Therapeutic Approaches in Child Hospice Care in the UK

The challenges faced by children living with a terminal illness and their families are immense; from financial to logistical, psychological and physical. To help ease some of these pressures and help children and families cope, various therapeutic approaches can improve their quality of life and foster understanding. Practices such as play therapy and speech therapy combined with child hospice care help in alleviating stress, promoting well-being, and gives children a way of expressing themselves. This article explores the positive impact of these therapeutic approaches and how different therapies can be integrated for the best, most compassionate care.

Hospice teams in the UK use various child behavioural therapy techniques and services of dedicated professionals to promote what are called adaptive coping mechanisms and manage behaviour where appropriate. “Positive behaviour plans are about taking a supportive approach to behaviour change, understanding the behaviours and triggers and working alongside parents, carers and other professionals to achieve the best outcome for the child or young person”, said a nurse at the Hospice In The Weald – a UK hospice providing care and support for both adults and children.

Some hospices specialise in these areas, whereas others will use an external practitioner when needed – the important thing is that a holistic approach is taken. This was echoed by the nurse at the Hospice In The Weald, who explained “If an assessment indicated that challenging behaviours could arise we would certainly contact other professionals working with the child and if a positive behaviour plan was already in place we would observe the child at school, work alongside staff, parents and carers and follow the same approach to ensure consistency.”

Positive Reinforcement and Modelling

In short, positive reinforcement involves rewarding positive behaviours. In a hospice setting, this could mean praising a child for expressing their feelings or engaging in social activities – interactions that are difficult for children who are dealing with so many stressors. Modelling, where caregivers demonstrate appropriate behaviours for children to imitate, also plays a significant role. By observing and mimicking these positive behaviours, children can learn more effective ways to cope with their emotions, environment and others.

Cognitive-Behavioral Strategies

Cognitive-behavioural strategies help children understand the link between their thoughts, feelings, and behaviours. This is especially difficult for children who are on the autism spectrum or have experienced trauma due to an injury or illness, for example. This is where cognitive restructuring can help. This approach has been shown to be particularly helpful in reducing anxiety and depression, which are common among children with life-limiting conditions.

Parent Training and Family Involvement

Parent training and involvement is not strictly a defined therapeutic approach as such, but is integral to overall care. For any child behavioural therapy techniques to really help, it needs the involvement of parents and family. Parents know their child the best, and their input and guidance is key. The nurse at the Hospice In The Weald said, “… It can be something really, really subtle…. if a child is non-verbal then it’s about how that child communicates and expresses themselves, it’s so important to listen to parents, they are the experts in their child’s care and will always be able to pick up on those subtle cues whether it’s a facial expression, or change of behaviour.”

Working together with the parents, hospices can cater to their individual needs and understand what will work best for the child. While parents offer guidance, hospices can also impart their expertise to families and further teach them how to use behavioural strategies effectively. Collaborating and sharing in this way creates better communication and strengthens the family unit, providing much-needed emotional support.

Child Speech Therapy in UK Hospice Settings

Speech therapy is essential for addressing not only communication difficulties but also swallowing disorders that are common in children with life-limiting conditions. Speech and language therapists (SLTs) working with hospices play a vital role in enhancing communication and ensuring that children with difficulties can express their needs, be heard, and interact socially. 

Alternative and Augmentative Communication (AAC) Methods

AAC methods include a wide range of tools and techniques that support or replace spoken communication for children with speech impairments. These can range from hand gestures to simple picture boards to sophisticated electronic devices. Struggling to communicate their needs is incredibly frustrating for children whose speech or movement is impaired, but with AAC they can be given a voice and some agency, and help SLTs to better help them.  

Swallowing Disorders Management

Many children in hospice care experience dysphagia, or difficulty swallowing. SLTs assess and manage these conditions to prevent complications such as aspiration pneumonia. Techniques may include more palatable and easy-to-swallow food textures, teaching swallowing exercises, and implementing feeding strategies for safe and comfortable eating.

Art Therapy

Art therapy allows children to express their feelings and experiences through drawing, painting, or any artistic medium that suits them best. This form of therapy can be particularly cathartic, helping children articulate emotions they might not be able to express verbally. It also gives them a sense of accomplishment and boosts self-esteem.

Music Therapy

Music therapy can be hugely beneficial, even if the child has no or limited mobility. Singing, playing instruments, and simply listening to music can be incredibly soothing for children, alleviating anxiety and pain. Music therapy also encourages social interaction and enhances mood. While children in hospice care might struggle to communicate, the language of music is universal.

Storytelling and Play

Storytelling and imaginative play enable children to explore their feelings and make sense of their experiences. Through role-playing and narrative creation, children can express their fears, hopes, and dreams. This therapeutic approach helps them process complex emotions in a safe and supportive environment.

Interdisciplinary Collaboration

To help children in hospice more effectively, collaboration is a must. Behavioural, speech and language and play therapists along with other healthcare professionals work together with hospice carers and share vital information. “It might be that we need advice from a tertiary centre for medication management, it may be that we need advice from a physio, OT, or dietician it’s about putting a child in the centre and everybody working collectively with a common goal”, said the Hospice In The Weald nurse.

Not all hospices have dedicated on-site therapists, but there is a network of shared knowledge and experience among parents, practitioners and hospices. In addition to this, we at HITW are always guided by the industry’s regulatory bodies, such as The Care Quality Commission (CQC), the National Institute For Health and Care Excellence (NICE), and the Nursing And Midwife Council (NMC).

Holistic Care Planning

This means that interdisciplinary teams develop holistic care plans tailored to each child’s unique needs. By bringing together insights from different therapeutic disciplines and families, these teams can create well-rounded strategies that include physical, emotional, and social support.

Regular Communication and Coordination

This is vital for delivering seamless care. Meetings between professionals, parents and hospices allow them to share observations, discuss progress, and adjust care plans as needed. This collaborative approach ensures that all aspects of the child’s condition are considered and addressed.

Family-Centred Care

As we’ve previously mentioned, involving families in the care process is a cornerstone of interdisciplinary collaboration – it cannot happen without the family. Families provide valuable insights into the child’s needs, history and preferences, making the therapies more effective and creating a nurturing environment that supports both the child and their loved ones.

The Impact of Therapeutic Approaches on UK Child Hospice Care

The impact of therapeutic approaches in UK child hospice care is profound, significantly improving the quality of life for children with life-limiting conditions and their families. Techniques such as play and speech therapy and behavioural interventions provide essential support, addressing the complex needs of these young patients. Along with the knowledge and caring experience of hospice staff, therapeutic approaches make a big difference. 

A comprehensive approach that integrates various therapies is how children are given the best care. By fostering collaboration and involving families in the care process, hospice teams can deliver holistic, understanding support that nurtures young lives. As child hospice care continues to evolve, these therapeutic approaches will remain vital in ensuring that every child receives compassionate and effective care. When it comes to child hospice care, “It’s all individualised depending on that particular child”, says Hospice In The Weald staff.

For more information on how you can support child hospice care or access services, connect with Hospice in the Weald – Care for Children. Together, we can make a difference.