Name of Activity: Happy thoughts necklace

Target Audience: 5-6  10

Individual or Group Play
Location: Bedside, Playroom, Waiting Room

Goals:
 Provide children an opportunity for creative expression that symbolically represents
places, people, memories, thoughts, and things that make them happy or feel good.
 Foster therapeutic relationship between facilitator and patient by getting to know more
about the patient, who they are, and what they enjoy
 Give children an opportunity to create a piece of jewelry that will represent things that
make the patient happy that they can carry with them throughout their admission as well
as after being discharged that they can be reminded about during difficult times or times
when they are not happy and feel stressed, sad, anxious, angry, etc.

Therapeutic benefits:
 Encourage children to reflect on things that make them happy
o Can serve as a distraction from hospitalization, pain, and/or discomfort
o Promote positive mindset in the moment and can serve as a coping strategy that
children can wear (When children begin thinking negative thoughts or feeling
angry, anxious etc. they can look at their bracelet and think of something that
makes them happy to promote cognitive reframing)
 Promotes the concept that children have some control over their experience in the
hospital and can have control over how they handle negative emotions, pain, and/or
discomfort, as realizing that emotions and behaviors can be regulated and managed is
empowering and can lead to improvements in self-control, emotion regulation, coping
skills, and emotional awareness (Li et al., 2016)
Name of Activity: Play dough emotions

Target Audience: Preschool-Kindergarten

Individual or Group Play
Location: Bedside, Playroom, Waiting Room

Goals:
 Help children learn to recognize and label various emotions and identify how it makes
them feel in their body and where in their body they feel certain emotions
o Previous research suggests that although emotion recognition continues to
develop throughout childhood, by preschool age, children are able to recognize
and label at least some types of emotional expressions. However, preschool age
children still benefit from practicing labeling and identifying various emotions
with scaffolding from adults (Kujawa et al., 2014)
 Help children put feelings into words and identify how their body responds to make
feelings less abstract and more understandable for young children through a fun activity
 Discuss coping strategies that can be performed for more difficult/negative emotions
 Foster emerging fine motor skills
 Help children identify positive and productive ways to express and manage emotions
both while at the hospital and after discharge by beginning to teach children emotion
recognition and healthy emotional expression

Therapeutic benefits:
 Helping children identify emotions they feel, how they feel in the hospital, and develop
coping plans to manage negative emotions that do not make them feel good
 Normalizing the hospital environment
 Provide opportunity for control and choices
Name of Activity: Mandalas

Target Audience: older school age/pre-teen  adolescent patients

Individual or Group Play
Location: Bedside, Playroom, Waiting Room

Goals:
 Promote individual and creative expression
 Promote mindfulness and being present with patient’s feelings through the healing and
therapeutic nature of creating mandalas
 Promote meditation and self-soothing
 Encourage self-reflection

Therapeutic benefits:
 Creative and individual expression
 Normalization of hospital environment through engaging in normative activity such as
drawing/painting
 Emotional awareness and regulation if patient would benefit from identifying colors
representing various emotions
 Distraction
 Continuation of rapport building and forming therapeutic relationship
 Reduce negative emotions or teach patients a way to engage in a therapeutic art activity
that has been shown to have the ability to reduce PTSD, physical illness/symptoms, and
depressive symptoms in individuals who have experienced a traumatic event (Henderson,
2007)
o Drawing and creating within contained spaces such as a circle like mandalas, can
provide a sense of containment and decrease anxiety
Name of Activity: Tree of strength

Target Audience: School age  teens

Individual or Group Play
Location: Bedside, Playroom, Waiting Room
Goals:
 Help patients identify strengths that can help build coping strategies
 Help patients recognize that they might have many things that make them strong to fight
against difficult times or negative emotions
o Emphasize that children can utilize existing strengths, talents, and their love and
support from special people in their life to help them cope.

Therapeutic benefits:
 Individual creative expression
 Identification of strengths and positive coping strategies
o Can be hung in room to serve as a visual reminder of what coping strategies are
available to them to support them during hospitalization (can also be taken home
to serve as a coping reminder after discharge)
 The visual symbol of a “strength” tree representing themselves, and all they have to
support them, can help patients connect to their own strength and coping strategies
 Additional benefits:
 Rapport building
 Therapeutic relationship formation and continuation
 Provide children opportunity for mastery, control, and choices
o Easy DIY drawing a tree strategy can be taught by child life intern that
can set children up for success, as this can make the activity accessible
to many patients and set them up for a positive experience, even if the
patient does not see themselves as a great artist (as tutorial begins by
simply tracing their hand and can be done easily by many patients).
Name of Activity: Personalized magazine collage

