Summary of the Study
Based on the National Cancer Institute , 9,500 children residing in the United States are identified as having cancer every year and from the twelve major kinds of pediatric oncology, over fifty percent of all new cases stem from various kinds of leukemia, brain, as well as other central nervous system tumors. Additionally, the Institute reports that 1,500 of those children may ultimately die in the disease, making cancer the key cause of death amongst American children from infancy to 15 years of age. With your a large number of children seeking strategy to many different types of cancer, many medical facilities are implementing creative arts therapy programs made to help these children as well as their families better understand and deal with the disease.
Creative or expressive arts therapies are therapies where the arts are applied through different techniques as a way of facilitating conversation in this manner, that healing, both emotionally and physically is promoted. Expressive or creative arts therapy programs may include, but are not restricted to, “art, drama, dance movement and music therapies” , in addition to, “poetry/creative writing” therapy. Creative arts therapy sessions could be conducted with an individual or group basis and programs are usually offered in hospitals, rehabilitative facilities, clinics, mental health centres, hospice programs, schools, daycare centres, shelters, halfway houses, prisons, correctional facilities, drug abuse treatment centres, businesses, senior centres, nursing facilities, community centres and practices (American Art Therapy Association, n.d.; American Dance Therapy Association, n.d.; American Music Therapy Association, 1999; Betts, n.d.; Malchiodi, 2005; National Association for Drama Therapy, n.d.; National Association for Poetry Therapy, 2006; Payne, 1993; Rubin, 1999).
The objective of this study would be to explore the creative arts therapy programs agreed to pediatric cancer patients at two hospitals, to find out what types of programs currently exist, using the mission of providing standard of living benefits to pediatric oncology patients as well as their families. Current creative arts therapy research appears to approach the subject from those of three main perspectives: 1) descriptive, 2) example, and 3) outcome based. Within the descriptive approach, scholars for example Bunt & Hoskyns , Corsini , Malchiodi, C. , Nathan & Mirviss Rubin , and Waller & Gilroy , give a description, definition or historical background to 1 or all the creative arts therapies. This method often takes the form of an introduction, handbook or guide and offers the reader having a basic knowledge of what the creative arts therapies are, what creative arts therapists do and why creative arts therapies are implemented. Within the second approach, researchers are usually practicing creative arts therapists who focus their research on documenting their experiences within the field by making use of single and/or multi-case study methods. Bertoia , Kamar , Orton , and Sundaram , for instance, frame their research inside the context from the single-case study method to be able to describe the more knowledge about their make use of a single patient. However, Prager , Oppenheim, Géricot and Hartman , and Savins , tap into multiple case studies that explain therapeutic act as it relates to the mobility or temperament of patients, the establishing which therapy sessions occur or the desired results of therapy activities.
The ultimate approach to current creative arts therapy scientific studies are outcome or benefit based. What this signifies, is that the work of researchers for example, Abrams , Ho , Lin, Lee, Kemper & Berde , Nainis, Paice, Wirth, Lai & Shott , and H. , seeks to conduct and report findings of research that’s focused on the emotional and physical effects that taking part in creative arts therapies sessions may produce. Outcome oriented research discusses the potential for the creative arts therapies to create benefits like relieving anxiety or fear, decreasing vomiting and nausea, helping with pain management, and promoting defense mechanisms development. Describing the creative arts therapies, documenting single/multi-case studies, and recording the end result of expressive arts therapies, while important, isn’t enough. When analyzing current arts therapy literature, there’s a gap within the research with regards to describing current creative arts therapy programming trends as well as in the search for the intricacies of those programs.
These studies seeks to increase the current body of data by identifying current programs and also the various components required to offer these expressive arts therapy programs inside a hospital setting. Additionally these studies project focuses specifically on two creative arts therapy programs to be able to assess and describe what types of programs currently exist, where they’re being offered and also to identify the medical reasons these participants take part in such programs. Statement of purpose The objective of this research project would be to explore various creative arts therapy programs hospitals agreed to pediatric cancer patients, to find out what types of programs currently exist, using the mission of providing standard of living benefits to pediatric oncology patients as well as their families.
