The Beads of Courage Program

What is the Beads of Courage Program?

Beads of Courage® is our flagship program and is a resilience-based intervention designed to support and strengthen children and teens coping with serious illness and their families. It is the standard of care in more than 300 children’s hospitals worldwide. Through the program children tell their story using colorful beads that serve as meaningful symbols honoring their courage displayed along their unique treatment path.

How Does it Work?

Upon enrollment each child is given the Beads of Courage bead color guide we call the Beads of Courage Bead Prescription (available from Beads of Courage, Inc). Their Beads of Courage experience begins when each child is first given a length of string and beads that spell out their first name. Then, colorful beads, each representing courage during their treatment experiences are given to the child by their professional health care provider as determined by the Beads of Courage Bead Prescription. As beads are added to their Beads of Courage collection, children and teens can RECORD, TELL, and OWN their stories of courage.

The Beads of Courage Program is available for the following:

  • Cancer and Blood Disorders
  • Cardiac Conditions
  • Burn Injury Recovery
  • Neonatal Intensive Care
  • Chronic Illness
  • Rehabilitation Care
  • Trauma Recovery
  • Pediatric Intensive Care
  • Palliative and Supportive Care

All Program Bead Prescriptions were developed in collaboration with experts in the field (nurses, doctors, child life specialists and social workers) so that each bead guide would reflect meaningful acknowledgment of a child’s courage displayed during their treatment experiences.

Major Benefits

Ongoing evaluation of the Beads of Courage program indicates that the program helps to decrease illness-related distress, increase the use of positive coping strategies, helps children find meaning in illness, and restore sense of self in children coping with serious illness. The program also provides something tangible the child can use to tell about their courage displayed during treatment and after.

Tools, Training, and Support

Beads of Courage, Inc. provides all hospitals the necessary program materials accompanied by education, training and support to implement the Beads of Courage Program. This includes:

  • On-site training to educate the clinical team about program implementation and the science that guided the development of this evidence-based program
  • Procedure and alphabet bead collections
  • Handmade one-of-a-kind treatment milestone beads
  • Program literature (training manuals, the Beads of Courage® Bead Prescription, posters, and more)
  • The Beads of Courage Ambassador Workshop for Reflection and Renewal
  • Opportunity for continuing education credits
  • Ongoing support for the staff during the longevity of the program
  • Sponsorship

Beads of Courage, Inc. believes strongly in collaborating with local non-profits, local businesses and private donors to provide the Beads of Courage Program at their community hospital. The Program Sponsor or Donor supports the program financially. Beads of Courage will seek sponsorship of your program if desired. Please contact us at if you have any questions.

Steps to Starting a New Beads of Courage Partnership or Program

  1. Determine your hospital’s Beads of Courage® Program interest and discuss with your multidisciplinary The success of any program requires that it is vetted with staff ideally across various disciplines of clinical care. Please take time to meet with staff and leadership about BoC programming to improve the quality of patient care, and the experience of caring for and by patients and their families.
  2. Identify a program sponsor or donor who can help support the program This can include local organizations, businesses, hospital foundations, individual donors or grants.

Custom logo beads ($750/500 beads). These beads have BoC logo on one side, and a custom logo on the other and include an intention card with customized mission statement or encouragement note from the sponsor. Logo beads are used to honor the chosen sponsor/donor and will accompany each child’s strand upon enrollment. This is a great way to highlight to Beads of Courage members, and anyone who views their beads, the caring people who sponsor their program.

  1. Identify Program Ambassadors. Beads of Courage, requires that the hospital identifies at minimum one BOC Program Ambassador. This is an important clinical leadership role. The Ambassador serves as the main point of contact with Beads of Courage, Inc. and is responsible for maintaining program integrity, including new orientation, staff continued education, ordering supplies, and regular communications. This information is collected in the program applications below.
  2. Provide the Site Information through the following These forms must be complete in order to proceed with establishing Beads of Courage® Programs at any participating hospital and information obtained will be used to draft the Program Participation Agreement.

