Besides the risk of future relapse, this population group is at risk of developing both psychological and neuro-cognitive late-effects, including symptoms of post-trauma. Children who encounter social difficulties when returning to school, following long periods of hospitalization and who have difficulty with school work as a result of neuro-cognitive damage (a result of both the illness and the treatments), will benefit from emotional and didactic therapies.

It is often said, that entire families are hit when a child is treated for Cancer, which can also be a cause for symptoms of trauma. Parents of young children bear the entire burden alone. They deal with the fear of losing their child, in fact just being informed that a child has cancer is undoubtedly extremely traumatic. And that is only the beginning of the "experience". Focus on the sick child and all his needs can cause difficulties with running the home, looking after other children and making a living – creating a multi-stressor situation. The fear of recurrence creates a situation of chronic stress.

Children surviving Cancer treatments are at-risk for developing symptoms of PTSD, due to a variety of reasons, to name a few:

• The fear of the unknown (death) which is often unspoken
• The loss of privacy caused by many of the treatments
• Ongoing suffering
• The fear of pain
• The loss of control over one's body, as a result of medical staff, who are strangers, forcing "unwanted" treatments onto the child
• Fear of recurrence

Project Description:

The Haifa Center for Chi.L.D. specializes in treating children, taking a holistic approach, to include all needs – be this didactic, emotional, behavioral or social. All treatments take place under one roof making treatment at our Center convenient to access.

A one day seminar was held at the Haifa Center for social workers from the Oncology Departments of Rambam Hospital and Bnei Zion Hospital, which are the two main medical centers in the north dealing with Cancer. The seminar took an in depth look at the sick child's experience and the trauma caused by hospitalization, loss of hair and other disfiguring effects of treatment, fear of pain and pain management, missing school and catching up with school work, social difficulties when returning to school, and more. Maskit Shochat, school principal at the Schneider Children's Medical Center and a Snoezelen Room therapist, presented the work done at the hospital in their 'Snoezi Room'. Using the Snoezelen Room as a multi-faceted location for treatment of children, amazing results have been achieved. The calming effects of the multi-sensory experience enable children to cope with the suffering of difficult treatments. In many cases there was reduced pain, with an increased ability to fall asleep. When accompanied by parents, all benefit from the room. In one unusual case a child was allowed into the room with his pet.

Taking this treatment model and based on the Haifa Center's past experience in treating PTSD in the Snoezelen Room (in the aftermath of the Second Lebanon War) we are offering services to Pediatric Cancer Patients who have terminated their hospital treatment and are in need of emotional therapies. Children will be referred to our Center by social workers from local hospitals and by working in conjunction with major hospitals: Rambam and Bnei Zion Hospitals – who will refer patients to our Center, and Schneider Children's Medical Center – who will train staff, we will be able to answer the need in the local community.

In addition, it has come to our attention that late-effects of Cancer include neuro-cognitive difficulties such as learning difficulties, memory problems and attention deficit. Some of these late-effects develop slowly and subtly and take time before they are apparent. Some children suffer from developmental delays and do not reach developmental milestones, making their recovery all the more traumatic. The staff at the Haifa Center is both qualified and experienced to deal with the myriad of problems arising as a result of Cancer in children, and all treatments can be provided at one location, saving parents valuable time and energy.

Areas to be addressed at the Haifa Center include:

• Expressive therapies to deal with ongoing trauma using a range of techniques including: Snoezelen Room – Movement Therapy, Art Therapy, Animal Assisted Therapy, Music and Drama
Therapy

• Didactic treatment to help close gaps after missing school and help cognitive functioning as a result of late-effects in the area of neuro-cognitive functioning
• Social Skills workshop to help overcome social difficulties encountered by children recovering from illness and returning to school

Further components of the project include:

• Parents will receive ongoing parental guidance
• Dyadic Treatments will enable family members to be part of the therapeutic process.
• Parents will be offered the option to participate in group therapy using an up to date method called DBT which will provide coping skills (this group therapy will be facilitated by two experienced therapists, qualified to use this method)
• A psychiatrist will be part of the therapeutic staff for those children/parents in need of such services.
• Staff will receive professional training by Schneider Children's Medical Center
• Staff will receive ongoing supervision to help deal with emotionally taxing cases and prevent burnout
  
• Seminars will be provided by our staff to educate other professionals on the work done at our Center