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Is Overprotective Parenting Linked to Anxiety and Depression?

Posted on January 30, 2018 by Kelly Zorzi

#BellLetsTalk #mentalhealthawareness

Ms. Amanda Sherman, BA, MA, PhD(c),  discusses her POGO-funded research study.

Your study looked at overprotective and overcontrolling parenting. Can you give us some examples of these two parenting styles?
I would define overprotection as a style of parenting that does not allow the child or emerging adult to experience stressful things. These parents might try to reduce harm even where the situation doesn’t require it. An overprotective parent might call their child’s friends to solve a problem or insist on driving them to destinations where they can easily walk or ride a bike. It is excessive care. Overcontrolling parenting has more to do with discipline and getting a child to behave in a specific way. A parent might say, “You can’t go out tonight because I don’t like some of your friends.” It is excessive control.

What is non-productive coping?
Coping strategies that are not effective in helping that person feel better (worrying, swearing,
avoidance and isolation, for example) are nonproductive because they may lead to more distress and anxiety. In children, one correlate of the development of anxiety disorders is overprotective parenting.

Are childhood cancer survivors more at risk for depression and anxiety?
When looking at levels of depression, we did not find that our sample differed significantly from  normative populations; but we did find that anxiety levels were markedly higher than the general population—participants’ scores on our questionnaire were within one standard deviation from the mean score of people with anxiety disorders. That was surprising to me and something we don’t yet know how to account for. Maybe for this population so much of their childhood was focused on getting better, that learning to cope with stress was less important than getting by and managing their illness. Now they are emerging adults and they are facing the potential late effects of their childhood disease, as well as regular life stresses, and perhaps they are less equipped to cope. These are hard questions to answer.


Amanda Sherman, BA, MA, PhD(c)

Ms. Amanda Sherman, BA, MA, PhD(c) was the recipient of the 2013 POGO Fellowship Award. Her research focused on maternal overprotection/overcontrol and its relationship to coping strategies, anxiety and depression in survivors of childhood cancer. Her study looked at 109 survivors aged 18-30 attending the POGO AfterCare Clinic at Princess Margaret Cancer Centre. POGO AfterCare Clinics  monitor survivors at regular intervals so that potential long-term effects of treatment can be identified as early as possible.


You are doing your PhD in psychology. How did your career path lead you to study childhood cancer patients? 
I did a practicum placement with Norma D’Agostino at Princess Margaret, where I was doing therapy exclusively with young adult survivors of childhood cancer. We noticed that problems with lack of autonomy, separating from parents and non-productive coping strategies kept coming up.

What can we take away from this research?
Now that we have this evidence that says overprotective parenting and anxiety are an issue in this  population, we can target those parents and teach them how to socialize coping in their children. Even the oncologist can spend five minutes asking the parents and children a few targeted questions to
determine if there is a bigger issue, flag it, and refer the family to a psychologist to help them develop better coping skills. 

What do you hope will come from your study?
This is preliminary research but even posing the question is opening doors and people are looking for potential issues when perhaps they weren’t looking for them before. Next steps from a research standpoint: our measure of overprotective and overcontrolling parenting needs to be validated and the study needs to be replicated with a non-cancer control group. I want to disseminate this research any way I can. 

What does this POGO Fellowship Award do for your career?
This grant has allowed me to have time, space and community to do research. What I have enjoyed so much about POGO is how open minded everyone is about psychosocial issues, and psychosocial  development. It has been nice to be accepted and encouraged for studying these kinds of issues, and working with medical professionals has helped provide a different perspective. It has been humbling, rewarding and encouraging at the same time.

Posted in Misc, Research | Tagged anxiety, depression, emotional health, late effects, parenting, psychosocial, stress

Workshop – Strategies for Optimizing Community Resources to Address Mental Health Issues

Posted on May 30, 2017 by Jamie Irvine

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Presentation Description:
This workshop will explore the complexities of managing mental health symptoms when they arise during treatment, as well as potential collaborative models of care to help facilitate improved quality of life outcomes for this population of children and families.

