Author: debvilasconsult

Our True North

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I have not blogged in almost two years. The everyday stress of the Pandemic coupled with work and personal obligations have siphoned much of my creative energy. But I feel called upon today to use my voice and my blogging platform to address something that we all need to talk about. I have heard through the social media grapevine that some child life specialists are asking for CCLS silence on social media regarding “political posts”, specifically in response to the overturning of Roe vs. Wade by the Supreme Court last week. I am here to say that as healthcare advocates, we owe it to our profession and to our patients and families to engage in these hardest of conversations. If we don’t, we will stay in our own opposite corners and lessen the possibility of joint intersubjectivity, learning, understanding, and ability to meet the needs of the children and families in our care.

In order to do this peaceably and professionally, we can keep these guidelines in mind:

  • Speak from an “I” place of sharing your beliefs and opinions.
  • Avoid “You” statements.
  • Seek to understand more than to be understood.
  • Avoid any and all vitriol (Telling people to shut up, step down, calling people names).
  • Speak with a gentle understanding that there are many viewpoints and beliefs and values that differ from yours.
  • No opinions are ever changed by shouting someone down and insulting them.
  • Start from the assumption that everyone in the room cares about the health of children and families.
  • Be accountable for your words – posting anonymously makes it more likely that you will not edit yourself and use your anonymity to shout someone down.
  • Be aware of your level of privilege, and the impact it may have on your audience.
  • Use your social media platform to make a safe space for conversation – @ChildLifeTherapy does this in a wonderful way on Instagram.
  • Understand that religious values that guide opinions are deep and sacred things that vary hugely in how they define the beginning of life.
  • Do regular check-ins with yourself to see if you are following your own True North, and helping others do the same.

Fact: The JUNE 24, 2022 DOBBS V. JACKSON WOMEN’S HEALTH ORGANIZATION decision will negatively affect access to life-saving healthcare for many women and girls, with the intersection of race, age, and poverty putting our less privileged and oppressed populations at the highest risk for mortality.

Questions to consider:

  • What does this mean for child life specialists who care for children and families in hospitals each and every day?
  • What does this mean for child life specialists who celebrate the overturning?
  • What does it mean for those specialists who rage against it?
  • How can we find common ground to ensure that we are fulfilling our ethical responsibilities to our patients (and colleagues)?
  • What do our competencies tell us about our ethical duties to all patients?
  • What extra training and support might we need to fulfill our duties in serving patients and families impacted by the change in healthcare access?
  • How do we manage our personal fears about our own bodies and access to healthcare?
  • How do we serve patients and families who have different religious, political, and personal beliefs and values than we do?
  • What is your True North and how do you balance it with serving patients and families?
  • Add your own many questions here……………

These questions can keep us on the right path. This path is new and daunting to most of us, but these conversations are the same ones we have always had as a profession about race, LGBTQ+ issues, immigration issues, and culturally-informed, trauma-informed care. We may need to stretch ourselves, but we have the built-in elastic with which to do this! More bifurcation and strife will not make us better providers.

In the words of Mother Theresa:

Lead me from Death to Life, from Falsehood to Truth.

Lead me from Despair to Hope, from Fear to Trust.

Lead me from Hate to Love, from War to Peace.

Let Peace fill our Heart, our World, our Universe.    

Peace    Peace    Peace

Home Away from Home

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How often is it in life that we truly feel at home in a place other than our own home? What are the ingredients that allow us to feel comfortable in our own skin, undefended, and at ease?

I seem to have stumbled upon many of these intangibles as I return for the seventh time in five years to the Czech Republic. Ostensibly I come here for work – collaborating with the Klicek Foundation to grow hospital play work in their country. We travel to various cities and venues, giving lectures to students and professionals of medicine, nursing, social work, psychology, and play work about the philosophy and logistics of providing humane, family-centered care to children and families facing medical treatment. I join them in the summertime to volunteer in their hospice summer camp.  But what happens here is so much more than work.

With each visit comes an immersion in the Czech culture, and more specifically, the culture of the family who sponsor my visits. In between travel and lectures, we gather at their hospice and home in the tiny village of Malejovice, about 40 kilometers southeast of Prague in the Bohemian countryside. Here in a century old schoolhouse on a small farm (replete with donkey, sheep, chickens, many cats and a dog), the Kralovitzes welcome children and families who seek respite and comfort from lives affected by illness, disability, and loss. It is not a hospice in the way most of us would imagine. It is neither a medical facility nor a place where children go to die. Rather, it is a retreat where individual children or the whole family can relax in a natural environment, receiving nurturing in the form of companionship, a warm and caring listening ear, opportunities for play and exploration of the surrounding fields, forrests, orchards and gardens, and astoundingly good and healthy food. One falls asleep to the quiet darkness of the countryside and awakens to the bray of the donkey. It is, quite simply, magic.

