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Social Work in Pediatrics

Social work in pediatrics (the care of sick and dying children) is both a fascinating and difficult field. In almost no other realm of social work is there the imminent and very real possibility that your client will die. I was led to this topic primarily through my family’s personal experiences, when my youngest sister was diagnosed with Type 1 Diabetes. Our whole family has had to undergo a serious change in routine and diet; we have had to come to terms with giving our baby sister and daughter needles four times daily – easy for my mother and other sister who wanted to be nurses, but much more difficult for my father and myself, who were jittery at the mere sight of needles – and we had to understand the urgency of accepting this routine. My diabetic sister has had to come through bouts of depression; she comes home sick often from school and is no longer able to eat what she wants, when she wants. She can no longer sleep in, but has to adhere to a strict routine of checking blood sugar levels, needles, diet and exercise. We all have had to accept the fact that failure to observe these rituals will result in coma, acidic blood, amputation, loss of sight and hearing, or even death. Personally, I’ve


The children even went out of their way to glean new information, by eavesdropping or lying, “One child went so far as to plant a tape recorder in the conference room [where the doctors held their meetings]” (p. 138). Since they are already so well informed and seek out the knowledge about their illness so readily, it would only make sense to tell them everything they desire to know. According to Bluebond-Langner (1978):

Music therapy is helpful for the child not only emotionally, but physically as well. P. Hinderer (1995) explains that, “[music] effects pulse, breathing, and muscle tone…can aid in relaxation…awakens memories, emotions, moods, and wishes…Music offers a sanctuary” (p. 46). Hinderer goes on to say that while art and writing also express emotion artistically, they can be destroyed – you cannot scribble out or paint over a song. The social worker can use music to allow children to express their rage or grief without feeling guilty, as Hinderer (1995) explains:

In stage one (seriously ill), the child begins to realize the severity of their condition. Bluebond-Langner states that, “Children at stage 1 would often exclaim, ‘I’m really pretty sick, you know,’ and then offer as evidence the changes in people’s behavior towards them or the physical changes in themselves, especially the ‘wounds’ suffered from procedures” (1978, p. 173). They were trying on their new identity, looking for feedback from others, and showing off examples of their illnesses in order to accept their new identity for themselves. The children and parents both tend to cling together, fearful of permanent separation, and the parents tend to overindulge the child’s wishes. They remain in this stage until they enter remission (for leukemics) or when the medicine begins to work.

Children facing [life-threatening] illness may experience helplessness, loneliness, anger, sadness, guilt, or any combination of these feelings. They are seeking ways to express their feelings, to let off some of the pressures that can be building up inside. (Stevenson, 1995, p.12)

Stage 3 (always ill and will get better) is brought on by the first relapse, and is characterized by the frequent information seeking the children do about their situation. Bluebond-Langner observes that they begin to eavesdrop on doctors and parents, and discussing their illness with other children more exclusively. They ask questions of everyone, but begin to distrust the scant information offered by doctors and other hospital staff. However, they hold on to the idea that, although they are sick again, they will always get better again, and things will go back to normal.

Some topics in this essay:
Myra Bluebond-Langner, Donna O’Toole, METHODS THERAPY, WORKER Besides, Ruth Snider, INTRODUCTION Social, According Bluebond-Langner, Personally I’ve, Toba Kerson, social worker, STAGES ACCEPTANCE, bluebond-langner 1978, 1995 explains, ill child, dying children, stages grief, seriously ill, accept situation, sick dying children, sick children, terminally ill, social worker provide, social worker’s role, allow children express, hinderer 1995 explains,

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Approximate Word count = 3479
Approximate Pages = 14 (250 words per page double spaced)


  

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