Chronic illnesses in children and adolescents present difficulties for the individual and family. A family systems perspective can provide directions for assessment and intervention with these children and their families. A review is made of research on family interventions for children with juvenile rheumatoid arthritis, cancer, and insulin-dependent diabetes mellitus (IDDM), and the influence of intervention on health outcomes is discussed. Few family interventions, particularly behavioural family interventions, have been rigorously evaluated, but multisystemic models show promise for improving children's health outcomes and family adaptation to chronic illnesses.

We evaluated the empirical validation model of target selection for two boys with interpersonal problems. Behaviours previously identified as distinguishing popular from rejected boys on a role-play measure of social behaviour were targeted for change in these boys who had histories of peer rejection. We trained three of these empirically-derived behaviours — appropriate body orientation, adequate speech intonation, and providing reasons for denying unreasonable requests — in a multiple-baseline-across-behaviours design. On a role-play measure of social behaviour, improvements in the targeted behaviours occurred upon, but not before, introduction of the intervention, confirming the controlling effects of the intervention. Behavioural improvements generalised to untrained role-play scenes and to a novel role-play partner, and were maintained for two of the three behaviours at 4- and 6-month follow-up assessments. The boys also showed improvements in parent-reported child behaviour from pre- to post-training. The study demonstrates use of an empirical approach to the selection of treatment targets for children.