Quinn Franklin, PhD, CCLS is President, Board of Directors, Association of Child Life Professionals and Director of the Psychosocial Division in the Cancer and Hematology Centers at Texas Children’s Hospital, Houston, TX.
Bailey Kasten, CAE, is Chief Operating Officer and Interim CEO of the Association of Child Life Professionals.
Originally published by the Beryl Institute
The Association of Child Life Professionals defines emotional safety as: an intentional, interdisciplinary practice to promote resiliency, healing, and trust for pediatric patients and their families during medical experiences.
In the world of child life, we are always focused on the emotional well-being and psychosocial support of pediatric patients and families - it is our profession’s mission, expertise, and purpose. Certified Child Life Specialists create and provide emotionally safe interactions and spaces for patients and families. But this is not something that child life can do alone - it requires the interdisciplinary support of the entire healthcare team to ensure that every interaction from the moment a visit is scheduled until their exit out the door is emotionally safe.
Child life specialists and patient experience professionals can be natural partners in this work. The value of child life’s perspective and focus on the human experience of healthcare has been outlined in The Beryl Institute white paper, What Patient Experience Can Learn from Child Life Professionals. Both disciplines also understand that to achieve the best outcomes, it cannot be left to a single profession to be responsible for implementing this level of change. The entire healthcare team needs to understand, have training, and be on board with this charge led by champions like child life specialists and with the support of the patient experience team to contribute to the work and to help track its success.
Why now?
Although research on Adverse Childhood Experiences has been ongoing for decades, we are only now seeing greater adoption of language and prioritization around children’s mental health and the impact of medical experiences on patients and families. The COVID-19 pandemic has had significant impact on the stress and emotional health of children. On a deeper level, many have begun to understand how the delivery of information, the context we are given, the environment we find ourselves in, and our emotional intelligence all impact our ability to cope with stressful or traumatic changes in our lives. Greater societal understanding has provided an opening in the dialogue about the future of healthcare to talk about emotional safety and to prioritize this part of the patient experience for administrators. It is in this larger context that the Association of Child Life Professionals has launched the Emotional Safety Initiative (www.emotional-safety.org) and declared that emotional safety is equally important as physical safety. There is evidence to support the use of emotionally safe techniques to minimize trauma and negative impacts of medical experiences on children and families, and for all institutions serving pediatric patients and their families to adopt their use. A full list of references can be found in the paper, Emotional Safety in Pediatrics.
The Emotional Safety Framework
Emotional safety encompasses specialized strategies including atraumatic, patient- and family-centered, trauma-informed, culture-centered, and developmentally appropriate care. These clinical components are woven throughout the four pillars of emotional safety: (a) screening and assessment; (b) intervention; (c) environment; and (d) education, training, and communication. The supporting framework includes primary and sub-goals of each pillar. These key drivers were identified by researching evidenced-based practices and interventions, reviewing current best practice models, and incorporating input from content experts.
The Emotional Safety Initiative provides the Emotional Safety Framework as well as the accompanying paper Emotional Safety in Pediatrics (https://emotional-safety.org/patient-emotional-safety-in-pediatrics-executive-summary/) as a free resource to encourage all healthcare organizations to commit to the adoption of emotionally safe practices and to form working groups to implement the different aspects outlined in the framework.
Next Steps
To move this important work forward, we ask for champions. We ask for engagement with the framework and with the Emotional Safety Initiative to bring more voices to the conversation and to bring the promise of emotionally safe care to our patients and families.
Additionally, as vaccination efforts continue with adolescents and are likely to expand to all children, there is an opportunity to bring the lens of emotional safety to one of the most common fears expressed in both children and adults regarding medical experience-needles. Pain management techniques, developmentally appropriate language, and comfort positioning are all examples of coping strategies that can be utilized by parents and caregivers, vaccine providers, clinicians and child life specialists.
Please visit www.Emotional-Safety.org to download resources for healthcare teams as well as for parents and caregivers. Together we can do more to create an emotionally safe medical experience for patients and families.
References:
Campbell, S., Cicero Oneto, C., Saini, M. P., Attaran, N., Makansi, N., Passos Dos Santos, R., Pukuma, S., & Carnevale, F. A. (2020). Impacts of the COVID-19 pandemic on children: An ethical analysis with a global-child lens. Global Studies of Childhood, 11(1), 105-114.
Gordon, J. (2021). (rep.). Emotional Safety in Pediatrics. Emotional Safety Initiative. McMurtry, C. M., Pillai
Riddell, R., Taddio, A., Racine, N., Asmundson, G. J., Noel, M., Chambers, C. T., & Shah, V. (2015). Far From “Just a Poke.” The Clinical Journal of Pain, 31(Supplement 10).
Wright, S., Yelland, M., Heathcote, K., Ng, S.-K., & Wright, G. (n.d.). Fear of needles-nature and prevalence in general practice. Australian Family Physician, 38(3).
Wolf, J. A. (2018). (rep.). What Patient Experience Can Learn from Child Life Professionals. The Beryl Institute. Retrieved from