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Play therapy for cancer children
- 1. PLAY THERAPY CHILDREN WITH CANCER Presented by RENITHA NAVIS M ASSISTANT PROFESSOR DEPARTMENT OF PEDIATRIC NURSING SHANMUGA COLLEGE OF NURSING SALEM
- 2. What is Play Therapy? “Play therapy is defined as a dynamic interpersonal relationships between a child (or person of any age) and a therapist trained in play therapy procedures who provides selected play therapy materials and facilitates the development of a safe relationship for the child (or person of any age) to fully express and explore self (feelings, thoughts, experiences, and behaviors) through play, the child’s natural medium of communication, for optimal growth and development” (Landreth, 2002)
- 3. History And Its Meaning It is a form of psychotherapy since 1990. Play therapy is generally employed with children aged 3 through it and provide a way for them to express their experiences and feeling through a natural, self guided, self-healing process. As children’s experiences and knowledge are often communicated through important vehicle of them to know and accept themselves and others.
- 4. Purpose of play therapy Develop a more positive self concept Assume greater responsibility Become more self accepting, self directing and self reliant Become more trusting of self Experience a feeling of control Become sensitive to process of coping Develop a internal source of evaluation Engage in self determined decision making
- 5. Importance of play therapy for pediatric cancer patients Playing is a natural way of building skills, confidence and personality in a child as well as a way to instill social relations and proper behavior. Children who are ill, particularly children with cancer, tend to lose interest in playing due to their long-term stay at the hospital and isolation procedures. Illness and hospitalization can be a major source of stress for young children. They meet many strangers and have to undergo many tests and procedures. This affects them deeply and could cause possible depression .
- 6. PARTEN’S SIX TYPES OF PLAY
- 7. UNOCCUPIED PLAY Child Is Completely Free To Think, Move And Imagine. The Child Is Not Playing Or Watching Anyone Or Anything In Particular. They Might Stand Or Sit And Just Do Nothing
- 8. SOLITARY PLAY (Independent play) Children will play with toys by themselves, independently. Not influenced by others Does not tent to approach others Solitary play helps a child to be a thinker
- 9. ONLOOKER PLAY The child watches others play but does not become engaged in their play. May sit or stand near the children playing Different from un occupied play as in this play the child is interested in other children activity. They might look or talk to the players but not involved.
- 10. PARALLEL PLAY The child plays with toys that are shared with others. The child plays beside other children but communication might be limited or none at all. The child mimics others children play but doesn't actively engage others.
- 11. ASSOCIATIVE PLAY The child plays with other children. The play is not coordinated. They may talk and share toys but they are still independent players. A child plays side–by-side with others, engaging at times but not coordinating efforts.
- 12. COOPERATIVE PLAY Children Come Together And Play A Group Of Children With A Common Goal Or Similar Interests, Acting Out Adult Situation Or Playing Formal Games.
- 13. IS THESE PLAY CAN BE APPLICABLE FOR PEDIATRIC CANCER CHILDREN
- 14. WHAT IS MEDICAL PLAY IT IS A TYPE OF PLAY WHICH CONCENTRATES ON EVENTS IN HEALTH CARE SETTING SUCH AS INJECTIONS, PROCEDURES, TREATMENTS AND THEIR ILLNESS.
- 15. PLAY IN ILLNESS Therapeutic play It is the use of play specially on a language for sick children to communicate their thoughts and feeling.
- 16. CHARACTERISTICS OF MEDICAL PLAY Part of its content medically themed and/ or it includes the use of medical equipment. Play may be offered or initiated by an adult/ parent, but its voluntarily maintained by the child. Medical play is usually enjoyable for the child and is accompanied by laughter and relaxation. However, the process of play can be intense and aggressive. Medical play and preparation are not the same. They are not interchangeable. When an adult attempts to prepare a child for a medical event by demonstrating a procedure or familiarizing a child with equipment, education may occur, but not necessarily play. Play may follow familiarization if play opportunities re made available.
- 17. PURPOSE OF MEDICAL PLAY Provide diversion and bring interaction Help to feel more secure in strong environment Lessen stress of sick child Release of tension and expression of feeling Encourage interaction and development of positive attitude An expressive outlet for creative ideas Means for accomplishing therapeutic goal Provide the child on active role.
