Holidays in the CHOC Children’s Cherese Mari Laulhere Mental Health Inpatient Center

By Liz Hawkins, Volunteer in the CHOC Children’s Cherese Mari Laulhere Mental Health Inpatient Center

Patients in CHOC Children’s Cherese Mari Laulhere Mental Health Inpatient Center (MHIC) were treated to several surprises this holiday season.

Made possible by the MHIC Dream Team and volunteers, patients kicked off the holidays with a Thanksgiving lunch and celebration.

Thanksgiving lunch hosted by the MHIC Dream Team

Several Child Life Specialists braved the chilly autumn rain to set up a tent for Thanksgiving lunch. Patients received personalized invitations including up to 3 friends or family members to the special outdoor festivities. Tables were set with formal place settings, fall décor and activities such as decks of cards, coloring sheets, games and modeling clay to help keep the fun and conversation flowing. Other activities for patients and families included a photo booth, a picture frame decorating area and seasonal crafts.

Patients, guests and staff were served turkey and trimmings by members of CHOC’s Mental Health Advocacy Committee while music selected for the occasion by our MHIC Music Therapist played softly in the background. It was chilly and wet outside, but under the tent was warmth in the air that only a holiday can bring. Those patients that did not have family and friends able to join them at lunch were surrounded by staff that ate and played games alongside them to make their day special. That kind of compassion is extraordinary in mental healthcare, but it’s typical here at CHOC.

Warm winter surprises

After watching The Polar Express with MHIC staff, patients left cookies and milk out for Santa and went to bed early the night before Christmas. They awoke to a magical scene: holiday music played, a yule log crackled on the Seacrest Studio TV channel and presents hand-picked by Child Life Specialists awaited each patient.

Just like any child on Christmas morning, MHIC patients experienced the thrill and excitement of opening gifts chosen just for them, thanks to hard work from our Child Life team, MHIC staff, community donations and a little holiday magic.

Holiday celebrations like these bring cheer and smiles to patients and families, help to normalize the hospital experience, reduce stigma and set CHOC’s MHIC apart from other inpatient mental health centers. The MHIC Dream Team strives to make every day special for patients and families, but these holidays proved to be especially incredible.

It was the perfect way to kick off a new year in the MHIC, our second year in service to the community, where we celebrate the little things every day. We look forward to celebrating holidays in a big way in the MHIC in 2020.

Learn more about the Cherese Mari Laulhere Mental Health Inpatient Center at CHOC.

CHOC Children’s Receives Transformational Gift from Cherese Mari Laulhere Foundation to Expand Pediatric Mental Health Care

CHOC Children’s announced it has received a transformational gift from the Cherese Mari Laulhere Foundation to enhance and expand its pediatric mental health system of care. The announcement comes on the heels of the Conditions of Children in Orange County report, which highlights an alarming increase in the number of children hospitalized in the county for mental illnesses.

The gift from the Cherese Mari Laulhere Foundation will:

  • Endow CHOC’s mental health inpatient center. Opened in April 2018 for children ages 3 to 17, the center is the only inpatient facility in Orange County that offers specialized programs for kids younger than 12. The center will now be named the Cherese Mari Laulhere Mental Health Inpatient Center.
  • Establish the Cherese Mari Laulhere Young Child Clinic for children ages 3 to 8 who are experiencing behavioral and emotional challenges, mental health issues and school readiness challenges. Filling a gap in care, the clinic’s goal will be to help prevent long-term developmental problems for these young children.
  • Expand CHOC’s Intensive Outpatient Program, a mental health treatment program for high-schoolers with moderate to severe symptoms of anxiety, depression or other symptoms related to mental health conditions. The program will be expanded to middle school-aged children to help address the risk of suicidal ideation that can occur among pre-teens in grades sixth through ninth.
  • Advance trauma-informed care, including providing tools to pediatricians to help in identifying adverse childhood experiences, and connecting patients and families with resources. The support from the Cherese Mari Laulhere Foundation will enable CHOC to catalyze systems-level change in the treatment of pediatric trauma in the county to improve the long-term health and well-being of children.

“Although her life ended far too soon, Cherese left a lasting impact on people because of her passionate commitment to make a difference in the world. The gift from the foundation named in her honor will help advance her dream by bringing newfound peace into the lives of children with mental illnesses and their families,” says CHOC President and CEO Kimberly Chavalas Cripe. “I can’t imagine a more fitting way to remember such a bright, beautiful and giving spirit.”

