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Section 6
Cancer-Related Stress in Children

Question 6 | Test | Table of Contents

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In the last section, we discussed therapeutic tools.  Two effective therapeutic tools for helping children get in touch with their feelings are therapeutic play and feelings football. 

In this section, we will discuss regression and failure.  Regression is an unconscious signal of increased need. These unconscious signals of increased needs are normal, and usually resolve when the children feel that their three fundamental needs are being addressed

♦ Regression
Do you agree that even with the benefits of play therapy and other techniques, children’s behavior may regress during crises?  Clients may expect to see some behaviors that had been abandoned long ago. 

Do you recall Jeremy from section 2?  Jeremy had a five year old named Aaron.  Aaron suddenly began wetting his pants, sucking his thumb, and using baby talk.  Mike, from the last section, was providing care to 13 year old Scotty.  Scotty had begun neglecting his chores, playing with toys intended for younger children, and shadowing Mike’s movements around the house. 

To both Mike and Jeremy, I stated, "These unconscious signals of increased needs are normal, and usually resolve when the children feel that their three fundamental needs are being addressed."  You might consider replaying section 1 of this home study course for a review of these three fundamental needs. 

Clients like Jeremy and Mike may find the children’s behavior annoying or frustrating.  Mike stated, "I just try to remind myself that Scotty’s not trying to be bad or cause more trouble for me."  How might you have responded to Mike?  I stated, "Good insight.  Scotty may just need some extra attention as well as some time to adjust to whatever stress prompted his regression." Once they become comfortable with new routines, could your client expect troublesome behaviors such as regression to resolve?

♦ Keep from Overreacting
Jeremy stated, "Unfortunately, I get angry sometimes when the kids say they can’t brush their teeth, get dressed, or drink a glass of milk without spilling it.  Sometimes it just seems like it means more work for me!  Then it taps into my frustration over not being able to control my cancer.  Shoot, I feel like I don’t have control over anything!" 

Think of your Jeremy.  How might your client keep themselves from overreacting?  I stated, "Try reminding yourself that when you lose ground, your emotions about other things can too easily be misdirected against the children.  Respond to a drop in a child’s performance quickly.  With the younger children, try to spend time with each one alone, free from distraction.  That may be all you need to do."  

Jeremy asked, "What if the problem persists?"  I stated, "You might consider a straightforward approach, such as saying, ‘Aaron, you stopped wetting the bed in January.  For the past couple weeks your sheets have been wet in the morning.  Do you have any idea what the reason may be?’  Just be sure to acknowledge the behavior in a supportive way so that Aaron does not feel ashamed."  Think of your Jeremy.  How might your client subsequently work through what might be causing regression in his or her child? 

Regarding Mike and Scotty, do you agree that with older children, clients may not want to acknowledge the evidence of regression?  I felt Scotty might feel embarrassed if Mike pointed out behavior that Scotty could consider babyish.  I stated to Mike, "In a non-threatening way, you can mention that rules are responsibilities that must be met, perhaps by saying, ‘I haven’t had to clean up after you for a long time, but lately I’ve had to.  I know it’s tough with Aunt Sara sick and everything, but it’s very important that we all keep doing our jobs.’ 

♦ Failure - "One way you can help Mom..."
Regression is one possible reaction to stress.  Failure is second.  When grades drop or behavior is unsatisfactory, I find that clients can benefit by sitting the child down and addressing the problem directly.  In a gentle and appropriate way, a client may say something like, ‘I see that your grades are lower than usual.  I know Mom being sick is distracting you and making it harder for you to do as well in school as you usually do.  But your job is to keep up your grades.  In fact, one way you can help Mom is by keeping up your work.  That way, she can concentrate on getting better.  Let’s figure out what we can do to help you get your work done well even while she’s sick.’ 

Would you agree that a conversation like this might help children understand that failure is not an acceptable response to a crisis? 

Clients can also benefit from trying to understand what is keeping a child from performing.  I find that a child answering, ‘I’m just not interested,’ may indicate fatigue from poor sleep, or concentration difficulties due to depression, anxiety, or unresolved anger.  Is your client aware that their child’s failure can be a cry for help and should never be allowed to continue unaddressed? 

Jeremy stated, "My friends and family sometimes push me to ‘be easy on them.’  They tell me the kids are under stress.  But isn’t that like saying of course there’s a fire alarm ringing.  There’s a fire.  And then not doing anything about it?"  Think of your Jeremy.  Could your client benefit from helping his children learn how to do their best regardless of the obstacles?  How might your client apply the information in this section?

In this section, we discussed regression and failure.  Regression is an unconscious signal of increased need. These unconscious signals of increased needs are normal, and usually resolve when the children feel that their three fundamental needs are being addressed.

In the next section, we will discuss coping with visits.  This will include reactions during visits, planning for the visit, and leaving children behind. 
Reviewed 2023

Peer-Reviewed Journal Article References:
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. 

Kaplan, L. M., Kaal, K. J., Bradley, L., & Alderfer, M. A. (2013). Cancer-related traumatic stress reactions in siblings of children with cancer. Families, Systems, & Health, 31(2), 205–217.

Katz, L. F., Fladeboe, K., Lavi, I., King, K., Kawamura, J., Friedman, D., Compas, B., Breiger, D., Lengua, L., Gurtovenko, K., & Stettler, N. (2018). Trajectories of marital, parent-child, and sibling conflict during pediatric cancer treatment. Health Psychology, 37(8), 736–745.

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

Stoppelbein, L., McRae, E., & Greening, L. (2017). A longitudinal study of hardiness as a buffer for posttraumatic stress symptoms in mothers of children with cancer. Clinical Practice in Pediatric Psychology, 5(2), 149–160.

When might regression become resolved? To select and enter your answer go to Test.

Section 7
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