How to Explain the Parents Cancer to their Children: A Specific Intervention to Enhance Communication Inside the Family

Objective: This article describes a multidisciplinary intervention dedicated to patients with cancer and with underage children. It is well known that children of severely ill parents can develop emotional and behavioral problems. Different studies underline the efficacy of an open communication with children about the parent’s illness to reduce distress but also the difficulties of parents to explain it to their children. The intervention, realized at San Gerardo Hospital, aims to inform or improve the children’s knowledge of their parent’s cancer, and to open communication about cancer inside the family. Methods: This intervention is characterized by the integration of a psychologist and a pediatric hematooncologist and by the direct involvement of children. After the fact-finding parents sessions, the pediatric hematooncologist and the psychologist meet children in specific settings, without parents present, to describe, with the support of images and metaphors, the parent’s cancer and to understand children’s needs or fears. In particular the pediatric hemato-oncologyst uses the flowered garden metaphor to explain to children the parent’s illness and the treatments. Then the clinicians share the content of the previous sessions with parents. Counseling sessions to parents are also organized to increase the parental competence and the sharing of cancer-related concerns in the family. In addition, a specific questionnaire has been realized to evaluate children’s psychological conditions after the intervention, family atmosphere and parents’ satisfaction. Results: 36 families and 53 children have participated in the project up to now. The results of the questionnaires have underlined the absence of psychopathological symptoms in children, the presence of more collaboration in the families and more possibilities in the family to have an open communication about the cancer. In addition, most of the parents reported a considerable satisfaction with the intervention. Conclusion: Support for open communication in the family about cancer should be acknowledged as an important aspect of oncology care to reduce family stress