Overcoming Depression in

Pediatric Oncology Patients

Alyssa Osborne
ISM- Fall 2017
Mrs. Click
 Disclaimer

Some of the information is from outside

sources
 What is ISM?
Independent Study Mentorship (ISM), is designed for students wishing to
mentor an adult professional in a chosen career. With the mentor and the
teacher-facilitator, each student will create a unique plan of study and receive
individual instruction. Students leave the high school campus and go to the
mentors place of business to study with professionals. This course is ideal
for the self-motivated student with a passion for a particular area of study.
Students in this course must perform at a collegiate or professional level.
 ISM Requirement's
1. Complete an in-depth mentorship/study in an area of interest.
2. Document a minimum of 3 hours of mentorship each week.
3. Complete a Journal Entry each week documenting mentorship experiences.
4. Complete an ISM Professional Portfolio, showcasing assignments completed during the course
and the final project.
5. Complete all of the required assignments.
6. Complete a Mid-Term Presentation.
7. Develop a final product and presentation at the collegiate/professional level that is presented to a
panel of graders at the conclusion of the semester must include PowerPoint, visuals, completed
product, portfolio and handouts.
 Meet My Mentor
Mentor- Lori Douglas, BSN, RN
Position- nurse coordinator/ Education
Training partner
Location- Texas Children's Hospital,
6621 Fannin St, Houston, TX 7703
Studied- SFASU (prerequisite), graduated
from UTMB nursing school.
 Why Overcoming Depression in Pediatric
Oncology Patients?
For my project topic I chose overcoming depression in pediatric oncology
patients because, I feel as though it is a big job to tackle especially with the
patients being children. Texas Childrens Hospital was a great location to have
my mentorship site at because it is one of the leading cancer centers in the US.
 What is Depression?
Depression is a mood disorder that can be treated. Depression in patients may make
it harder to cope with cancer treatments (Depression) and may not help them make
well informed choices about their health. Symptoms of depression can range from
mild to sever (Depression). Symptoms can start to appear right after being
diagnosed or during the course of treatment. Some symptoms may include, but not
limited to, distancing yourself from loved ones, loss of joy/ excitement for activities
you once loved, crying a lot of the time, and not wanting to do basic daily activities.
Some mood related symptoms maybe, feeling gloomy, sad, irritable, feeling as
though there is no hope, and feeling worthless.
 Prevalence in Pediatric Oncology Patients
20.68% of kids in a cancer group are more likely to have depression
(Arabiat). However the prevalence can vary depending on what
procedures are done during their time of treatment, what type of
cancer they have and stage they are in.
 Clinical Support
There are 4 clinical supports available to use during the time of the
patients battel with cancer.
1. Child life
2. Social work
3. Chaplain
4. Psychologist
5. Psychiatrist
 Child Life
Child life specialist are people who work with the patient to help
them cope with the diagnosis and help them while they are in or
even out of the hospital. The most common way they help is play
therapy. They do a lot of hands on activities to help the patient be at
ease and more comfortable.
 Child Life
The use of child life is the use of play
therapy. One of the many things they
use at Texas Childrens is the Port-A-
Cat. The Port-A-Cat is a stuffed
animal they use to show the children
and also let them play with the central
line.
 Child Life
Another type of play therapy is
the medical play therapy bag. It
helps the kids get use to all of
the medical equipment's the
doctors and nurses will be
using.
 Social Work
The social workers help more with the patients family. It is not
only hard on the patient when they first find out they are
diagnosed, but it is also hard on the family. Many families go
through the 5 Stages of Greif, and the social workers help them
through each stage.
 5 Stages of Greif
There are 5 stages of grief, denial, anger, bargaining, depression,
and acceptance. Different people grieve differently and some may
not go in order but they will experience all 5 stages at one point.
You can spend a different amount of time on stages, not all of them
will be the exact same.
 Denial
The first reaction to leaning about a terminal illness, loss or
death of loved one is to deny the reality of the situation. (The 5
Stages of Greif & Loss, Pg. 1)
A quick fix to not having to face your true emotions at that point,
it is only temporary.
Denial is when you dont want to face reality because the
emotions are too much to cope with at the moment.
 Anger
Anger occurs when your denial stage starts to wear off, you all of
a sudden feel a sudden rush of anger at the world and the anger
can last for however long.
Your anger can be towards your loved one knowing they arent
the one to blame for becoming sick or dying we may blame them
for causing us pain. (The 5 Stages of Greif & Loss, Pg. 1)
 Bargaining

Take me instead of them can be used as a bargaining

phrase.
You may try to make a deal with god as a chance or hope
that they will keep them around for as long as possible or
try to cure their illness.
 Depression
There are 2 different types of depression in the grieving process
and they are, reactions to practical implications relating to loss this
may include sadness and regret. The second is more subtly and
private they dont want to show they are hurting or they try to
keep their pain to themselves.
 Acceptance
Acceptance is knowing that the unexpectedness of the disease or illness is
not theirs, yours, or anyone elses fault.
Coping with a loss is never easy, it will always be different for everyone, and
there is no short cut and not easy way.
The best thing to do is to allow yourself to feel the grief as it comes over
you. (The 5 Stages of Greif & Loss, Pg. 1)
To gain a better understanding of what your loved one is going through, try
to understand/ learn as much as you can about their illness.
 Beyond Diagnosis

