Child Life Theory- Exam 2

  1. Guidelines for establishing and maintaining supportive relationships
    • contact each child and family prior to or at the time of admission to the hospital
    • interact with child and family throughout stay
    • communicate with children developmentally
    • be respectful and responsive
    • help children prepare in ways that tailor their individual needs
    • provide reassurance and express genuine interest
  2. Process of initiating supportive relationships
    • providing age-appropriate info
    • familiarizing them with hospital facilities, routines and practices, and staff roles
    • introducing children and families to the CL program
  3. Use of medical dolls
    • diversion
    • establish relationship
    • tool for quick rapport
    • initiates supportive, trusting relationships
  4. Supporting natural roles of family
    • honor them, involve them
    • family members are the primary, ongoing caregivers for the child
    • family roles, routines, and rituals are the most familiar and predictable for the child
    • family members know child best
    • family's commitment to best interest of the child deserves respect and support
  5. What to share with families
    • ways children tend to respond to illness, injury and treatment at different stages of development
    • methods of effectively supporting child patients
    • how to facilitate therapeutic "hc play"
  6. Importance of health care play
    • allows child to approach threatening situation
    • assimilate info at their own pace
    • opportunity for self-expression
    • reduction in emotional distress
    • improves information processing
    • effective coping with hc experiences
    • opportunity to recreate situations of concern
    • familiarization
    • allows the care providers opportunity to observe coping
    • misconceptions revealed
  7. Health care play:
    • consists of spontaneous and guided play focusing on health care themes
    • initiated by an adult but child is in control
    • can be enjoyable but the process can be intense and aggressive
    • get emotions out
    • health care play and preparation are not synonymous
    • sometimes just let them play
  8. Health care play provides opportunities
    • express feelings and concerns
    • familiarization
    • increase understanding of hc experience
    • learn and practice new ways of coping
    • rehears hc experience
  9. familiarization activities
    • collages
    • painting with tooth care sponges
    • band-aid ornaments
    • mobiles
    • water play
    • exploration and manipulation
    • medical equipment decoration
    • plaster activities
    • surgical masks
  10. Initiation of HC dramatic play
    • engage child in play by asking younger children help you make baby feel better
    • have appropriate equipment for older children
    • CLS initiate play; guide; but let kid direct it
  11. communication during dramatic hc play
    • reflect or repeat child's comments
    • do not interpret
    • encourage child to express feelings and concerns
    • continue to assess child's perceptions, understandings, and knowledge
    • ask questions
    • clarify misconceptions vs expression of feelings
    • reinforce
    • child has knowledge of staff understanding and support
  12. Documentation of HC Play
    • types of material used
    • child's emotional status
    • child's play interaction
    • child's understanding
    • further follow up needs/plans
    • any unusual occurrences
    • CLS assessment of intervention
    • modification in care plan
  13. Facilitating communication between child and family or home
    • let children know when parent/other family members are leaving
    • be as specific as possible about when they will return
    • call to explain or leave a message when their plans change
    • bring or send audio or video tapes of parents-home
    • bring pictures and familiar objects from home
    • leave something of theirs behind
  14. Preparing children and families for health care experiences
    • accurate info
    • developmentally appropriate info
  15. Information includes
    • reason for threatening or painful procedure
    • anticipated sequence of events
    • sensations that accompany the experience
  16. Why do we want to prepare?
    • increase their confidence and ability to cope, trust
    • prep leads to more effective coping with specific events
    • increase confidence and competence that generalizes to other similar situation
    • overall reduction of emotional distress
    • prevent later developmental disturbances or adjustment problems
  17. Process of preparation
    • child variables
    • family variables
    • hc variables
    • child life care
  18. child variables
    • physical and dev. age
    • past experiences
    • temperament
    • coping strategies
  19. family variables
    • past hospital experiences
    • stress, coping
    • cultural and religious views
    • support
    • other needs and responsibilities
  20. health related variables
    • who is on the team
    • physically altered
    • diagnosis
    • length of stay, number of people involved
    • values of health care providers/staff
  21. Support during procedures
    • providing info regarding the progress of the procedure
    • reminding of coping behaviors
    • performing coping behaviors along with child
    • playing specific role in child's coping process
    • reassurance
  22. Who should be prepared?
    • toddlers should be told JUST BEFORE
    • more verbal toddlers can be told a DAY IN ADVANCE or EARLY in same day
    • young children should receive explanations of future events
    • time between expl. and event should DECREASE WITH AGE
    • no earlier than a week
    • depends on if the family are worriers
    • not too far in advance; too much time to labor over it
  23. Who should prepare children?
    • child life worker
    • nurse
    • other ind. with adequate knowledge of medical procedures
  24. Individualized nature of preparation process
    • child's developmental level
    • medical condition
    • past responses to stressful conditions
  25. How should children be prepared?
    • facilitation of emotional expression
    • information
