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Filling Gaps in Service: What Child Life Work Looks Like in a Private Practice

For some people it can be hard to imagine what the role of a Certified Child Life Specialist might look like outside of a traditional hospital based setting. Many hospital child life programs take years to develop and become fully integrated into the healthcare team. 

Collaboration between medical providers, education, training, and funding are just a few obstacles that programs face. Despite obstacles, programs strengthen and continue to expand, providing a greater awareness of the role of a child life specialist within the hospital walls.

So how can a specialist make it work in a private practice without the support of hospital infrastructure? Can a practitioner be financially independent outside the hospital construct? What does their daily schedule look like? How can their professional identity adapt to such a change?

Meet two specialists, Morgan Livingstone and Shani Thornton that have entered the private practice world on a very different journey. Both practices are unique and impactful in their community.

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Morgan Livingstone, a Canadian based CCLS has had a successful private practice for over 15 years which she started after years of working in a hospital-based child life program. Morgan has always remained focused on her identity as a CCLS providing direct clinical child life sessions to young patients in their homes, and takes direct referrals from medical professionals she has worked with in hospitals, hospices, institutions and programs. Patient populations are wide ranging, from pediatric oncology and palliative care, to Traumatic Brain Injury, to children of maternal breast cancer patients. Morgan has a diverse caseload making everyday an adventure. The beauty of her private practice is that Morgan is able to devote more time to each patient and family she works with by offering 2 hour long sessions, allowing for greater exploration of all traditional child life activities including medical play and preparation, assessment of overall coping and the feelings and fears related to the child’s medical experience. Through hard work and determination, Morgan has been successful in working directly with insurance companies to best support trauma patients needs in the community.

Beyond direct patient supports, Morgan works with many charities to extend child life supports and strategies to reach more children and families around the world. As the Child Life Director of World Eye Cancer hope for over 13 years, she has worked with medical teams around the world to improve the experiences of young retinoblastoma patients, and helped build a locally sustainable clinical Child Life program in Eldoret, Kenya at the Shoe4Africa pediatric hospital within Moi Teaching and Referral Hospital, a large public hospital. Through year round clinical supervision and annual training, Morgan is proud to have worked with the ACLP in bringing the Child Life Certification Exam to Kenya where there are now 2 Certified Child Life Specialists!

Morgan’s passion for supporting children when Mom has been diagnosed with breast cancer led her to work closely with the charity Rethink Breast Cancer to write and publish a handbook for parents about how to talk to their children about breast cancer. At Rethink, Morgan also offered annual fun-filled 8 week long group support programming to children and their caregivers, and collaborated on the creation of 5 child-focused animated videos about breast cancer. This partnership continues as Morgan prepares a new handbook about Metastatic Breast Cancer.


The booklet is available online for free; Talking To Your Kids About Breast Cancer 

The series includes the following animated videos:


Shani Thornton, a CCLS for 14 years, took the leap to start a private practice five years ago while living in the New York City area. She has recently relocated to Northern California, where she is relaunching her client based child life services.

Her journey to private practice began to organically evolve after she created a website and blog for parents and medical providers called; ChildLifeMommy.com. Her professional identity had to change when she made the decision to stay at home to care for her two young boys, but still be an active specialist in the community. Her website gave her the opportunity to educate others on the child life profession, providing resources for parents and collaborate with local and global organizations.

One thing that stood out to her as both a parent and specialist were the limited reading resources to prepare children and families for a wellness visit. She immediately teamed up with a local pediatrician and self published, It’s Time For Your Checkup What To Expect When Going to a Doctor Visit. Her goal for the book wasn’t to make money, but instead to have a tool that parents and providers could utilize.

"It's Time For Your Checkup" by Shani Thornton, MS, CCLS

Just like child life specialists in a hospital-based setting take on new projects when they see a need, Shani did the same in the community. She began to lead parent education workshops that gave her audience tools to use at home or in a clinical setting. She covered information on the role of a CCLS, advocacy, play techniques, coping strategies and support. She also provided presentations to colleagues at local and regional child life conferences.

The workshops and conferences lead to referrals for in-home child life services. Some of the populations that she has worked with are clients coping with a chronic illness, procedural preparation and bereavement.


A mother reached out to Shani when she saw her business pamphlet advertised at a local dentist’s office. Her eleven year old daughter, Candice (pseudonym) was diagnosed with Crohn’s disease and juvenile arthritis. She explained that Candice had been struggling with weekly injections of medication, feeling isolated from school peers and fighting with her parents over her medication regimen.

Shani provided weekly 60 minute sessions with Candice over a four-month period. Sessions included medical education and play, creative art modalities, increased coping and advocacy strategies, parent education and anger related play techniques. She connected with a few organizations; Digging Deep Journal and Project Sunshine to provide some of the materials used in the sessions. She also referred Candice to Team IMPACT, where she was accepted as a new teammate for a local college women’s basketball team. Shani, Candice and her family were able to participate in the meet and greet of her new team mates and mentors.

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Working in a private practice setting can feel very isolating. Child life specialists need to feel supported by colleagues in similar settings. Both Morgan and Shani use a variety of methods to stay within the ethical boundaries of a CCLS and receive constructive feedback. They are active ACLP committee members, regular presenters at the annual conference, remain engaged with colleagues on the ACLP forum, provide and receive supervision and attend networking sessions for child life specialists in a community based setting. Participating in local and regional child life groups as well as large child life conferences can help combat feelings of isolation, and strengthen relationships great collaborations with other child life colleagues.

Beyond child life, private practitioners can foster relationships with greater medical team members through participation on health-related committees, research and strategy groups. By nurturing these connections you create pathways for increased awareness of your child life work and potential referral sources.

ACLP Community Based Retreat

ACLP Involvement:

Recently, the ACLP Committee for Community Based Non-Traditional Roles met in Austin, Texas for a work retreat. We worked incredibly hard to create proposals for the ACLP Board on how to best serve children and families in the community and in non-traditional roles within the hospital. Stay informed on the ACLP Community for further developments.

Be sure to listen to the podcast from Jen Lipsey, CEO and Bailey Kasten, COO on their discussion of the community based work retreat and the strategic plan.

***Added Information from initial post

Please keep in mind that if you are considering starting a practice, that you need to think about the logistics and ethical components. For example, there should be a business model, you should have supervision, obtain liability insurance, and have a foundation of previous work experience under a CCLS in a clinical setting. Going into private practice is rewarding with filling a large gap in service, however as a professional you need to be mindful of your skill set, scope of practice, and representing the profession with high ethical standards and boundaries.

Additional Resources


ACLP Position Statement on Child Life Practice in Community Settings 

ACLP Standards and Guideline for Child Life Practice in Community Based

ACLP Summer Bulletin: Filling Gaps in Service: What is The Identity of a Child Life Specialist in Private Practice?

How to Help Kids Cope with Their Mom’s Breast Cancer

Serving Our Community: Child Life in Private Practice


Wonders & Worries Webchat: Setting Your Program up for Success

The Continuum of Care: Providing Child Life Service in the Community 

Breaking The Mold: Child Life Specialists Working in Community Based Programs


ACLP Episode 6- Child Life Setting and Focus 

Child Life on Call: Shani’s Story of Child Life Mommy

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