This post comes a bit off topic as it is not an intervention for adolescent patients but a story that I felt needed to be shared to show the power bibliotherapy can have on patients and siblings.
The Story of Melanie and Her Brother Mark
About two weeks ago, a patient named Melanie (pseudonym) was transferred to my unit from the NICU. I was told that this patient had a poor prognosis and would most likely remain with us for a long period of time. I was also told that Melanie had a 6 year old brother named Mark (pseudonym) who the parents were looking for help in supporting. I introduced myself my role to Melanie’s parents and found out more information about their family who were very receptive to child life services. I provided them with some resources and offered to spend time with Mark whenever they felt appropriate to help familiarize him with the hospital environment, provide education, and support his coping with separation from family members and the overall stress of his sister’s hospitalization.
One thing I provided the family was a copy of “The Invisible String” by Patrice Karst along with a zip-lock bag with a long piece of soft yarn. I talked with the family about siblings’ experience with separation during hospitalization and about introducing the concept of an invisible string to Mark so that he would always feel connected to his parents and sister while they were away. I told them about the typical intervention I use after reading the book that involves the child holding on to one end of a long string while the parent/caregiver/sibling walks out of the room and out of sight holding the other end. I have the parent/caregiver/sibling tug on the string to see if the child can feel the tug. I then have the child perform the reciprocal action and ask the other person if they also felt it. From there, I would have the child cut the string and give one to each person he felt an “invisible string” attachment to. Then, I would have the child take the extra pieces and tie them to places that are important to them to serve as reminders of all the important invisible strings they have to the people they love. I gave this information to the family and had them encourage him to tie these pieces around transitional and bedtime objects like his backpack, his favorite stuffed animal, his bed frame etc.
After trying this at home with Mark, these parents reported back to me that he really connected with the idea of an “invisible string.” They stated that he loved the book so much that he brought it to camp with him that day along with the string tied around the handle of his backpack. Unfortunately, the next time I saw Mark, it had been determined that Melanie was approaching the end of her life. I continued providing support to Mark and his parents through this process, and his invisible strings came up again and again. He continued to process both separation and loss through this book even after Melanie’s passing. Before his final visit, we talked again about the string he still had with Melanie while she was in Heaven (which was the family’s belief).
Though his verbalized connections were so meaningful and impactful, nothing could prepare me for the beautiful representation of the book the family chose to incorporate in their everlasting memory of Melanie. When I attended the wake as a representative of the hospital, I was taken aback when I looked down at Melanie to find that the same string I had given Mark with the book was draped across her torso with each end held in her tiny hands. As child life specialists, we may not always see the direct impact of our interventions. But it was clear to me from this display that this book helped this family to process, grieve, heal, and yet remain connected to their beautiful daughter and sister.
To anyone reading this, know that even when you can’t see the direct impact of your work or the book you recommend, you may be making an even greater impact than you had originally foresaw.