THE CHILDREN S HOSPITAL OF PHILADELPHIA CHILD LIFE, EDUCATION and CREATIVE ARTS THERAPY DEPARTMENT

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1 THE CHILDREN S HOSPITAL OF PHILADELPHIA CHILD LIFE, EDUCATION and CREATIVE ARTS THERAPY DEPARTMENT Dear Applicant, Thank you for your interest in our child life training program. Three times a year, for 16 weeks, we offer comprehensive child life internships in the Child Life, Education and Creative Arts Therapy Department. A certified child life specialist (CCLS) will supervise the student as he or she participates in individual and group clinical experiences with children and families. These are full time training positions with sessions beginning in January, May and August/September. To be an eligible candidate, you must be a college senior or a college graduate and possess: Successful completion and documentation of ten core curriculum classes, including a course taught by a CCLS as approved by the Association of Child Life Professionals Eligibility Assessment/Course Review A minimum of a cumulative GPA of 3.0 on a 4.0 grading system from your college or university Student or work experience with children and teens in group settings for a minimum of 100 hours Training experience working with children in an established child life/therapeutic recreation program in a health care setting under the direct supervision of a Child Life Specialist classified as a Child Life Practicum experience resulting in a minimum of 100 hours Knowledge of psychosocial issues related illness and hospitalization The Children s Hospital of Philadelphia does not accept items that are In Progress (including practicums, coursework, Eligibility Assessment Reports) as meeting the requirement. All requirements must be completely met and indicated in the application by the postmark deadline be considered an eligible candidate for the session being applied for. As recommended by the Association of Child Life Professionals, application deadlines are as follows: Training Dates Application Deadline Initial Offer Date Acceptance Date Spring (January start) Summer (May start) Fall (August/September start) September 5 th January 5 th March 15 th 2nd Tuesday of Ocber beginning at 1pm 2nd Tuesday of February beginning at 1pm 1 st Tuesday of May beginning at 1pm Following Wednesday Following Wednesday Following Wednesday ** All applications materials must be postmarked by the application deadline in order be considered for the session being applied for. Application is not a guarantee of acceptance. Due the expectation that we provide students with quality supervision and education during placement, a limited number of students are accepted per semester. Should you have any questions about the application process please call the Child Life, Education and Creative Arts Therapy Department at Sincerely, Training Supervisor Child Life, Education and Creative Arts Therapy Department

2 CHILD LIFE INTERN DESCRIPTION Internship training is offered three times a year, beginning in January, May, and August/September, for 16 weeks at 40 hours per week. The child life intern is responsible for supervised involvement in the planning and implementation of a developmentally and emotionally supportive program for children and adolescents. The student will be expected incorporate play, emotional support, health care education, and family involvement in order enhance the social, emotional, intellectual, and physical well-being of children and families in the health care setting. The student will actively participate in initial orientation and ongoing guidance and evaluation by the student program coordinar and child life/therapeutic recreation staff enable him/her : Provide meaningful therapeutic relations and activities: O in the inpatient playrooms o in the patient s rooms at the bedside o in outpatient areas o in treatment areas and other hospital areas as appropriate Assist children and families in adjusting the health care setting and experience. Share observations and experiences with on-site supervisor. Participate in the interdisciplinary team approach care. Prepare and carry out healthcare education for patients and/or family members. Participate in the facilitation and delivery of family-centered care. Student Intern Program Components: Orientation The Children s Hospital of Philadelphia Orientation policies and procedures (safety, infection control, etc.) Participation in child life staff meetings (including staff in-services, quality improvement activities, etc.) Daily reflective journals Assigned readings and discussion Orientation patient populations and observation of child life/therapeutic recreation services may exist in the following areas: o Oncology (inpatient, including bone marrow transplant unit, and outpatient) o Cardiology and Cardiac Intensive Care Unit o Surgical and trauma unit o Adolescent unit o Pulmonary unit o Emergency Department o Day Surgery o Pediatric Intensive Care Unit o Radiation Oncology o Pediatric Rehabilitation o Radiology Training experience in two clinical units (7 weeks on each of the two clinical units) Formal weekly in-service training including, but not limited, the following pics: o Child Development: The Impact of Illness and Hospitalization

