Childhood cancer can be a traumatic, physically painful and emotionally turbulent experience. Little is still known on the psychological impact of receiving medical treatment for children with cancer, in particular children displaying symptomology of posttraumatic stress disorder (PTSD) as a result of their painful medical procedures. Literature indicates that art therapy can be a powerful therapeutic tool for paediatric oncology patients, faced with the uncertainties of their illness allowing for exploration of diagnosis and control over an uncontrollable sickness. A crucial first step for art therapists would be the need to focus on understanding the unique perspectives of children living with cancer, in order to effectively tailor interventions. To address this gap, this study aimed to understand children's lived experience of cancer, and art therapy as a therapeutic intervention in managing the emotional repercussions of their condition. Six case studies of expatriate (Western) children residing in Singapore, diagnosed with Acute Lymphoblastic Leukaemia aged between five and eight years, are presented with fragile ego structure, suspected PTSD, displaying poor awareness of their disease and having an inability to effectively cope with their illness are presented. Research has been carried out over a duration of eight one hour sessions. Images depict the child's progression in developing ego strength by working through the child's defense mechanisms, and strengthening of the ego through the framework of sublimation of internal instinctual drives (id drives). Positive gains were evident through the results of pre/post parental questionnaires, pre/post PTSD evaluation, pre/post art therapy assessment assessing ego strength 'superhero assessment', and analysis of case content and artwork. This indicated a reduction of PTSD symptoms, management of external stimuli (treatment related procedures) was better managed due to an increase in the child's ego strength which resolved internal conflict through the act of sublimation of internal id drives. The findings offer preliminary support not only limited to the use of art therapy as a modality for a child diagnosed with cancer, but also provides insight to the child's emotional experience helping health care professionals managing paediatric oncology and the parents of children with cancer. Thus, emphasizing art therapy as a non-invasive therapeutic support, a support vital for a child diagnosed with a potentially terminal illness. Ongoing research is warranted to investigate ways in which art therapy can assist in managing paediatric oncology. Keywords: paediatric, oncology, art therapy,PTSD


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