1. The Center for Grieving Children 555 Forest Ave, Portland *phone (207) 775-5216* fax (207) 773-7417
cgc@cgcmaine.org email * www.cgcmaine.org website
HELPING CHILDREN COPE WITH SERIOUS FAMILY ISSUES
Kathleen McCue, MA, LSW, CCLS
PRINCIPLES FOR COMMUNICATION WITH CHILDREN ABOUT FAMILY ILLNESS
Children are part of their families. Any important events in the family affect all
members.
Children are individuals, with unique needs and reactions.
Children are not just small adults. Development phases impact coping style and level
of understanding.
Children need honesty to retain trust. A trusting relationship between an adult
caregiver and a child is the foundation for mastery of any stressful experience.
Parents are the best to help children deal with confusing or stressful events.
THE ULTIMATE DILEMMA WHEN THERE IS SERIOUS FAMILY ILLNESS
Children need more support, more time, more attention, and more patience…
And parents have less available personal resources, less time, and less tolerance.
Therefore, parents feel the effects of being pulled in multiple directions.
THE THREE MOST COMMON CONCERNS OF CHILDREN
1. How will my life be affected?
2. Did I cause this?
3. Can I catch this? or, Will this happen to me?
STRESS POINTS FOR CHILDREN
Diagnosis
Times of separation
Treatment cessation
- Due to control or cure
- Due to disease progression
Death

2. CHILDREN’S REACTIONS TO PARENTAL ILLNESS
NORMAL NEEDS SIGN OF STRESS
♥Trusting relationships ♥Upset, fearful behavior
♥Consistent routines ♥Problems in eating or
Infants sleeping
♥Parental guidelines ♥Angry, acting out behavior
♥Opportunities to exert ♥Loss of skills such as
Toddlers some control ♥toileting, self dressing
♥Simple explanations for ♥Sleeping, eating
new or unexpected disturbance
Preschoolers situations ♥Being “too good”, quiet,
♥Identifications of feelings withdrawn
♥Opportunities for play ♥Clinging, baby-like
about life events behavior
♥Accurate information ♥Worry and sadness
♥Reassurance about own
School Agers health illness
♥Clear rules and ♥Anger
expectations ♥School problems
♥Isolation
♥Privacy and respect ♥Unusual hostility and
♥Complete information defiance
and involvement ♥Extreme mood swings
Adolescence in family decisions ♥Trouble with friends
♥Strong peer ♥Withdrawn and
relationships significantly non-
responsive

3. TO HANDLE SERIOUS FAMILY ILLNESS, CHILDREN NEED…
Preparation for what they will experience:
♥ Children handle change and disruption best if they have time to understand
potential impact on their lives.
Education about the unfamiliar aspects of the situation:
♥ Material should be provided at the child’s development level.
♥ Avoid euphemisms.
♥ Use familiar experiences.
Opportunities to Express Feelings:
♥ Allow children to see adult expressions of feelings.
♥ Expect emotions to vary widely, and to cover a wide spectrum of possibilities.
Support and Guidance:
♥ Provide clear boundaries.
♥ Maintain normal expectations.
THERAPEUTIC PLAY MATERIALS
FOR
CHILDREN OF SERIOUSLY ILL ADULTS
Basic White paper, markers, crayons, scissors, small
“medical” kit with real equipment, soft baby
doll, assorted small animals, assorted small
cars, cloth puppets, nerf ball, book of jokes and
riddles, magic wand, mazes, several books on
feelings, illness and parent/child issues
More Elaborate Punching bag; doll house, tape recorder and
blank tapes, Velcro dart set, tea party supplies,
Legos or blocks

4. REFERENCES
Christ, GH; Siegel, K; Sperber, D; “Impact of parental terminal cancer on adolescents”, American
Journal of Orthopsychiatry, 1994, 64(4), 604-613.
Davis, B “sibling Bereavement: Research-based guidelines for nurses”; Seminars in Oncology
Nursing, 1993, vol. 9,no2, 107-113.
Lewis, FM; Ellison, E; Woods, NF; “The impact of breast cancer on the family”, Oncology
Nurse, 198, 1:206-213.
Lichtman, RR; Taylor, SE; Wood, JV; “Relations with children after breast cancer: The mother-
daughter relationship at risk”, Journal of Nursing and Social Oncology, 1984, 2:1-19.
Morgan, J; Sanford, M; Johnson, C; “The impact of a physically ill parent on adolescents: Cross-
sectional findings from a clinic population, Canadian Journal of Psychiatry, 1992, 37, 423-427.
Norris-Shortle, C; Young, PA; Williams, MA; “Understanding death and grief for children three
and younger, Social Work, 1993, 38(6), 736-742.
LITERATURE
When A Parent Is Sick, Edna LeShan, Atlantic Monthly, 1986. Written for older school-agers and
young adolescents, this book identifies the many responses a child might have to a parent’s
illness, hospitalization or death. Special focus is given to living with a chronically ill parent and
to mental health problems.
Why Me? Coping With Family Illness, Ann Kosef, F. Watts, 1986. For the older child, this book
presents interviews and case examples of various young people who are coping with serious
illness, either their own or a member of their families. Several good summaries of responses to
parental illness are included.
Helping Your Child Handle Stress. Katherine Kersey, Acropolis Books, 1988. Gives excellent,
practical examples of how parents can help children who exhibit signs of stress. There is a good
example of an intervention with a three year old whose mother has been hospitalized with a brain
tumor.
Moms Don’t Get Sick. Pat Brack with Ben Brack, Melins Publishing Corp., 1990. An excellent
description of one woman’s reactions to the diagnosis and treatment of breast cancer. It includes
multiple comments by the author’s 10-year-old son. Emphasis is placed on emotional reactions of
all members of the family to the major illness, and various coping styles and techniques are
highlighted.
How To Help Children Through A Parent’s Serious Illness. Kathleen McCue with Ron Bonn, St.
Martins Press, 1994. A practical guide for helping children at each stage of a parent’s illness.