    • emotional support
  26. facilitation of emotional expression
    • individual preparing child must have understanding of child's state of mind
    • constant encouragement of self-expression, child's prior knowledge, misconceptions, fears, and anger can be revealed
  27. Information
    • presented in an age appropriate manner
    • active participants
    • procedural info as well as sensory info
  28. Emotional support
    • during stressful periods need support
    • parents included in prep process
  29. What materials should be used?
    • doctor equipment
    • hospital furniture
    • books, audio visual
    • films, etc
    • as supplement to, not substitute
  30. Guidelines for planning prep sessions?
    • review guidelines for working with specific age group
    • consult the physician concerning the child's treatment plan
    • review the parents understanding of the child's condition and determine what info they have transmitted to the child
    • determine whether the parents will be taught with the child or separately
    • determine appropriate method of explanations
    • gather all teaching aids to be used in the session
    • cover the material in two to three sessions
    • outline material to be covered in each session
  31. Public relations
    • role to promote positive image of hospital
    • CLS will be involved in arranging special media events
    • important to remember to make sure no children are exploited
  32. Sources of resistance
    • implied criticism from staff
    • territorial
    • jealousy
    • apathy
    • perceived medical and or emotional needs
    • financial considerations
    • responsibility
    • need to maintain control
    • status/training concerns
    • job security
    • personal inconvenience
  33. Where do you find most resistance from?
    medical staff
  34. How to approach resistance
    • education
    • reassurance
    • offering services that meet the needs of members of the resistance
    • "oh she won't be here long"
  35. Family centered care
    • An approach to health care that is based on mutually beneficial partnerships between patients, families, and healthcare professionals
    • beyond the caregiving process
  36. Core principles of family-centered care
    • people are treated with dignity and respect
    • healthcare providers communicate and share complete and unbiased info in affirming and useful ways
    • individuals and families build on their strengths by participating in experiences that enhance control and independence
    • collaboration among patients, families, and providers occurs in policy and program development and professional education as well as delivery of care
  37. benefits of family-centered care
    • improvement in medical and developmental outcomes
    • greater responsiveness to patient and family
    • enhanced patient, family and staff satisfaction
    • creation of more supportive workplace environment
    • wiser use of scarce resources with reduction of healthcare costs
    • families able to advocate
    • enhance competitiveness for hospital in marketplace
  38. 9 elements of family centered care
    • recognize that the family is the constant in child's life; we change
    • facilitate parent and professional collaboration on all levels
    • honor racial, ethnic, cultural and socioeconomic diversity of family
    • share complete and unbiased info in supportive manner
    • implement comprehensive policies and programs that provide emo and financial support
    • recognize individual family strengths and respect various methods of coping
    • understand and incorporate the developmental needs of infants, children and adol. and their families into healthcare system
    • encourage and facilitate family to family support
    • design accessible healthcare delivery systems that are flexible, culturally competent, and responsive
  39. Child Life Council's mission
    we are committed to relationships built on trust, respect and professional competence which contribute to the development of confidence, resilience, and problem solving skills that enable individuals and families to deal effectively with challenges to development, health and well being
  40. what is the meaning of therapeutic?
    • relating to or dealing with healing
    • providing assistance in a cure
    • therapy: remedial treatment of mind, body and soul
    • relations: mutually interested or involved
  41. two types of interventions
    • proactive or preventive
    • reactive
  42. clinical relationship
    clinical service is provided by a professional to a client
  43. therapeutic relationship
    has an implication of trust and interpersonal connection
  44. professional relationship
    • relationships that are established in connection with specific profession engaged by any individual
    • ester to doctor
  45. supportive relationships
    relationships both clinical and non-clinical advocating for psychosocial coping and adjustment
  46. Michael Kahn
    • wrote about Freud's view regarding bedside manner
    • said that bedside manner was irrelevant, do whatever it takes
  47. Carl Rogers
    talked about therapy that required warmth, genuineness and positive regard toward patient
  48. three types of relationships
    • social realm- friendship
    • intimate- personal relationships with partner
    • professional- therapeutic (us)
  49. Phases of therapeutic relationships
    • initiation or orientation
    • working
    • termination
    • possible 4th phase- alliance phase
  50. three theoretical bases of clinical mental health
    • psychoanalytic- interpreting symbolic play
    • humanist- supportive relationship
    • learning theory- helping learn to adapt
  51. zone of helpfullness: Rosemary Bolig
    • diversion
    • activity/recreation/play
    • child development
    • therapeutic
    • comprehensive
  52. Goal for psychological preparation
    • increase sense of predictability and control
    • have lowest possible level of upset/distress
  53. preparation approaches
    • informational- sensory
    • behavioral- desensitization
    • stress-coping framework- what type of learner are they?
Card Set
Child Life Theory- Exam 2
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