When a Child Is Diagnosed: A Psychologist's Advice

When a child gets a diagnosis of cancer, the life of every member of the family changes drastically.

Dr. Carol Goodheart knows this professionally and personally. She is a psychologist practicing in Princeton, N.J., and the author of "Living with Childhood Cancer: A Practical Guide to Help Families Cope." Her family also has been touched by childhood cancer.

Goodheart spoke to ABC News about a subject that is close to her heart:

ABC NEWS: What made you want to research and write a book on this subject?

DR. CAROL GOODHEART: My granddaughter was diagnosed with cancer at the age of 9 months. And what I learned in that process is that people talk to me in a different way as a family member in the hospital than they ever spoke to me when they came to consult me in my office.

ABC NEWS: What are the first things a family goes through when they get this news?

GOODHEART: The diagnosis of cancer for any family is truly frightening. It's like an earthquake, an upheaval that happens to people. And they need to assimilate that and then say, "All right, this is the new reality. How do we go forward?"

The treatment often makes children very ill. Modern treatments for cancer are very aggressive, so they're hard to bear. They're hard for the child and they're hard for the family to watch. But as long as there is treatment, there is hope.

ABC NEWS: This kind of news comes to only a small number of families. Is anyone, therefore, ever prepared to hear it?

GOODHEART: I don't think so. When the diagnosis itself comes, it is a terrific shock. The parents are the ones who are told. And then, depending on the age of the child, the child needs to understand what's going to happen to him or her.

The initial period is a very steep learning curve. Families want to know: Where is the best place to get treatment? Can we do it near home? Will our medical insurance cover this? Should we go to the local hospital or fly to a place that specializes in treating children with cancer?

At the same time those decisions are being made, families are reorganizing their ordinary life. Which parent is going to go with the child? Who's going to take the other child to soccer practice? If both parents work, is one parent going to take a leave of absence?

So it's a period of reorganizing internally with all the feelings, externally with how the family runs, and on the outside learning a whole new medical system.

ABC NEWS: Talk more about the feelings different family members are going through.

GOODHEART: It's very important to reassure the child and their brothers and sisters that it's not their fault. It's not that they didn't eat right, didn't eat all their vegetables. It's not that one sibling teased another one and wore their resistance down. Cancer does not happen because it's someone's fault. No one caused it, and that's a very important message to give to all the children in the family.

ABC NEWS: How do parents gauge how much to include the sick child in the medical decisions?

GOODHEART: Part of how you gauge it is you're talking with the child and you're listening to what their understanding is. In other words, you're not just speaking at the child, but you're encouraging the child to express his or her feelings and thoughts and understanding.

ABC NEWS: How do parents deal with the child's fear?

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