The beyond diagnosis book is available to

the parents that talks about educational
materials and information about support
organizations. It also helps you understand
your child's diagnosis better and the
different procedures they will be going
through.
 Book for Siblings
This book is for the siblings of the patient. It is hard for them to
understand what is happening to their brother or sister, like why
they arent always happy, or why they are always sleeping, or why
they are always at the hospital.
Book for Sibling
 Chaplain
A Chaplin is someone who makes a plan and assesses the case and
leads the patient and family through spiritual needs through their
diagnosis and treatment or through end of life care. They help
family friends and loved ones find peace/ comfort. Patients are not
required to have a Chaplin. If they do want one, then they can
choose at any time that they would no longer have the need of one.
 Chaplin
A Chaplins job when helping with the family is to be an active listener to the
family as they maybe angry. When the family is angry it help that the Chaplin
is there because they need the spiritual guidance because they might blame
their spiritual figure. It will help them understand the illness. Chaplains also
give care to caregivers. Caregivers spend a lot of time with the ill patient and
begin to come attach to them so it is best to help give them some guidance
too.
 Hospice Chaplain
Hospice Chaplin is a very important to people nearing end of life because
they seek spiritual guidance for comfort. They want to make sure that no one
dies alone. They also help instill peace with the patient and their disease or
illness then they can help find rituals, spiritual practices.
 Chapel
The chapel at Texas Childrens is a place where parents, family, friends and
staff can go to pray, attend religious services or even to be alone with their
thoughts. The shape of the chapel represents the infinite love for god,
eternity and the never ending love. The ceiling creates an illusion of the sky
and changes from dawn to midday to the twinkling night sky all in 12
minutes.
Texas Childrens Chapel
 Psychologist
The psychologist at Texas Childrens specialize in treatment for patient with
chronic medical illness and those with out chronic disease just those needing
outpatient assistants. Many patients are referred by their medical team
because they feel as though the help of a psychologist will help with their
treatment or recovery. Psychologist do a lot of talk therapy and a lot of
hands on activities such as art therapies.
 Beads of Courage
Beads of courage is a organization that partners with hospitals to help
children with illnesses help record their story and show everything they have
been through by the beads they have. Beads of Courage is an art therapy used
by the psychologist.
Beads of Courage
Drawing Art Therapy Book
Art Creation by Patient
 Psychiatrist
Psychiatrist do more of a medical support.
They can prescribe what they feel will help or tell you things you can do that
will help more through out your course of treatment.
They also have patients keep journals to keep up with their health or mental
state.
Counseling for Oncology Handout
Diary/ Journals
 Video Product
https://www.youtube.com/watch?v=YExEhmA0LV4&feature=youtu.be
 Current Event
Parents of 10-year-old boy who died of cancer claims hes watching over the Astros
This article is about a young boy who passed away from liver cancer just last year.
The little boy, Joseph, was a big baseball fan. His first stay at the hospital 2 Houston
Astros players came to visit him, Jose Altuve and Lance McCulllers. McCullers and
Joseph had a special bond and kept in touch. It was on game 5 of the World Series
between to Astros and the Dodgers that the price family attended that they knew
their little boy Joseph was watching over them. The night was significant because it
was #21 who scored the winning run on the early morning of October the 30th.
The reason #21 is so significant is because that was josephs baseball number. That
morning McCullers texted Mrs. Price and said An Angel in MMP.
 Current event continued
This connects to my project topic, overcoming depression in pediatric oncology patients,
because it is dealing with a little boy who had cancer and how the hospital used the Astro
players to help keep him happy. Joseph, 10-years-old had liver cancer and passed away last
year from it. With him being diagnosed you could imagine that it would be hard on such a
little boy. So on his first day at the hospital he was surprised with a guest visit from his
favorite baseball teams players. You can bet that put a smile on his face for a long while.
Having them come really helped with him overcoming depression because he did just get
put into the hospital and it can be hard on such a young kid. Especially with McCullers
keeping in touch it helped him keep strong and want to fight. With McCullers staying in
touch it not only helped the kid but the family too because they see that their child is happy
so it makes them happy too.
 Conclusion
In conclusion over the few weeks of my mentorship I have learned several
ways to help overcome depression. There are many tools and organizations
used to help prevent depression during their course of treatment. Many are
ways to help the child keep up beat, and help them maintain some type of
normalcy in their life.
Different Organizations Used by TCH
Different Organizations Used by TCH
 Thank you!
I would like to say a big thank you to my mentor Mrs. Lori for being the
absolute best mentor I could possible have. I would also like to thank my
parents for allowing me to travel to Texas Childrens Hospital to receive such
a great education. I would also like to thank Mrs. Click for the opportunity
of being in ISM. Lastly, I would like to thank my evaluators and Kayla for
taking the time out to come watch and grade my final presentation.
 Visit my Weebly account!
https://alyssaosborneismportfolio.weebly.com/
 Works Cited
Foundation, Crossroads Hospice Charitable. What Is a Hospice Chaplain? Crossroads Hospice Charitable

Foundation, Crossroads Hospice Charitable Foundation, 12 Apr. 2017,

Depression. Cancer.Net, 18 Aug. 2017

The 5 Stages of Grief & Loss. Psych Central, 19 Feb. 2017

Frillici, Leigh. Parents of 10-Year-Old Boy Who Died of Cancer Claim He's Watching over Astros. KPRC, Channel 2

News, 31 Oct. 2017, www.click2houston.com/news/parents-of-10-year-old-boy-who-died-of-cancer-claim-hes-

watching-over-astros.

Rest of the pictures were from clip art