A hospital stay can be a terrifying experience for a child – especially those with cancer and other life-changing illnesses. Recent research indicates 20% of children who are hospitalized with cancer and 30% of their mothers suffer full symptoms of Post-Traumatic Stress Disorder (PTSD). These rates are comparable to that experienced by U.S. War Veterans serving since the Vietnam War. The good news is trauma can be minimized and outcomes improved through experiences that reduce stress.Ryan’s Case for Smiles (formerly ConKerr Cancer) was founded in 2007 to bring comfort and support to young patients and their families in hospitals around the globe. We started with a simple goal: to create and distribute whimsical pillowcases that give children an emotional boost and remind them that they are not defined by their illness. Case for Smiles volunteers have delivered over 1,258,323 pillowcases to children during our first 9 years of service. While seemingly simple, a pillowcase provides comfort, distraction, familiarity, a connection to home, hope and conduits for self-expression(during our hospital sewing days) and a sense of choice to children whose days consist of mostly unpleasant experiences over which they have no control. The total in-kind value of these pillowcase donations through 2015 is $13,841,553. Our programs have expanded to include the children’s entire families so they can better navigate and cope with a very difficult experience and avoid long term emotional trauma. Today each of the over 200,000 pillowcases we deliver contains an insert card that alerts parents to the risk of PTSD and directs them to internet resources for self-assessment, referrals, and evidence-based coping tools. These resources are particularly important given that limited funds mean that local hospitals often lack sufficient psychology, social work and child life resources.