Please complete the application to Become a Member Hospital (or renew information about your hospital) through this link:

In order for BOC to learn more about the area where the new BOC program(s) will be licensed for use, please complete the application below for the BOC program(s) you desire:

  1. Complete/Renew a Program Participation Agreement. A Program Participation Agreement drafted by Beads of Courage, outlines the shared responsibility of Beads of Courage, Inc. and the hospital for program success. The agreement outlines specific guidelines regarding patient safety, use of the Beads of Courage® registered trademark, approved content for communications, program terms and conditions and payment terms. The Agreement must be signed by the hospital legal representative and by Beads of Courage, Inc. before the program can proceed. Those who implement the program, the hospital’s marketing and communications, and the hospital foundation should review the agreement for program success.
  2. Complete Beads of Courage® Ambassador Beads of Courage, Inc. believes strongly in program integrity and effective implementation of the Beads of Courage® Program. We encourage a multidisciplinary team to attend the 2 hour Ambassador Training, designed to educate the clinical team about the design and implementation of the Beads of Courage® Program and the theory used in the development of the program. Beads of Courage, Inc. will work with your clinical educator to help participating staff members apply for CEU credits upon completion of this training, if interested. Staff will also have the opportunity to participate in the Caring for the Clinician bead stringing retreat for reflection and renewal.

Beads of Courage, Inc. is a non-profit organization that is dedicated to improving the quality of life for children and teens coping with serious illness, their families, and the clinicians who care for them through our Arts-in-Medicine Programs. We believe in creating a context for caring transactions to transpire through our community and encouragement programs. Since 2005, Beads of Courage, Inc. has established collaborative partnerships in caring with over 200 hospitals nationally and internationally, and worked with several community organizations to make healing happen through the use of beads as a historical art form.

Through our programs you can provide the opportunity for COURAGE to be honored, HOPE to be given, and JOY to be experienced.

Our Mission: To provide innovative Arts-in-Medicine programs for children coping with serious illness, their families and the clinicians who care for them.

Our Vision: To advance the science of caring. Beads of Courage, Inc. is proud of to be affiliated with the Watson Science Caring Institute and in 2013, we established the Center for Arts-in-Nursing to boldly pursue our vision.

Our Goals: 1. To transform the bedside experience of caring for children and teens with serious illness through innovative Arts-in-Medicine Programs; 2. To model collaborative strategies to strengthen human connectedness through the gift of beads that bestow honor and express human caring; 3. To contribute to the science, practice and implementation of evidence-based interventions.

Our Programs: Every Beads of Courage® program integrates the use of beads, the earliest art form known to humans, as visible, tangible symbols of human experiences that need and deserve to be expressed. Every time a bead is given courage is honored, suffering is alleviated, resilience is strengthened, and the experience of human caring is affirmed.

Bead Courageous: For Children and Teens in Active Treatment

Beads of Courage® is our flagship program and an evidence-based intervention that supports the psychosocial and emotional care of children and teens coping with serious illness and their families. It is the standard of care in more than 260 children’s hospitals worldwide and is intended to be implemented in a clinical setting. Beads are given based on the Beads of Courage® bead prescription that serves as a clinical protocol. The beads are transformed into a form of narrative medicine that allows children and teens to RECORD, OWN, and TELL their story of courage.

Cost to establish a new program: $5500 with an average cost of $3000-$5000 to maintain the program annually.

BEad Caring: Beads of Courage for Clinicians Clinicians are on the frontlines of caring for children coping with serious illness and their families. We know how important it is to prevent or alleviate compassion fatigue to keep each clinician strong and competent in extending their caring presence.

Beads of Courage® BEad Mindful was created for clinicians to create a consistent practice of personal reflection and rejuvenation. This program is designed to be implemented on a monthly basis and combines mindfulness with supportive intentional statements, mantras, meditations and a focal bead. BEad Mindful provides an object-focused intention with a broad goal of decreasing stress and enhancing the experience of caring.

$250 to provide mindfulness-based support for 10 staff for a full year ($25 per staff member/$2.10 a month for support/includes 4 handmade glass beads per staff member valued at $20).

To order, click here: BEad Supportive: Beads of Courage for Parents, Caregivers and Siblings The family is the immediate source of support for a child or teen receiving treatment for a serious illness. The support for parents, caregivers, and siblings is just as important as the support for their loved one who is ill.

The Beads of Courage® Sibling Program was designed to honor, support and acknowledge siblings who have a brother or sister with a serious illness. The Beads of Courage® Sibling Program provides encouragement to the sibling who needs to know they are not alone during a very challenging time for their family, and an experience where parents, caregivers and/or clinicians can foster opportunities for communication and emotional support. Each kit includes a colorful program book with 25 unique beads and 25 collector cards that promote sibling self-reflection, encouragement, communication, and emotional support.

$500 to provide psychosocial and emotional support for 20 siblings To order the Sibling Program, click here:

BEad Connected: Beads of Courage for everyone Our arts-in-medicine workshops are designed for people

of all ages and were developed by Beads of Courage over the years to provide an opportunity for more people to experience the important reflective work that a bead can facilitate.

