Children have a unique power to integrate their realities in ways that we adults have long forgotten. It may be time for healthcare organizations to tap into that quality children possess to promote healing.
When I was a child, there was a prevalent view that “Children should be seen and not heard.” Adults ruled, and children would be addressed when convenient. The notion was exemplified by George Banks, who was eventually influenced by the magical Marry Poppins to adopt a more enlightened view.
I recall my unenlightened pediatrician talking to my mother while I was being poked and prodded as if I was not a sentient entity. At one point, I yelled at him, “Hey, talk to me! I’m not a piece of meat.”
Too often, children are treated as less than fully developed human beings who are needy and inclined to make exasperating demands on us. We love them, but they also test our patience, and we assume they must grow and evolve before they can offer any meaningful contributions in the adult world.
But perhaps that view is short-sighted.
Many have attested to the power of children to promote healing, and we should not be too quick to dismiss such reports as being fanciful.a Children have a unique perspective of the world that can provide a lesson for adults on maintaining and improving mental and physical health. And their ability to openly convey that perspective goes far beyond the warm and fuzzy feeling one derives when marveling about a sleeping infant.
Just to be clear, I am not suggesting that children be used as crutches to help their parents deal with psychological and emotional traumas, which unfortunately does occur.b Rather, I am suggesting that we should appreciate children’s unique power to integrate their realities in ways that adults have long forgotten.
Children’s propensity for mindfulness
As an example, the ability of children to transcend their disease states in unique ways has begun to catch the attention of the healthcare community. Children have a heightened ability to use mindfulness-related approaches to decrease anxiety and stress. They have a capacity for being present-minded through a natural ability to focus on noting, observing and accepting the present moment, without judgment.c
Researchers have found that cognitive control, flexibility and memory in patients with ADHD improved with mindfulness-based meditation and that these improvements were considerably more robust in children than adults.d I have also seen clear evidence that martial-arts-based meditative intervention can help children with cancer and other disease states manage their illness in a non-conventional manner, incorporating elements of mindfulness, psychosocial temperance in addition to tai chi and other elements.
This method does not simply attempt to distract children from thinking about their condition. It actually imbues the child with a sense of power, peace and purpose, thereby changing their perception and receptivity to their environment, emotions, interactions and disease-related insults and impositions.e
The benefits of cultivating mindfulness in children – and adults
The power comes from the way activities focused on promoting mindfulness can move a patient from a state of passive acceptance of their predicament to becoming actively engaged in each life experience. The patient acquires a gestalt of peace, where disease-related melancholia and corresponding negative stagnation give way to an empowering sense of purpose. This transformation instills in patients a conviction that helps them transcend their disease-state. It also conveys that idea to others, demonstrating how one can not only cope with a disease but also ameliorate it. This approach is now practiced globally, and it has be recognized by CNN and others as a paradigm shift in healthcare management.e
Further, disease can affect not only the patient but also all family members, fostering disruptions caused by the need to allocate resources and attend to the sick child, in addition to the impact on the siblings and other life metrics.f The mindful approach can counter these effects by unifying, rather than splintering, the family around the patient’s care. As a martial artist and tai chi-ist for more than 20 years, I recall my sensei saying, “The family that kicks together, sticks together.” And my experience has shown that is often the result.
Economic viability
The practical question for cash-strapped health systems is, “What about the cost, and even if it’s affordable, how could we begin to invest in promoting such programs?” The good news is that the economics of a such an approach appear to be favorable to the healthcare system. Most of these programs are incorporated into the healthcare and hospital setting as volunteer programs, often supported through philanthropy and grant funding, and they are designed to work synergistically with conventional healthcare to augment patient improvement.
Furthermore, in the current epoch of COVID-19, such interventions can occur in the virtual setting, as a means to reach socially distanced, homebound and isolated individuals. Online options can include both individual “one-on-one” interactions as well as access for patient and their family to a virtual community as an adjunct to allopathic therapy and management.
