Cultivating Gratitude in Children with Serious Illness

Anna KozasAnna Kozas earned her Master’s in Counseling with an emphasis in Health Psychology from the School of Education and Counseling Psychology at Santa Clara University (SCU) and is currently the Bioethics Program Coordinator at the Markkula Center for Applied Ethics at SCU. In her role at the Ethics Center, Anna coordinates the Center’s bioethics […]

jennys-sketchbook-gratitude-journal1Like so many others, I spent years battling serious health challenges, also helping to care for others facing their own struggles, and learning to navigate complex social dynamics. And while I have definitely had my weaker moments, for the most part I feel that I have been able to remain fairly positive, and I believe that is largely because of the ways I have learned to practice gratitude.

We are beginning to understand that gratitude certainly has health benefits for adults (Hill, Allemand, & Roberts, 2013). But can gratitude help kids cope with what they are experiencing when they have health challenges? Stoeckel, Weissbrod, and Ahrens (2015) found that gratitude has protective qualities in kids whose parents were sick—that they experienced less depression and anxiety and that a greater quality of life was enjoyed by the entire family. I don’t think it is too much of a stretch to say that gratitude can have similar health promoting and protective effects in kids as well, when they themselves are sick.

Part of the challenge is that gratitude is a complex emotion and one that kids may not be cognitively developed enough to understand.  Development must be considered as a key factor when creating interventions for cultivating gratitude that are age appropriate for kids. When we teach these interventions to adults, it’s under the assumption that they already understand what gratitude is, and that it can have positive effects on others also. With children, teaching the intervention might need to go along with teaching what gratitude is and how it makes people feel.

DSC_8819We have learned that there are at least two types of interventions that are effective in cultivating gratitude—letter writing and gratitude journaling. What is wonderful is that letter writing and keeping a gratitude journal can be modified for children. Journaling can include writing, but also artwork. Letter writing can be done with the help of an adult, or just by writing a very simple “thank you,” which is really all that needs to be said.

In order to cultivate gratitude in kids who are sick, I think the focus must be on allowing them to tell their own story, creating a safe space for them to share, and creating opportunities to highlight the blessings and strengths around them.  Helping children explore their own story, whether through conversation, journaling, or art is not only healing, but can be profoundly helpful in shaping how the young person views their own story.  In “hearing” their story, they can begin to uncover the strengths and the positive attributes from which gratitude can be cultivated.  By lifting up and nurturing their spirits, young people are supported to be mentally and emotionally healthy and strong, and are much better equipped to fight their battles.




Hill, P. L., Allemand, M., & Roberts, B. W. (2013). Examining the pathways between gratitude and self-rated physical health across adulthood. Personality and Individual Differences, 54(1), 92-96. doi: 10.1016/j.paid.2012.08.011.

Stoeckel, M, Weissbrod, C., & Ahrens, A. (2015). The adolescent response to parental illness: The influence of dispositional gratitude. Journal of Child and Family Studies, 24(5), 1501-1509. doi: 10.1007/s10826-014-9955-y.