To be able to better comprehend the components of hospital offered creative arts therapy programs, a comparative example was conducted using the Music Rx Program provided by the Children’s Cancer Association at Doernbecher and Legacy Emanuel Children’s Hospitals in Portland, Oregon along with the Ponzio Creative Arts Therapy Program in the Children’s Hospital in Denver, Colorado. Significance from the study Current creative arts therapy research concentrates on three main approaches: describing and historically placing each one of the creative arts therapies, documenting accounts from creative arts therapists’ research with single/multi-case studies, and recording the end result or advantages of expressive arts therapies sessions. When analyzing creative arts therapy literature, there’s a gap within the research with regards to the concept of programming.
Few researchers dedicate their time for you to exploring the compulsory components required to offer creative arts therapy programs. This research is significant since it seeks to deal with the gap in current creative arts therapy literature by closely examining two programs agreed to pediatric oncology patients as well as their families. A comparative example was conducted to be able to identify the various needed to offer these programs inside a hospital setting. This research provides pediatric cancer patients as well as their families with information you need about the offerings and goals of numerous types of creative arts therapy programs. Additionally, it aims to supply interested hospital administrators, medical staff, and inventive arts therapists using the opportunity to take particular notice at current types of expressive arts therapy programming, to find out what resources are essential to offer most of these programs inside a pediatric medical facility. Additionally, this research helps to foster a larger awareness about creative arts therapies and just how they complement the fields of drugs and arts administration. The findings of the research project assistance to propel expressive arts therapy research and scientific research forward into new regions of discovery.
Research Design and Methodology
These studies project aligns using the critical social science perspective since the researcher believes in “going beyond surface illusions to show underlying structures and conflicts of social relations in an effort to empower individuals to improve the social world. It’s the hope from the researcher this research can help patients, their own families, the medical and inventive arts therapy staffs to enhance upon current creative arts therapy programs, to create better programming for those who are influenced by the effects of cancer. Additionally, in qualitative research, objectivity isn’t assumed. Whenever using medical and inventive arts therapy staff, the researcher felt it might be inappropriate to merely observe from the distance.
The only method for the researcher to genuinely understand the impact of those programs ended up being to interact directly with those involved with providing these programs and also to report findings from both an inward and outward perspective. Design of the research The purpose of the research is to better know very well what kinds of creative arts therapy programs for pediatric oncology patients currently exist with an examination of two expressive arts therapy programs. These studies compares and contrasts pediatric oncology creative arts therapy programs at Doernbecher Children’s Hospital in Portland, Oregon and also at The Children’s Hospital in Denver, Colorado. Both of these sites were specifically chosen with this research project due to their varied methods to creative arts therapy programming.
Music Rx, the expressive arts therapy program at Doernbecher concentrates on music therapy, emerges on an inpatient basis and processes as an extension of the non-profit organization known as the Children’s Cancer Association. In comparison, The Ponzio Creative Arts Therapy Enter in Denver emerges as both an inpatient and outpatient program, is implemented by hospital staff, and concentrates on applying a mix of multiple expressive arts therapies. A comparative example addresses a gap within the research by giving an in-depth study of current methods to creative arts therapy programming for pediatric oncology patients as well as their families. Case studies by their very definition permit specific cases to become examined within an in-depth manner, during a period of time (McLaughlin & Carolan, 1992; Neuman, 2003; Orton, 1994; Rosal, 1992; Stake, 1995). Based on Neuman , “cases can be individuals, groups, organizations, movements, events, or geographic units”.
