Promoting Self Esteem After a Childhood Cancer Diagnosis

Childhood cancer, along with its treatments, puts children at risk for struggling with self esteem. Self esteem, generally, is a positive sense of worth or value. Healthy children and adolescents find their sense of self in a number of ways. Some examples include attending school and doing extracurriculars such as sports, fine arts, and clubs. These activities are far more than fun hobbies for children. They provide opportunities for developing unique skills and meaningful relationships with their peers. As children master a new play on the soccer team or a new song on the piano, they learn what it is like to succeed as a result of their own hard work. The feeling of confidence that comes from success is called self efficacy, or a belief in one's ability to achieve their goals. Self efficacy is a critical aspect of self esteem.
After a child is diagnosed with cancer, they often lose access to many of the activities where self efficacy, and self esteem, are cultivated. Many children are hospitalized for long periods of time, fully isolating them from their peers. Even when children are medically stable enough to be treated at home, chemotherapy and other treatments leave them in an immunocompromised and fatigued state. These side effects further remove children from environments where they can grow and evolve alongside their peers. Children may go months or years without being able to use their bodies to run, jump, or play in the ways they used to. At the most difficult times, children may be unable to walk or independently complete tasks such as feeding themselves or using the restroom. These challenges can leave children feeling incapable, lowering their self esteem. 
Challenges with self esteem are not unique to diagnosed children. Siblings of children with cancer also face challenges to their identity. Families often must change their daily routines in ways that prevent siblings from fully participating in school or extracurricular activities. Many siblings often feel guilt or sadness when they watch a brother or sister suffer the side effects of cancer treatment, powerless to fix the problem. Siblings' difficulties may not be as obvious as those of the child with cancer, which can lead to even more issues with feeling valuable or important.
The good news is, there are many ways to solve this problem.
Promoting self esteem is all about consistency. Finding opportunities each day to praise children for the ways they show maturity, kindness, and resilience is key. For some children this may include taking medications without arguing or helping clean up after a meal. No achievement is too small to celebrate, especially for children whose illness drastically limits their physical functioning. Some children may need more targeted support from a mental health professional. After all, cancer completely turns a child's world upside down. Children may struggle with the awareness that their lives no longer look the way they used to, or that they cannot keep up with their friends. Some signs that deeper mental health concerns may be present include becoming withdrawn, irritable, or angry for days or weeks at a time.
One fun and simple way that families can promote self esteem at home is by making a "Word Cloud". A Word Cloud is a colorful, customized image that highlights positive traits - like this example below.
  Here are a few tools to get started with making a custom Word Cloud:
1. Word Lists
Use these word lists for inspiration with traits to recognize and celebrate in a child or sibling who has faced childhood cancer. They focus on three unique elements of a child's identity: their personality, how they approach challenges, and how they treat others. Some of these words may be unfamiliar, especially for younger children. Sharing stories that illustrate how a child has shown a trait such as "resourceful" or "imaginative" can help them both understand these concepts and feel recognized in important ways. Choosing between 5-10 words from each list will provide a good starting point for creating a Word Cloud.

2. Word Cloud Generator
Both of the Word Cloud examples on this post were created using Free Word Cloud Generator. This website allows users to create Word Clouds with custom colors and fonts which can then be downloaded and saved for future viewing. To make the words appear larger, type them (or copy and paste) multiple times. Word Clouds can be updated and edited over time to reflect a child's or teen's growth.
Childhood cancer causes challenges for children in many areas of their lives, and self esteem is no exception. Over time, with the right support, children can find ways to express themselves confidently regardless of where their cancer journey takes them.

All content on Cancer Cushion is provided for informational purposes only. Individuals experiencing a mental health emergency should contact their local crisis line or dial 988.

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