Daily outings to local farmers and vendors, for cabbage, potatoes, apples, bread, butter and other essentials are interspersed with visits to hospitalized children and home visits to grieving families in neighboring towns and cities. No trip seems too far if someone can be served. This past weekend, my hosts drove a six hour round trip journey so that a teen could enjoy a visit to the hospice following a hospital discharge post heart- transplant.

Over the past five years, I have joined the family in celebration of the anniversary of the Velvet Revolution, decorated Christmas gingerbread cookies, accompanied them to church, fetched water with them from a natural spring, traveled with a theater troop visiting holy places throughout the country, played with Roma children in their neighborhood, and viewed many monuments such as the sculpture memorializing  the children of Lidice, murdered during World War II,  and the sculpture honoring Jan Palach, the young man who set himself on fire in martyrdom in Wenceslas Square during the Velvet Revolution. We have traveled to the far corners of the Republic, and visited neighboring Poland and Austria. With each visit, Marketa draws up a map and schedule to help orient me. 

We have explored curriculum, translated documents, done voiceovers for video, co-presented at global conferences, met with political leaders, and have appeared on local Czech TV.  We have driven countless hours in cars, vans and their iconic 1950’s bus, stopping for never-ending errands and house calls.  We have shared life stories, played music, laughed and cried (Well — I’VE cried!) and sat talking by the fireplace late into the night. 

And so perhaps this is the secret ingredient, the simple yet rare experience of being included in everyday family life while pursuing a shared vision, that ill children and families everywhere might feel witnessed and safe. What we wish for them is what I end up experiencing in a profound way.

Undo Racism Every Day: Exclusive Interview with Children’s Author Anastasia Higginbotham

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ANASTASIA HIGGINBOTHAM has written a courageous children’s book that seeks to dismantle institutionalized racism and white supremacy, one conversation and action at a time. Not My Idea: A Book About Whiteness  challenges adults to face their own discomfort and biases in order to validate the truths that children intuit. In this exclusive interview, Anastasia discusses her process of expanding her world view and becoming a disruptor of the very best kind.

Deb: “What prompted you to write this important book?”

My answer is a who and a what. Who inspired me were Black women: Noleca Anderson Radway, Brooklyn Free School Executive Director; Reverend angel Kyodo williams, Zen priest and co-author of Radical Dharma: Talking Race, Love, and Liberation; and Anyanwu Uwa, The Human Root Co-Founder and Executive Director. Noleca made me see white power in action and in myself; Rev. Angel dared me to connect with my deepest conditioning into whiteness and grow from a place of heartbreak; Anyanwu insisted I view myself as worthy. What inspired me is everything that the Black Lives Matter movement shows us about state-sanctioned murders of Black women, men, trans people and kids by police, plus no accountability for those crimes and new ones committed against the BLM activists themselves. Continue reading →

Kenya Child Life Program Spotlight Continues: Liz Kabuthi

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Liz Kabuthi prepares children for surgery using a book of photos

Last week, I spotlighted the work of Child Life Specialist Jayne Kamau at the Sallie Test Pediatric Centre at Moi Teaching and Referral Hospital in Kenya. This sustainable Child Life program is one of a kind in East Africa. The Child Life staff and founder Morgan Livingstone are especially proud  this year to be working with Courtney Moreland of  Child Life United to offer child life practicums in Kenya.

This week, we hear from Liz Kabuthi, who I had the pleasure of meeting when she represented her country as a delegate at the Child Life Council International Summit on Pediatric Psychosocial Care in 2014. Her reflections on her child life journey and work are deeply moving, and give us a glimpse at how this profession influences and betters our lives even outside of the actual hospital work. Continue reading →

Sustainable Child Life Services in Kenya

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The Sally Test Pediatric Centre in Kenya is proud to have the first sustainable child life program in East Africa. By sustainable, I mean that rather than mission-based services that come and go, it is staffed by citizens of Kenya who have obtained child life certification through the Association of Child Life Professionals (ACLP). Morgan Livingstone of Toronto, Canada, saw the need of such services and has worked tirelessly over the years to train and support the staff at Sally Test.

Over the next several blogs I am spotlighting the work of the child life specialists in Kenya. The team has faced many challenges in becoming child life specialists, and they are doing extraordinary work to humanize medical treatment for children and families in their care. A special thank you to Morgan Livingstone and the Sally Test Child Life team for taking the time to answer my interview questions and send along great photos.

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Jayne Kamau

 WHAT INSPIRED YOU TO BE A CHILD LIFE SPECIALIST?

I had worked in pediatrics unit as a social worker and was so comfortable and passionate with the children and their families. I had not heard about the Child Life profession until when Morgan Livingstone (CCLS Canada) came to Kenya for a one day workshop and introduced the concept of Child Life. An interest was triggered there and then and my mind and heart were in agreement that this profession though new to me was what I wanted to do. I started doing my own research about the profession and what qualification was needed to become a certified child life specialist.  So when the program was set up in our hospital and people were called for interview, I was among the very first to apply and now here I am. Continue reading →

Cooperative Play in Nature at Camp Klicek, Czech Republic

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the volunteers!

Photo credit: Jiří Královec

(Thanks to Jiří Královec for many of the photos! The best ones are his and noted beneath each photo. The rest are my amateur work.)

At Camp Klicek in the Czech Republic, a place where children and adults affected by illness and loss gather, activities run the gamut from a tiddlywinks tournament to bussing campers to a Shakespearean play.  The Accace Corporation provides tax advice to the foundation during the year, but they look forward to visiting the camp in person to have fun with the children and families each summer. This July, a fabulous group of volunteers  arrived with a day full of activities to engage us all. Their choices promoted creativity and cooperation amongst the campers, and nature threaded its way through the day’s activities. The volunteers brought their A game to the endeavor – with wonderful materials and activities – but more than anything, they brought their hearts. Continue reading →

Making Hospitals More Hospitable with The Tongue Depressor Challenge

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My colleague, child life specialist Jon Luongo, is one of the most playful professionals that I have the pleasure of knowing. He taught me all about the “tongue depressor challenge”, which is described in detail in our co-authored chapter in the Handbook of Medical Play Therapy and Child Life.  Below is a brief introduction to the activity by Jon:

I encourage the doctors to tap into their imaginative playfulness to complete what I call the ‘tongue depressor challenge.’ The task is to co-construct a teaching tool alongside a patient to explain a part of the body, a particular medical condition, or piece of medical hardware. The challenge for doctor and patient is to use at least one tongue depressor in their design; like a single LEGO brick in a set of construction toys, the tongue depressor represents a humble piece of medical paraphernalia with limitless creative building potential.

 

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As with many great ideas, I borrowed Jon’s and tweaked it a bit. This past July, I brought the activity with me to the Klicek Foundation Summer Camp in Malejovice, Czech Republic. Camp directors Jiri and Marketa Královcovi graciously allowed me to lead the campers in a slight variation on Jon’s theme. Continue reading →

Children Ponder Good & Evil at Camp Klicek

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We are all capable of good and evil.  People do bad things – sometimes they make mistakes that cause harm unwittingly. Sometimes they hurt others purposefully. Sometimes, doing nothing causes more pain for others than we can possibly imagine. At Camp Klicek in Malejovice, Czech Republic, founders Jiri and Marketa Královcovi make room for children to discuss and think about tough issues. They want kids in their care to be more than followers and simplistic thinkers, to see the humanity in everyone and the possibility that although conflict might be inevitable when a large group of people gather, people can make mistakes and still not be bad people.

And so, on one bright summer morning, following a hearty breakfast of porridge, bread, tomatoes, peppers, tea and hot carob with milk, the adults at camp led the children in an activity that reverberated throughout the week. The children gathered in small groups by age bracket. Some sat in the meadow, some under the mess tent, others in the courtyard. With adult guidance, they contemplated these questions:

  • What are bad or evils things?
  • Why do people do them?
  • What can be done about it?

The children took the assignment seriously, taking notes and including the voices of all. I moved amongst the groups, catching a snippet here and there from a kind translator. The children mentioned everything from the past and present atrocities of the world to the more mundane, including genocide, torture, terrorism and bullying on their lists. The youngest camper, when asked why people do bad things, answered, “Because they don’t love each other.”

