How Play Therapy Is Helping Kids Fight Cancer at SKMCH&RC

Play is the universal language of childhood that helps children to understand the world around them and helps them express their feelings. The opportunity to play is every child’s right and the value of play increases manifolds when a child is grappling with a disease, especially cancer. At Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC), play therapy is an integral part of the treatment programme for cancer in children and is offered by Hospital’s Ancillary Health Services. At the heart of all the children friendly programmes and their implementation across the Hospital are our play therapists, who help create a friendly environment for children seeking care at the Hospital. We talked to one of our play therapists to understand how play therapy works and its role at SKMCH&RC.

Inspiration and memorable moments for our play therapist

“Since the moment my mother passed away from cancer, I had decided to do something to ease the suffering of cancer patients. I chose art therapy because I have loved art since my childhood. I ended up studying an area of psychology that would later allow me to use art-therapy and work with children. Fate brought me to SKMCH&RC where I got the chance to pursue my childhood passion in a field that was relatively young in Pakistan. I wanted to concentrate my efforts on paediatric patients in particular because children inspire and their expression is very pure and innocent.

There are many memorable encounters and it is difficult to choose one. I remember a patient who had become unresponsive after having to stay in isolation. We tried to make him talk and smile using play therapy. Our persistent efforts started showing results when finally, he lifted his arms towards the balloons. Then one day he came to see me in the play room and gave me a big hug, making it a truly rewarding moment. Many such instances serve as a source of motivation and help us get going.”

Techniques that are employed to reduce anxiety in children at SKMCH&RC

If a child is scheduled for a medical procedure, we use methods such as Medical Doll Play therapy to reduce procedure-induced anxiety. By familiarizing the child with the procedure, pre-procedural play therapy addresses the child’s fear of the unknown. For example, a anaesthesia mask can be particularly scary for young children. We introduce the masks to children in a child-friendly manner by painting the masks and making children wear these before the procedure. This activity helps to reduce children’s anxiety before the actual procedure.

Similarly, receiving injection can be a traumatising event for young children. We encourage parents to use methods that will help children going through such situations. For example, by holding the child’s hand, saying comforting words or making them look away while holding them in their lap. Distraction methods such as story-telling are also very helpful in overcoming needle phobia in children.

We have designed a regular Distraction Activity Schedule for children admitted to our inpatient facilities. The schedule includes a range of different activities catering to a wide-range of interests so children have something exciting to look forward to each day:

• Monday: Super-hero Day
• Tuesday: Arts & Crafts Day
• Wednesday: Movie Day
• Thursday: Puppetry Day
• Friday: Music & Computer Day

Volunteers are also engaged to assist in these activities with children either at bed-side or in play-room during group activity. Apart from this, events such as Children Mela and Paediatric theatre plays keep patients engaged so they do not feel excluded from social activities.

Positive impact of play therapy on children’s treatment

In 2015, our “Child Friendly Initiative” in the Gamma Camera Suite was selected in top 5 projects for “2015 Patient-Centric Imaging Awards”. SKMCH&RC was the only non-US hospital to receive the coveted award.  The project aimed to compare the impact of child-friendly environment in terms of reduction in number of children requiring sedation.

The gamma camera room and injection rooms were given a child-friendly makeover as the walls were painted with cartoon characters and a screen was installed where children could watch cartoons while undergoing the imaging process.  It proved to be a big success as the number of patients who required sedation declined due to this effort.

Expansion over the years

Over the years, play therapy has emerged as a more recognised area within the Hospital as well as the country. A Child-Friendly Project has been initiated across the Hospital to encompass a wide range of areas. Wherever children are booked for procedures, they have access to play therapy comprising of colouring, painting, and other activities. It has become a part of the weekly Paediatric Oncology Grand Rounds where the need for play therapy in specific areas is identified. Lectures on play therapy have been introduced for nursing students to equip them with techniques on how to deal with paediatric patients using play therapy. Parents and guardians of all first time paediatric patients are guided about the benefits of play therapy in Paediatric Support Groups. We hope to extend this service to our other facilities as well so more children can benefit from play therapy.