- 18. Problems of cancer children INTERNALIZING PROBLEMS Feelings of loss of control Hopelessness Depression Anxiety Frustrations
- 19. EXTERNALIZING PROBLEMS Withdrawal Aggression Non-compliance OTHER COMMON DIFFICULTIES Poor self-esteem Poor self-image Changing sense of identity, more negative Decreasing social competence Learning problems
- 20. TYPES OF MEDICAL PLAY
- 21. ROLE REHERSAL/ ROLE REVERSAL PLAY This is the most traditional medical play. Children takes on the roles of health care professionals, acting out medical procedures and events on dolls, puppets, stuffed animals or other people ( children or adults). Real medical material and equipment is used , as well as specially made toys created for medical play, such as toy doctor kits, a patient puppet, a doll sized MRI or hospital bed. Children often use these type of medical play to re- enact events they have experienced.
- 22. MEDICAL FANTASY PLAY This also involve role playing medical themes. However, traditional play materials, blocks, doll houses, cars, trucks and stuffed animals are used to create roles and stories for medical play, instead of actual medical equipment. In medical fantasy play, children avoid contact with feared objects, but can still play out topic for concern.
- 23. INDIRECT MEDICAL PLAY Hospital themed activities such as puzzles, games and songs enable familiarization, exploration and education related to medical experiences. This type of play also uses medical materials in non- traditional ways, such as using syringes to squirt water, and using IV tubing as drinking straws.
- 24. MEDICAL ARTS PLAY This offers many different ways for a child to express themselves, their understanding of and reaction to their medical experience. Art activities can vary greatly, including painting, drawing, collage and 3D sculptures. Basic art materials are appropriate. Paint, paper, markers and glue offer a wide range of choices. Including some medical materials, such as band aids, plasters, gauze and tongue depressors can enhance the medical theme.
- 25. How is Play Therapy Administered? The child is the one who leads the session, so the format in this sense is free and there is no pressure put on the child to talk about their difficulties. The trained therapist will use specific techniques in order to assess how the child reacts to the world, events and the people who inhabit their world. Gently the therapist will lead the child to help them gain an awareness of their feelings and allow them to express their feelings safely.
- 26. Points to remember It is primarily non verbal approach Age range of mostly children are 2 to 12. but it vary according to the cognitive and development delay may participate in play therapy at an older chronological age. Time session 30 to 50 minutes but it vary Mild issue may improve in 6 to 12 session, complex issue like cancer may require up to 40to 80 sessions.
- 27. How to use play therapy To take the patient's mind off treatment To identify any developmental issues To encourage children to express themselves
- 28. Basic principles of play therapist Must develop a warm and friendly relationship with the child Accepts the child as she or he is Establish a feeling of permissiveness in the relationship Maintain a deep respect for the child ability to solve his/her problems and gives the opportunity to do so. Does not attempt to direct the child’s actions or conversations in any manner. Does not hurry the therapy along. Only establish those limitations necessary to anchor the therapy to the world of reality and to make the child aware of his/her responsibility in the relationship. The therapist recognizes then reflects the child feelings.
- 29. Procedure of play therapy THE PLAY ROOM The Necessary elements within the play rooms are; The child, The therapist, and the play therapy contents. The play therapy space is usually a designated room, set up in a particular and predictable way. Within the room, there are a wide range of expressive tools and toys, Toys including craft materials, dress ups and masks, musical instruments, puppets, toy animals, toy weapons, medical equipment, doll houses and balloons. Therapy room as needing to contain something to represent everything in the child’s world. The range of toys allow a child to understand that a range of behaviors are permitted in the playroom.
- 30. Play therapy activities for cancer children Share messy moments( babies to 12 year old) Trade something personal or special ( babies to 12 year old) Flying feeling balloons( 18 months to 6 year old) Reading books( 2 to 12 year old) Popping cancer bubbles( 3 to 12 year old) Hugging hand activity ( 6 years old and up) Plan a party( 3 to 16 years old) Make friendship bracelets( 4 to 12 years old) Play doctor( 6 to 12 years old) Write thank you card( 4 to 12 years)