3 o Play in the Hospital o Medical Play Techniques o Building Supportive Relationships o Therapeutic Activities o The Child Life Assessment Process o Documentation and Charting o Preparation: A Review of the Research, Techniques, and Materials o Developing Preparation Skills o Family Stress and Child Life Intervention o Death and Dying: A Family Crisis o Coping Techniques: An Overview o Helping Children Learn and Use Relaxation Techniques o Creative Arts Therapies o Cultural Effectiveness in the Health Care Environment Periodic self and supervisor evaluation of performance Interdisciplinary team involvement Child Life Internship Program Objectives: Upon completion of the internship at The Children s Hospital of Philadelphia, the intern will be able : apply theoretical knowledge comfortably navigate the hospital environment discuss the psychosocial effects of health care on children and families identify the meaning of specific medical terminology, diagnoses, and procedures; understand their relationship the child s and family s level of understanding demonstrate entry-level professional skills in the use of play and therapeutic activities effectively provide medical education/preparation for specific procedures utilize simple distraction and relaxation techniques assist children in their coping attempts facilitate supportive relationships within the boundaries which define therapeutic relationships demonstrate developmental and psychosocial assessment techniques plan child life or therapeutic recreation interventions demonstrate professional attitudes, growth, maturity, and judgment function and communicate as a member of the interdisciplinary team gain broader knowledge of the field of child life or therapeutic recreation through readings, in-services, and interactions with child life staff communicate skills and learning in an interview process

4 Additional application materials required by CHOP checklist In order be considered for placement, you must submit the following application materials : Training Supervisor Child Life and Education Department The Children s Hospital of Philadelphia 3401Civic Center Blvd., Main Hospital Room #8540 Philadelphia, PA Cover letter indicating the program which you are applying Completed Association of Child Life Professionals Common Child Life Internship application, with all fields completed, including tal documented hours for each experience listed List of personal/professional goals for the training experience at Children s Hospital of Philadelphia (minimum 4) word essay describing your philosophy of child life Official transcripts from all academic institutions attended verifying a minimum cumulative GPA of a 3.0 or higher (Electronic transcripts directly from the university the childlifestudentprograms@ .chop.edu are accepted. Unofficial transcripts, advising worksheets or copies of official transcripts are not accepted.) Resume/Curriculum Vitae 2 personally signed letters of professional recommendation in sealed, author initialed envelopes (at least one of whom has observed your direct work with children) Association of Child Life Professionals Eligibility Assessment complete evaluation report documenting a minimum of 10 approved courses, including the course taught by a CCLS, (summary and specific courses approved) and your name Evaluation ol/form(s) from CCLS/CTRS supervisor of practicum or field placement in a child life /therapeutic recreation that was utilized evaluate performance during Child Life Practicum training Application fee of $25 (check or money order only made payable The Children s Hospital of Philadelphia Child Life Department) Continued on next page

5 If the internship placement is be conducted in affiliation with a university, a description of academic requirements and of the role of the university supervisor must be included (i.e. letter from internship supervisor and list of academic requirements for placement). Signed application checklist By signing, I indicate that I have reviewed and met the application requirements. I am submitting all necessary documentation be considered for a Child Life internship experience at The Children s Hospital of Philadelphia. Signature: Date:

6 Common Child Life Internship Application For Internship Session: Application Checklist Review Completed and Signed Application Form Official ACLP Eligibility Assessment Report Attached Reference Letters Resume/Curriculum Vitae Attachment of additional application materials as required by each program I attest that the information in this application is true and accurate the best of my knowledge. Signature: Date: REMINDER: Applicants must check with EACH internship program verify that internship eligibility requirements are met and determine whether additional items are required be submitted with this application form. Examples of additional requirements that MAY be required include, but are not limited : A completed background check form Completion of additional essay questions or exercises Official documentation of volunteer hours **Specific number and type of reference letters SUBMITTING YOUR APPLICATION: Completed applications should be mailed directly the internship programs which you are applying. DO NOT MAIL YOUR APPLICATION TO THE ASSOCIATION OF CHILD LIFE PROFESSIONALS OFFICE. Please contact individual programs for their direct mailing information. Applications should be postmarked by ACLP s Recommended Internship Deadline for the specific internship session in which you are applying. Please note that some sites may follow other guidelines; please contact each program confirm their individual requirements. 1

