Sarah Turner and J’nae Christopher are assistant psychologists within Health in Mind at Birmingham Children’s Hospital. They explain that for a child going through treatment, to be given choice and control over even seemingly small things, can be of real value.
During your child’s cancer journey, you’re faced with a lot of information, and sometimes you and your child may have no control over what happens: treatment, outcomes and side effects, hospital stays, and more. So, it’s important that, where possible, your child is provided with opportunities to make their own age-appropriate choices, to feel included and empowered in their care.
Choices may allow children to build independence at a time when they have to rely on others for support. They can also encourage them to build relationships with their medical team and feel comfortable asking questions. Having a sense of control can help to manage feelings of fear and worry that arise in uncertain situations. It’s the little things that matter and make us feel valued by others.
How can we offer choice?
Sometimes decision making is hard, especially for children and particularly when they are stressed or upset. However, they may become increasingly involved as time goes on, and it’s important to think about how to offer them choice. You could provide two clear options, and offer the chance to ask questions to increase understanding. Remember, it’s ok if they can’t make a choice or you don’t know what they want. If it’s too hard, why not ask your child if it’s ok to make a decision for them? This in itself is providing them with some form of choice.
It’s also important to remember that decision making can be a process, it doesn’t have to be a definite or immediate choice. It can be something that is continually reviewed. All children are different, and this makes them special. You know your child best. Consider their understanding, and what choices they can reasonably make. Big choices might be overwhelming but perhaps they could choose:
- What they bring into hospital
- Who is with them at key points
- Elements of treatment and procedures e.g. time of day
- If or when they shave their head
- ‘How’ they want to take medication, rather than ‘if’
- What helps when they’re feeling sad or scared
- How transition to adult services is managed
Offering choices on challenging days
For difficult procedures, you could create a ‘recipe for success’. This is where parents or clinicians work with a child to create a plan for the day, offering them choices where possible. It’s then written down and shared with their medical team.
Communication is key
We always remember the way something made us feel. Communication ensures children understand their care and can make informed decisions. Some children might prefer to hear clear facts, but for others this may feel scary, and they’d prefer to be told a story. Choices about communication could include:
- How staff introduce themselves
- What your child would like to be called
- How doctors deliver news
- How information is provided: verbally, written down, or visually
Final thought
When a lot of things are out of their control, consider what your child can choose, even if it’s just the colour of their socks. Something like this is incredibly simple, but it can have a hugely positive effect on them
