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Section 13
Parents Coping with Children's Cancer

Question 13 | Test | Table of Contents

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In the last section, we discussed compartmentalizing cancer thoughts. .  Because obsessive thinking rarely solves any problems and it drains clients, this section offers strategies for avoiding obsessive thinking through compartmentalization. 

In this section, we will discuss supporting the children.

This section includes four guidelines for helping your clients as parents dealing with children who are trying to cope with cancer in the family or of a friend or loved one.  The four guidelines for supporting children are preparing to tell the children, talking to children about cancer, evaluating reactions, and discussing cancer with multiple children. 

Although the examples in these sections are limited, the guidelines can essentially be applied to any relationship affected by cancer.  Your client may not be able to use all of these suggestions, but as you listen you can decide which techniques can benefit your client.

4 Guideline to Support Children

♦ Guideline #1 - Preparing to Tell the Children
First, let’s discuss preparing to tell the children.  Greg and his wife Sandy had a daughter Melinda.  Melinda, age 8, was very close to her aunt Heidi.  Heidi, age 37, had been diagnosed with breast cancer

I stated to Greg and Melinda, "You might consider evaluating your own feelings about the illness before discussing it with Melinda.  The hardest part about talking with your children is tolerating your own feelings while you tell them.  No matter how you tell them or how they react, you will still hurt for them.  The more comfortable you are with your emotions, the easier it will be to tell them.  One way to reduce some of the pain is to learn more about helping.  The more equipped you feel to support them, the less pain you will all experience." 

How can increased knowledge aid your client in discussing cancer with his or her child or children?  What resources might you provide your client to read and find out as much as he or she can?  Could this also be an ideal time to dispel the myth that cancer is contagious?

♦ Guideline #2 - Talking to Children about Cancer
Next, let’s discuss talking to children about cancer.  As I explained to Greg and Sandy, an effective method for beginning a conversation on cancer with children is by asking them what they already know about the disease.  Sandy and Greg brainstormed questions to help assess Melinda’s level of understanding prior to sharing the news of Heidi’s cancer with her. 

Sandy stated, "We came up with, ‘What does cancer mean to you?  How does someone get cancer? What do you think happens when someone gets cancer?  And we also thought we might ask her if she remembers when Greg’s friend Ray had cancer." 

Another discussion strategy I suggested to Greg and Sandy was to be honest and realistic.  I stated, "Children like Melinda can handle even the worst news surprisingly well, if you tell it to them in ways they can comprehend.  But if you don’t tell them what is happening, children have a way of imagining the situation as worse than it is.  For example, Melinda might think Heidi is dying when in fact she is simply recovering from chemotherapy.  In that way, misinformation of misunderstandings can be more frightening and confusing to children than the truth.

Sandy asked, "What do we tell Melinda if we find out that Heidi is dying?"  How might you have responded to Sandy?  I stated, "No matter what happens, be realistic.  You can explain the essential facts without sharing every gory detail.  If the patient has only a short time left or months of treatment ahead, don’t tell Melinda that everything will be fine.  Instead, consider that a cue to begin preparing her for what lies ahead."

♦ Guideline #3 - Evaluating Reactions
In addition to preparing to tell the children and talking to children about cancer, a third step in supporting the children is evaluating reactions.  Clearly, each child reacts in his or her own way and even the same child may have different reactions.  But do you agree that children don’t always react expectedly, yet need their reactions to be understood? 

I stated to Greg and Sandy, "While you are telling Melinda about Heidi’s cancer, watch for signals indicating how she is taking it.  If Melinda stiffens, dodges questions, looks away, raises her shoulders, or acts angry or defensive, be careful how much you share.  These reactions may indicate that Melinda is not ready to hear any more."  Greg and Sandy expressed concern regarding the reaction they anticipated Melinda might have.  Greg stated, "Melinda has always gotten mad when things turn out badly.  I think anger might be her fall back position." 

As you know, we have discussed anger in previous sections in this course.  Regarding child anger, however, I stated, "An angry outburst may be an opening for you to comment, ‘I wonder if you are mad because Heidi is sick.’  Then you can acknowledge her anger by saying something like, ‘I get angry sometimes, too.’"  Also, when the child calms down, clients might ask the child what motivated the anger.  For example, your client might ask his or her angry child, ‘Was something bothering you yesterday?  It’s not like you to kick the cat.’ 

♦ Guideline #4 - Discussing Cancer with Multiple Children
Last, regarding supporting the children, let’s examine discussing cancer with multiple children.  If necessary, your client might separate the children and tell them individually as much as each seems able to handle.  You might suggest the client not bombard the children with a lengthy dissertation at first.  Would you agree that children need to assimilate at their own pace?  I find that several discussions spaced out over a period of time can be productive.  Your client can then use the methods described earlier for evaluating reactions to decide which topics might be discussed  with all the children together and which should be addressed on an individual level. 

Think of your client.  Might he or she benefit from the interventions for children coping with the cancer of a loved one as described in this section?  How might you apply these interventions in your practice?

In this section, we have discussed supporting the children.  This section includes four guidelines for helping your clients as parents dealing with children who are trying to cope with cancer in the family or of a friend or loved one.  The four guidelines for supporting children are preparing to tell the children, talking to children about cancer, evaluating reactions, and discussing cancer with multiple children. 

In the next section, we will discuss techniques for child affect integration.  The two techniques in this section are storytelling and playing, and drawing.
Reviewed 2023  

Peer-Reviewed Journal Article References:
Compas, B. E., Desjardins, L., Vannatta, K., Young-Saleme, T., Rodriguez, E. M., Dunn, M., Bemis, H., Snyder, S., & Gerhardt, C. A. (2014). Children and adolescents coping with cancer: Self- and parent reports of coping and anxiety/depression. Health Psychology, 33(8), 853–861. 

Dunn, M. J., Rodriguez, E. M., Barnwell, A. S., Grossenbacher, J. C., Vannatta, K., Gerhardt, C. A., & Compas, B. E. (2012). Posttraumatic stress symptoms in parents of children with cancer within six months of diagnosis. Health Psychology, 31(2), 176–185. 

Høeg, B. L., Johansen, C., Christensen, J., Frederiksen, K., Dalton, S. O., Dyregrov, A., Bøge, P., Dencker, A., & Bidstrup, P. E. (2018). Early parental loss and intimate relationships in adulthood: A nationwide study. Developmental Psychology, 54(5), 963–974.

Oberoi, A. R., Cardona, N. D., Davis, K. A., Pariseau, E. M., Berk, D., Muriel, A. C., & Long, K. A. (2020). Parent decision-making about support for siblings of children with cancer: Sociodemographic influences. Clinical Practice in Pediatric Psychology, 8(2), 115–125.

Pariseau, E. M., Chevalier, L., Muriel, A. C., & Long, K. A. (2019). Parental awareness of sibling adjustment: Perspectives of parents and siblings of children with cancer. Journal of Family Psychology.

QUESTION 13
What are four guidelines for helping your clients as parents dealing with children who are trying to cope with cancer in the family or of a friend or loved one? To select and enter your answer go to Test.


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