Cherese Mari Laulhere

Established to honor Cherese Mari Laulhere, who died in a tragic accident when she was 21, the Cherese Mari Laulhere Foundation provides funds to charitable organizations that reflect Cherese’s dedication to enriching the lives of children. In 2017, the Cherese Mari Laulhere Foundation donated $5 million to endow the child life department at CHOC Children’s Hospital.  In recognition of the foundation’s generosity and to honor the memory of Cherese, the department was named The Cherese Mari Laulhere Child Life Department.

“Our donations are gifts from our daughter, who brought so much light and love into this world. As someone who advocated for the underserved, Cherese would be very proud of her role in supporting CHOC’s mental health efforts and helping change the trajectory of thousands of young lives,” says Cherese’s parents, Chris and Larry.

For information about Cherese and photos, visit www.cherese.org.

Music therapy in a mental health setting

Music therapy has been part of CHOC Children’s specialized therapeutic programming for more than 10 years. The program has grown recently, due to increased awareness of its effectiveness and a rising need among CHOC patients. We sat down with Kevin Budd, a board-certified music therapist in CHOC’s Mental Health Inpatient Center, to discuss the benefits of music therapy in an inpatient psychiatric setting.

Q: What comprises music therapy as a practice?


A: Music therapy is the clinical, evidence-based use of musical interventions to accomplish individualized goals. This occurs within a therapeutic relationship between a credentialed professional who has completed an approved music therapy program and a patient. During music therapy, we address physical, psychological, cognitive and/or social functioning challenges for patients of all ages. Essentially, music is the tool that helps support a patient’s non-musical need.

Q: How does music therapy support clinical goals?

A: A patient’s clinical goal is the starting point for determining which musical intervention will be most effective. In the Center, these goals could include: mood regulation, self-expression, self-esteem, anxiety, interpersonal effectiveness, treatment motivation, positive coping skills and others. There’s no one-size-fits-all treatment when it comes to music therapy and mental health. We might work towards a patient’s goals several different ways, such as through focused music listening, songwriting, song discussion, group instrument playing, music and relaxation, singing and more.

Music therapists rely on assessment, treatment planning and evaluation to determine whether a patient’s current music therapy methods are meeting their needs. Without treatment goals, there could be no effective music therapy.

Q: What is an example of using music therapy to address a clinical goal?


A: If a patient’s clinical goal is to increase identification of positive coping skills, we might work on lyric analysis within the patient’s preferred style of song. We could discuss triggers, resilience and negative life situations in the song. After this discussion, we could rewrite the chorus of the song, including identification of a negative situation and a positive coping skill to help address it. The patients can then be encouraged to share what they created—by singing, spoken word or other creative means.

Within this exercise, not only has the patient used a creative medium to identify a negative situation and how to cope with it; they have also built confidence after completing and sharing their creation, felt more connected with others in the group by being vulnerable and feeling validated, improved their mood and increased their treatment motivation.

Q: What kind of impact have you seen in mental health patients who have participated in music therapy?


A: Sometimes it’s hard for patients to verbalize past trauma or express their struggles. But with music therapy, they can discuss a song that relates to their current situation—whether it is bullying, family problems, hopelessness, anxiety or another stressor. During this process, patients may be able to process and verbalize more, since the lyrics are an easier gateway for expression.

During group ukulele playing, patients who have difficulty with interpersonal relationships can cohesively and successfully play music together in a positive, supportive space without the need to talk. They can work on distress tolerance and problem-solving skills while persevering through a challenging task—and by the end, they have improved self-esteem.

In any setting, music instantly affects our bodies—mentally, physically and behaviorally. It’s amazing how one musical intervention can address multiple goals.

Q: What is unique about music therapy in an inpatient psychiatric facility?


A: Music therapy can look different in the inpatient psychiatric setting than in other areas of the hospital. Within the Center, goals for music therapy are focused on combatting the reasons why a patient is admitted—these could include suicidal ideation, depression, anxiety or other factors keeping a patient from participating in a healthy way in daily life. The goal of the MHIC is to stabilize these patients and provide them with as many resources as possible to cope with their mental health challenges.

