A unique hospital initiative in Singapore, the Child and Adolescent Family Support Services (CAFSS) programme offers psychosocial support to the parents and siblings of young patients, as well as to children of adult patients
Singapore — When Mdm Tan’s son developed severe eczema and asthma, her caregiving journey became overwhelming. Similarly, Mdm Adilah, a mother of three, struggled after her youngest daughter, who has Down syndrome, was diagnosed with a chronic kidney condition. The stress of caregiving affected their families, with siblings displaying behavioural changes including tantrums and emotional outbursts.
“The psychological burden of caregiving for a child with chronic illness is great, impacting not only their parents who are often the primary caregivers but other family members indirectly involved in the care of the ill child, such as their siblings,” said Ms Ng Siau Hwei, Head of Psychology, Department of Paediatrics, Khoo Teck Puat – National University Children’s Medical Institute (KTP-NUCMI), National University Hospital (NUH). Ms Ng leads the Division of Paediatric Psychological Services, which comprises psychologists, child life therapists, art therapists and play therapists, providing psychological services to patients up to the age of 18.
In 2022 and 2023, both mothers, whose children are patients of NUH’s KTP-NUCMI, sought help from the Child and Adolescent Family Support Services (CAFSS), a pilot programme offering psychosocial support to families of young patients.
Direct access to subsidised care for family members
CAFSS provides specialised psychosocial support to families of young patients with chronic illnesses, from allergies to severe conditions like renal failure. The programme, made possible through a $100,000 gift from EtonHouse Community Fund (ECF), is Singapore’s first hospital service that extends subsidised psychological care to both parents and siblings and aims to strengthen family resilience.
Paediatric psychologists at NUH have observed a rising trend of family difficulties when a child is diagnosed with a chronic condition, including behavioural issues in siblings and declining mental wellness in parents due to the mental, financial and emotional stress of caregiving.
Ms Ng, the lead of CAFSS, added: “Currently, the needs of family members impacted are provided for indirectly through referrals made to community support networks such as Family Service Centres or community counselling centres. As greater coordination and collaboration can enhance this system of care, CAFSS hopes to bridge this gap by enabling direct access to subsidised, family-centred psychosocial care in a public hospital setting.”
Since its inception in 2022, the programme has supported nine families through individual and group therapies, improving mood, reducing anxiety, and helping families cope with change. Families are also connected to external social support networks for further follow-ups.
With the programme running till 2026, the team is recruiting 12 families and has expanded its reach to include families of adult patients with chronic illnesses, whose children have trouble coping with their parents’ diagnosis.
Helping families one at a time
Mdm Adilah’s family benefitted from 11 months of CAFSS family-centred therapy, which improved their communication, emotional well-being and quality of life. Her daughters learnt to express their emotions more effectively, leading to a more harmonious family. “I’ve learnt how to process my feelings and emotions, and now, I know I’m not alone,” said Mdm Adilah.
Similarly, Mdm Tan and her family received counselling and psychosocial support. Mdm Tan and her husband also learnt positive parenting strategies, helping them create a more secure and nurturing environment for their son, who suffers from food allergies.
With ECF funding covering 80 per cent of each session with a psychologist or therapist, beneficiaries only co-pay 20 per cent of the charges. This funding goes beyond financial savings as caregivers would typically forgo seeking help for their own mental health even when they are in crisis, due to the strain of hefty medical bills brought about by chronic illness that requires long-term care.
Both Mdm Adilah and Mdm Lee expressed gratitude for the CAFSS programme and the financial support by Etonhouse Community Fund, highlighting the tailored care and attention their families received.
“Given the lack of local studies on such care models in Singapore, we hope the programme will provide valuable insights into supporting families with a chronically ill patient,” said Ms Ng.
Ms Fannie Lim, Chief Executive Officer of ECF, added: "For every child and youth to thrive, we need to take a holistic lens in their developmental/growing up journey. At EtonHouse Community Fund, we are glad to play a small part in supporting this first pilot programme in NUH to offer psychosocial support to families of young patients. By reviewing the results of this pilot, we're glad to see overall improvements in these patients and their families' quality of life and hopefully would set them up for more positive life milestones ahead, individually and as a family unit."
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