Puppetry and doll play as an adjunct to pediatric orthopaedics

The loss of a considerable segment of body tissue is often psychologically more traumatic than is the actual surgery to the unprepared child. In an attempt to improve the preparation of the child for ablative surgery, as well as to facilitate the pre- and postoperative management of the pediatric patient and family, we have developed a system of doll play and puppetry to educate and prepare children for this type of surgery. Guilt feelings are minimized, an outlet for hostility is provided, and the ever present fear of the unknown is confronted and dealt with in a manner acceptable to the child. The nonthreatening role of this technique also helps alleviate parental fears and concerns. Our experience with this technique has confirmed its usefulness in the preoperative psychological preparation of young children facing amputation or major musculoskeletal procedures.