Therapeutic play and child life programs aim to help pediatric patients cope with hospitalization through play. These programs employ child life specialists who work to prevent emotional distress, provide a comforting environment for play and socialization, allow children choices in activities, and continue their education. The goals are to prepare children for medical procedures, provide alternative spaces to the patient room, and offer developmentally-appropriate programming.

1. THERAPEUTIC PLAY
AND CHILD LIFE
PROGRAMS
Sheila Lechado, RN

3. Play
• A central mechanism in which children
cope
• Through play, children communicate,
learn, and master a traumatic
experience such as hospitalization.

4. • Many hospitals have established
programs with a specially trained staff
whose job it is to concern themselves
solely with the social and emotional
welfare of every pediatric patient
• Such programs are called by a variety of
names, including “Child Life,”
“Children's Activities,” “Recreational
Therapy,” “Play Therapy,” and others

5. • Collaboration between nurses and child
life specialists extends the benefits of
these approaches across time and
settings of care.

6. GOALS OF CHILD LIFE
PROGRAMS

7. 1
• To prevent some of the emotional
pain and fear associated with
illness and hospitalization
– Child life workers may assume
primary responsibility or a
supportive role in the preparation of
patients for hospitalization, surgery,
or particular procedures

8. – In many hospitals, child life workers
arrange preadmission tours, puppet
shows, and similar activities to which
all children who are planned
pediatric admissions are invited
– A child life worker can work with the
team to promote a family-centered
care environment.

9. 2
• To provide a comfortable, accepting,
and nonthreatening environment where
the child may play and interact with
other children and with an adult who is
not involved with health care
– Ideally, there is a separate child life
playroom in every unit
– However, there may be only an open area at
the end of the corridor or in the middle of
the unit

10. – Generally, there is a specific regulation that
no medical procedures (even a relatively
benign one such as taking a child's
temperature) are to be carried out in the
play area
– In many settings, children are encouraged
to have their meals in the playroom.
Generally, they not only enjoy the
opportunity to eat with others, but also
seem to eat better.

11. 3
• To provide the child with an
opportunity for choice
– The child may choose whether he
wishes to come to the playroom.
Once there, the child may choose
what to do
– A variety of craft and play materials,
including real and miniature medical
equipment, are available

12. – Should the child choose to sit and
watch or be held and rocked, these
activities are seen as acceptable
choices
– Certain items (puzzles, games) may
be brought back to the child's room
for use when the playroom is closed
– Portable TVs and video games may
be available.

14. 4
• To provide a continuing
educational program.
– In some settings, teachers are paid by
the hospital and are an integral part
of the child life program. In others,
teachers are provided by the local
public schools, and they work in close
cooperation with the child life
department.

15. – In most hospitals, the educational
program includes special activities
for preschoolers and toddlers as well
as a program of infant stimulation
that may be in collaboration with
physical and occupational therapists.