Psycho-art-drama: development and testing a new integrated complementary method of psychiatric treatments for hospitalised children with cancer (a case study).

Objective: Art therapy as a psychotherapy method using art, and psychodrama as a therapeutic method using role play, have different roots, principles, techniques and different effect mechanisms and advantages. Integrated psychotherapies are aimed to maximise each of the component advantages, as well as minimising disadvantages. Therefore, the main objective of this study was to develop a new integrated psychotherapy method, named psycho-art-drama (PAD) for hospitalised children with cancer and testing its effectiveness.Methods: After designing the PAD protocol, five hospitalised children with cancer accompanied with their mothers selected based on inclusion and exclusion criteria to participate in this single-subject study.Results: The results showed that PAD was significantly effective in reducing the bio-psycho-social expressions of incompatibility in the hospital (BPSEIH) in all of the five children.Conclusions: Findings of this study give preliminary support using the PAD model in similar conditions.

Expressive writing as a therapeutic intervention for people with advanced disease: a systematic review.

BACKGROUND: Expressive writing involves writing about stressful or traumatic experiences. Despite trials in people with advanced disease, no systematic review to date has critiqued the evidence on expressive writing in this population. To synthesise the evidence of the effects of expressive writing on pain, sleep, depression and anxiety in people with advanced disease. METHODS: A systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. CINAHL, CENTRAL, PsycINFO and PubMed were searched from January 1986 to March 2018. Other sources included clinical data registers and conference proceedings. Studies were included if they were randomised controlled trials that assessed the impact of an intervention involving expressive writing for adults with advanced disease and/or studies involving linguistic analysis on the expressive writing output. Methodological quality was assessed using the Cochrane risk of bias tool and the Mixed Methods Appraisal Tool. The Grading of Recommendations Assessment, Development and Evaluation tool was used to assess the level of evidence for the outcomes of interest. The protocol of this systematic review has been registered on PROSPERO (CRD42017058193). RESULTS: Six eligible studies with a total of 288 participants were identified, including four randomised controlled trials. All of the trials were in cancer and recruited predominantly women. None of the interventions were tailored to the population. Studies had methodological shortcomings and evidence was generally of low quality. Combined analysis of the four trials, involving 214 participants in total, showed no clear difference in the effect of expressive writing on sleep, anxiety or depression compared to an active control. Pain was not evaluated in the trials. In contrast, analysis of the four studies that included linguistic analysis alluded to linguistic mechanisms for potential effects. CONCLUSION: Although the trial results suggest there is no benefit in expressive writing for people with advanced disease, the current evidence is limited. There is a need for more rigorous trials. It would be of benefit first to undertake exploratory research in trial design including how best to measure impact and in tailoring of the intervention to address the specific needs of people with advanced disease. TRIAL REGISTRATION: The protocol of this systematic review has been registered on PROSPERO, which can be accessed here (registration number: CRD42017058193 ).

Finding peace in clinical settings: A narrative review of concept and practice.

The purpose of this review was to investigate and review the concept of "peace" and the role it plays in the spiritual well-being and care of people with a chronic or terminal illness. Our objectives were, first, to examine the importance of peace in palliative care as a measure of acceptance and in chronic illness settings as a predictor of improved survival. Second, we explored the dimensions of peace and their relationships with spiritual well-being. We further examined how the constructs of peace are assessed both within valid spiritual well-being measures and as individual items related solely to peace. Finally, we examined therapies aimed at promoting peace and emotional well-being in palliative and chronic illness settings. Despite much being written about different constructs of peace and the positive effects of being at peace during times of illness, the effects of therapies on the feeling of peace are not well-studied.

[Arts therapies in severe mental illness: are they effective?]. / Künstlerische Therapien bei schweren psychischen Störungen : Sind sie wirksam?

Arts therapies are widely used treatment strategies for people with severe mental illness. Generally, only a few randomized trials are available, however, the studies show that additional use of arts therapies reduces the appearance of negative symptoms among people with schizophrenia. The most significant evidence can be seen with music therapy. The treatment of severe depression has shown that additional music therapy improves depression. The S3 guidelines on psychosocial therapies in severe mental illness of the Germany Society for Psychiatry, Psychotherapy and Neurology (DGPPN) recommended arts therapies are with recommendation level B.

Supportive care with art therapy, for patients in isolation during stem cell transplant.

