Play is a freely chosen activity that can be fun and relaxing. Every child has a fundamental right to play, as recognised by the United Nations Convention on the Rights of the Child (UNCRC, Department of Education, 2010). In the hospital setting play brings a sense of normality to children at what can be a distressing time for them. Play promotes a child’s physical and emotional well-being and reduces stress.
Play Specialists and other health professionals use play preparation to help psychologically prepare children and young people and their families for hospital procedures that may be frightening and/or painful. Using a wide range of tools – such as photographs, videos, real hospital equipment, preparation dolls and role play - the play specialist can help children and young people understand the procedure they are going to experience at a developmentally appropriate level. This will help to alleviate any concerns and assist coping as the child or young person gains a sense of control through understanding.
Play Specialists should get as much information as possible about the child or young person and their understanding of the procedure before preparing them. This can be done by talking to them and their family, observing them and having discussions with the nursing team. It needs to be made clear to children and young people that although some procedures may be unpleasant, they are necessary. It is important that procedures are explained in an honest but age-appropriate way so that the child or young person gains a good understanding of the procedure and can build a trusting relationship with staff.
During preparation play, the patient and their family will have the opportunity to ask and discuss any questions they may have regarding their procedures. It may be a one-off event or an ongoing piece of work, for example a child or young person with a needle phobia may require several sessions with a stepped approach to de-sensitise them.
Play preparation is done before a procedure and sometimes the Play Specialist will then accompany the child or young person and their parent/carer, providing support and distraction during the procedure. Distraction therapy can help children and young people cope with procedures and can include bubble blowing, noisy books, counting games and breathing exercises. The early input of distraction techniques is crucial for the long-term success of relieving children's anxieties and fears during hospital admissions.
Psychological approaches to reducing pain and anxiety make a significant difference to the child or young person’s experience of repeated and painful procedures (National Clinical Guideline Centre, 2010). Successful preparation and distraction techniques can help a child or young person develop strategies to be able to cope better with future procedure and often reduces the need for therapeutic holding under force and immobilization. Where restrictive physical intervention is needed, it should be necessary, proportionate and justifiable and only used to prevent serious harm. Any use of planned or unplanned restrictive physical intervention should be carried out using the least restrictive interventions and for the minimum amount of time (Royal College of Nursing, 2019).
Following the procedure/treatment the play specialist may return and provide post procedural play, giving opportunities for the child or young person to express any feelings and to offer ongoing support and reassurance, providing coping strategies where appropriate. Good play preparation can dramatically cut down on the stress levels for all involved – professional, patient and family (Spence, 2004).
References
Department of Education. 2010. United Nations Convention on the Rights of the Child (UNCRC): how legislation underpins implementation in England. Available from: https://www.gov.uk/government/publications/united-nations-convention-on-the-rights-of-the-child-uncrc-how-legislation-underpins-implementation-in-england (Last Accessed 1st August 2025)
National Clinical Guideline Centre (UK). 2010. Sedation in Children and Young People: Sedation for Diagnostic and Therapeutic Procedures in Children and Young People. London: Royal College of Physicians (UK). (NICE Clinical Guidelines, No. 112.) 5. Available from: https://www.ncbi.nlm.nih.gov/books/NBK82227/ (Last Accessed 1st August 2025)
Royal College of Nursing (RCN). 2019. Restrictive physical interventions and the clinical holding of children and young people Guidance for nursing staff. Available from: https://chg.osimebcu.co.uk/resources/007-746.pdf (Last Accessed 1st August 2025)
Spence, N and Price, J. 2004. Play in the community, quality care for children with cancer. Cancer nursing practice 3(8). Available from: https://journals.rcni.com/cancer-nursing-practice/play-in-the-community-quality-care-for-the-child-with-cancer-cnp2004.10.3.8.31.c140 (Last accessed 1st August 2025)
Last reviewed August 2025