Short-term hospitalizations or outpatient surgeries may create only minor disruptions in your family’s routines. However, long-term treatments or lengthy hospitalization increases the need for consistent rules. Parents of children with difficult or long-term illnesses share the following techniques to help improve communication and maintain discipline within the family.

• Make sure all the children clearly understand the family rules. Stressed children feel safer in homes with structured, predictable routines.

• Enforce family rules consistently. Make sure all caregivers know the rules.

• Give kids some power. Offer choices and, as appropriate, let them control some aspects of their lives and medical treatment.

• Take charge of incoming gifts. Too many gifts can make an ill child worry (“If I’m getting all of these great presents, things must be really bad”). Gifts also make siblings jealous. Be specific if you want people not to bring gifts, or if you want gifts for each child, not just the sick one. When a child has an illness or injury that requires long-term care, some parents gather the gifts and hand them out at regular intervals throughout treatment.

• Discuss acceptable ways to physically release anger. Children can ride a bike, run around the house, swing, play basketball or soccer, pound nails into wood, mold clay, punch pillows, yell, take a shower or bath, or draw angry pictures.

• Teach your child to use words to express her anger, for example, “It makes me furious when you do that,” or, “I am so mad I feel like screaming at you.” Expressing anger verbally is a valuable life skill to master.

• Treat the sick or hurt child as normally as possible.

• Try to determine whether the illness or injury is aggravating a preexisting problem. If so, treat the problem, not the symptoms.

• Find a professional counselor who specializes in children whenever you are concerned about your child’s behavior. Mental health professionals know how to resolve problems—give them a chance to help you.

• Teach children relaxation or visualization skills to help them cope with their feelings.

• If your child likes to draw, paint, knit, do collages, or other artwork, encourage it. Art is soothing and therapeutic. It allows the child a positive outlet for feelings and creativity. Making something beautiful really helps raise children’s spirits.

• Allow your child to be totally in charge of his art. Do not make suggestions or criticize (by saying, “stay inside the lines,” or, “skies need to be blue not orange”). Rather, encourage him and praise his efforts. Display the artwork in your home or your child’s hospital room. Listen carefully if your child offers an explanation of the art, but do not pry if it is private. Being supportive will allow your child to explore ways to soothe himself and clarify his feelings.

• Help your child start and keep a journal to draw in and to record feelings, events, and visits. This can become an important emotional outlet.

• Have reasonable expectations. If you are expecting a sick four-year-old to act like a healthy six-year-old, or a teenager to act like an adult, you are setting up your child to fail.

• Give children time to process the experience of illness, hospitalization, and treatment. Many children talk about their hospital experience for months after returning home or recreate it when they play.