Children and adolescents suffering from chronic medical conditions face significant psychological stressors, as do their families. A diagnosis of a chronic or serious medical illness can be particularly distressing to the child and the family when the child had been previously healthy. Chronic illness is a very difficult challenge for a child, who may often be afraid of both the illness and the burdensome processes of medical treatment regimens. Initially, these children face the task of comprehending the complexities of diagnosis and treatment.
Such a diagnosis can also trigger feelings of guilt and punishment, as well as fears of what is to come. Other psychological stressors resulting from the diagnosis and experience of pediatric medical illness include fear of rejection, low self‐esteem, fear of restrictions (physical, educational, etc.) inflicted by the situation, and anxiety about how others will react to the illness, particularly with regards to peers. The anxiety generated by their situation and negative cognitions tends to interfere with the child’s ability to deal with the medical symptoms and to learn ways of coping with their physical and resulting psychological challenges. A distraught child can, in turn, increase parental stress, which can further increase the stress of the child, decrease parental effectiveness and support, and may even lead to behavioral disturbances in the child.
With regards to medical treatment, a child with a chronic disease cannot always follow the treatment easily, so more help and support is needed in comparison with an adult. These children and families need psychological support to help them comply with their treatment regimen and to cope with issues such as restricted physical activity, absences from school, and social problems. In these cases, psychologist play a vital role in helping children and their families cope with feelings and fears concerning the disease, learn tools to manage stress, reduce noncompliance in children, and improve psychological outcomes, thereby improving the child’s and family’s quality of life and possibly the course of the child’s illness.