7 Common Child Life Internship Application For Internship Session: a (Example: Fall 2015) Personal Information Last Name First Name (M.I.) Present Phone Permanent Phone Address Present Address Permanent Address City State/Province ZIP Code Country City State/Province ZIP Code Country In case of emergency, notify: Emergency Contact Name Relationship Address Home Phone Work Phone City State/Province ZIP Code Country Application Category University-affiliated (Internship hours will count ward course credit.) Independent (Internship hours will NOT count wards course credit. Please note: Some child life internship programs DO NOT ACCEPT independent interns.) If University-affiliated: University Supervisor/Advisor Name Address Phone University Name University Department Address 1. College/University Name Dates Attended (mm/year) Academic Information (Note: Please list ALL colleges/universities attended. If additional space is necessary, please go page 7.) Graduation Date (mm/year) Page 2 Major City, State/Province (Example: Fall 2015) Level (check one): Bachelor s Master s GPA Cum GPA in Major

8 Common Child Life Internship Application For Internship Session: TOTAL HOURS with Infants, Children, Youth and/or Families in Healthcare Settings: (Include hours from any additional experiences on page 8.) Experience with Infants, Children, Youth, and/or Families in Healthcare Settings (e.g., volunteer, practicum student) 1. Institution Supervisor s Name and Credentials Supervisor s Title Yes No 2. Institution Supervisor s Name and Credentials Supervisor s Title Yes No 3. Position Title (e.g., nanny, counselor, teacher) If additional space is necessary complete the list, please go page 9 of this form. 3

9 Common Child Life Internship Application For Internship Session: (Example: Fall 2015) TOTAL HOURS with Infants, Children, Youth and/or Families in Stressful Situations: (Include hours from any additional experiences on page 9.) Experience with Infants, Children, Youth, and/or Families in Stressful Situations (e.g., camps for children with chronic illnesses, programs for children with special needs, advocacy programs, bereavement/hospice experiences) If additional space is necessary complete the list, please go page 10 of this form. 4

10 Common Child Life Internship Application For Internship Session: (Example: Fall 2015) TOTAL HOURS with Well Infants, Children, Youth and/or Families: (Include hours from any additional experiences on page 10.) 1. Experience with Well Infants, Children, Youth, and/or Families (e.g., nanny, counselor, teacher) Position Title (e.g., nanny, counselor, teacher) 2. Position Title (e.g., nanny, counselor, teacher) 3. Position Title (e.g., nanny, counselor, teacher) Briefly describe population and responsibilities: (approx. 100 word limit If additional space is necessary complete the list, please go page 10 of this form. 5

11 Common Child Life Internship Application For Internship Session: (Example: Fall 2015) Essay Questions Please answer the following questions: How did you first become interested in or aware of child life? (approx. 200 words) What have you done increase your knowledge/awareness of this profession? (approx. 200 words) Briefly describe the ways in which the work of a child life specialist contributes the health care experience of a child and his/her family. (approx. 200 words) Provide a specific example of a time that you used play meet the developmental needs of a child. (approx. 200 words) 6

12 Common Child Life Internship Application For Internship Session: Professional Involvement (Example: Fall 2015) Please list the names of any professional organizations you are a member of: The following sections are for completion ONLY if additional space is required for the applicant s listing of academic information and/or experiences with children and/or families. 2. Academic Information, continued (Note: Please list ALL colleges/universities attended.) College/University Name City, State/Province Dates Attended (mm/year) Graduation Date (mm/year) Major Level (check one): Bachelor s Master s GPA Cum GPA in Major 3. College/University Name City, State/Province Dates Attended (mm/year) Graduation Date (mm/year) Major Level (check one): Bachelor s Master s GPA Cum GPA in Major 4. College/University Name City, State/Province Dates Attended (mm/year) Graduation Date (mm/year) Major GPA Cum GPA in Major Level (check one): Bachelor s Master s 7

13 Common Child Life Internship Application For Internship Session: (Example: Fall 2015) Experience with Infants, Children, Youth, and/or Families in Healthcare Settings, continued 4. Institution Supervisor s Name and Credentials Supervisor s Title Yes No 5. Institution Supervisor s Name and Credentials Supervisor s Title Yes No 6. Institution Supervisor s Name and Credentials Supervisor s Title Yes No 8

14 Experience with Infants, Children, Youth, and/or Families in Stressful Situations, continued (e.g., camps for children with chronic illnesses, programs for children with special needs, advocacy programs, bereavement/hospice experiences)

15 Experience with Well Infants, Children, Youth, and/or Families, continued 4. Position Title (e.g., nanny, counselor, teacher) 5. Position Title (e.g., nanny, counselor, teacher) 6. Position Title (e.g., nanny, counselor, teacher) 10