The cost centers are modest, and the idea of introducing such initiatives as a standard of care has been promoted as a value-added offering in healthcare training curricula and as a general cost containment benefit to the general healthcare system.g Moreover, billing for services can be instituted under select CPT codes for revenue cycle management.h
Engaging children to promote healthcare improvement among adults
The positive effect of children on adults’ state of health is novel. Other countries have begun assessing the potential benefits for select healthcare settings. Israel has begun a pilot physical therapy program for adult seniors that integrates a connection with children. Another pilot program incorporated the mindfulness approach drawn from the martial arts therapy practiced by children with cancer to positively affect adult patients with substance use disorder by significantly reducing their pain, drug craving, anxiety and depression over a 12-week study period.i
4 ways to move forward
To tap into the potential benefits of such an approach, finance leaders of hospitals and health systems can begin with four practical steps.
1. Assess the clinical landscape. Finance leaders should identify the service lines and disease spaces in their organizations’ healthcare milieu that offer the potential for active engagement. For example, a pediatric cancer hospital should be able to employ already existing resources, while a pediatric obesity clinic would need to institute only a few minor adaptations toward implementing such a method.
2. Determine output measures of success. This recommendation applies to any service, and to patients of any age range. Tai chi programs have been shown to decrease pain and increase range of motion in those suffering from arthritis, for example.j Pain scores have been shown to decrease in children with cancer upon implementation of a martial-arts-based meditative intervention. Measures of success can range from a simple questionnaire to changes in biometric parameters, pain scales and laboratory values.
3. Interact with the organization’s constituencies. The communities served by a healthcare domain can be very supportive of such initiatives. Promoting such avenues where children become the center focus to help themselves and others usually resonate with most community members, both healthy and sick, as a higher calling, ensuring such a program is well received.
4. Follow the numbers. Value can take the form of basic cost containment to patient and community allegiance. Monitoring such intangible metrics can provide value added outcomes for patient satisfaction and recruitment, attrition reduction, and hospital or clinic branding. Such value, in addition to conventional costs and receivables, can be monetarily defined and added, in many cases, to a balance sheet, as well.k
A new horizon for healthcare
In short, the healing power of children on each other as well as adults is curious and provocative. This novel approach can be incorporated into the healthcare system to maximize resources, empower patients, parents and family, improve revenue cycle management and provide evidence to the world that children can heal us and themselves in ways that previously may have seemed unimaginable.
Footnotes
a. Nicole, R., “Healing powers of children,” Vocal Media, 2018.
b. Iloabugichkwu, A., “It’s not a child’s job to heal their wounded mother,” Human Parts, May 23, 2019.
c. Gelles, D., “Mindfulness for children,” Well, The New York Times, accessed Sept.5, 2020.
d. Azarian, B., “The mindful child,” Well, The New York Times, May 10, 2016.
e. CNN, “CNN Heroes Tribute: Rabbi Elimelech Goldberg,” 2014; Bluth, M.H., Thomas, R., Cohen, C., Bluth, A.C., and Goldberg, E., “Martial arts intervention decreases pain scores in children with malignancy,” Pediatric Health Medicine and Therapy, July 8, 2016.
f. Deavin, A., Greasley, P., and Dixon, C., “Children’s perspectives on living with a sibling with a chronic illness,” Pediatrics, August 2018.
g. Lebensohn, P., et al., “Increasing resident recruitment into family medicine: effect of a unique curriculum in integrative medicine,” Explore, May-June 2014; Herman, P.M., “Evaluating the economics of complementary and integrative medicine,” Global Advances in Health and Medicine, March 1, 2013.
h. Hallisy, K., Clinical application of Tai Chi for pain management, International Tai Chi Symposium, July 7, 2014.
i. Faraj, M.M., et al., “A virtual reality martial arts-based intervention reduces pain, drug craving, and stress in patients with opioid use disorder,” Digital Commons @ Wayne State, March 2020.
j. Uhlig, T., et al., “Exploring Tai Chi in rheumatoid arthritis: a quantitative and qualitative study,” BMC Musculoskeletal Disorders, March 5, 2010.
k. Hamilton, W., “Top 10 most valuable intangible assets in healthcare services,” www.buckheadfmv.com, Jan. 3, 2019; Rider, E.A., et al., “Identifying intangible assets in interprofessional healthcare organizations: Feasibility of an asset inventory,” Journal of Interprofessional Care, Nov. 11, 2018.
