Psychology & CL

Distinction:
- PSY –meeting with parent and children 3 yrs +
o Assesses and develops plans
o Talk based
o Reframing
o Sorting out difficult events
o Play therapy
o Processing traumas (attempting to avoid PTSD)
 Symptoms 1 mo post off = acute stress disorder (not PTSD yet)
 Not addressing issues can often lead to higher rates of PTSD
- CL
o Implementors of interventions
o Assesses and develops plans
o Play and activity based
o Work more directly in pt in less formal meetings and settings, allows us to
sometimes get a better idea of what’s really going on and communicate that
to other team members
o Ex) When a child is ready to see their face for the first time following a burn

Rehab / OT

Burn Therapists
- OT (practical tasks/ function focused) & PT (strength, walking focused)
- Kid’s #1 job is to play
o Similar to CL!
- Splinting
o Starts at the acute phase
o Helps to prevent contraction in the healing process
o Must be worn all the time at first
- Major difference between Shriners and regular OT
o Shriners OT doesn’t modify takes to make them easier
 o Adapting can decrease pain but it can be highly unproductive to the healing of
skin and muscles
- Play
o Ex) incorporate play to help encourage them to reach by themselves
- CL & rehab collaboration
o Distraction and diversion
o Extreme anxiety
o Therapeutic relationships
o When a child needs to sit still to be measured for a face mask
o Forming a safe environment
o Therapeutic relationships
- Healing
o Strengthening
o Scar management
 Scars will often come back raised and bumpy= more contraction.
 Results from increased collagen/ healing wrong
 Scare massage and pressure
o Helps to break up the excess collagen and prevent raised
scaring
o Must be done 2-3 times a day
 Often involves hyper or under sensitivity to touch
- Itch
o Associated with scaring, not clear why
o Results from a return of sensation back to the skin
 Can be persistent over one’s life time
 Gets worse in the heat
 Laser can help
- Lasers can help:
o pigment reduction
o scar thickness
- Pressure garments and face masks
o must be worn for 23 hr a day for 1 year
o garments can be measured and custom made
 can help to decrease itch
o clear face masks
 child can still see
 hand held scanners can measure the child’s face
 $2,500 per mask
SWK – Melissa 2/15

- Shriners has 4 SWK team members, also called SWK case managers
- They are in charge of:
o Discharge management
o Running team meetings
o Coordinating care, travel, educational needs and housing if needed
 Visa applications
 Notes for school
 Organizing airport accommodations if needed
- The vertical model = Pt and families are usually either referred by a nurse to a pt who
they would like them to check in with if they think the child and family could benefit
from their services or if abuse or neglect is suspected.
o Once assigned, either on inpatient or outpatient, the worker will stay with that
pt until they no longer come to Shriners or turn 21
o Collaboration with the other departments is critical for allowing SWKs to do all
they can to offer supportive services
o SWK will also contract out to psychology or other departments if appropriate
- They serve as the primary resource (specifically) for parents as a way of managing their
child’s care
o They are the “link” once families leave to country to stay connected and in
communication about a child’s care.
 They must be educated and aware of cultural norms, beliefs, practices
and behaviors
- Court
o When parents are involved with DCF or custody cases, SWK will be on top of
those situations and in communication with others
o 51A’s are filied through them
- Bereavement
o SWK plays a large role in bereavement
o Primary supports for parents
o Takes the lead in coordinating what happens following the death, getting pt’s
bodies home, documentation to send pt’s back internationally
- CL& SWK
o Melissa thinks there’s much more overlap with CL and psy then SWK in terms of
interacting directing with the pt
o Both address a different level of pt care beyond the physical component
o Both require a lot of thinking out of the box
o Communication between team members is very important for pt care