Family Counselling Service
1. How can parents help child cancer patients who may react and display anxiety after intensive treatment or repeated check-ups?
Here are some suggestions:
- Comfort: Through physical touch, such as patting hands and back and holding children’s hands, parents can show their support and give comfort. Listening to light music or children’s songs while holding young children is particularly comforting.
- Time: Children require time to recover from traumatic experiences. If possible, try to allow some time between a series of tiring medical treatments.
- Distraction: Distract their attention by arranging some activities to relieve children’s stress.
- Expression: Encourage children to express negative feelings such as anger and anxiety during play therapy. Through expression, their emotion can be relieved.
- Let’s talk: Encourage children to talk about their experience, views and feelings. Parents should try to be empathetic towards the child’s viewpoint, encouraging and reassuring them. This will enhance their self-confidence and help them develop positive thinking.
- Professional counselling: If facing any difficulties or questions, parents should seek professional advice from family counsellors and hospital play therapists.
2. Can parents talk about cancer with children?
Why not? We believe:
Cancer is just one kind of disease.
Children have good powers of observation and can deduce when something is wrong even without parents noticing.
- If children do not get accurate information, they will develop negative thoughts, such as “having cancer is a punishment for my mistake”, “cancer is contagious and I should avoid contact with others”, “cancer is incurable”, etc.
- With the support of the people they trust most, children can accept the fact that they are unwell and adjust to face their condition.
- If parents avoid discussion of the illness, children will consider cancer as a secret not to be discussed. But even children have a lot of thoughts in their minds, and if they hide their feelings and thoughts their emotions will suffer more.
3. Why do children need to learn about their disease and treatment?
- To avoid speculation: Even if parents avoid discussion about the illness, children will develop uncertainties as they endure various check-ups and treatments when hospitalised. This will lead some children to speculate about their illness. Because of their limited knowledge and analytical powers, such a lack of guidance can lead some children to panic.
- To facilitate the child’s cooperation for treatment: It is natural for young patients to resist long, uncomfortable and painful treatment. Therefore, the more they understand about their illness and effects of treatment, the more their feelings of unease will be alleviated.
- To build up trust and a feeling of security: Hospital is a strange environment for children, forcing them to have to interact with many strange people during treatment. This will lead to feelings of insecurity. Through communicating with children and helping them to understand and adjust to the treatment, parents can reassure them that they are not alone.
4. What is family counselling?
Family counselling is one kind of counselling. Through conversation and face-to-face discussion, family counsellors help the whole family to identify and resolve difficulties and disturbing issues within the family. The Children’s Cancer Foundation family counsellors are veteran social workers who strictly follow the principles of confidentiality. Counsellors do not instruct you or criticise your decisions as we believe that each individual has the ability to solve problems. But anybody can be affected in times of adversity. The main purpose of counselling is to help people to help themselves.
5. How can I contact a family counsellor?
You can contact us through a doctor, by nurse referral to our family service centre or you can call +852 2328 8323 to contact us. Our family counsellor will schedule an appointment time with you. We can also meet you at the hospital or our service centre upon your request. Cancer comes suddenly and disturbs a whole family’s life. We hope to walk with you and share other families’ experiences with you.
6. How do I help my child to understand what is happening to him or her?
- Who should be the one? Parents are the best people to talk to their child. Parents may consider inviting other people close to their child, or the attending doctor to tell the child about the disease. Parents should encourage the child to ask as much as possible.
- When is the right time? It depends on the emotional state of the child and parents themselves. If doctor has already made the diagnosis and the parents’ emotional state is stable, parents should consider explaining the facts to the child as soon as possible.
- What should I tell my child? Help your child to understand that it takes time to complete the whole process. At first when explaining the facts, try to tell your child about their illness and the treatment process clearly and honestly, and in a way appropriate to your child’s age. Encourage your child to ask questions and try to focus on their concerns. State clearly that the medical team will do their best to help and that the family will be there at every step. You child is not alone. State clearly that it is not because of something your child has done wrong. The illness is not a punishment.
