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Professors Dalton and Rapa responded following the Princess of Wales' announcement of her cancer diagnosis and how she told her children.
They lead a programme of work focusing on the importance of communicating with children about a loved one’s serious illness.
Research consistently shows that when children are given an explanation of what is happening in their family this leads to better family functioning and mental health outcomes for everyone.
Professor Rapa says:
The powerful and personal announcement by the Princess of Wales today highlights the unenviable task facing millions of adults around the globe when they are diagnosed with a serious illness. Should we tell the children about what is happening? How do you explain something like cancer to a young child?"
Professor Dalton added:
Despite adults’ understandable desire to protect children from upsetting or worrying news, it is important to talk honestly to children and young people. Even very young children notice when the adults around them are more stressed or start taking telephone calls behind closed doors.
Research shows that when children are not told about what is happening, they reach their own conclusions. This can lead to children mistakenly feeling they are in some way responsible or to blame for these changes e.g. when a parent can’t play in the same way as before. Research shows that children want to know about what is happening when an adult they love is ill and that effective communication with children about illness is associated with better psychological functioning.”
They say adults need to be authentic about some of the uncertainty and psychological challenges when someone is unwell. This honesty not only offers a coherent explanation for what children are observing, but also provides them with a model of how to talk about feelings and gives children permission to share how they are feeling. Normalising their emotional reactions and reassuring children about how the family will look after each other helps to contain anxiety and provides a shared focus.
Professor Rapa explains that: “Effective communication includes talking to children not only about the facts of what is happening, but also sharing and exploring some of the emotional impact of the news. It’s important to include children in conversations about illness in the family as soon as possible (e.g. after a diagnosis) so that they have time to understand and make sense of the situation and they are not left to worry alone.”
Professor Dalton and Rapa have made evidence-based step by step guides for families on how to have these conversations including words and phrases to use, as well as children's common reactions to being told about a serious illness
They have also created films to help the public understand the importance of these conversations with children, including this one with Oxford Sparks.
Adult patients report wanting help from their healthcare team to think about what, how and when to share their diagnosis. Healthcare professionals have described feeling uncertain about asking patients about their relationships with children so this sensitive topic can be avoided during medical appointments. Healthcare professionals can play a crucial role in supporting patients in talking to children; Professors Dalton and Rapa have made a guide and animation for healthcare professionals in every area of medicine to help have these conversations with their patients: