Music and creative opportunities in healthcare.

During a hospital or visit to a healthcare setting the senses can often take a major hit- and not always with a positive impact.
If we take a moment to visualise a setting such as a hospital our senses will be required to take a high level hit -stimulation overload in order to separate and work out what is a threat and what isn't.
The announcements, the buzzers, the people, the smell, the lights and that is before a department is reached.

For children and young people what they see, hear, smell and feel impacts on how they respond and react.

The Playroom- a colourful and non clinical space- complete with musicians can immediately minimize the fear of what a children's ward feels like.

The coloured window decorations are plastic strips- curtains from IKEA!

(so easy to clean)

(Christmas 2015 Music in Hospitals Concert) 

The environment plays a vital role in how we provide and facilitate healthcare, and what we do to that environment needs careful consideration.

Working with children and young people it is important that their needs are met, and this requires their voices to be heard in order to deliver, not what we think looks great, but what actually fulfils their need.

It is tricky- adhering to trust policies and infection control guidelines is a must- but it can be done and achieved if the whole team is involved.
Research and evidence shows us that the least amount of trauma children and young people experience in-between clinical interventions - the better in terms of recovery and well-being.

We know that staying calm, relaxed, and having the opportunity to experience joy and laughter allows the body to produce increased amounts of serotonin which regulates mood and increases happiness - even for just short moments.
This has a major impact in the way children, young people and their families react and cope with periods of time in hospital.

Music and the creative arts is another way we can enhance an environment- opportunity to paint, draw, sing, dance, make music, tell stories and be a bit silly- have moments of stillness and of relaxation- allows them to break down sterile boundaries- creates a calm environment and provides children and young people a space to explore, create, and have a voice.

There are many charities and organisations that can support this type of play and exploration within a clinical setting.

www.createarts.org.uk

Create uses the creative arts to transform lives, there priority groups are carers, children in hospital, older people and people with additional needs and disabilities.

www.musicinhospitals.org.uk

To improve the quality of life for adults and children with all kinds of illness and disability.

Further reading-

Exploring the impact environments have on children and young people's experience of healthcare: a review of literature - Alison Tonkin

www.hpset.org.uk/environmentsofcare2015.html

Copyright- Sian Spencer-Little Dec 2016.

The Power of Metaphor.

What is a metaphor, is it something that is provided to make things up, to avoid talking about worries or concerns, can a metaphor really open up a time and space where exploration of emotions can happen?

Metaphor can be  a word or phrase that is used to describe a object or an action, an emblem, to paint a picture or create an image.
Some children and young people use the work of metaphor as it offers a visual description of a thought, feeling or action- with the focus being shifted away from talking about deep feelings, or events that have impacted their lives.

When I started working alongside children and young people using metaphor  felt clumsy at times, I struggled with finding the right language and when I did, my responses felt like I had adopted some new dialect that only made sense to me, so it took a lot of practise, reading, learning and observing others using metaphor to find its natural place in my work,  to the support I can offer children, and young people coming into hospital and those living with a long term and life changing health condition.

Using the medium of play and specialised distraction with children and young people lays a platform for using different techniques and skills, it is something that requires training, and mentoring, and time.

Working in metaphor using play gives children and young people the space and tool to create and work through an unknown thought,  using metaphor allows them to name the thought, then it can be explored, it can be felt, and it can be held safely, and acknowledged.

Often children and young people store and bury feelings that are so powerful, they just don't know what to do, what to say or how to be.

Spending time with children and young people allows you to gain a snap shot of their lives, and if they give permission and invite you in, play and metaphor is a powerful tool and skill to have, but as always the right level of training and practise - and care should be gained first, this is a skill that requires specific training, working in metaphor is powerful and shouldn't be under estimated.

Children and young people use metaphor a great deal when trying to describe an event or emotion that is just too painful to say out loud, using metaphor removes the attention from them, and allows them to communicate in another way.

Here are some examples.

" Its like this you see, a straw works really well with water, but if you put it in milkshake or it gets blocked, nothing moves, and when the straw is used, nothing happens, everything is blocked, full up, doesn't work"

An example of a description from a child who tried everything to tell others that she was sad and anxious and worried - but she just couldn't find the words, she was fed up and she was too full up of worry and uncertainty, why does the bad thing happen to me.

"There was this thing and it had fallen out of a suitcase, it tried so hard to get back in but the suitcase was so full up and heavy that it just couldn't find a place to hide anymore"

"There was a spaceman and he was attached to the rocket by a long elastic band, one night while he was out exploring space, the elastic band snapped, and he floated away from the rocket, and he just kept floating and floating, lost, and alone"

A young person full up with hospital appointments, so many that her life consisted of nothing else.

Using specialised play opportunities allows the child or young person the option of sharing in a way where the attention isn't solely on them- they feel slightly removed, but if metaphor is introduced - exploration and testing of the waters takes place- as a practitioner my role is to hold and keep safe the experience and narrative, offering creative resources to enhance the experience how ever tricky that might be.

Weather and the range of powers it has is often used as a metaphor to describe the inner fear and upset being experienced, and the pressure of keeping everything alive.

Further Reading

• Creative Metaphors of life experiences seen in Play Therapy www.counselling.org
• Using therapy stories and Metaphor in child and family treatment www.lianalowenstein.com
• Using storytelling as a therapeutic tool with children - By Margot Sunderland

Training and courses

There are many places to undertake further study and training, I have done the bulk of mine here.

Centre for Child Mental Heath- www.childmentalhealthcentre.org

@CCMH_London

Sian Spencer-Little

Copyright 2016.