Children and adolescents with cancer face far more than the physical challenges of treatment. They are also trying to make sense of frightening procedures, disrupted routines, changing relationships, and an uncertain future while continuing to grow and develop. Yet young patients are often left out of conversations about their own care. Many are viewed as “too young to understand,” while others hesitate to ask questions or voice their concerns because they worry about upsetting their caregivers or healthcare providers, or because conversations about illness feel difficult or off limits. Without opportunities to share their perspectives, many young people are left carrying uncertainty, helplessness, and emotional distress on their own.
The challenge is often not that young people lack the ability to understand or communicate their experiences. Rather, they need developmentally appropriate opportunities and supportive environments that encourage them to share their perspectives. Oncology social workers are uniquely positioned to create these opportunities by fostering safe, trusting, and child-centered spaces for self-expression. One approach that is particularly well suited to pediatric oncology is photovoice, a strengths-based practice that uses photography and storytelling to help young people communicate experiences that may otherwise be difficult to put into words.
Photovoice was developed by Caroline Wang and Mary Ann Burris in the 1990s and formally described in 1997 as a participatory approach in which people use photographs and dialogue to identify, represent, and strengthen their communities. Its foundations in participatory learning and reflection, feminist theory, and documentary photography distinguish it from simply asking an individual to take pictures: participants create and interpret the images, reflect together on the conditions shaping their lives, and may use what they learn to advocate for change (Wang & Burris, 1997).
In oncology, photovoice and related photo-based methods have been applied across treatment and survivorship with people of different ages and cancer diagnoses, as well as caregivers and families. Reviews indicate that these methods have been used primarily to understand patients’ and caregivers’ lived experiences, including psychosocial challenges, coping, healthcare barriers, health behaviors, and opportunities for agency and advocacy (Lanoye et al., 2024; Hoover et al., 2026). Among young people specifically, studies have shown how photographs can illuminate changes in identity, relationships, and daily life across the cancer trajectory (Yi & Zebrack, 2010; Bood et al., 2022). Beyond generating knowledge about lived experiences, photovoice has increasingly informed the development of structured psychosocial interventions. For example, the Photographs of Meaning Program for Adolescents and Young Adults (POM-AYA) combined photographs, narratives, and guided meaning-focused prompts. Participants reported high satisfaction, reduced depressive symptoms, and improved quality of life (Beaupin et al., 2019; Pailler et al., 2020).
Informed by POM-AYA, Jennifer Currin-McCulloch and Danielle Peterson developed Through the Lens (TTL), an eight-week synchronous virtual group intervention integrating photovoice with meaning-centered group psychotherapy for young adults with cancer. Through weekly photography prompts, participants take or select photographs, create brief narratives about their meanings, and share and reflect on their images during facilitated group discussions. These activities invite participants to explore identity, relationships, sources of meaning, personal strengths, hope, and life beyond cancer while fostering connection with other young adults who have faced similar experiences. An initial evaluation found TTL to be both feasible and acceptable, with participants describing the photography, narrative reflection, and group-sharing activities as meaningful opportunities to explore their cancer experiences, connect with other young adults, and strengthen their sense of meaning and belonging (Currin-McCulloch et al., 2024). The broader TTL team continues to implement and refine the intervention and, in partnership with the Young Adult Advisory Board (YAB), has developed a national photovoice campaign, dedicated website, and traveling photo exhibits to share participants’ photographic narratives, foster public dialogue, and advance advocacy for young adults affected by cancer.
In photovoice activities, young patients are invited to capture what matters most to them, what brings them comfort, and what has been weighing on their minds through photographs they take themselves. Instead of relying on words alone, children can use familiar images to communicate both tangible aspects of their lives, such as favorite places, meaningful relationships, or treasured objects, and more abstract ideas, including hope, friendship, a sense of belonging, supportive connections with healthcare providers, or uncertainty about the future. For topics that may feel especially difficult to discuss, such as fear or thoughts about death, photographs can offer a gentler, more accessible way to begin the conversation. During individual or group sessions, oncology social workers invite young people to share the stories and meanings behind their images. The focus is never on artistic ability. Instead, the photographs become a bridge for self-expression, reflection, and authentic dialogue.
