The diagnosis of childhood cancer is a de-stabilizing event for the entire family. Cancer affects not only the individual child but also the people with whom he or she is closely involved: parents, siblings, grandparents, friends and classmates. The Social Work Department of the Pediatric Hemato-Oncology Department is concerned not only with the child's experience of his illness but also with the experiences of those closest to the child.

Our overarching concern is the child and the family's adjustment to the illness with its accompanied treatment and enhancing family resilience to meet the stressful demands placed upon them.

Members of our staff accompany each new family as they enter the Pediatric Hemato-Oncology Department and remain with the family through the entire treatment process including relapse, end of life care and bereavement, as needed. We provide individual family treatment as well as support group services. We have ongoing support groups for new families in the department; families in active treatment including a group for siblings; and families post treatment including a bereavement group for parents and grandparents.

During the initial phase, families are assisted to negotiate the complexities of the medical setting including: receiving and integrating new information, (e.g. learning about the disease process and treatment protocol), developing collaborative relationships with health care providers, and learning about the rights and entitlements available to children diagnosed with cancer. Families are also coached through the process of reorganizing the family routine to accommodate the needs of the sick child and the multiple treatment demands (e.g. travel arrangements, childcare for siblings, time off work, financial constraints, etc.)

Once treatment begins the child and his or her family is faced with new demands and tasks. Social workers work with families during this time on issues regarding adjustment to illness and enhancing coping skills in the face of ongoing stress. Both children and families are required to adapt to new roles. Children are placed in the role of a "patient" and can experience physical discomfort as well as social isolation from friends and classmates. Parents have to adjust to caring for a sick child, which includes mourning the loss of their child's health, while balancing the responsibilities of home and work.

When treatment ends and children reintegrate into their previous community life, new fears arise for families. The loss of intensive involvement with health care professionals can create increased feelings of vulnerability and what were previously routine aches and pains can now trigger fears of relapse. Group support with other families at this time can help reduce the experience of isolation that comes with these concerns.

Throughout their time with the Hemato-Oncology Department, children are seen as more than their illness. Maintaining a proper balance in life for children and their families is essential for healthy coping and normative development. For this reason, our social work staff collaborates with numerous outside agencies to provide a variety of social and recreational activities for children and their families.