Target Audience: School age  Adolescents

Individual or Group Play
Location: Bedside, Playroom, Waiting Room
Goals:
 Encourage patient to think about who they are outside of the hospital, their abilities, likes,
interests etc. that make them a unique individual and create a collage that can be
displayed in their room
 Provide patient a creative outlet to show who they are as an individual
 Help staff learn more about the patient which can promote social and emotional
wellbeing of the patient, being seen as more than just a patient in the hospital but also as
a person with unique talents, interests, etc. that staff can discuss with the patient and
recognize
Therapeutic benefits:
 This activity has many benefits for children in the industry vs. inferiority stage of
psychosocial development, as children within this stage begin to accurately assess their
abilities (Hart & Rollins, 2011).
o Children thrive when given positive feedback and recognition for their abilities
and strengths they begin to identify, which can be very therapeutic for the
hospitalized school-age child. This can be fostered if staff are able to learn more
about the patient as an individual and can discuss their collage with them.
 Additionally, at this point in development, children can verbalize their
overall feelings of self-esteem and will be able to easily reflect these
perceptions in this creative expression activity.
 Adolescents will also gain a lot from this activity as well, as they are in a developmental
stage defined by searching for sense-of-self and identity, as well as seeking
independence and creative expression for their individuality
 Adolescents will be able to express their unique interests, attributes, and abilities in
a creative art activity to foster this developmental need and provide therapeutic
benefits
 Children and adolescents experiencing long hospital stays can find it difficult in
their routine environment to feel a sense of empowerment and capability, which
are necessary elements in the development of self-esteem (Thompson, 2009). This
activity will foster positive self-esteem at a time when this can feel difficult or
interrupted by encouraging teens to focus on their abilities, interests, and
individuality that make them feel unique and special.
Name of Activity: Shrinky-dink hand necklaces

Target Audience: Preschool  School-age

Individual or Group Play

Location: Bedside, Playroom, Waiting Room

 Could be done at bedside or 1:1 in playroom for best results and therapeutic
benefits
Goals:
Help children cope with separation when caregivers cannot be present
Provide a creative activity that can promote feelings of connectedness and foster
understanding
 Help the child cope with the fact that their caregiver might not always be
physically present in the hospital while giving them a way to feel better, knowing
that both they and their caregiver are wearing their Shrinky-dink hand necklace
and are still together in some way and/or their caregiver still has a part of them
with them and is thinking about them even when they can’t be there.
Therapeutic benefits:
 Gives the child a tangible way to cope with separation which can be especially helpful for
younger children
o Children in this preoperational stage of cognitive development begin to acquire
the ability to engage in symbolic representation
 This necklace made by both the child and the caregiver that they can wear
when having to be separated can be used as a symbolic representation that
 their caregiver is “always with them” even when not physically present at
the hospital to help cope with physical separation
 Allows the child to engage in an activity that can be done with the caregiver to promote
bonding and normalization while in the hospital
 Allows the child to participate in a creative expression activity that can promote feelings
of mastery and self-confidence
**This activity can be appropriately paired with the book “The Kissing Hand,” by Audrey Penn
which is a children’s book about two racoons, where the baby racoon is afraid to leave his
mother for his first day of school. The mother racoon responds by kissing his hand and
reminding him that every time he misses her he can think of her kiss in his hand**
 Although this book talks about separation due to a child’s first day at school, it is
applicable in many ways and relates well to the hand necklace and could be read by the
CCLS or parent to pair with this activity when appropriate

Name of
Activity: “Safe Space Pillow Case”

Target Audience: Older Preschool  School-age

Individual or Group Play
Location: Bedside, Playroom, Waiting Room
Goals:
 Normalization of hospital environment, specifically the hospital room, to promote
positive adjustment and coping
 Provide children a creative expression opportunity
 Build rapport to promote therapeutic relationship as well as trust with staff and the
hospital environment
 Provide ample opportunities for control and choices
 Help children solidify the idea that the hospital is a safe place and that they themselves
are safe and taken care of
o Can be done by talking about what makes them feel safe and calm and encourage
them to draw this on their pillow case
o Children can also be encouraged to draw (or write out if desired and adult can
scaffold) developmentally appropriate positive affirmations, positive memories,
helpful self-talk statements, reminders of coping skills, etc.

Therapeutic benefits:
 Provide children of preschool age who are in the stage of initiative vs. guilt opportunities
for control over their environment and choices that many children in this psychosocial
stage are seeking, which will also help normalize the hospital environment
 Provide children who are of school-age and are in the industry vs. inferiority stage
opportunity for choices and control that they often seek as well as an opportunity to
exhibit mastery, as creative expression crafts such as these are an excellent way for
children to showcase their abilities and create something they can take pride in for staff to
see
 Help child to feel safe and calm before going to bed at night and when he or she wakes
up in the morning. Also helpful for nightmares, commonly seen post trauma, as facilitator
can encourage child to draw dreams they want to be having to comfort themselves.