Speakers:
Jane Cassano, MSW, RSW
Pediatric Oncology Social Worker, McMaster Children’s Hospital, Hamilton, ON

Jane Cassano has been a pediatric oncology social worker at McMaster Children’s Hospital for the past 18 years. Her focus has been adolescents with cancer and their transition to off therapy. In recent years, Jane has been advocating for mental health services for pediatric oncology patients.

Danielle Cataudella, PsyD, CPsych
Clinical Psychologist, Departments of Pediatric Psychology and Oncology, Children’s Hospital, London Health Sciences Centre, London, ON Adjunct Professor Schools of Medicine and Psychology, Western University, London, ON

Danielle Cataudella is a clinical psychologist at Children’s Hospital, London, Ontario. She completed her doctoral degree and residency program in 2002, and is registered with the College of Psychologists of Ontario with specialized practice in health and rehabilitation across the lifespan. For the past 15 years, the focus of her work has been in the area of pediatric oncology. She has been involved in multi-centre provincial and national research studies including validation of a family distress screening tool in Ontario, the development of an instrument to assess quality of life in children with advanced cancers, and a social skills intervention for childhood brain tumour survivors. Dr. Cataudella is a member of the Children’s Oncology Group’s Behavioural Science Discipline and is actively involved in the Patient-Reported Outcomes Sub-Committee. She has served on several POGO committees, currently acting as Co-Chair of the Psychosocial Services Committee and member of the Provincial Research Unit; she is also collaborating with the Supportive Care Committee on the development of fatigue guidelines for this population.

Posted in 2017 Satellite Education Day | Tagged 2017 Satellite Education Day, emotional health, mental health, patient care

Workshop – More Smiles, Fewer Tears: Adaptable Child Life Strategies to Improve the Patient Experience

Posted on May 30, 2017 by Jamie Irvine

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Presentation Description:
This interactive workshop will identify common fears and anxieties children face during cancer treatment and highlight strategies and hands-on tools used to support these patients and families to enhance coping in a satellite setting.

Speakers:
Ruth Cull (Molly Penny), Therapeutic Clown
Children’s Hospital of Eastern Ontario, Ottawa, ON

As a registered practical nurse working in the operating room at Children’s Hospital of Eastern Ontario (CHEO), Ruth Cull would sometimes clown around on the job, but she never imagined that one day clowning around would be her job! In 2001, Ruth went off to the University of Wisconsin’s clown school where she successfully graduated as a clown.

Back at CHEO, Ruth discovered the inherent power of a clown’s red nose to make kids, families and staff laugh. For the next four years, Ruth worked in the operating room two days a week as an OR tech, and in the Child Life Program three days as “Molly Penny,” therapeutic clown. Ruth now dedicates her  time to working only in the therapeutic clown program three  days a week where her medical background comes in handy when taking kids on “Clown Rounds,” and when working with staff, and medical, pharmacy and psychology students to raise awareness and understanding of the therapeutic clown program.

Alexandra Frankel, BSc, CLSt Dipl, CCLS

Certified Child Life Specialist, Scarborough and Rouge Hospital, Centenary Site, Scarborough, ON
Alexandra Frankel completed both her undergraduate and professional education at McMaster University. Alexandra is currently working as a certified child life specialist at the Scarborough and Rouge Hospital (SRH), Centenary Site and in the Emergency Department at McMaster Children’s Hospital. At the SRH, Alexandra provides child life services to children in various areas of the hospital including the POGO Satellite Oncology Clinic. She leads the pediatric pain-working group and is a member of the pediatric palliative care committee. Alexandra has had a longtime clinical interest in working with pediatric oncology patients and families in a psychosocial capacity. She has been involved with Camp Oochigeas in a volunteer role for the past 11 years.

