Where the Spirit Meets the Bone: The Role of Child Life Specialists in Troubling Times

ACLP Bulletin | Winter 2017 | VOL. 35 NO.1


Deborah B. Vilas, MS, CCLS, LMSW
Bank Street College of Education, New York, NY

The morning after the 2016 election, we woke up to a new normal, which included a stark awareness about the level of bifurcation in our country. Some folks are joyously celebrating the prospect of change; some are terrified about what this change might mean for their future. There is no question that we face an enormous task in figuring out how to work for the common good when many of us have differing views of what that good should look like.

I believe that child life specialists are uniquely poised to address this rift, in all of the same ways that we are equipped to help families cope with medical challenges. We reach out from a strengthbased, cooperative front, moving forward from a place of deep inquiry, witnessing and advocating for those in our care. No matter what our political beliefs, we know the value of the developmental interaction approach. We meet the needs of children and families first by asking what their needs are, then by listening and validating, and then by empowering them to find expressive outlets and coping strategies to address these needs. We facilitate children’s inner abilities to make meaning out of their individual path to healing, whatever that may look like. We do all of this while taking into account the child’s developmental needs and the family’s resources and cultural beliefs. These beliefs often conflict with our own, but we consciously choose to serve our patients with kindness and respect, despite our differences. We seek the common denominator of humanity to find common ground to work from. 

We also do this side by side with medical staff, who often see things very differently than we do. We work in an interdisciplinary fashion to cooperate within the system, being positive members of the team while we gently, yet firmly, advocate for some approaches that may be outside the present medical culture. We make mistakes. We stumble and fall. But we learn from them, reflect upon them with bravery, and get up and try again.

As we seek to make room for our patients and families to share their narratives, it behooves us to consider creating time and space for our own conversations. If we avoid talking about our feelings and thoughts with each other, how can we create safe spaces for patients? I urge ACLP members to consider various venues for conversation: within your departments, at interdisciplinary gatherings, at places of worship, in colleges and university classrooms, and on the ACLP Forum. Not every venue is right for everyone. When approaching tough topics, it helps to set some parameters for the conversation, a protocol if you will, so that participants feel safe, respected, and cared for in one another’s presence. If we can do this, we will continue to build our empathic skills for supporting our patients and families in any conversation we find ourselves engaged. 

When I asked people in the field about what they were seeing in hospitalized children and families the past few days, they first seemed compelled to speak about their own experiences and emotions before being able to move to sharing observations about children on their unit.

My first thoughts about how we might structure the conversation included the following steps:

1. Guiding questions are supplied. It might take more than one conversation to address them.

2. In face-to-face or virtual conversation, participants respond to the questions, one at a time, making time for each participant. It may be necessary to impose time limits, so that airtime is evenly divided.

3. Participants agree to:

  a. Refrain from sharing personal political views.
  b. Refrain from commenting on anyone’s share—in other words, no cross talk.
  c. Stick to the questions.
  d. Use kind and inclusive language that is respectful of all, considering race, gender, sexual         
      orientation, religion, country of origin, and culture.
  e. Observe confidentiality of our patients by not using names or identifying information.

After the past several days, however, I have been questioning the efficacy of rule “3a.” In conversations with faculty at the Bank Street College of Education, our emotions and beliefs were intricately woven in with our concerns and questions about how to best support our students. When I asked people in the field about what they were seeing in hospitalized children and families the past few days, they first seemed compelled to speak about their own experiences and emotions before being able to move to sharing observations about children on their unit. So I am wondering if we are skipping a crucial step in holding back our own stories as we seek answers for how to support children and families. We are the ones who go where angels fear to tread with children—engaging them in conversations about everything from an impending needle stick to an upcoming amputation, even loss of life. We need to be as brave with one another as we are with children. As with anything, it begins with us.
With that in mind, here are some suggested questions to guide us in respectful and kind conversation. Others may surface organically during the conversation.

1. What are some of the emotions you have been experiencing in the current social climate?

2. What are some of the questions and concerns that you have—for yourself, your loved ones, and your patients?

3. What are you observing at your worksites: in the environment, and in conversation with children and families?

4. What emotions, questions, and concerns are children and families expressing?

5. What skills, techniques, activities, and language are we drawing upon to respond to patients and families?

6. What is working?

7. What doesn’t seem to be helping?

8. What other ideas do we have about how to respond to patient concerns?

It is my deepest hope that these guidelines serve as a reminder of the toolkit we have right at hand. Our training. Our leadership skills. Our humanity. Our deep desire to serve and make the world better. Let’s make sure that every staff member we work with, every child in our care, every family member, feels safe and respected within the health care environment. Let us risk sharing who we are with one another, and then ask kids how they feel, listen to what they tell us, and provide witnessing and reassurance that we will do whatever possible to ensure that their safety and comfort, no matter their color, socioeconomic status, country of origin, religion, gender, sexual orientation, or family makeup, are protected.

I would like to end this article with the following poem:

Have compassion for everyone you meet, even if they don’t want it. What seems conceit, bad manners, or cynicism is always a sign of things no ears have heard, no eyes have seen. You do not know what wars are going on down there where the spirit meets the bone. — Miller Williams, from The Ways We Touch



Michael, A. (2016). What do we tell the children? Retrieved from http:// what-should-we-tell-the-children_ us_5822aa90e4b0334571e0a30b Polacco, P. (2001). Mr. Lincoln’s way. New York, NY: Philomel.