Child life specialists are healthcare professionals educated in child and family development, with particular training related to childhood medical experiences. Child life specialists hold a bachelors, masters, or doctoral degree, and must complete a rigorous internship in a clinical setting before sitting for the child life certification exam. In order to maintain certification, child life specialists must recertify every 5 years. They are experts in child-friendly language, developmental support, family-centered care, and the therapeutic elements of play.
What does a Child Life Specialist do?
Child life specialists work closely with the medical team to provide psychosocial and emotional support to the patient and family. The typical development of children can be disrupted during a stressful and uncertain healthcare experience. Child life specialists utilize play techniques to alleviate stress and anxiety in children.
They can help prepare a child for medical procedures, support the child through the procedure, process stressful events, provide non-medical pain management, engage children in creative self-expression, and assess the child’s understanding of an illness, injury, or treatment. In a palliative care setting or in the home, child life specialists will partner with the palliative care team as well as the primary medical team to develop interventions for the patient, siblings, and caregivers. The overall goal is to support development and positive coping throughout the healthcare continuum, both in a clinical setting and in the home.
Psychological Preparation for Medical Experiences
Children are similar to adults in the sense that they cope more effectively when they are prepared for medical experiences. Children differ from adults in that children require repetition, simple language, and concrete, hands-on methods of preparation in order to understand what will happen following a new diagnosis or during a medical encounter.
Child life specialists utilize photo preparation books, dolls, and real medical equipment when possible in conjunction with simple, child-friendly language to help children develop coping plans prior to each procedure or experience. Even a simple blood pressure check, or a routine procedure that the child has experienced many times can bring upon intense stress and anxiety depending on the child’s additional stressors and past experiences.
Child life specialists utilize a step-by-step approach to preparing children for medical procedures and treatments in order to assess related fears and misconceptions. Some children require real-time information about each step of a procedure, while others are able to cope through constant distraction. Child life specialists work with the patient and family to find the most effective approach to preparation and guidance for each individual child.
In a home-care setting, child life specialists can provide preparation and support for children receiving palliative care services during procedures in the home (port access, blood draws, dressing changes, etc.), or prior to medical appointments and planned hospital admissions. Children require developmentally supportive care through each step of their medical experience, and child life specialists aim to enhance that care.
Minimize Stress & Anxiety
Child life specialists work to minimize potential stress and anxiety by empowering children to make decisions related to their care, whether in the hospital setting or in the home. Children and families experience increased stress when they feel powerless or uncertain. In most situations, children can be offered choices to increase compliance with treatment. For example, children can be offered the choice to take a medication with juice or with water, or they may have an option as to which finger to poke, or which arm to try first for an IV placement. During procedures or treatments, child life specialists anticipate the need for breaks, further preparation, or modified approaches in addition to offering choices to foster patient and family participation.
Children receiving palliative care or hospice services often experience increased distress related to caregiver stress, lack of understanding, and fear of pain or the unknown. Through developmentally appropriate explanations and creative interventions, a child life specialist is able to help children express their concerns in a safe and supportive environment, while developing methods of expressing and coping with stress.
Facilitate Therapeutic Medical Play
Play is the universal language of childhood, and children of all ages, developmental levels, and stages of illness have an innate need to play. Play helps to normalize the health care experience, and has been shown to reduce children’s emotional distress. Child life specialists will tailor play activities to the unique needs of each child, based on their interests, physical ability, medical condition and developmental level.
When allowed to play freely and without judgement, a child’s play often imitates real life while allowing children to express their concerns without words. Child life specialists can help to interpret themes observed in play, and provide necessary guidance to help children develop mastery over their experiences, or diffuse misconceptions that may be evident through play. Even a simple card game can open the doors for a child to begin sharing emotional experiences with a trusted child life specialist.
Provide Emotional Support for the Whole Family
An important component of child life services involves the presence and participation of family members throughout the healthcare process. When caregivers or family members display signs of stress, frustration and anxiety, those feelings can be perceived by the child and affect how they approach medical staff and clinical treatments. When guided through these difficult emotions, family members can learn to express their emotions in a way that gives permission for the patient to express their very real, and difficult emotions. With the intention of protecting their child, many adults hide their difficult emotions, which can result in children feeling shameful or fearful of their own emotions. Families who are able to balance the expression of challenging emotions with periods of calm, patience, and optimism can have a positive impact on the child’s adjustment to the healthcare experience, and their comfort in sharing their emotions with trusted caregivers.
Child life specialists work to ensure that caregivers are included into the psychosocial care plan, and help to provide support to family members, referring for additional support when needed. Child life specialists can provide caregivers with strategies for comforting their child throughout the healthcare experience, and promote child-centered play opportunities between the patient and caregivers.
Siblings experience unique fears and stressors related to a sibling’s illness and caregivers attention to their sibling. A child life specialist can work individually with siblings to aid in understanding, coping, resilience and involvement while developing skills to cope with anxiety and stress. Sibling involvement and support is largely important in the treatment of the family as a whole.
Legacy Building and End of Life Care
While many children receiving palliative or hospice care services can recover from their illness and graduate from palliative care services, there are children who receive palliative or hospice services when medical treatments are no longer effective in treating the illness.
Child life specialists are uniquely skilled in partnering with the patient and family in order to provide memorable and meaningful experiences and tangible legacy items. The concept of death is complicated and often confusing for children. A child life specialist can assess the family’s beliefs and wishes in order to help the patient and other children to understand concepts related to death and dying. This understanding can be hugely important in allowing the patient to express fears and develop their own wishes, and can help siblings prepare for the emotions that may arise as they witness the decline of their brother or sister.
Contact KidsCare of the Rockies Today
We hope this informative article has helped you understand the vital role child life services play in the palliative care process. Contact KidsCare of the Rockies today to learn more about our child life specialists and how they can provide excellent support to your to your child and family.