Child Life Coping and Stress Reduction Flashcards

A 2-year-old child who was previously toilet-trained begins having frequent accidents and becomes intensely distressed when their parents leave the hospital room. These behaviors are most likely manifestations of stress related to what?

Answer: Separation from primary caregivers.

For toddlers (ages 1-3), the primary stressor in a healthcare environment is separation from their parents or primary caregivers. Regression (like loss of toileting skills) and intense separation anxiety are classic behavioral responses to this stress. While loss of control is a stressor, separation is the most significant one for this age group.

The acute physiological stress response, often referred to as the 'fight-or-flight' response, is primarily driven by the release of which two hormones from the adrenal glands?

Answer: Epinephrine and cortisol

The fight-or-flight response is a rapid physiological reaction to a perceived threat. The adrenal glands release epinephrine (adrenaline) for an immediate surge of energy and cortisol, which sustains the stress response. Understanding this biological basis helps explain the physical symptoms of stress in children.

A 14-year-old newly diagnosed with diabetes is actively researching the condition online, asking the medical team detailed questions about managing blood sugar, and creating a schedule for insulin injections. This behavior is a primary example of which type of coping?

Answer: Problem-focused coping

Problem-focused coping involves taking direct action to manage or solve the problem causing stress. The adolescent is actively seeking information and creating a plan to manage their new diagnosis, which are classic examples of this coping style. Emotion-focused coping would involve managing the feelings associated with the stressor (e.g., talking about fears).

A Child Life Specialist is helping a 7-year-old child manage anxiety while waiting for a procedure. Which of the following interventions is a classic example of using guided imagery to reduce stress?

Answer: Asking the child to close their eyes and describe their favorite place in detail.

Guided imagery is a stress reduction technique that involves using the imagination to create a calming mental scene. Asking the child to visualize and describe a favorite place, engaging all their senses, is a direct application of this technique to promote relaxation. The other options are forms of distraction or physical release, but not guided imagery.

According to Lazarus and Folkman's Transactional Model of Stress, what occurs during the secondary appraisal process?

Answer: The individual evaluates their resources and ability to cope with the stressor.

In the Transactional Model of Stress, primary appraisal involves assessing the nature of the stressor ('Is this stressful?'). Secondary appraisal involves the individual's evaluation of their own coping resources and options to deal with the stressor ('What can I do about this?').

When assessing a school-aged child's typical coping strategies, which of the following methods would provide the most insightful information for the Child Life Specialist?

Answer: Asking the child, 'What do you do when you feel scared or worried about something?'

While all options can provide some information, directly asking the school-aged child about their own coping methods in a developmentally appropriate way empowers them and provides the most direct insight into their personal strategies and perceptions. Parent report is valuable but secondary to the child's own voice, and physician notes or general observation may not specifically address coping with stressors.