Music therapy does just that and provides opportunities for patients to learn, process, practice and discover new skills through tailored music interventions. The MHIC offers opportunities for a diverse group of kids and teens to express themselves in a supportive, safe and validating environment. Individual music therapy sessions are available to patients in the Center who need additional one-on-one support to complement their other treatment.

Q: Why did you want to become a music therapist? Why a mental health setting specifically?


A: I’ve gone through my own mental health challenges throughout my life, and I always found that music validated my journey. Music helped me distract myself and process my feelings. Music met me where I was in the moment and gave me hope. It also gave me a platform to express myself in ways I didn’t know how to otherwise.

When considering career paths, I wanted to find a way to harness the role music had played in my life in a therapeutic way. After receiving my undergraduate degree in music, I developed a special interest where psychology and music intersect—the space where music therapy truly breathes. I pursued my graduate degree in music therapy and then became a board-certified music therapist.

I feel humbled and fulfilled to be able to support kids and teens at CHOC with the tool of music. By creating an authentic therapeutic alliance, I can support them through a harsh and challenging time in their lives. I am thrilled to be on the front lines of the music therapy program at CHOC Children’s, and I look forward to supporting its growth and success in treating pediatric patients.

Learn about Specialized Therapeutic Programs at CHOC

Talking to children after traumatic events: Six resources to share with families

Helping children cope through the aftermath of a traumatic event can be difficult.

Acts of mass violence bring up widespread worry, anxiety, uncertainty and trauma, and it can be overwhelming for parents to know where to start when talking to kids about it.

People often turn to healthcare providers for advice about the best ways to approach tough conversations with young people. The following is a list of helpful resources you can share with families about coping with the complicated feelings after a traumatic event.

Guidelines for helping youth after the recent shootings

This fact sheet by The National Child Traumatic Stress Network (NCTSN) offers guardians tips about helping children after an act of mass violence. It is presented in both English and Spanish versions.

For teens: coping after mass violence

Another NCTSN resource, this handout is tailored to parents of teens and includes information for adolescents on self-care after trauma.

American Psychological Association response to mass shootings in Texas, Ohio

American Psychological Association President Rosie Phillips Davis, PhD, offers an official statement, as well as a helpful list of resources, in the aftermath of mass gun violence.

How to help your child navigate the emotional aftermath of a traumatic event

This CHOC Children’s Blog post presents the five E’s, a clear series of steps parents and guardians can follow when talking to children, alongside a list of additional resources.

Talking to Children About Violence: Tips for Parents and Teachers

The National Association of School Psychologists offers points to emphasize when talking to kids of all ages about violence. Companion flyers are also offered in English, Spanish, Korean, Vietnamese, French, Amharic, Chinese, Portuguese, Somali, Arabic and Kurdish.

Should you talk to young children about tragic events?

This CHOC Children’s Blog post breaks down factors parents should consider before talking to their kid(s) about tragedy, including appropriate approaches by age group.

A day in the life of a mental health nurse

The CHOC Children’s Mental Health Inpatient Center is an inpatient psychiatric center exclusively dedicated to the treatment of children ages 3-17 with mental illness who are in immediate risk of hurting themselves or others. It is the only inpatient facility in Orange County that can treat patients younger than 12. Our doctors and care team are all specially trained to treat children and provide the very best patient- and family-centered care 24 hours a day, seven days a week.

During a child’s stay, he or she engages in daily multidisciplinary therapeutic groups and receives individual therapy, family therapy, brief psychological testing and psychiatric care.

In observance of Mental Health Month, follow along for a day in the life of Madeline, a clinical nurse in CHOC’s Mental Health Inpatient Center.

5:15 a.m. – After fighting my snooze button, I wake up, shower, and drink some much-needed coffee.

6:30 a.m. – My cat yells his goodbyes to me as I give him a treat and leave for work. On the way, I vibe out to music to get pumped up for the day. I’ve worked at CHOC for over a year now. Last year, I was accepted into CHOC’s Registered Nurse Residency program. As a new nurse, I felt called to work in a mental health setting. I am beyond proud to stand alongside the brilliant CHOC team on the frontlines of mental healthcare.  

