In 2006, approximately eleven years after its inception, the PACT Program was bestowed a generous endowment donation by the Korff family in honor of Marjorie E. Korff (pictured left), for whom the program is now named. Marjorie was a loving wife, mother and friend to many, and "was all about the kids, always," according to her husband Robert (pictured below and right with their two children).
Through the transformative gift of the Korff family, combined with the ongoing philanthropy of others, the hope is that the program can both continue and expand into the future, reaching more families and more professionals who care for them during the challenging circumstances of a parent's serious illness.
The program had its early beginnings in 1995 when one of Dr. Paula Rauch’s close friends, who had children of similar ages to her own, was diagnosed with breast cancer. Her friend had questions about how to best understand the needs of her two young children during this difficult time, and turned to Dr. Rauch for help. The friend wondered what reactions to her illness she could anticipate from her children and which behaviors to watch for that might signal reason for concern. She was simply seeking guidance in how to keep her healthy, well-loved children on track. When Dr. Rauch was unable to find an expert to address these concerns, she offered to provide support by drawing on her own experience caring for seriously ill children and their families. The important parenting questions posed by her friend challenged Dr. Rauch to integrate and apply the principles of child development, temperament, child mental health, a child’s understanding of illness, family communication, and the resiliency factors that support a child’s coping.
This personal experience impressed Dr. Rauch with the need for specialized guidance during a parent’s serious illness. She recognized that such guidance could offer parents the additional skills and confidence to continue providing the very best for their children. She also realized that appropriate guidance could provide interventions and ultimately reassurance that children could continue to thrive and have a bright future, despite a parent’s serious illness.
These insights provided the impetus for the beginnings of the Marjorie E. Korff PACT Program. In 1997, Dr. Rauch and the chief of child psychiatry at Massachusetts General Hospital for Children, Dr. Michael Jellinek, joined with the leadership of Massachusetts General Hospital Cancer Center, Dr. Bruce Chabner, and then vice president Kate Walsh, to launch an initiative to address the needs of parents with cancer. Attention, time, and resources were committed to helping parents who were concerned about the emotional impact their illness might have on their children.
Dr. Rauch took the lessons learned from her years of work with seriously ill children and applied them to the challenges faced in families in which a parent is living with cancer. She also began educating concerned members of the medical team (including oncologists, social workers, and nurses) who were eager to learn more about child development, temperament, and family dynamics, and how these affect a child’s ability to cope when a parent has a serious illness.
The program started small. In year one, Dr. Rauch spent fours hours a week doing patient consultations and teaching members of the medical team. However, within a year’s time, it became evident that there were many parents who could benefit from these consultations.
The patients and the oncology team appreciated the customized and timely interventions that Dr. Rauch provided, and the need for such interventions grew. In 1998, Dr. Rauch’s consultation time with families and healthcare providers increased from four hours per week to eight. This allowed her to see a greater number of families, as well as to form the first “drop-in” parent group, where parents with cancer could meet with a professional and share concerns with one another.
Given the success of these efforts and interventions, the demand for child mental health professionals to assist parents with cancer continued to rise. In 1999, Dr. Stephen A. Durant joined Dr. Rauch. Dr. Durant’s path to the PACT Program was also directly related to an experience he had in helping a close friend who was the father of three young children and whose wife was battling cancer. Dr. Durant realized the beneficial impact that guidance during a parent’s illness could provide when he utilized these lessons in consultation with his friend’s family. He and his friend were struck by the clear, direct, practical, and reassuring approach, and Dr. Durant decided that he would like to help additional families in a similar way.
Together, Drs. Rauch and Durant were able to provide an increased number of families with specialized parent guidance. They also added a “fathers’ group,” where men could come for additional support and direction.
This work continued to gain momentum over the next couple years, and in 2001, Dr. Anna C. Muriel joined the PACT Program as the first full-time Faculty Fellow funded by a generous gift from Jack Connors, Jr., CEO of Hill, Holliday, Connors, and Cosmopulos. After clinical training in general child and adolescent psychiatry, Dr. Muriel expanded her interest in how families and children cope with a child’s illness to include the impact of parental illness on the family. During her fellowship, Dr. Muriel appreciated getting to know families through consultations with Dr. Rauch, and was impressed by how families coped with the complexities of raising children while a parent is ill. These experiences inspired her to spread the message about the impact of a parent’s illness on the whole family to other professionals caring for people with cancer. To this end, Dr. Muriel developed research with the goals of providing data about the importance of parenting concerns to adults with cancer, and ultimately to help oncology providers address this particular need among their patients. In addition to her research, Dr. Muriel continued to provide clinical consultations to parents as the third PACT team member.
