical views by the parents. Regular group meetings with physicians utilizing this ma tenial may prove valuable. In this study only some of the material was discussed with in dividual resident physicians on an informal basis. However, the material was used ad vantageously in teaching groups of medical students, student nurses and postgraduate nurses.
gained insight into the parents' feelings re garding the child's illness, their reaction to illness, the hospital and its personnel. Two nurses participated in succession.
Lastly, some of the remarks by parents constituted valuable suggestions for admin istrative changes such as timing of visiting hours, arrangements for doctor-parent con fenences and handling of admission proce dures.
Acknowledgment
I wish to express my thanks to the Bureau of Public Health Nursing of the Baltimore City Health Department for arranging the part-time services of Mrs. Margaret Miller, P.H.N., and Mrs. Mary T. Brown, P.H.N., whose interest and co-operation were of great value to the study.
REFERENCES
1. Gofman, H., Buckman, W., and Schade, G. H. : Parents' emotional response to child's hospitalization. A.M.A. J. Dis. Child., 93:629, 1957.
2. Prugh, D. G., Staub, E. M., Sands, H. H., Kirschbaum, R. M., and Lenihan, E. A.: A study of the emotional reactions of children and families to hospitalization and illness. Am. J. Orthopsychiat., 23: 70, 1953.
3. Bowlby, J., Robertson, J., and Rosenbluth,
D. : A two-year-old goes to the hospital.
Psychoanalyt. Study Child, 7:82, 1952. 4. Spitz, R. A., and Wolf, K. M. : Anaclitic
depression : an inquiry into the genesis of psychiatric conditions in early child hood. Psychoanalyt. Study Child, 2:313, 1946.
5. Engel, C. L., Reichsman, F., and Segal, H. L. : A study of an infant with gastric fistula. Psychosomat. Med., 18:374, 1956.
6. Sonis, M., Cecil, H., and Harrington, E.: Pediatric supervision: an orthopsychi atnic tool. Paper presented at 35th Annual Meeting of the American Ortho psychiatric Association, Chicago, 1957. 7. Luzzatti, L., and Dittmann, B. : Group
discussions with parents of ill children.
PEDIATRICS, 13269, 1954.
8. Korsch, B., Fraad, L., and Barnett, H. L.: Pediatric discussions with parent groups.
J. Pediat.,44:703,1954.
9. Milman, D. H. : Group therapy with par ents: an approach to the rehabilitation of physically disabled children. J. Pediat., 41:113, 1952.
1960;26;132
Pediatrics
Kurt Glaser
GROUP DISCUSSIONS WITH MOTHERS OF HOSPITALIZED CHILDREN
Services
Updated Information &
http://pediatrics.aappublications.org/content/26/1/132
including high resolution figures, can be found at:
Permissions & Licensing
http://www.aappublications.org/site/misc/Permissions.xhtml
entirety can be found online at:
Information about reproducing this article in parts (figures, tables) or in its
Reprints
http://www.aappublications.org/site/misc/reprints.xhtml
1960;26;132
Pediatrics
Kurt Glaser
GROUP DISCUSSIONS WITH MOTHERS OF HOSPITALIZED CHILDREN
http://pediatrics.aappublications.org/content/26/1/132
the World Wide Web at:
The online version of this article, along with updated information and services, is located on
American Academy of Pediatrics. All rights reserved. Print ISSN: 1073-0397.
