A critical piece of providing comprehensive follow-up care is interdisciplinary research to develop and demonstrate the effectiveness of psychosocial interventions consistent with or integrated into follow-up care. There are relatively few evidence-based interventions for survivors, although the largest set of interventions available are helpful in targeting health behaviors (e.g., [14, 58, 59, 72]). As an example of an intervention targeting PTSS across members of the family, the Surviving Cancer Competently Intervention Program (SCCIP; [46]) integrates cognitive behavioral approaches to distressing symptoms of posttraumatic stress within a family systems intervention model. SCCIP has been shown to reduce PTSS in survivors and in their fathers [40]. Other more general pilot programs suggest the feasibility of interventions that aim to educate survivors during a follow-up visit on their medical vulnerability and on the need for continued participation in follow-up care (e.g., [18]) and that aim to provide sustained psychosocial via telephone contact after a follow-up visit [90]. The longer-term effectiveness of such programs is not yet known.

Overall, survivors of childhood cancer report good psychological adjustment and have low rates of psychopathology. However, a significant minority may experience psychosocial challenges that threaten their ongoing development, including PTSD, impaired physical quality of life, and maladaptive beliefs about their health. Particularly for survivors of a central nervous system malignancy, these challenges may be associated with educational and employment challenges. Social and relationship differences, particularly in brain tumor survivors, are also vulnerabilities in many survivors. It is essential that comprehensive follow-up care includes sensitive assessment of these issues and referral to appropriate community resources, as well as health-care interventions that account for and are informed by any specific psychosocial concerns that a survivor demonstrates. Involvement of psychosocial professionals, including social workers, psychologists, and psychiatrists, on comprehensive follow-up care teams should therefore be seen as essential.

Finally, it is important to emphasize that the psychological experience after childhood cancer is not unidimensional and negative. Emerging theoretical models and early research explorations indicate many survivors and their parents experience positive psychological outcomes that they ascribe to the childhood cancer experience (e.g., [73, 108]). Many psychologists working with survivors have qualitative or anecdotal reports that parents and survivors grow to appreciate at least some parts of the cancer experience. Parents and survivors frequently explain that childhood cancer taught them to put things in perspective in ways that other people do not do and that they are not as materialistic and are more empathic. Survivors frequently feel that they are more mature than others their age and that they value their family relationships more. Family members and survivors may feel grateful to the medical professionals who worked with them and proud of their ability to manage – and survive – a challenge like childhood cancer [41]. Drawing on these strengths and the positive contributions of the cancer experience can help survivors and their family members weather any challenges they might face. Understanding the complicated interplay of these strengths with the more challenging psychological late effects experienced by some survivors can help providers work more effectively to promote positive adaptation and growth in the decades after childhood cancer survivorship.