Integrating Therapeutic Play Into Nursing and Allied Health Practice

Description:

This book helps support developmentally sensitive nursing and allied health practice by integrating the therapeutic powers of play into child and adolescent health care service provision. It is designed to link play, child development, neuroscience, biopsychosocial and attachment theories with the biomedical model of health.

Nurses and allied health professionals work with children aged between 0-18 years and with diverse childhood illnesses, injuries, diseases, disorders, and conditions, and are therefore in a prime position to understand and support children through potentially painful and traumatic health care experiences. Understanding of the role of play and the application of the therapeutic powers of play in communicating with children and families has the potential to significantly optimise paediatric care. The theory and play based strategies, tools and techniques presented in this book assist nurses and health care professionals to engage with children in an age-appropriate manner and ‘speak’ with children through their natural language of play, to enhance comprehension, coping, resiliency, and healing.

Play is recognised as a sequentially developing ability and can be aligned with the child’s age and stage of life. Play based approaches can be placed on a continuum from fully child led or non-directive play to adult facilitated educative play. Medical information can be tailored according to the various points along this continuum to inform clinical reasoning and to help children prepare for procedures, recover from medical interventions and / or make sense of their diagnosis.

Whilst this book is directed at nurses and allied health professionals who work with children and their families, it may also be a valuable resource for medical and other professionals in community or educational settings to work systemically as a team. The book takes the reader on a journey to illustrate various professional and therapeutic roles in how to playfully engage children through a range of case vignettes.