In 2002, Dr. Cynthia Moore began a two-year, half-time Faculty Fellowship with the PACT Program. After spending several years as director of an intensive research study about couples’ communication, Dr. Moore was eager to return towork that would allow her to make a more immediate difference in families’ lives. She learned of the PACT Program from a colleague and immediately felt that this was work she was meant to do, as it would draw on her clinical experience counseling children, adults, and families, her research experience with couples in emotional distress, and her personal experienceof the joys and challenges of being a mother. After her two-year fellowship, Dr. Moore continued her work with PACT as a faculty member.
Dr. Susan D. Swick also began a two-year, half-time Faculty Fellowship in 2002 with the PACT Program. She had completed training in adult psychiatry and forensic psychiatry in New York City before moving to Boston to pursue training in child and adolescent psychiatry. During her training in Boston, she was involved in a project describing the special needs and risks faced by children who lost a parent in the attacks of September 11, 2001. It was this experience, combined with her interest in working with parents and her knowledge about the legal concerns that parents with a serious illness may face, that made working with the PACT Program particularly compelling. Dr. Swick found consulting with families through the PACT Program to be exceptionally rewarding and educational for both the families and her, and chose to continue this work after fellowship.
At five members strong, the PACT Program was able to expand its work, with both families and oncology professionals. In addition, PACT clinicians expanded their educational outreach and increased the number of local, national, and international forums in which they shared their work with others.
Feedback from parents and from professionals learning about the program and its clinical approach was strongly positive and supportive. In 2003, Dr. Rauch received the Kenneth B. Schwartz Center’s Compassionate Caregiver of the Year Award, which brought additional visibility and opportunity for PACT to accomplish its mission. In addition, the Institute of Medicine cited the PACT Program as an example of an implementation strategy for the goals of its 2004 report Meeting Psychosocial Needs of Women with Breast Cancer.
Through both experience and primary research initiatives, the PACT Program continued to accumulate a growing body of knowledge and skill. In 2005, the wisdom of the five-person team was combined and transcribed into a book at the invitation of Harvard Health Publications. Raising an Emotionally Healthy Child When a Parent Is Sick has helped to further propagate the experienced message of the PACT Program’s clinicians to a wider public audience.
In 2006, the Korff family bestowed a generous gift on the program in honor of Marjorie E. Korff, as described above, with the hope that the PACT Program's work could continue and grow.
As part of this mission, the PACT Program continued the tradition of training new members. Dr. Vaughn L. Mankey completed the faculty fellowship with PACT in 2008, and has stayed on as staff since that then. Dr. Mankey, an adult, child, and adolescent psychiatrist, brings with him experience in international child mental health, medical student education, and the development of the patient-doctor relationship. The privilege of guiding families through the most trying of medical circumstances is what compelled Dr. Mankey to seek further training with the PACT Program. He is also interested in facilitating communication between and among healthcare providers and patients and played a key role in the development of this website.
Dr. Kristin Russell is currently training with the PACT Program as the most recent faculty fellow. Dr. Russell also has extensive training in adult, child, and adolescent psychiatry. She was drawn to the PACT Program because she appreciates how it highlights the remarkable resilience of children and families. She has interests in parenting relationships throughout the life-span, and in writing for diverse audiences about child development and psychiatry. She looks forward to extending the reach of the PACT Program to communities without access through writing and education.
In the fall of 2009, Dr. Susan Swick began working with the Newton Wellesley Hospital's Vernon Cancer Center, and has spearheaded the extension of PACT services there.
Collectively, the PACT clinicians and the many professionals with whom they work still strive to understand and meet the important needs of parents and families that were recognized by Dr. Rauch and her friend with breast cancer many years ago. Through years of experience, ongoing collaborations with families, clinical research, and the generosity of donors who fund this work, the PACT team is hopeful that the future will hold more answers and more guidance for families facing the difficult circumstances of a parent’s serious illness, as well as for the professionals who care for them.
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