At the end of the small group conversations, each group reported out to the whole camp, as we sat in the shade of the mess tent and processed together. The discussions were the scaffolding for the real fun. The next step of this activity involved each group choosing one of their examples, writing a play script to demonstrate the concept, and videotaping the enactment. The kids were deeply involved in this process throughout the day, and that night, they set up an outdoor theater in the courtyard, complete with a movie screen, the moon shining down upon us, and homemade apple strudel made from the summer apples, the Klicek version of popcorn. We smacked our lips and licked our fingers as we watched the completed movies, along with some movies created in past years.

My favorite play depicted two different families heading off to summer camp.  One family had no luggage or sleeping bags, just the clothes on their backs. The mother handed her children 10 crowns apiece and kissed them goodbye. The other family stood in front of a Mercedes Benz with their fancy clothes, belongings, cell phones, and the mother dolling out hundreds of crowns to each child. The scenario played out with the rich kids arriving at camp, immediately making fun of the poor kids, an act of kindness when one of them falls down and the other helps them up, and all of the kids ending up playing a game of football (soccer in the US) together.

A simple message, but one not lost on any of us. The campers did indeed come from a variety of backgrounds, and would probably not be interacting at school or in social circles outside of this camp environment. When I think of acts of evil, I think about how we create separation by dehumanizing people who we label as “other.” It is harder to keep these stereotypes and misconceptions in place when we wake, sing, break bread, play, and rest our heads together in the same teepee. I saw many acts of kindness each day between campers, whether it was an older child helping another child navigate steep steps, the hard work of the volunteers in our kitchen, or folks pitching in to help a teen search for her lost eyeglasses.

The thoughtful planning applied to activities that built community astounded me. Along with a mess kit and clothes, the camp packing list asked each child and adult to bring a glass jar with a lid to camp. The campers decorated these jars with their names and artwork, and hung them by ribbons on the branch of a low tree in the meadow behind the house. They left messages of appreciation in each jar, to adults and kids alike throughout the weeks. At the end of camp, they each took their jar with them, with strict instructions to hold off on opening it until they had arrived home. Marketa said that this is a concrete way to further the bonds created at camp. “Some of these children are isolated because of their illnesses. These jars and their notes are a lifeline for them throughout the year.”

My jar sits on my desk at home and reminds me of the generosity of spirit that children share so willingly. I can see why these campers return year after year to the meadow, the tree and the love.

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Camp Klicek: A Dose of Nature and the Universal Language of Play

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I remember the endless swath of time that summer brought when I was a young child. Unstructured free time in nature, with neighborhood kids, and my family. I also played alone, exploring the back roads on my bike and the woods on foot. At the age of seven, I would be gone for hours, playing in brooks, creating forts under the shelter of giant boulders, climbing trees, making up stories in my head, and writing poetry.

These days, we are hard put to find children at play in this kind of open-ended, unsupervised milieu. Their play is planned, highly structured by adults, and often close-ended. When left to their own devices, kids often choose tablets, smart phones and video games as their go to. Child life specialists and hospital play specialists know the value of deep, open-ended play that encourages self-expression, exploration, self-regulation, social development, and problem solving. My friends at the Klicek Foundation in the Czech Republic provide these play opportunities at their summer camp for children and families affected by illness and loss. This year, they invited me to partake in a unique camp experience, and I immersed myself in the healing environment of Camp Klicek, which has been in operation since 1992.

 

Children after a long-term therapy (and sometimes even patients under treatment, if their health allows it) take part in the camp, as well as their friends, siblings, parents and pets. Several bereaved families come too.

Our camp activities began as an attempt to offer a two-week stay in beautiful natural surrounding also to those children who couldn’t participate in a “normal” summer camp. We have always tried to create a friendly, open-hearted and open-minded atmosphere in our camps, and we hope that the camp program gives its participants enough opportunities to have fun, to do some useful work, to talk about things that are important to them, to simply be with friends.

The camp games and plays (mostly non-competitive) follow the make-believe story of a man who decided to spend some time with nature and is thus confronted with new situations and thoughts and starts to meditate on his own life and on the civilization he lives in.

Children live in big Indian “tee-pee” tents which are able to accommodate up to six inhabitants and have a fireplace inside.

Since 2000, we organize our camps on a meadow just behind the respite hospice building at Malejovice – thanks to this, children whose condition requires special attention can also participate in the camp program, backed by the safe environment of our house.

 

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Indeed, I found myself amidst a remarkable mix of campers and staff, a combination of people and circumstances that is hard to imagine anywhere else. The youngest camper was seven years of age, the oldest, twenty. The children’s diagnoses differed significantly, as did their abilities, disabilities, ethnic and socio-economic backgrounds. There were children undergoing treatment, survivors of serious illness, siblings, friends, parents, and bereaved parents who had lost a child. The camp leaders, Jiri and Marketa, are purposeful in their choice to bring children and adults together where they might not otherwise interact in larger society. Watching connections form between the campers and staff of varied backgrounds was a blessing on so many levels.