OBJECTIVE: The aim of the art therapy study was twofold: 1) to identify the specific factors of the art therapy experience perceived as helpful by patients undergoing an allogenic hemopoietic stem cell transplant (HSCT); and 2) to establish an appropriate criterion for referral to art therapy among this population. METHOD: Between 2006 and 2010, a dedicated art therapist met all the patients who were referred to her by the hematologist. The art therapy approach and techniques are described. Outcome was evaluated by self-assessment, based on written questionnaires that were given to the patients before discharge. RESULTS: Seventy-four patients followed the weekly individual sessions during isolation and filled out the questionnaire. All of them defined the art therapy experience as "helpful" and specified in which way it had been helpful. Through a thematic analysis of the patients' written comments, three specific aspects of art therapy, which the patients found most helpful, were identified: (1) being able to calm down from anxiety, through the use of art therapy techniques (77.02%); (2) feeling free to express and share difficult feelings, which they had not communicated verbally (75.67%); and (3) establishing meaningful connections with their loved ones, through images made in art therapy (36.48%). Case illustrations are provided. SIGNIFICANCE OF RESULTS: The results suggest that referral to art therapy from the team might be helpful and appropriate: (1) when patients are anxious; (2) when they are uncommunicative and hide their feelings; and (3) when they feel disconnected from their loved ones at home.

Art therapy and education between peers connecting the group: an experience report.

OBJECTIVE: to report the "Talent Workshop: Art Therapy Connects the Group". METHOD: this is an experience report of a workshop developed in November 2018, in 3 meetings, at the Family Clinic setting - Rio de Janeiro. Twenty-eight users participated, including diabetics and health professionals. In the first meeting, dynamics was used for presentation. At the second meeting, the circular process and peer education were used to address issues related to diabetes, in addition to exposing talent to workshop participants. At the third meeting, there was exposure of talents to every health unit. RESULTS: the workshop provided comprehensive, individual and collective health promotion of users, allowing knowledgemultiplicationin their living environment. FINAL CONSIDERATIONS: the workshop was relevant for health education, changing the understanding of the subject's autonomy about his role in self-care.

Pilot Study of Videos to Deliver Mindfulness-Based Art Therapy for Adults With Multiple Sclerosis.

BACKGROUND: Mindfulness-based art therapy (MBAT) has been shown to provide a strategy for adults with multiple sclerosis (MS) to self-manage their symptoms. There is a need for the use of an MBAT intervention that can be delivered in any setting for adults with MS. The purpose of this pilot feasibility study was to test the feasibility and acceptability of an MBAT intervention delivered via videoconference. METHODS: We developed an MBAT intervention to be delivered by videoconference to adults with MS recruited from an academic center registry. We also conducted phone interviews to collect acceptability data. RESULTS: Most of the participants (n = 5) were very positive about the MBAT video sessions and stated content as clear and easy to follow and understand. The time and delivering method were acceptable. CONCLUSION: Mindfulness-based art therapy sessions delivered through videoconference are acceptable and feasible for adults with MS.

Effects of Art and Reminiscence Therapy on Agitated Behaviors Among Older Adults With Dementia.

BACKGROUND: Cognitive degeneration and agitated behavior symptoms of dementia in older adults are the main causes of disability and inability and increase the cost of medical care. Agitated behavior symptoms of dementia are the main causes of early institutionalization and make caregivers exhausted. PURPOSE: The aim of this study was to examine the effects of art therapy and reminiscence therapy on the alleviation of agitated behaviors in older adults with dementia. METHODS: An experimental research design with two experimental groups and one comparison group was conducted to examine the effects for each group on agitated behaviors. Participants were recruited from two dementia care centers in central and northern Taiwan. The study included 54 older individuals who met the sampling criteria and completed the data collection process. The participants were randomly allocated into the art therapy group (n = 24), the reminiscence therapy group (n = 22), and the comparison group (n = 8). The intervention consisted of 50-minute sessions conducted weekly for 12 weeks. Regular activities were continued in the comparison group. The structured questionnaires were completed, and observations of agitated behaviors were collected before the intervention and at 1 and 6 weeks after the intervention. RESULTS: Significant differences were found in agitated behavior symptoms at the three time points in the art therapy group, whereas reminiscence therapy was found to have had a clear and immediate effect on decreasing agitated behavior. The generalized estimating equation exchange model test revealed a significant and sustained, postintervention effect of art therapy on agitated behavior. In contrast, no significant and sustained effect on agitated behavior was observed in the reminiscence therapy group. CONCLUSIONS: The findings of this study support that art therapy may have a positive effect on dementia-associated agitated behaviors in institutionalized older adults. Reminiscence therapy activities conducted weekly for 50 minutes each session did not reach statistically significant implications. It is suggested that future studies consider conducting art and reminiscence therapies for a 16-week duration with two weekly sessions to evaluate the effectiveness of the therapy. The duration of follow-up should be extended as well in future studies.

