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Section 14
Assessment of Affect and Physical Activity in Children with Cancer

Question 14 | Test

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In the last section, we discussed supporting the children. This section included four guidelines for helping your clients as parents dealing with children who are trying to cope with cancer in the family or of a friend or loved one.  The four guidelines for supporting children are preparing to tell the children, talking to children about cancer, evaluating reactions, and discussing cancer with multiple children. 

Since the last section provided information on how a client might talk to children about cancer, this section will focus on techniques for child affect integration.  The two techniques in this section are storytelling and playing, and drawing.  You might find that the techniques in this section can be provided for client information or applied directly in your practice with a child client you may be treating.  Also, could playing this section in an upcoming session be productive?

First, let’s discuss creating ways to express feelings.  More often than not, the moments children are ready to talk about feelings are those for which the parent is least prepared.  Parents or guardians can, however, create an environment that encourages the expression of feelings.

2 Techniques for Child Affect Integration

♦ Technique # 1:  Storytelling and Playing
I find that storytelling and playing can be a productive way for younger children to begin to understand their feelings.  By using a doll or toy, the client might start a story by stating, "When teddy didn’t feel well, he went to the doctor and found out he had cancer."  The client may decide to tell the story alone or have the child join in.  For example, the child might describe how teddy got to the doctor and handled the news, then how he took his medicine and how he acted afterward. 

Older children might be encouraged to write a short story or poem about when the patient got sick.  Perhaps they can write a letter to the patient telling him or her about his feelings.   Letters written to friends and relatives can help share stories about the changes in the child or teens lives. 

In my practice, I suggest to the parent or guardian that he or she validate the child’s emotions by sharing with them a personal experience.  For example, Todd, age 34, validated his daughter Jamie’s emotions.  Todd stated, "I remember when my father had cancer.  I was very scared."  Jamie then knew it was okay to be scared because her father felt the same way.  How might storytelling and playing benefit the child of a client you are treating?

♦ Technique # 2:  Drawing
Drawing is another productive technique for expressing emotions.  Children might be asked if they would like to draw pictures of the family or friends.  The client then asks the child to explain what they are drawing while they are drawing it or after they have finished.  Pictures can also help children express feelings. 

Todd tried the following exercise with his 8 year old daughter Jamie.  Todd brought Jamie into a comfortable room which was the den.  Todd sat with her, symbolizing that he was engaged in this exercise too.  I had given Todd a chart with drawings of faces, each of which depicted a different emotion: anger, sadness, happiness, or nervousness.  Todd stated, "We cuddled up together to establish some intimacy.  Then I pointed to the face that represented how I felt.  I asked Jamie, "Which of these drawings looks like you feel?"

This exercise gave Jamie a way to assign pictures to her feelings.  Would you agree that by putting words or pictures to feelings, younger children can begin to express their feelings.  To help Jamie verbalize, Todd stated, "You look so sad. It must feel like all of my attention is on Mommy now."  A child who may think it’s childish to be afraid of losing a parent or being abandoned may point to the sad face and share her fears.

Your client’s children may feel more comfortable exposing their emotions this way than in a heart-to-heart talk. The client can also draw faces or ask your child to draw her face.  Then talk about the drawing.  Could cutting out pictures of different emotions help a clients child make up his or her own chart?

In this section, we discussed techniques for child affect integration.  The two techniques in this section are storytelling and playing, and drawing. 
Reviewed 2023

Peer-Reviewed Journal Article References:
Dunton, G. F., Huh, J., Leventhal, A. M., Riggs, N., Hedeker, D., Spruijt-Metz, D., & Pentz, M. A. (2014). Momentary assessment of affect, physical feeling states, and physical activity in children. Health Psychology, 33(3), 255–263. 

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. 

Poort, H., Müller, F., Bleijenberg, G., Verhagen, S. A. H. H. V. M., Verdam, M. G. E., Nieuwkerk, P. T., & Knoop, H. (2021). Condition or cognition? Mechanism of change in fatigue in a randomized controlled trial of graded exercise therapy or cognitive behavior therapy for severe fatigue in patients with advanced cancer. Journal of Consulting and Clinical Psychology, 89(9), 731–741.

Schepers, S. A., Russell, K., Berlin, K. S., Zhang, H., Wang, F., & Phipps, S. (2020). Daily mood profiles and psychosocial adjustment in youth with newly diagnosed cancer and healthy peers. Health Psychology, 39(1), 1–9.

QUESTION 14
What are two techniques for child affect integration? To select and enter your answer go to Test.

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