Beads of Courage® BEad Strong activities encourage participants to BEad Strong in mind, body, and spirit by teaching children in treatment, their families and friends, as well as the clinicians who support them, how mindfulness can be an important life skill that can serve them in their daily life. Each unique Bead Strong activity provides an opportunity to use three components that are grounded in mindfulness: a mantra, a mindful art activity, and a basic breathing technique. The experience promotes mindfulness, self-reflection, communication and creative expression. Several Bead Strong activities are available for use as a therapeutic support for various settings: one-on-one with clinicians, groups, workshops, support groups, staff support and events. Includes a therapeutic art activity paired with a one-of-a-kind pewter bead

per person. $75 to support 10 people | $375 to support 50 people

To order, click here:

Beads of Courage® Camp Workshop is designed to support the camp experience. Beads are provided to acknowledge and celebrate the courage to try new things, to be away from home (often for the first time), and to make new friends at camp.

$100 to support 10 campers at an established camp

(Additional camp beads and custom camp logo beads are available).

To order the Camp Program, click here:

“We appreciate this program and the ability to offer it to our PICU families in a smaller, more intimate setting which allows our families to feel more comfortable opening up where they can share their bereavement journey with us through the use of beads in the Strand of Strength Workshop. They can tell a story of their bereavement journey through the beads they select and have a symbol to keep and share with others. Thank you!”

–Diamond Children’s Hospital Staff

Beads of Courage® Strand for Strength and Remembrance is an arts-in-medicine workshop for compassion and courage created for families who are coping with the death of a loved one. The program is a bead stringing experience for bereaved families, created to honor the legacy of a loved one in a very meaningful way. This program is suitable for children (5 yrs+), teens and adults.BEad Compassionate: Support for children, families and communities coping with grief and Bereavement Since the beginning of human history, beads have been transformed into material representations of emotions, physical connections, thoughts and desires. Our Arts-in-Medicine Workshops for Compassion and Courage honor and remember a loved one by transforming beads into metaphors of remembrance and memory.

$120 to provide bereavement support to 10 people

(includes 3 artist-made glass beads valued at $25 per person).

To order the Strand for Strength Program, click here:

For more information on any of our programs or for assistance in securing donor support to use these programs, please contact us at *Donation amounts to use each program may change at Beads of Courage discretion.

Beads of Courage® Program Frequently Asked Questions

Q: Why is there are a cost for the Beads of Courage® Program?

A: Beads of Courage, Inc. is a non-profit organization that depends on donations from the public to pursue our mission. We work with every hospital to find donors in their community to help cover related program costs. This is the essence of community-based program partnerships and we are very proud of the many program partners in caring we have established worldwide that make our programs a success.

Q: What is included in the $5000 program start-up cost?

A: The program start-up cost includes the initial program materials and set up, program beads, on-site staff training, and reflection and renewal bead stringing workshop for training attendees. Please note that the training can be an opportunity for staff professional development by contributing toward CEU credits, but more importantly, the value of the Beads of Courage® Program lies in its success as a program that directly supports the quality of life, sense of well- being for children and families and a strong therapeutic alliance among clinicians, patients, and families.

Q: What happens if I need more supplies and who pays for these?

A: Program supplies can be ordered on the Beads of Courage, Inc. website and are paid for as stated in the Services and Payment Terms, a part of the Program Participation Agreement. The bead refill costs vary depending on the size of the patient population, the number of Beads of Courage Programs used and how they are used, but average $3000-5000 annually. BoC provides options for refill order payment and requires payment before materials are shipped. (See Payment Options Q&A document).

Q: What is the Annual Dues/Licensing fee for?

A: The Annual Licensing fee is collected annually and is paid for by the hospital or as stated in the Program Agreement. This licensing fee allows the program to be licensed to the hospital as per the terms in the Agreement and is an investment in the Beads of Courage, Inc. organization that is used to cover related program costs that are above and beyond the actual costs of beads required for program outreach and availability (i.e. program management and support, bead order and inventory processing). Additionally, a portion of the annual membership dues are used to maintain clinical advisory committees dedicated to ongoing program research and evaluation and direct outreach to Beads of Courage® members, all of which are necessary to advance the science and practice of caring for people across the lifespan through innovative Arts-in-Medicine Programs. There is no separate annual licensing fee for use of the BoC Complimentary Programs and implementation of these programs is strongly encouraged to further strengthen and build a full Arts-in-Medicine Program at your hospital.

Q: Why does my hospital need to complete a Program Participation Agreement before starting the program? A: The Program Participation Agreement is a legal document that licenses the hospital the use of the program.

Embedded in the agreement is information about patient safety, use of the trademark, terms and conditions, approved content for communications, and payment terms. Protection of the Beads of Courage trademark is important for long- term stability of the program and the honor it bestows upon those children who are members.