Drawing soldiers out of post-traumatic stress disorder.

Art therapies are a broad suite of treatments including drawing, painting and music that can facilitate non-verbal communication through artistic expression. They have been used as adjunctive therapies for a range of mental health conditions. Significant numbers of returning military personnel experience post-traumatic stress disorder (PTSD), and discontinuation of care is a concern. Using drawing-based art therapy as an adjuvant to classical therapies may provide a benefit for such military patients.

Perceived Impact of Participation in a One-Time Expressive Arts Workshop.

INTRODUCTION: This 2015 study examined the use of art to express the experience of the cancer journey of military cancer patients/cancer survivors, family and friends, caregivers, volunteers, and staff members through a one-time art-making workshop, administered by non-art therapists.Using art to express a medical/cancer journey may give participants, who cannot express their feelings in words, the ability to articulate their experience through art that looks at the creative process rather than the end result - expressive art. MATERIALS AND METHODS: This mixed methods study examined the use of art to express the cancer journey of participants. Twenty-eight adults participated in a one-time expressive arts workshop conducted by non-professional art therapists at a military medical center. The five domains of the Emotion Thermometer were analyzed to determine if the pre-event and post-event assessment results would differ. The Silver Drawing Test and Draw-a-Story assessment tools were used to identify emotions and attitudinal stance on six separate five-point scales. A qualitative analysis was done using the phenomenological method of the post-interviews that facilitated open expression to identify themes. RESULTS: A significant difference was found between the pre-event and post-event analyses using the Emotion Thermometer, with post-assessment results revealing lower levels in the three domains of distress, anxiety, and depression. The Silver Drawing Test and Draw-a-Story were analyzed for six components using a five-point scale, with the highest scores being content/meaning, ability to combine, and creativity. A qualitative analysis was done using the phenomenological method; post-interviews provided information to categorize the experience into four key themes: environment, connection, emotions, and discoveries. CONCLUSIONS: Using art to express one's journey through cancer allows participants to articulate that journey "beyond language." This mixed methods study was administered by five non-professional art therapists with three having no expressive arts background. This study established that an expressive arts workshop can effectively be conducted by non-professional art therapists. The team of non-professional art therapists, who facilitated this one-time art-making workshop, demonstrated that a military member's stress can be decreased by giving them "a voice" through expressive art.

Photojournalism-Based Intervention Reduces Caregiver Burden and Depression in Alzheimer's Disease Family Caregivers.

Purpose: Art interventions have demonstrated holistic benefits for persons living with dementia and their caregivers. In this article, we describe the results of a pilot photojournalism program for 10 unpaid caregivers of persons living with dementia, with respect to caregivers' experience in the program and their psychological well-being. Design: Caregivers participated in four sessions led by a professional photojournalist who taught principles of photography. Between the sessions, caregivers took photographs that represented what caregiving meant to them using digital cameras provided in the program. During the sessions, instruction was interspersed with discussion of caregivers' photographs. Method: Caregiver burden and depressive symptoms were measured pre- and postprogram. Qualitative exploration included sessions' observations, viewing caregivers' photographs, and recording caregivers' accompanying comments. Findings: For participants with pre- and postprogram data, caregiver burden decreased significantly (p = .037). For caregivers with pre- and postprogram data, depressive symptoms decreased nonsignificantly (p = .066). Clinically meaningful reductions in caregiver burden and depressive symptoms were attained. Qualitative findings highlighted caregivers' strong engagement with the project, the facilitator, and other participants, and reflection on multiple aspects of their experience. Conclusions: This intervention helped caregivers creatively communicate their experience and demonstrated efficacy in the improvement of caregivers' psychological well-being.

Art therapy as an adjuvant treatment for depression in elderly women: a randomized controlled trial.

