Steering in a Different Direction Norma Scobie
Brain storm  <ul><li>Relaxation </li></ul><ul><ul><li>Breathing / Massage  </li></ul></ul><ul><li>Distraction </li></ul><u...
RELAXATION <ul><li>massage </li></ul><ul><li>Breathing </li></ul><ul><ul><li>Exercises </li></ul></ul><ul><ul><li>Bubbles ...
Distraction <ul><li>Pop-up books </li></ul><ul><li>Interactive story telling </li></ul><ul><li>Bubbles </li></ul><ul><li>T...
Imagery <ul><li>“ Engaging the child’s imagination & concentrating on a specific event to modify a particular response” (D...
Imagery <ul><li>Visualize, imagine, fantasize, day-dream, pretend </li></ul><ul><li>GI provides relaxation & distraction t...
Imagery <ul><li>Preparation- realistic goals, practice </li></ul><ul><li>Environment – quiet, undisturbed, comfort –suppor...
IMAGERY <ul><li>Some limitations </li></ul><ul><li>Requires the child to have attained cognitive dev. to engage  </li></ul...
Precautions and potential problems <ul><li>Providing superficial relief of mental health problems </li></ul><ul><li>Causin...
Response indicators <ul><li>Eyes closed (not always at first) </li></ul><ul><li>Eye movements (under closed eyes) </li></u...
Response indicators <ul><li>Easy flowing description of imagery </li></ul><ul><li>Appropriateness of affect and imagery </...
Technique <ul><li>Rapport and trust </li></ul><ul><li>“ I know a way that we can make this easier – Would you like to try ...
TECHNIQUE <ul><li>Inform the child as to what is happening whilst s/he is “in imagery” </li></ul><ul><li>Reinforce and / o...
Important to realise <ul><li>THIS IS NOT A REPLACEMENT FOR GOOD PHARMACOLOGICAL THERAPY </li></ul><ul><li>It is complement...
Imagery & massage <ul><li>Achieve enhanced state of health when touched in a caring way (Montagu,1986) </li></ul><ul><li>E...
Play Therapy
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Play Therapy

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Play Therapy

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

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