Psychosocial Care for Pediatric Hematology and Oncology Patients
by Margaret M. Mannix, PhD, Psychologist, Hasbro Children’s Hospital
For a young person with a chronic illness, the complexities of their external world, family life, school, and life in general can become overwhelming to manage. Psychosocial care is an effective way to improve their quality of life.
Treatment for the Whole Patient and Family
The Hasbro Children’s Hospital psychosocial team can include social workers, child life specialists, pediatric psychologists, chaplains, family liaisons, and complementary therapists (massage therapy, Reiki, art therapy). They provide emotional, psychological, and spiritual support with the goal of helping families maximize their strengths at all stages of their child or teen’s illness. This approach to the “whole patient” helps to maintain their quality of life while not allowing the illness take center stage.
At Hasbro Children’s Hospital, our psychosocial teams are often imbedded in specialty clinics. This gives the advantage to the child or teen who is receiving treatment for an illness that requires multiple visits for treatment, check-ups, and other care. It is especially beneficial for patients with a blood disorder or cancer. By incorporating time with a member of the psychosocial team during one or more of their visits, patients and their families save time and receive immediate attention when anxiety, fear, tension, and stress may be at its highest. Furthermore, this multidisciplinary approach alleviates the need for additional appointments or waiting for an available appointment.
Pediatric psychologists (as opposed to child psychologists) are trained specifically in treating children and teens with medical needs. Pediatric psychologists can offer interventions to encourage adaptive behavior change, decrease pain, cope with procedures, follow treatment plans and medical regimens, and more. Psychologists can screen for neurocognitive/learning issues and help the team facilitate referrals to pediatric neuropsychology.
Psychosocial care benefits patients with a myriad of chronic illnesses, including inflammatory bowel diseases, asthma, diabetes, and sickle cell disease. These conditions require frequent visits, elevating the hospital and providers to a level where they become part of the patient’s microsystem. With the support of psychosocial treatment, the broader scope of the patient’s life, activities, relationships, and interests are intentionally integrated.
Psychosocial Treatment at Work
A recent example highlights how integrated, psychosocial care helped a family avoid an emergency room visit and perhaps an inpatient psychiatric admission.
A parent called their teen son’s medical specialty clinic and asked to meet with a psychologist. An appointment was arranged that same week. During that appointment, it became evident that the teen was suffering from an initial episode of major depression. Major depression can be an emergency if it includes suicidal thinking.
With the support of the psychosocial team, this teenager was able to plan with the psychologist and parent to maintain safety at home and schedule an appointment in an intensive outpatient program just two days later. After about a month in the program, the teen was discharged, prescribed a new medication and a referral for long-term care (therapy and medication management). The psychologist met with the teen two days after discharge and will continue to see them for a couple of weeks until the first appointment with the community provider.
An Ounce of Essential Prevention
Psychosocial treatment is an essential component of a patient’s comprehensive treatment plan. It provides emotional and psychological support for the patient’s well-being within the context of their social world – not their illness.
Psychosocial care allows the child to be a child, the teenager to be a teenager.