Staff approaches during episodes of fear in children

Theresa Ann Downey, University of Rhode Island


The purpose of this qualitative descriptive study was to investigate staff approaches to transient-developmental fear in children in a Cognitive Behavioral Inpatient Program. The study was important because transient-developmental fear in these children interfered with their participation in crucial program activities and diverted staff attention from other children. Disruptive fear behavior interfered with the progress and security of other children. The study used a cross sectional design to focus on fear in 5-to-11-year-old children with behavioral, interactional, and learning difficulties.^ Key elements of the framework of this study--adults' interpretations of the events and children's emerging cognitive competencies--emerged from the literature. In 1954 Florence Blake proposed that nurses clarify the nature of children's fear. Arthur Jersild, in 1935, introduced the notion that fear of specific objects/events in children was related to children's cognitive immaturity. Frances Holmes, in 1935, proposed providing support for children during fearful events. The hallmark of a successful approach--children's participation in the event which elicited fear--was derived from Holmes' work in 1936.^ An ethnographic approach--participant observation--was used. Focused observations of program activities and children were guided by theoretical sampling (Glaser and Strauss, 1967; Strauss, 1987). The primary source of data was derived from focused observations of 8-to-11-year old children in a Cognitive Behavioral Inpatient Program (CBIP). Similarities and differences in approaches used by staff were then examined during focused observations of 5-to-7-year-old children in the CBIP.^ The primary unit of analysis was the interaction between the staff and the children accompanying children's participation in various activities comprising episodes of fear. The Ethnograph (a program for the computer assisted analysis of text based data) was used for coding data during concurrent analysis. This program facilitated the process of constant comparative analysis and simplified consistent coding.^ Preplanned group approaches as well as unplanned personalized approaches were used by the staff. Sequences of an empathic-supportive approach--integrating the approach advocated by Blake with the approach used by Holmes--were apparent. When staff used empathic-supportive approaches, children were able to take part in important program activities which had elicited fear. ^

Subject Area

Psychology, Social|Health Sciences, Nursing|Psychology, Developmental

Recommended Citation

Theresa Ann Downey, "Staff approaches during episodes of fear in children" (1993). Dissertations and Master's Theses (Campus Access). Paper AAI9332433.