What is empowerment?
Medical encounters can be a very challenging experience for some children. They often take place in unfamiliar environments where they are expected to engage with unfamiliar people and perform unfamiliar tasks. Whether it’s a plaster cast, blood test, dressing change, general observations, x-rays, surgery or any other medical interventions in between; the whole experience can be overwhelming for little people. From when we are toddlers, we have a developing sense of self and a growing need for control and autonomy. Medical encounters can be seen as a perceived threat to this as we are put in situations where that control is often taken away.
Empowerment is defined as “the process of becoming stronger and more confident, especially in controlling one’s life and claiming one’s rights”. Setting little people up for success in medical settings, and instilling a sense of empowerment, can help them feel more confident and promote a more positive view on health care for the future.
Why is empowerment important?
Increases self-confidence
Supporting empowerment gives children increased confidence and self-esteem. It enables children to feel more comfortable with who they are, as well as to try new things. It also promotes self-regulation of emotions and behaviour.
Sense of control
Empowerment supports children to have a sense of control when it is often perceived to be taken away. When we can provide opportunities for control during an unfamiliar experience, children feel a sense of autonomy and develop new coping strategies.
Builds resilience
Empowerment is a key factor in building resilience. It supports children to be able to bounce back from challenging experiences, both in medical encounters and through life.
Encourages independence
Supporting children to have a voice in their own experiences and to make choices, helps them to become more independent.
What can you do to support empowerment?
Planning
It is important if you are aware of an upcoming medical encounter, that you share this information with your child. For young children, you can talk to them the day before, or for older children, a few days before. By explaining what needs to happen, you can help reduce anxiety by supporting children to process and prepare for the experience. Being honest with your child builds a sense of trust and allows them to ask questions and feel more in control.
Preparation / Explanations
Once you’ve told your child about their medical encounter, you can help them prepare by understanding what to expect. Children understand their world well through their senses. You can help your child by talking to them about:
· What they are going to see
· What they might feel
· Who might touch them, where and why
· The sounds they might hear (plaster cast removal can be quite loud and dentist drills are an acquired taste!!)
You can ask your child if they have any questions and address any misconceptions about the experience – you’ll be amazed to hear how their imagination creates all sorts of weird and wonderful ideas about what will happen! And, a lot of the time, they are a lot worse than the reality!
Choice
Providing your child with as much choice as possible during their medical encounter will help instil a sense of empowerment over the situation. It is important that we provide choice over the things that they can control. For example, if your child needs to have a blood test, you don’t provide a choice over whether they would like the test or not (99% of children would abort at this point!!). The choice lies in how they want to be positioned or what they would like to watch or read during the test. It might be a choice about what treat they are going to have after the procedure or what sticker they would like when they are finished.
Normalising
It is important to a child’s sense of empowerment that we respect and acknowledge how they are feeling. Often, with all good intentions, we downplay a child’s experience by saying things like “it’s not that bad”, or “you shouldn’t be scared about that”. If we can acknowledge the child’s experience and normalise their feelings, we can help them to recognise uncomfortable feelings and sit with them, knowing that they will pass. Statements like: “I know you are feeling scared right now, and that’s ok; but I am here with you, and we will get through this together” Or, “it’s ok to feel upset about having this done; but you have done lots of scary things before and got through them all.” By doing this, you are not dismissing their emotions, but helping them realise that all emotions are ok and that you are there to support them through it.
Celebrating
What seems like a small thing to us, can be massive in a child’s world. Celebrating your child’s achievements in medical encounters provides an opportunity to build their self-esteem and recognise resilience. Even if the medical encounter was a ‘disaster’ or wasn’t completed, try and find an aspect that they did well: “I really liked the way you sat up on my lap and gave it a try” or “I really liked that you tried to take some deep breaths to help you calm down”. If you can leave the medical encounter on a positive note, you are more likely to have a positive experience the next time.
Empowerment is built up over time and will not necessarily be achieved over night, however, supporting children to engage in some of these steps will begin a life-long process and build skills to enable more positive future health care encounters.
Kate Strickland is a community-based Child Life Therapist with a background in Occupational Therapy and Education. She works with infants, children, and young people along with their families in managing the stresses associated with health care encounters, procedures, hospitalisation and medical trauma. Visit healingheartsbeyond.com.au for more information.