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Foreword
Preface
Contents
Editors and Contributors
About the Editors
About the Contributors
Part I: Theoretical Background
Integrating Play into the Context of Health Settings
Introduction
The Importance of Play
Supporting Children in Health Systems
Definitions of Play and Play Therapy in the Health System
United Nations Convention on the Rights of the Child
Providing Atraumatic Care
Reflective Questions and Activities
Orientation to the Text
Additional Resources
References
Play in Therapy and the Therapeutic Powers of Play
Introduction
Play in Therapy and Play Therapy: Early Origins
The Therapeutic Powers of Play: Mechanisms of Change
Self-Expression
Access to the Unconscious
Direct Teaching
Indirect Teaching
Catharsis
Abreaction
Positive Emotions
Counterconditioning of Fears
Stress Inoculation
Stress Management
Therapeutic Relationship
Attachment
Social Competence
Empathy
Creative Problem Solving
Resiliency
Moral Development
Accelerated Psychological Development
Self-Regulation
Self-Esteem
Conclusion
Reflective Questions and Activities
Additional Resources
References
Caring for Children, Families, and Health Care Professionals
Introduction
Attributes of Caring for the Hospitalized Paediatric Patient: A Nurse’s Perspective
The 7 C’s of Caring
Compassion
Competence
Conscience
Confidence
Commitment
Comportment
Creativity
Implementing Play through the Art of Caring
Critical Reflection
The Individual’s Belief System, Knowledge, and Skill Set
The Context
The Child
Caring for Yourself as You Engage in Play with the Hospitalized Child
Conclusion
References
Assessing the Sick, Injured, or Vulnerable Child
Introduction
Immediate Treatment
Physical and Neurological Assessment
Pain Assessment and Experience
Integrating Therapeutic Play into Clinical Assessments
Assessing Neurobiology
Assessing Play
Application of Play Assessments in Health Settings
The Child within the System
Activity
Questions
Reflections
Building Rapport as an Interpersonal Assessment Skill
Activity Building Rapport: Helping the Child to Feel Safe
Playful Approaches to Physical Assessment
Activity: Setting Considerations
Conclusion
Additional Resources
References
Attachment Theory in Paediatric Health Care
Introduction
A Brief History of Attachment Theory and Research
Bowlby, Bombs, and Babies
The Wire Mother Monkey
A Two-Year-Old Goes to Hospital
The Strange Situation
Type B Patterns
Type A Patterns
Type C Patterns
Contemporary Models of Attachment
ABCD Model
The Dynamic Maturational Model of Attachment and Adaptation
The Application of Attachment Theory to Paediatric Health Care
Understanding the Health Care Professional
Understanding the Child
Type B Patterns
Type A Patterns
Type C Patterns
Understanding the Caregiver
Type B Patterns
Type A Patterns
Type C Patterns
Further Considerations
Attachment and Medical Trauma
Attachment and Health Outcomes
When Caregivers Harm
Chapter Summary
Reflective Questions and Activities
Additional Resources
References
Part II: Child Development
Therapeutic Play and Maintaining Hope in the Infant Child
Introduction
Child Development and Assessment
Physical Development
Psychosocial Development
Neurological Development
Play Development
Considerations for Nursing and Allied Health Care
Common Fears and Anxieties
Grief and Loss/Death and Dying
Pain Management
Therapeutic Play Approaches for Clinical Practice
Parents as Partners
Considerations for Referral
Chapter Summary
Reflective Questions and Activities
Additional Resources
References
Therapeutic Play, Volition, and the Toddler
Introduction
Child Development and Assessment
Physical Development
Neurological Development
Psychosocial Development
Play Development
Considerations for Nursing and Allied Health Care
Common Fears and Anxieties
Pain Management
Therapeutic Play Approaches for Clinical Practice
Environmental Considerations
Engaging the Child
Parents as Partners
Considerations for Referral
Chapter Summary
Reflective Questions and Activities
Additional Resources
References
Therapeutic Play and Aiding Purpose in the Preschooler
Introduction
Child Development and Assessment
Physical Development
Psychosocial Development
Language Development
Neurological Development
Play Development
Considerations for Nursing and Allied Health
Common Fears and Anxieties
Grief and Loss
Pain Management
Therapeutic Play Approaches for Clinical Practice
Parents as Partners
Chapter Summary
Reflective Questions and Activities
References
Therapeutic Play and Instilling Competence in the School-Aged Child
Introduction
Child Development and Assessment
Physical Development
Psychosocial Development
Neurological Development
Play Development
Considerations for Nursing and Allied Health Care
Common Fears and Anxieties
Grief and Loss/Death and Dying
Pain Management
Therapeutic Play Approaches for Clinical Practice
Parents as Partners
Considerations for Referral
Chapter Summary
Reflective Questions and Activities
References
Therapeutic Play, Fidelity, and the Adolescent
Introduction
Reflection Activity
Adolescent Development
Physical and Psychosocial Development
Play Development
Neurological Development
Considerations for Nursing and Allied Health Care
Ethical Considerations
Reflective Activity
Parents as Partners
Therapeutic Play Approaches for Clinical Practice
Consideration for Referral
Chapter Summary
Reflective Questions and Activities
References
Part III: Case Presentations
Preparing Jess for an Allergy Assessment
Introduction
Introducing Jess
The Clinical Setting
Assessment
Learning More about Jess
Building the Foundation—The Therapeutic Relationship
Meeting Jess
Interventions
Strategies to Support Needle-Related Procedures
Where to Next?
Learning Activities and Reflective Questions
Activity One
How May the Child Present?
What Would Enable them to Feel a Sense of Safety in this Environment?
Activity Two
What Information Would Be Important to Inform your Interventions?
How Could You Assess and Prepare the Carer for Their Role in the Procedure?
What Might the Toddler and Carer Experience from a Sensory Perspective?
Consider Some Ways You May Be Able to Support and Prepare them for this
Activity Three
Some Helpful Resources
References
Supporting Evan with Pain
Introduction
Cerebral Palsy
Case Vignette—Evan’s Experience
Psychosocial Iatrogenic Trauma
Therapeutic Assessment
Therapeutic Intervention and Play Strategies Tailored for Iatrogenic Trauma
Practical Considerations
Normative Play
Therapeutic and Medical Play
Systemic Considerations
Chapter Summary
Reflective Questions and Activities
References
Connor Struggles to Stay in School
Introduction
Meeting Connor in the Clinical Setting
Background to the Presenting Condition
Literature on the Presenting Condition
Elimination Disorders
Case Conceptualisation
Individualised Intervention Design
Considerations for Health Care Needs Based on Diagnosis
The Assessment Phase
Adverse Childhood Experiences
Playtime Exercise
Paediatric ACEs and Related Life Events Screener
Strength and Difficulties Questionnaires
Getting to Know Connor through Projective Assessments
Blob Tree
3D Birds Nest
Family Play Genogram
Connor’s Play Therapy
Systemic Practice
Reflection on the Case Conceptualisation Process
Reflective Resources and Activities
Titration and Reciprocal Inhibition
Reflective Journaling
Self-Care
Additional Resources
References
Bartholomew Learns about Diabetes
Introduction
Batholomew’s Background
Background to the Clinical Setting through the Eyes of the Child: Batholomew’s Experience
Activity
Diabetes Mellitus
Case Vignette—The Child’s Experience
Hospital-Based Initial Assessment
Intervention and Health Teaching Support
Strategies for Blood Glucose Monitoring
Systemic Considerations
Chapter Summary
Additional Resources
References
Charlotte’s Hospice Stay: Time for Play
Introduction
A Progressive Brain Tumour—Charlotte’s Experience
Child-Centred Play Therapy
Case Vignette—Charlotte’s Experience
The Family Experience
Systemic Approach to Support the Child and Family
Chapter Summary
Reflective Questions and Activities
References
Conclusion