Individual and Family Counseling

Common feelings and reactions when a child is diagnosed with cancer

When your child has been diagnosed with cancer, there are no right or wrong feelings. Some parents have trouble believing that it is happening, others cry and other parents focus on making treatment decisions. All of these reactions are normal. Some of the most common reactions when hearing a child has cancer are:

• Shock
• Disbelief and denial
• Fear
• Anxiety
• Guilt
• Sadness
• Depression
• Anger
• Overwhelmed

How can counseling help you and your family?

When your child is diagnosed with a life-threatening disease, it can affect the entire family. Coping with illness can be stressful. Professional counseling services are available through the clinic whenever you need additional encouragement and support. The counselor will work closely with the hematology/oncology team(s) to help you and your family cope with the emotional impact of living with illness, and the impact of the diagnosis on everyday life. Services provided include listening, empathy and a way for children, parents, siblings and other family members to express their feelings that result from a serious diagnosis.   

What does counseling offer?

• Helps you and your family adjust to diagnosis and treatment
• Provides counseling to parents and caregivers about the impact of illness on family relationships
• Helps you communicate the needs or questions to the medical team
• Offers guidance to international and culturally diverse patient families
• Provides transitional counseling from active treatment to after completion of treatment
• Offers guidance

If your child is going to receive treatment, the counselor will meet with you to complete an initial assessment and discuss what services you think would be helpful for you and your family.

When should you talk to a counselor?

• When your child begins treatment or has a change in treatment, the counselor can help your child and family adjust and plan for the emotional impact of treatment. The counselor will also help your child’s medical team understand any emotional, social or family issues you are coping with that may impact your child’s treatment. 
• If you feel stressed or are experiencing a family crisis, coping with illness can be overwhelming.  Counseling services are available to provide you additional emotional support or encouragement if you and/or your family is struggling with the psychological stress of cancer.      

Why should you speak to a counselor?

Counseling services are used to evaluate and treat distress that’s moderate to severe. This distress may be caused by the emotional impact of receiving a life threatening diagnosis or can magnify emotional issues the person had before cancer was found.  Some problems that can make it harder to cope include:

• Depression
• Anxiety
• Panic attacks
• Mood disorders
• Adjustment disorders
• Substance abuse

All of these may be worsened by the distress of being diagnosed with a blood disorder or cancer.

Anxiety

Anxiety may be described as feeling nervous, on edge or worried. It is a normal emotion that alerts your body to respond to a threat. But intense and long-term anxiety is a disorder. It may interfere with your daily life and relationships. Acute anxiety occurs in short episodes that end quickly. Chronic anxiety remains over time.  Anxiety symptoms may be mild or severe, and some of the symptoms may be similar to those of depression. Often this is because depression occurs along with anxiety. Anxiety may make it harder to cope with cancer treatment. It may also reduce your ability to make choices about your care. As a result, identifying and managing anxiety are important parts of cancer treatment.

Many people with cancer have symptoms of anxiety. A cancer diagnosis may trigger these feelings:

• Fear of treatment or treatment-related side effects
• Fear of cancer returning or spreading after treatment
• Uncertainty
• Worry over losing independence
• Concern about having relationships change
• Fear of death

Anxiety and distress can affect the quality of life of young patients with cancer and their families. Mental health professionals use a range of counseling and therapy approaches to help the patient and/or family cope. The counselor will often start by helping you figure out what has worked well for you in the past. They will respect your coping style and try to help you strengthen it. They can help you understand how past problems or experiences may be making it harder to deal with the diagnosis. They may also teach you techniques like relaxation and meditation to help control distress.

Depression and the person with cancer

It’s normal to grieve over the changes that cancer brings to a person’s life. The future, which may have seemed so sure before, now becomes uncertain. Some dreams and plans may be lost forever. But if a person has been sad for a long time or is having trouble carrying out day-to-day activities that person may have clinical depression. In fact, up to 1 in 4 people with cancer have clinical depression. 

Clinical depression causes great distress, impairs functioning and might even make the person with cancer less able to follow their cancer treatment plan. The good news is that clinical depression can be treated.  Some people with cancer may experience depression before, during or after cancer treatment. As a result, identifying and treating depression are important parts of cancer treatment.

Mood-related symptoms 

• Feeling sad
• Feeling hopeless
• Feeling irritable
• Feeling numb
• Feeling worthless

Behavioral symptoms

• Loss of interest in activities that you previously enjoyed
• Frequent crying
• Withdrawal from friends or family
• Loss of motivation to do daily activities

Cognitive symptoms

• Decreased ability to concentrate
• Difficulty making decisions
• Memory problems
• Negative thoughts. In extreme situations, these may include thoughts that life is not worth living or thoughts of hurting yourself.

Physical symptoms

• Fatigue
• Appetite loss
• Insomnia, which is the inability to fall asleep and stay asleep
• Hypersomnia, which is feeling very sleepy most of the time

The cognitive and physical symptoms listed above may be side effects of the cancer or cancer treatment. As a result, doctors place more emphasis on mood-related and behavior symptoms when diagnosing depression in a person with cancer.

The symptoms of depression may appear right after diagnosis or anytime during or after treatment. These symptoms range from mild to severe. Severe depression interferes with a person's relationships and day-to-day life. This is called major depressive disorder. Talk with your doctor if you have any of the above symptoms, especially if they last two weeks or longer.

If someone you know has symptoms of clinical depression, encourage them to get help. There are many ways to treat clinical depression, including medicines, counseling or a combination of both. Treatments can reduce suffering and improve quality of life.