In a collaboration with Emily Murray, CCLS from Heal, Play, Love we decided to talk about a population of patients that can be bit more challenging to work with at times; adolescents. Emily has written about the development piece, which gives us the foundation of understanding what their body is going through. Click here to check out her post.
In this piece, I will be focusing on how to build a therapeutic relationship and offer both individual and group interventions.
Child life specialists are trained to work with children from infancy to early adulthood. However, some specialists may feel that certain age groups are more challenging to work with than others. Adolescents are an incredibly fun and amazing, but sometimes specialists feel intimidated or unsure on how to interact with this age group.
Here are a few tips in therapeutic interventions with teens.
Build Rapport– With any age group you have to build rapport in order to establish a trusting relationship. It is easy to bring in a toy and start playing with a younger child. Adolescents are really no different. Instead of bringing in a toy, bring in teen magazines, video games or a deck of Uno cards to start-up a conversation. Adolescents are typically into hanging out with peers, pop culture, music, sports, school, relationships and preparing for their future. There is a variety of topics that can start-up a conversation about who they are and what they are interested in. Be yourself, go with your gut and talk to them as you would talk to another adult. They will feel more connected with you if you are coming from a genuine, honest and accepting place.
Advocacy and Empowerment– Adolescents want to be included in their medical care, as any child should be. The questions, concerns and treatments should be directed to them, not their caregivers. They are going through the medical experience and should have a voice in their care. Child life specialists can help model this to their family members and medical team by talking with the patient directly. Validating and normalizing their thoughts and feelings to help them feel safe and confident to speak up.
Obviously, you need to speak with the caregivers on the side about what information they want their child to know and be respectful of that. If they choose to withhold medical information from their child, you can help to educate the caregivers on how that can cause mistrust and increase the patient’s anxiety. Hopefully the rapport built with the family will guide them into including their child, but as a professional following family centered care, you have to be obliged by the caregiver’s decision.
Story Telling– As they go through the Identity vs. Role Confusion stage, narrative writing or scrapbooking is an outlet to let them share their story of who they are, how they perceive themselves and how they want to be perceived. Writing can be cathartic and way for them to process their experience and build resiliency.
Photographing their hospitalization is a way to document what they went through and will give them a concrete image to reflect on. Photos could be of their treatment, surgeries, medication, scars and rehabilitation. It could also include their hospital community; staff, friends, family and fellow patients. Adolescents can explore layers of emotions in this type of intervention and have the choice in sharing it with others or keeping it private.
Art Modalities– Using a three-dimensional art piece, such as a blank mask or box is an excellent way to encourage a patient to explore their feelings and express them creatively. Masks and boxes can be used as a metaphor on revealing what people see on the outside and how one feels on the inside. There are other therapeutic angles that could be used for this type of activity. Offer a variety of art materials to decorate their piece or take it a step further by making a personal mold of their face with casting material.
Strengthening Their Voice– Helping them to find their voice and encouraging them to speak up and advocate for themselves is a life long tool that they will use. Providing them with a notepad and pen to write down questions and concerns and then voicing them to the right people (parents, doctors) is a simple intervention. They can also build their communication skills by interviewing medical team members, fellow patients and family about their knowledge and role that they play in the patient’s treatment plan.
Social Media- With the permission of the caregivers, child life specialists can help a teen create a social media page to share their story, stay connected to friends and family and make new connections with other peers with similar medical needs. This can help them gain mastery over their experience and feel empowered to help others.
Teen Room/Group– Having a specific room or meet up time for just the adolescents on the unit is a great way to encourage peer socialization and bring a sense of normalcy. Having activities organized with outside food (if possible) is an easy way to encourage them to leave their rooms and hang out with other patients their age.
Mural Making– Collaborating as a group to create a mural, encourages them to work together or at least work next to one another on a project. There could be a themed discussed and then explored with art materials on the mural. This will help build self-esteem, problem solving and bring a sense of comrade to the patients.
Playing Together– Video games, board games and a deck of cards are all ways to encourage peers to hang out and play together. You can make it a competitive with the winner moving to the next bracket or receiving small rewards of a trophy, certificate or medal. Teens want to hang out with friends and have fun. This type of activity is a good starting point to make a connection with someone going through a similar experience as themselves. Often times teens will begin to open up and talk about their hospital experience over a game of Monopoly.
Music Video– This is a fun activity that adolescents can play different roles in. It could be to create a new song, change the lyric of a current one or lip synch to an empowering tune. Teens can choose to be on camera, create props, choreograph moves, design the backdrop, help film, edit and plan a screening event of the video. They can work together as a team, strengthening their social skills, forming friendships, and feeling empowered by what they put together. Plus it could be something posted on social media to bring an awareness to their illness or place of treatment.
We would love to hear your feedback on working with teens. Have you tried some of these interventions before? Have you used something different that worked?
A recent transplant to the Bay Area, Emily Murray graduated from Bank Street College’s child life master’s program in 2011, and went on to start the child life department at Harlem Hospital Center in New York City. She saw first-hand how the simple ideas practiced by skillful child life specialists, can be put into practice to powerfully impact on a child’s experience of the hospital, and of healthcare in general. Now that she is no longer practicing in a hospital setting, she hopes to bring the skills, tricks, and tips she learned there to a wider audience, and help more children and families.