Integrating Therapeutic Play Into Nursing and Allied Health Practice: A Developmentally Sensitive Approach to Communicating with Children

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. 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