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Transcript

  • 1. Steering in a Different Direction Norma Scobie
  • 2. Brain storm
    • Relaxation
      • Breathing / Massage
    • Distraction
      • Bubbles
      • Toys / books
    • Visualization /Guided Imagery
      • Pain Switch
  • 3. RELAXATION
    • massage
    • Breathing
      • Exercises
      • Bubbles (add guided imagery)
  • 4. Distraction
    • Pop-up books
    • Interactive story telling
    • Bubbles
    • Toys especially interactive
  • 5. Imagery
    • “ Engaging the child’s imagination & concentrating on a specific event to modify a particular response” (Doody et al., 1991)
    • “ The internal experience of an event without the external stimuli” (Zahourek, 1988)
    • Flow of thoughts –see, feel, smell, taste, hear (Murphy, 2001)
  • 6. Imagery
    • Visualize, imagine, fantasize, day-dream, pretend
    • GI provides relaxation & distraction technique & allows child to maintain some control (Jonas et al., 1998)
    • Cost-effective, child-controlled
    • Most common form – worry (Rossman, 2000)
  • 7.
  • 8. Imagery
    • Preparation- realistic goals, practice
    • Environment – quiet, undisturbed, comfort –support limbs, blanket
    • Implementation – relaxation
    • Evaluation – image, emphasis, timing, effect
  • 9. IMAGERY
    • Some limitations
    • Requires the child to have attained cognitive dev. to engage
    • Need to have reached pre-operational level (2-7yrs) (Whitaker & McArthur, 1998)
  • 10. Precautions and potential problems
    • Providing superficial relief of mental health problems
    • Causing tension by using images that promote fear
    • Withholding other treatment modalities
    • Caution with delusional or hallucinating subject
    • Contact lenses
  • 11. Response indicators
    • Eyes closed (not always at first)
    • Eye movements (under closed eyes)
    • Slowing of resps
    • Relaxed & absence of muscle tension
    • Speech: normal to calm with no sign of apprehension
  • 12. Response indicators
    • Easy flowing description of imagery
    • Appropriateness of affect and imagery
  • 13. Technique
    • Rapport and trust
    • “ I know a way that we can make this easier – Would you like to try it?”
    • Identify interest focus – FUN
    • Deep breaths and progressive muscle relaxation
    • Child describes imagery
  • 14. TECHNIQUE
    • Inform the child as to what is happening whilst s/he is “in imagery”
    • Reinforce and / or reframe imagery where necessary
    • Round off imagery
    • Count backwards 4,3,2,1
    • Eyes open – look at the floor then up
  • 15. Important to realise
    • THIS IS NOT A REPLACEMENT FOR GOOD PHARMACOLOGICAL THERAPY
    • It is complementary
  • 16. Imagery & massage
    • Achieve enhanced state of health when touched in a caring way (Montagu,1986)
    • Effect of touch provides pleasure & relaxation of mind, body & relieves stress (Rouse, 1993)
    • Inc circulation blood & lymph, slows pulse, lowers B/P, releases muscle tension, tones & strengthens, relieves cramp(Price & Price, 1995)