Photovoice does not require a formal research project or professional photography skills. It can be easily incorporated into everyday social work practice through simple, open-ended prompts tailored to a child’s age and developmental stage. For younger children, prompts might include, “Take a picture of something that makes you feel brave,” “Show us a place where you feel safe,” or “What helps you get through a hard day?” Adolescents may respond well to questions such as, “Take a photo that represents what cancer has taught you,” “What gives you hope?” or “Capture something that people would not know about your cancer experience unless you showed them.” Young people can also be invited to share meaningful photos from their phones, document important moments during treatment, or create simple photo journals. Even brief photo-based activities can open the door to meaningful conversations, amplify youth voice, strengthen therapeutic relationships, and keep children’s voices at the center of psychosocial care.
Photovoice offers benefits that extend well beyond creative expression. Making thoughts and feelings visible helps young patients communicate experiences that might otherwise remain unspoken. Reflecting on their images also encourages children and adolescents to recognize personal strengths, appreciate supportive relationships, and consider what gives their lives meaning during and beyond treatment. In doing so, photovoice supports meaning making by helping young people understand how cancer has shaped them while recognizing the strengths, relationships, and hopes that continue to define who they are. When used in group settings, sharing photographs can foster peer support by helping young people realize that they are not alone in their experiences. Seeing the world through another child’s lens often creates empathy, mutual understanding, and a stronger sense of connection.
Photovoice also strengthens communication within the child’s support system. Sharing photographs can deepen conversations with caregivers, siblings, healthcare providers, and other members of the care team, offering valuable insight into each child’s priorities, concerns, and sources of hope. By centering children’s perspectives, photovoice promotes more collaborative, child-centered psychosocial care and reminds us that every young patient has a unique story worth hearing. Beyond clinical practice, photographs shared through community or public exhibitions can raise awareness, educate policymakers, and advocate for more child-centered cancer care, ensuring that young people’s voices extend beyond the clinic and help shape the future of pediatric oncology care.
References
Beaupin, L. K., Pailler, M. E., Brewer-Spritzer, E., Kishel, E., Grant, P. C., Depner, R. M., Tenzek, K. E., & Breier, J. M. (2019). Photographs of meaning: A novel social media intervention for adolescent and young adult cancer patients. Psycho-Oncology, 28(1), 198–200. https://doi.org/10.1002/pon.4896
Bood, Z. M., van Liemt, F., Sprangers, M. A. G., Kobes, A., Weeseman, Y., Scherer-Rath, M., Tromp, J. M., van Laarhoven, H. W. M., & Helmich, E. (2022). This is what life with cancer looks like: Exploring experiences of adolescent and young adults with cancer using two visual approaches. Supportive Care in Cancer, 30(4), 3353–3361. https://doi.org/10.1007/s00520-021-06775-9
Currin-McCulloch, J., Peterson, D., Kaushik, S., & Borrego, J. (2024). Through the Lens: The feasibility and acceptability of an online meaning-making photovoice group among young adult cancer survivors. Social Work with Groups, 47(1), 47–63. https://doi.org/10.1080/01609513.2023.2212391
Hoover, R. L., Xu, J., Hammersla, M., Garcia, B., Betancur, S., & Woodard, N. (2026). Photovoice utilization for research in cancer survivors: A systematic review. Psycho-Oncology, 35(3), e70431. https://doi.org/10.1002/pon.70431
Lanoye, A., Cai, L., Thomson, M. D., & Hong, S. (2024). Use of photo methods in research studies with cancer survivors and their caregivers: A scoping review. Journal of Cancer Survivorship, 18(3), 698–709. https://doi.org/10.1007/s11764-022-01321-w
Pailler, M. E., Beaupin, L. K., Brewer-Spritzer, E., Grant, P. C., Depner, R. M., Levy, K., & Tenzek, K. E. (2020). Reaching adolescent and young adult cancer patients through social media: Impact of the Photographs of Meaning Program. Journal of Adolescent and Young Adult Oncology, 9(4), 508–513. https://doi.org/10.1089/jayao.2019.0140
Wang, C., & Burris, M. A. (1997). Photovoice: Concept, methodology, and use for participatory needs assessment. Health Education & Behavior, 24(3), 369–387. https://doi.org/10.1177/109019819702400309
Yi, J., & Zebrack, B. (2010). Self-portraits of families with young adult cancer survivors: Using photovoice. Journal of Psychosocial Oncology, 28(3), 219–243. https://doi.org/10.1080/07347331003678329
