THERAPEUTIC PLAY AND CHILD LIFE PROGRAMS Sheila Lechado, RN
Play• A central mechanism in which children cope• Through play, children communicate, learn, and master a traumatic experience such as hospitalization.
• 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,” “Childrens Activities,” “Recreational Therapy,” “Play Therapy,” and others
• Collaboration between nurses and child life specialists extends the benefits of these approaches across time and settings of care.
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
– 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.
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
– Generally, there is a specific regulation that no medical procedures (even a relatively benign one such as taking a childs 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.
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
– 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 childs room for use when the playroom is closed– Portable TVs and video games may be available.
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.
– 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.