Post on 22-Dec-2015
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HOLDING THE PIECES TOGETHER: USING THERAPEUTIC PLAY WITH GRIEVING CHILDRENBen Broxterman, CCLSChild Life SpecialistWesley Medical Center
CHILD LIFE SPECIALISTS: AN OVERVIEW
Minimum of bachelor’s degree with coursework focusing on children/families
Completion of 480-hour internship under Certified Child Life Specialist
Successful completion of standardized examination to earn CCLS credential
Work to promote optimal coping for children & families through developmentally-focused, family-centered interventions
WHAT IS PLAY?
Play, in particular, is the special manifestation of freedom in childhood.
From: “White Paper #6: The State of Children’s Play.” www.academyofleisuresciences.org/alswp6.html
WHAT IS PLAY?
Webster’s definition: exercise or activity for amusement or recreation
The Association for Play Therapy, Inc. states: “… play is a natural medium for self-expression, facilitates children’s communication, is conducive to cathartic release of feelings, and can be renewing & constructive.”
WHAT IS PLAY?
Most play researchers agree that, to be called “play”, an activity must be:VoluntaryInternally motivatedPleasurable, relaxed“as if” or present textOrganism rather than object dominatedUnique, unpredictableActive, both motorically & cognitively
From: Meeting Children’s Psychosocial Needs Across the Healthcare Continuum. Rollins, J., Bolig, R., & Mahan, C.
THERAPEUTIC PLAY Therapeutic play is a term used for play in health care
settings, classified as “play that is used to prevent psychologic injury.” Its goals are to: Meet children’s ongoing developmental needs Help children cope with unfamiliar hospital environment Increase children’s understanding of their hospitalization &
treatment Promote a sense of control, mastery, positive self concept Facilitate self-expression Meet children’s needs to cope with separation &
deprivation.
From: Meeting Children’s Psychosocial Needs Across the Healthcare Continuum. Rollins, J., Bolig, R., & Mahan, C.
THERAPEUTIC PLAYThe National Association for Hospital Play Staff
(NAHPS) in England, states that play: Creates an environment where stress & anxiety are
reduced Helps child regain confidence & self-esteem Provides an outlet for feelings of anger & frustration Helps the child understand treatment & illness. Through
play, children are able to effectively learn the sensory and concrete information they need to prepare for hospital procedures and treatment
Aids in assessment& diagnosis Speeds recovery & rehabilitation
THERAPEUTIC PLAY Usually consists of at least one of the following types of
activities: Encouragement of emotional expression (ie- re-enactment of
experiences through doll play) Instructional play to educate children about medical
experiences Physiologically enhancing play (ie- blowing bubbles to improve
breathing)
From the Child Life Council Evidence-based Practice Statement: Therapeutic Play in Pediatric Health Care: The Essence of Child Life Practice. Koller, D.
THERAPEUTIC PLAY VS. PLAY THERAPY
Goal is to prevent psychological injury
Focuses on the process of play as a mechanism for mastering developmental milestones & critical events
Goal is to alleviate psychological injury
Addresses basic & persistent psychological issues
Therapeutic Play Play Therapy
USING PLAY AS A TOOL WITH GRIEVING CHILDREN
Play helps to make the grieving process more approachable
Play “normalizes” experience & can allow time for children to return to their normal state in between periods of active grief
CHILDREN’S PERCEPTION OF DEATH BY AGE
Newborns-3 years old: don’t comprehend death, but are very aware of changes in caregivers, routines, & are aware that someone in the home is missing
Preschoolers (3-5 years old): can understand biological differences between dead and living, but sees these changes as temporary & reversible. May assume responsibility for the death through magical thinking.
Young school age (6-9 years old): begin to understand the concept of death, but feel it only happens to others. Begin to worry that important people in their life might die.
CHILDREN’S PERCEPTION OF DEATH BY AGE
Middle school (10-12 years old): Understand finality of death, & develop a personal fear of death. Might be more interested in gruesome details of violent deaths, or in what happens to the body after death.
Adolescents (13+): have an adult concept of death; ability to deal with loss varies greatly depending on their personal experiences. Still see selves as invincible.
USING PLAY WITH THE FAMILY OF THE DYING PERSON
Play can help children understand in developmentally appropriate terms
Play can serve as a medium for self-expression, and an outlet for concerns, misconceptions, or other needs
Case example
PLAY AS MEDIUM FOR PARENT-CHILD OR FAMILY-CHILD INTERACTION
Case example: Sandra
Family expressed concern to medical staff, who consulted CLS Single mother, 8 y/o daughter, “very close” Mother given a few weeks to live Family stated in conversation with this CLS that mother had
shut down, & daughter was trying to understand but had become increasingly quiet after visits with her mother
PLAY WITH THE GRIEVING PATIENT
Can help the patient express questions/fears/desires that might not be brought out in other formats
Helps promote a sense of control in an otherwise “out-of-control” situation
Case examples
QUESTIONS?