OBJECTIVE: There are few quantitative studies on art therapy for the treatment of depression. The objective of this study was to evaluate if art therapy is beneficial as an adjuvant treatment for depression in the elderly. METHODS: A randomized, controlled, single-blind study was carried out in a sample of elderly women with major depressive disorder (MDD) stable on pharmacotherapy. The experimental group (EG) was assigned to 20 weekly art therapy sessions (90 min/session). The control group (CG) was not subjected to any adjuvant intervention. Patients were evaluated at baseline and after 20 weeks, using the Geriatric Depression Scale (GDS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and cognitive measures. RESULTS: Logistic regression analysis adjusted for age revealed that women in EG (n=31) had significant improvement in GDS (p = 0.007), BDI (p = 0.025), and BAI (p = 0.032) scores as compared with controls (n=25). No difference was found in the cognitive measures. CONCLUSION: Art therapy as an adjunctive treatment for MDD in the elderly can improve depressive and anxiety symptoms. CLINICAL TRIAL REGISTRATION: RBR-2YXY7Z.

"Making the Ordinary More Extraordinary": Exploring Creativity as a Health Promotion Practice Among Older Adults in a Community-Based Professionally Taught Arts Program.

PURPOSE: Document psychosocial and mental well-being outcomes across artistic mediums and classes of a community-based, professionally taught arts program for older adults. METHOD: One hundred and thirty-eight students completed pre and post class surveys about expectations/experiences when creating art in four mediums (painting, drawing, mixed media, creative writing). In addition, 162 students composed one-paragraph biographical narratives describing their relationships to art and creative engagement. Text was coded for a priori and emergent themes to identify and explain well-being outcomes. FINDINGS: Results of this new study supported and expanded our earlier model of improved psychosocial and mental well-being due to creative engagement: impact of class-cognitive focus and outcome of class-cognitive focus, happiness as component of mental and social well-being due to creative engagement, and robust sense of calmness during the creative process. CONCLUSION: Results suggest that professionally taught arts programming can contribute to well-being and may contribute to brain health through promoting an enhanced ability to focus. Holistic nursing treats creativity as healing, and results suggest that creative engagement should be a priority in therapeutic programming, and individual counseling for older adults to begin engaging in some form of art making suited to their abilities should be incorporated into nursing practice.

Promoting Holistic Well-Being in Chronic Stroke Patients Through Leisure Art-Based Creative Engagement.

PURPOSE: To examine the potential value of a creative art-based activity as a caring modality for promoting holistic well-being among chronic stroke patients, and to explore the feelings and meanings that stroke patients derived from their experience in leisure art-based creative engagement (LACE). DESIGN: Qualitative design. METHOD: Participants were recruited through purposive and snowball sampling. Individual semi-structured interviews were conducted. Qualitative content analysis was performed. The design and implementation of LACE was guided by Watson's theory of caring. FINDINGS: Twenty-four participants completed the study. Four themes emerged from participants' account of experiences with the LACE: (1) appreciation of opportunities, (2) appreciation of self, (3) appreciation of others, and (4) appreciation of life. CONCLUSION: From the perspective of the participants, engaging in LACE enhances their sense of enjoyment and self-expression. Furthermore, they perceived LACE as an affirmation of life and an empowering process strengthening their connection and appreciation with the self and others. CLINICAL RELEVANCE: This study adds evidence to existing literature on Watson's theory-guided design and implementation of caring initiatives for community rehabilitation and has laid the groundwork for developing further evidencebased research in leisure art-based caring occasions for promoting holistic well-being in stroke rehabilitation.

The Effect of Art Therapy with Clay on Hopelessness Levels Among Neurology Patients.

PURPOSE: This study was performed to determine the effect of art therapy with clay on hopelessness levels of patients under treatment in departments of neurology. DESIGN: The study was of one group, pre- and posttest design. METHODS: This study was performed on patients who were hospitalized in the neurology departments of a university and a state hospital between February and May 2012 in Turkey. The sample for the study comprised 50 neurology patients with diagnoses of epilepsy (17 patients) and stroke (33 patients). The patients in the study were asked to create objects of clay of any shape they desired. Data for the research were collected with a sociodemographic data form and by using the Beck Hopelessness Scale (BHS). FINDINGS: While BHS scores of neurology patients before clay therapy were found higher compared to the scores after therapy with clay, there was also a statistically significant difference. After clay therapy, BHS scores were lower in women, in married patients, in patients who suffered from a stroke, people who had chronic disease, people without psychological illness, and in the case of children. CONCLUSION: The study showed that clay therapy had an impact on the hopelessness levels of neurology patients. CLINICAL RELEVANCE: Art therapy with clay may be used for rehabilitation purposes in neurology patients, both in the hospital and at home after discharge.