Todd Wharton, CRPO, OATA, CACPT
Registered Psychotherapist; Registered Art Therapist; Certified Play Therapy Assistant, Children’s Hospital, London Health Sciences Centre, London, ON

Todd Wharton has been practicing in the field of child and youth mental health for over 30 years, with over 20 years as an art therapist. He has been providing assessment and treatment in a variety of settings and modalities throughout Children’s Hospital, both in medical and mental health areas. The practice of art and play therapy offers a unique approach in being able to provide services to all ages as an alternative to the traditional “talk therapies.” Having been employed at Children’s Hospital for 18 years, Todd has utilized both conventional and sometimes rather unusual and fun approaches to connect with children and youth to provide them the opportunity to explore and express their concerns regarding the impact of their diagnoses and treatment. Working at Children’s Hospital provides the flexibility of allowing children and youth to direct their involvement in their own healing processes.

Posted in 2017 Satellite Education Day | Tagged 2017 Satellite Education Day, emotional health, patient care, psychosocial

Behavioural versus Pharmacological Interventions to Treat Anxiety and Depression – When to Prescribe What?

Posted on May 30, 2017 by Jamie Irvine

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Presentation Description:
This presentation will describe clinical approaches to the assessment and treatment of anxiety and depression in youth with cancer. Using case examples, we will review the range of symptoms that may present, and describe behavioural as well as pharmacologic approaches to treatment.

Speaker:
Anna C Muriel, MD, MPH
Division Chief, Paediatric Psychosocial Oncology, Dana Farber/Boston Children’s Cancer and Blood Disorders Center, Boston, MA

Dr. Anna (Nina) Muriel is a child psychiatrist and Chief of the Division of Pediatric Psychosocial Oncology at the Dana-Farber Cancer Institute. She is a graduate of Brown University and Tufts University School of Medicine, and trained at Massachusetts General and McLean Hospitals in Boston. Her clinical and academic interests include the impact of cancer on children and families, the delivery of mental health services, and the use of psychiatric medications in pediatric oncology. She is Assistant Professor of Psychiatry at Harvard Medical School, co-author of the book “Raising an Emotionally Healthy Child When a Parent is Sick,” and co-editor of “Pediatric Psychosocial Oncology: Textbook for Multidisciplinary Care.”

Posted in 2017 Satellite Education Day | Tagged 2017 Satellite Education Day, emotional health, patient care, psychosocial

Managing Behavioural Changes During Treatment for Leukemia

Posted on May 29, 2017 by Jamie Irvine

 


VIEW THE PRESENTATION

Speaker:
Nina Kadan-Lottick, MD, MSPH
Associate Professor of Pediatrics
Director of HEROS Survivorship Program
Leader Clinical Trial Program
Section of Pediatric Hematology-Oncology
Yale University School of Medicine, New Haven, CT

Dr. Kadan-Lottick, a pediatric hematologist-oncologist, is an Associate Professor at the Yale University School of Medicine and Director of the Yale HEROS Program for childhood cancer survivors. Dr. Kadan-Lottick’s research has concentrated on measuring and optimizing outcomes after treatment of childhood cancer, with an emphasis on leukemia. These studies have included cross-sectional and longitudinal studies of chemotherapy-induced cognitive changes, anxiety and depression, and family functioning during and after therapy. She was the principal investigator of two large multi-site longitudinal studies of quality of life outcomes and emotional functioning in children with acute lymphoblastic leukemia enrolled on front-line Children’s Oncology Group (COG) clinical trials. As a part of her focus on survivorship outcomes, Dr. Kadan-Lottick serves on the Children’s Oncology Group Survivorship Steering Committee, the Psychology Committee of the Childhood Cancer Survivorship Cohort Study, Consortium for New England Childhood Cancer Survivors Steering Committee, and the Board of Trustees for the Connecticut Chapter of the Leukemia and Lymphoma Society. She has also helped to author and revise the COG Long-Term Follow-up Guidelines.

Posted in 2016 Symposium | Tagged emotional health, leukemia, mental health, Symposium 2016

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