What do you need to learn in paediatric psycho-oncology?

Abstract

Paediatric psycho-oncology is an evolving speciality and is increasingly being recognised as an essential component in children’s cancer care. Modern paediatric oncology services aspire to integrate physical care with psycho-social care and build capacity within clinical teams to address the emotional needs of parents and children side by side with other aspects of medical care. This article discusses the unique challenges of paediatric psycho-oncology and common situations where psychological assessment and management of children and young people with cancer become especially important. The authors propose a tiered structure of training. Providing empathic evidence-based psycho-social care is ‘everyone’s business’ in paediatric oncology and not merely that of mental health professionals. However, there are times when a more specialist intervention by a paediatric liaison psychiatrist and/or a clinical psychologist is needed for optimum outcome. Learning interviewing techniques suitable for children and adolescents should be a core part of the training in paediatric psycho-oncology. Professionals should be encouraged to reflect on their own emotional wellbeing, which in turn will provide a stable foundation of emotionally matured care to children, young people and their families.

The Crucial Role of Psychosocial Research for Patients and Caregivers: A Narrative Review of Pediatric Psycho-Oncology Research in India

“…Survivorship research is also often heavily focused on health-related QoL that involves overall health-related functioning and physical late effects but make generalized mention of psychosocial problems with little focus on specific psychological stressors such as relational issues, self-esteem, or other concerns specific to the individual survivor, which are paramount in effective coping for survivors. 13,22 Little is known about supportive care needs for survivors after they have transitioned to adulthood and the impact of leaving regular pediatric health care. Pediatric cancer survivors are far more likely to face psychosocial complications alongside further health anxieties and there is a need to explore these dynamics.…”

“…Pediatric psycho-oncology falls between psychiatry, psychology, and pediatric health care. 22 Cancer diagnoses during childhood are highly likely to impact both the child and their family and pediatric psycho-oncology attempts to understand their psychosocial, emotional, and supportive care needs while coping with this life-altering situation. 4 Over the past few decades, research in pediatric psycho-oncology has expanded to include communication and treatment-related information sharing and understanding parent and caregiver concerns.…”

Children with cancer: Are we healing the body & missing the mind?

“…Many children adapt quickly to the hospital environment and procedures that they must undergo. However, some children with cancer may be distressed at the time of diagnosis, and others during treatment, or following treatment completion 4 . Common psychosocial issues that affect children with cancer may be slightly different for different age groups.…”

“…This can be distressing not only for children but also for their parents 3 . Children may be scared of hospital settings and health professionals 4 . The hospital wards and outpatient clinics should have a child-friendly design that provides a healing environment to the sick child.…”

“…In a country like India, which has a paucity of mental health resources for children in general, it would be easier to adopt a tiered approach towards identifying and managing mental health comorbidities in children with cancer. We had earlier proposed a model for this 4 that suggested all paediatric oncology staff be trained in primary psychosocial skills that would be useful for the majority of children undergoing treatment for cancer. Specialists in children’s mental health should be involved when problems are of acute onset and disabling or when the diagnosis is complex requiring multimodal treatment.…”