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Section 3
Parental Cancer Adjustment

CEU Question 3 | CE Test | Table of Contents | Cancer
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On the last track we discussed breaking the news.  This included talking to children, timing, and three goals to breaking the news.  Three goals to breaking the news are to provide enough facts to calm the child’s immediate fears, to reassure them that they will be kept informed and be well taken care of, and to prepare them for what’s coming next.

On this track we will discuss sorting out priorities.  An effective technique for sorting out priorities is the creating an energy bank account technique. 

Adjusting to the Major Change of Cancer
Do you find that even the most mundane tasks can be complicated by the combination of emotions characteristic of cancer patients?  You already know that this is not unique to cancer survivorship, though.  Any time there is a major change in a client’s life, stress levels can rise.  Stressors like cancer can disrupt rules and routines within a family. 

Would you agree that some of the stresses of cancer can be subtle yet still demand a significant adjustment of routines, priorities and roles, often for an extended period of time?  I find that when clients understand and respect how conditions at home can be affected by cancer, they are better able to make effective decisions based regarding adaptive priorities and rules that serve everyone’s best interests.  Clients find themselves in trouble when they make decisions based on old sets of priorities and rules that can’t work under the new circumstances. 

Case Study: Modifying Janet's Priorities
Modifying priorities was not something new to Janet.  Before Janet, age 42, had children, she met her impulses with spontaneity.  When Janet had a family, she began to deny certain impulses.  In other words, sudden desires began to trigger a different response because her circumstances were different after having children and therefore Janet’s priorities and rules had changed.  In many cases, however, compromises allowed Janet to take care of her needs as well as her children’s needs. 

However, Janet asked, "How do I figure out which tasks I should do, which I can leave undone, and which I should delegate?"  I responded, "The answer can sometimes be found by asking yourself the following two questions.  The first question is, ‘What does your child really need as opposed to what does he or she simply want?’  The second question you can ask is, ‘Under the circumstances, who is the best person to meet those needs?’ 

Janet later stated, "At first I found prioritizing and delegating responsibilities extremely laborious."  I felt that even after Janet had developed some sense of how things had changed, she felt stressed because of the unpredictable day to day fluctuations in her energy and emotions, as well as the roller coaster nature of her breast cancer treatment.  Janet stated, "My calmness gives way to irritability as my checkup dates approach.  My treatment goes smoothly for awhile and then I’ll find myself in the hospital receiving antibiotics."  I responded by stating, "Each time your specific circumstances fluctuate, you may benefit from readjusting."

Technique:  Creating an ‘Energy Bank Account’
I continued, "Another way to help you determine which of your children’s needs are best fulfilled by you personally is to imagine yourself as having an energy bank account which holds your emotional and physical energies.  Whenever possible, make deposits so that you have some reserve for the bad times that often occur. 

In order to keep your account balanced, you must have some idea of the price of responding to your children’s wants and needs.  Will taking your children to the movies drain your energies and be a withdrawal from the bank, or make a deposit by replenishing you?  Will going to the library when you are tired deplete more or less energy than dealing with a child who is rightfully upset if you don’t go?"

Janet stated, "Calculating the cost of my activities seems like a lot of work."  How might you have responded to Janet?  I stated, "Be patient.  Your efforts will benefit your entire family because keeping your bank account in the black will minimize the problems, mistakes, and tensions that occur when you are over exhausted and trying to function.  With time, you will start to compute your deposits and withdrawals almost automatically." 

Janet then asked, "What if I calculate wrong?"  I stated, "You will.  For instance, you decide to go to the movies because you anticipate family togetherness.  Unfortunately, your youngest child spills his drink all over your older child, as the others complain about their uncomfortable seats in the packed theater.  Those are the times you have to shrug it off and remember that the best you can do is the best you can do.  When you overdraw on your energy bank account, pay the penalty and then start making more deposits.  This way, your children also learn to accept and laugh at such problems and move on. 

Think of your Janet How might your client benefit from learning how to sort priorities through an energy bank account?  Would playing this track in your next session be beneficial?

On this track we discussed sorting priorities.  An effective technique for sorting out priorities is the creating an energy bank account technique. 

On the next track we will discuss dealing with child grief.  Regarding child grief, reestablishing security is one way to help children cope effectively.  Four methods for reestablishing security are actively manage the level of change in the child’s life, actively increase the level of predictability in the child’s life, deal with any of the child’s health concerns, and increase the child’s feelings of control. 

Peer-Reviewed Journal Article References:
Egberts, M. R., Verkaik, D., Spuij, M., Mooren, T. T. M., van Baar, A. L., & Boelen, P. A. (2021). Child adjustment to parental cancer: A latent profile analysis. Health Psychology.

Flahault, C., & Sultan, S. (2010). On being a child of an ill parent: A Rorschach investigation of adaptation to parental cancer compared to other illnesses. Rorschachiana, 31(1), 43–69.

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.

Kissil, K., Niño, A., Jacobs, S., Davey, M., & Tubbs, C. Y. (2010). “It has been a good growing experience for me”: Growth experiences among African American youth coping with parental cancer. Families, Systems, & Health, 28(3), 274–289. 

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.

Online Continuing Education QUESTION 3
What is an effective technique for sorting out priorities? To select and enter your answer go to CE Test.

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