Art therapy and education between peers connecting the group: an experience report / La terapia del arte y la educación entre parejas que conectan al grupo: informe de experiencia / Arteterapia e educação entre pares conectando o grupo: relato de experiência

ABSTRACT Objective: to report the "Talent Workshop: Art Therapy Connects the Group". Method: this is an experience report of a workshop developed in November 2018, in 3 meetings, at the Family Clinic setting - Rio de Janeiro. Twenty-eight users participated, including diabetics and health professionals. In the first meeting, dynamics was used for presentation. At the second meeting, the circular process and peer education were used to address issues related to diabetes, in addition to exposing talent to workshop participants. At the third meeting, there was exposure of talents to every health unit. Results: the workshop provided comprehensive, individual and collective health promotion of users, allowing knowledgemultiplicationin their living environment. Final Considerations: the workshop was relevant for health education, changing the understanding of the subject's autonomy about his role in self-care.

RESUMEN Objetivo: informe "Taller de talento: la terapia del arte conecta al grupo". Método: este es un informe de experiencia de untallerdesarrolladoennoviembre de 2018, en 3 reuniones, enelescenario de la Clínica Familiar - Río de Janeiro. Participaron 28 usuarios, incluidos diabéticos y profesionales de lasalud. En la primera reunión, se utilizó la dinámica para la presentación; en la segunda reunión, el proceso circular y la educación entre pares se utilizaron para abordar cuestiones relacionadas con la diabetes, además de exponer los talentos a los participantes del taller; y enlatercerareunión, la exposición de talentos a cada unidad de salud. Resultados: el taller proporcionó la promoción integral, individual y colectiva de la salud de los usuarios, permitiendo la multiplicación del conocimiento en su entorno de vida. Consideraciones Finales: el taller fue relevante para la educación sanitaria, cambiando la comprensión de la autonomía del sujeto sobre su papel en el autocuidado.

RESUMO Objetivo: relatar a "Oficina de Talentos: a arteterapia conecta o grupo". Método: trata-se de um relato de experiência, de uma oficina desenvolvida em novembro de 2018, em 3 encontros, no cenário Clínica da Família - Rio de Janeiro. Participaram 28 usuários, entre diabéticos e profissionais de saúde. O 1º encontro, foi utilizada dinâmica para apresentação; no 2º encontro, foi utilizado o processo circular e a educação entre pares, para tratar de temas relacionados a diabetes, além da exposição de talentos aos participantes da oficina; e no 3º encontro, a exposição dos talentos a toda unidade de saúde. Resultados: a oficina proporcionou a promoção da saúde de maneira integral, individual e coletiva dos usuários, permitindo a multiplicação dos saberes no seu ambiente de convivência. Considerações Finais: a oficina foi relevante para a educação em saúde, modificando a compreensão da autonomia do próprio sujeito acerca do seu papel no autocuidado.

Evaluation of music therapy and other treatment modalities by adult psychiatric inpatients.

The purpose of this study was to investigate adult psychiatric patients' evaluation of music therapy and other aspects of their overall treatment. Twenty-seven patients hospitalized on an open psychiatric ward of Tulane Medical Center in New Orleans served as subjects. They rated music therapy, art therapy, recreation therapy, traditional therapies, and general aspects of care provided during their hospitalization with a semantic differential consisting of four adjective pairs. Results from a one-way analysis of variance showed that music therapy was rated significantly higher than art and recreation therapy on the pleasurable/painful scale, but no significant differences were found among the activity therapies on the three remaining scales. Further one-way analyses of variance showed that the activity therapies taken as one aspect were rated significantly higher than several therapies on specific scales; also, they were not significantly less important or less successful than medication, which was rated highest on these two scales. The author suggests that an instrument with multiple evaluation scales may be specifically adapted to any program, and can provide information to guide music therapists in delivering valuable therapeutic services.

Drawing together hope: 'listening' to militarised children.

Art can be used as both a therapeutic tool and a communication tool. Art has been used with refugees/militarised children but has tended to focus on their pathology. Art in this study was used to explore children's hopes for their future. Children talk more when they are/have drawn what they are trying to describe. Art can be used to understand children's world-view and explore their beliefs and opinions.

Using scrapbooks & portfolios in group work with women who are chemically dependent.

This article provides a rationale and strategies for using scrapbooks and portfolios within the context of group work with minority women recovering from chemical dependence. An expanded model of recovery-based group work places the use of scrapbooks and portfolios within the context of a practice model that seeks to increase general and social self-efficacy in these women. Memory scrapbooks, lifecourse scrapbooks, and recovery portfolios are defined; their differential use in group work is described; and ways group members can use the tools to strengthen their sources of self-efficacy are explored.