7. My child became very irritable and lost his temper. Should I discipline him?
Some parents do not want to discipline their child because they worry it will result in additional stress and demands on the child. Some parents think they should discipline their child because they worry that if they don’t the child will become out of control. Parents need to find out the reasons for the bad temper. Is it the side effect of the treatment, the personality of their child, or their own parenting style? Parents should let the child express his emotions and feelings. Parents should let the child cool down. Parents should listen to his in-depth feelings, his fears, and focus on any misunderstandings. Parents should consult social workers, a clinical psychologist, or hospital play specialists. Parents should teach their child how to manage his emotions.
8. My child has already completed treatment and we plan to let him go back to school to repeat Primary 3 in the new academic year. I am worried that he may not be able to catch up with the rest of the class. What should I do to help him?
Since the treatment period is quite long, children always need to suspend schooling for a long period of time. There will be some adjustment problems as well as learning problems, some of these problems may be due to the side effects or late effects of the diseases or the treatment. Parents may consider having their child undertake an assessment to determine if his learning ability is able to meet the requirements of the school. Contact the school to discuss any preparation work. Let your child adjust to the school step by step. The principle is to let your child have successful experiences as far as possible. These successful experiences can help your child to move ahead.
9. Should I tell the facts to the child’s grandparents?
It is normal to try to protect the grandparents from the shock of the bad news by hiding the facts. But on the other hand, the grandparents may prefer to know the facts as soon as possible as they can offer help. When the parents’ emotional state becomes stable, it is the right time to tell the grandparents. Parents may disclose the facts step by step. Parents always have the choice whether or not to tell the facts.
10. How do the patients’ siblings help the fight against cancer?
In the family, every member will be involved when a child contracts cancer. Siblings of the patient will feel fear, sorrow and even guilt due to the treatment and illness their brother or sister is going through; they feel anxious when seeing their parents in pain and in grief; daily habits will change because of long-term isolation from the parents and this will produce anger and jealousy among the siblings; siblings will sense the risk of cancer and death and feel frustration and their own sense of grief.
While parents are tired of taking care of their sick child and adjusting to the changes in life, they will be less sensitive to the siblings’ feelings or will assume the siblings will understand what they’re going through.
Likewise, siblings will not share their inner feelings as they do not want to create any extra burden to their parents. If parents and siblings cannot handle emotions effectively, it will create a negative impact on their family and social relationships, as well as on their and personal development.
To help the siblings fight with the young patient’s cancer, parents should first create an open environment to raise and answer their questions. Parents can ask the children, “Do you know what cancer is?” or “What are the reasons that children contract cancer?” If you do not know the answers, you can write them down and then ask the relevant professionals to help with the answers.
Secondly, parents explain the changes to their daily life due to cancer and provide siblings with the opportunity to express thoughts and needs. Parents can ask children, “How do I let you know I treasure and value you?” “In these time of challenges, what do you need?” or simply “How can I help you?”. Sharing can encourage siblings to learn how to express feelings and family unity. “I can feel your pain…”, “Your voice is full of fear and so is mine…” or “When I take your sister for chemotherapy in hospital, I miss you. Do you?”
Thirdly, during the treatment, the siblings are labeled as sister or brother of XXX. This will make them lose their identity and feeling of being respected. Parents can remind relatives to greet them personally when approaching them before asking about the situation of the patient.
Fourthly, parents should let the daily lives of other siblings continue as usual and make sure they continue their own social life. Parents should also set aside time daily to understand their life and schoolwork. Sometimes, parents expect the elder children to take up some of the responsibilities of adults and this can make the relationship become tense. It is advised that parents or relatives should share the workload of the household.
In summary, listening to the siblings of patients and trying to understand them and provide chances for them to get involved will make them feel they are respected and treasured. Even if the parents do not have much time to be with them, siblings can maintain a close relationship with their parents and thereby increase their self-confidence and sense of responsibility.
If parents find siblings of the ill child are becoming emotional, bad-tempered, losing concentration, losing appetite, having nightmares and sleepless and losing interests in activities, they should seek help from social workers or psychologists for further assessment and assistance.