7:00 a.m. – I join my team in our conference room for a daily briefing report. Together, we review any newly admitted patients, our current population of patients, and any safety concerns. One of the ways we keep kids safe is through trauma-informed care. Upon admission, we work with patients and their families to determine any triggering situations or actions the patients may have, and then learn how strong emotions may manifest outwardly; such as pacing, shaking, or becoming very quiet. This information helps us to rapidly identify when patients are struggling and may need extra support or encouragement to utilize their coping skills. One of my favorite environmental adaptations we can provide for patients is our sensory room. It helps stimulate a few of our five senses to help kids cope and be more present in the moment. Sometimes, just hearing the rhythmic movements of the bubbles can be soothing and have a great calming effect.

7:30 a.m. – Once I have an understanding of our environment, I walk the unit to check on the patients. Most are still asleep, so I then look up my patient’s medications, while verifying medication consents. All pediatric psychiatric medications need parental consent obtained by the patient’s psychiatrist.

8:15 a.m. — Our medication room has a barn door, so I can efficiently and safely administer patients’ morning medications, preform a quick mental status check-in, and obtain vitals.

9:30 a.m. — One of my patients is currently taking a new medication. In order to better understand her body’s acceptance and tolerance of the drug, we need to run labs. Before drawing her blood, I numb a small area of her skin using a J-Tip®. During the blood draw, a child life specialist and I help the patient cope by offering her modeling clay and a hide-and-seek activity book.

10:00 a.m. — Throughout the day, our patients are divided into groups based on age to attend group sessions. This creates a structured environment that promotes the development of coping and social skills they can utilize when they go home. The sessions focus on our various themes of the day that can range from problem solving or emotional regulation to nutrition and wellness. These sessions are led by our team of nurses, social workers, child life specialists, plus art and music therapists. This morning’s group session is focused on gross motor skills. Our group leaders soak up some sunshine in our beautiful outdoor area while supervising patients socializing and joining in on a game of handball.

11:00 a.m. — I sit down with one of my patients to discuss their day so far and check in on any thoughts of self-harm that we can work through together. Afterwards, as part of the patient care team, I meet with that patient’s psychiatrist Dr. Lavanya Wusirika, and social worker Gaby, to discuss the patient’s care plan.

12:30 p.m. – It’s time for the patients to have lunch. Our patients eat together, so I assist with passing out lunch trays and pouring drinks. One of our licensed vocational nurses, Brenda, has become our unofficial DJ, and she plays music during lunch to help create a fun, therapeutic environment.

1:00 p.m. – I receive a call from a patient’s parent. After addressing their questions, I update them on their child’s plan of care, medications and current temperament.

2:00 p.m. – I use my own lunch break to catch up with my coworkers. We spend a lot of time together, and I’m lucky to have such an amazing work family.

3:00 p.m. – It’s time for one of our patients to head home. Upon admission to the unit, our team begins organizing outside resources and planning ways to increase safety and support at home. This information is built upon throughout their stay and is incorporated into an individualized safety and coping plan. After our social workers discuss the plan for home with the patient and their parent, I review current medication information and additional discharge instructions. Staff members and fellow patients send off their peer with warm wishes and words of encouragement.

4:30 p.m. –As a nurse, it’s my turn to lead one of our nursing groups. After the patients participate in a discussion about favorite coping skills and we do a check-in of their current emotions, we follow a painting tutorial to practice our theme of the day, mindfulness.

6:00 p.m. – I spend time updating my patients’ charts, including their mental status assessments and treatment plans. This way our whole team can see the patient’s progress and any concerns.

6:45 p.m. – During daily community meetings, all of our patients join together, and our staff leads a check-in to summarize what has been learned from our theme of the day. Patients take turns sharing their high and low of the day and how we can build on these experiences for tomorrow.

7:00 p.m. – As our night shift nurses arrive, we take turns giving a report of their patient’s day and mental status. We share new triggers that we have learned from the patients as well as new coping skills that were helpful. Knowing how we can best care for patients before, during and after a crisis or stressful situation is fundamental for trauma-informed care. By caring for every patient as a whole, not as a diagnosis or as someone defined by their trauma or maladaptive behaviors, we are able to better understand and care for them.

8:00 p.m. ― Get home and share a delicious meal with my husband. A long hug and many kisses are bestowed unto my cat Boots. The three of us will cuddle up and watch a show before we head to sleep and start again.