The focus of our days involved living in nature, eating good, healthy food, exploring tough topics such as “What is evil?” and “How can we make the hospital experience more pleasant?”, and above all, building community. The virtual lack of technology at camp was so refreshing. I felt myself detoxing from my smartphone addiction as I wrapped myself in nature, old fashioned, simple play, and grand company.

Many friends have asked me what it was like for me to be surrounded by children who spoke Czech. Did I learn any Czech? How did I communicate with them? Well, I was immersed in a foreign language – of that there is no doubt. Most children spoke no more than a few words or phrases in English, and my Czech is abysmal. But the children understand more English than they speak, and play is a universal language.  The children’s welcoming of me was profound, inviting me into play, making me feel immediately part of the group. “Frisbee?” “Will you play?” “Come play football.” “Ping pong?” “Draw.” Once engaged in a game or project, there was much good will and laughter as we all tried our best to communicate.

I too, grew my Czech vocabulary one word and gesture at a time. I made it my goal over the week to learn everyone’s name – a challenging feat with names that were not familiar to me.  But with each name and greeting, I could see the rapport growing, the shy kids responding, the teens warming. Some of my favorite moments were when I would board the 1970’s retro bus for a field trip, and a kid would smile at me and pat the seat beside them to show they’d been saving it for me. Or that wonderful moment, when the quietest camper, one who spent much time alone and looked down or sideways rather than meeting your gaze, took my hand as I stepped off the bus and walked quietly with me to our destination.

It’s the small stuff, really.

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Children berry picking on a picnic in Czech countryside

 

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Klicek Foundation cofounder Marketa leading us in a trivia game in the camp’s mess tent, where we ate all of our meals.

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In my next several posts, I will dive deeper into some of the activities we did, the games we played, the lessons I learned.

 

Playroom Design Made Easy

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Auckland, New Zealand

In my career as a child life specialist and educator, I have seen many hospital playrooms throughout the country and across the globe. In my mind’s eye, I have an idea of what makes a playroom wonderful, combining the best parts of every playroom I have ever seen. My imaginary perfect playroom is a large open space, filled with natural light, a warm, cozy atmosphere, comfy furniture, child-sized sinks and work areas, and a working kitchen. The toys are within reach so that all children can

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Mural in Mexico City

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Playspace in Mexico City

play freely. There is a well stocked medical play corner. There are safe spaces for infants to have tummy time and room to crawl. There are climbing bolsters for toddlers and a wheelchair accessible playhouse for preschoolers and young school-aged children. There are riding toys and sensory play tables. Ping pong and pool tables are there for teens and caregivers to gather around.

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Czech Republic

The best part about this imaginary playroom is that it is staffed with child life specialists, or hospital play specialists, who have been trained in play theory and play techniques, including the child-centered approach and the Floortime approach. They have also undergone training in racial literacy, and speak many languages. There is cleaning personnel on staff who disinfect toys and surfaces as needed. The playroom has daily programming that includes expressive art. medical art, and medical play. Outdoor playspace is available for children and families facing lengthy hospitalizations.

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Japan

In order to make my fantasy one step closer to reality, I designed the Vilas Playroom Assessment Rubric VIPAR to guide hospital staff in creating new play spaces or revamping existing ones. I recently updated it with the help of Meagan Roloff from the Association of Child Life Professionals (ACLP). It is a fillable pdf document that you can download and use to assess your current playspace, or give you ideas for how to design new space. Many hospitals have funding from big corporations to build dramatic and eye-popping play spaces in hospitals. But it isn’t always about the glitz. Sometimes it is the simplest of things, like the sensory room filled with homemade sensory toys in Japan, the custom designed foot high cushioned wall to protect an infant/toddler area from exuberant older kids in New Zealand, or a set of wooden blocks for children to create their own miniature worlds. A doll bed and medical supplies to encourage medical play in Iceland. A wooden playhouse whose door can accommodate a wheelchair and IV pole in New York City. And often, it is about the policies, programming, and training of the staff that make the space a truly child-centered place of healing.

Think outside the box and see where your imagination takes you. And please, drop me a line to let me know how it turns out — I would love to see more photos from around the world!

 

 

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Bethlehem

 

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Iceland