Neuman’s definition was vital that you study since it allowed for that examination of programs and individual participants using a case study approach. The use of a case study method are available in many types of research, however in creative arts therapy research, case research is traditionally regarded as an important method to communicate the result expressive arts therapies might have on a patient. Creative arts therapy case studies assistance to develop an awareness of the course of treatment and enables the evaluation of practices and operations. Applying an instance study approach to research can offer the extensive quantity of qualitative data required to accurately describe a particular case. However, limitations can happen with the use of this approach. Based on McLaughlin and Carolan , “a primary difficulty just in case studies is the fact that there is no grounds for determining exactly what the outcome could have been without the specific interventions…little attention pays to the threats to bodily and mental validity or reliability”.
Diamond echoed the ideas of McLaughlin and Carolan by discussing these limitations because they pertain to art therapy research: Art therapists used the case study extensively to validate their various treatment approaches. The main problem with the situation study being an evaluation tool is it does not eliminate the many conflicting explanations for that observed results which may be offered. Add this to experimenter bias and also the subjectivity of the observations, and also you do not have a powerful tool for determining expected outcomes.
This is to express, a case study technique is an effective way to support a researcher’s hypotheses about change causing variables. However, this method provides limited evidence to prove which variable causes the resulting change. As well as the above stated limitations, Stake found case studies to become limiting because cases can’t be generalized to represent a bigger population. However, case studies permit the possibility of lessons to become learned and findings might be applicable with other areas of research. Many creative arts therapy researchers apply the situation study approach to their research design (Bertoia, 1993; Kamar, 1997; Orton, 1994; Prager, 1993; Savins, 2002; Sundaram, 1995).
By doing this, these researchers began the documentation process by explaining the study topic, defining key medical terms, introducing the particular case or subject, discussing research procedures, concluding with results and research findings. In Orton’s case study of the young mother grieving losing her child to Cot death for example, Orton begun by describing parental grief, continued by defining Cot death, then introduced nineteen years old Ashley as the subject from the study, explained the therapeutic procedures from the study with the application of the Coping Resources Inventory and also the Grief Scale, and concluded by having an explanation from the research results. Orton’s research document provided a good example of how researchers can best apply an instance study method in neuro-scientific art therapy. Implementing a comparative example method within this research design allowed to have an in-depth examination of multiple pediatric oncology creative arts therapy programs. To be able to identify what kinds of creative arts therapy programming currently existed, it had been essential to begin the documentation process by defining the role of creative arts therapy programming for pediatric cancer patients, describing the particular case study programs, discussing the creative arts therapy practices and operations each program implements, and also to conclude with key findings from the components required to offer each pediatric oncology expressive arts therapy programs.
Approaching the research in this manner enables comparing and contrasting across program models, to make suggestions about what creative arts therapy practices may be applicable in other medical settings for young cancer patients. Research questions The primary research question of the study was, “What types of creative arts therapy programs are hospitals currently offering to pediatric cancer patients, to be able to provide standard of living benefits to pediatric oncology patients as well as their families?” Additional sub-questions include: _ What roles do creative arts therapists play inside a pediatric oncology patient’s treatment? _ What types of training perform the creative arts therapy programs’ staffs have to be able to work with pediatric oncology patients as well as their families? _ What types of resources are essential to implement an innovative arts therapy program inside a hospital setting? _ How are these creative arts therapy programs designed and implemented inside the hospital setting? _ How are these creative arts therapy programs taken care of and do insurance providers cover a few of the cost? _ Do you know the perceived benefits and connection between a creative arts therapy program for pediatric oncology patients as well as their families?
Data collection This can be a comparative example that examines the creative arts therapy programs offered by Doernbecher Children’s Hospital in Portland, Oregon and also the Children’s Hospital in Denver, Colorado. Formal interviews were conducted using the creative arts therapy staffs and program coordinators at both sites and something Registered Nurse in the Children’s Hospital was interviewed included in this study. The researcher attended a Ponzio Creative Arts Therapy Program staff meeting in order to be better familiar with the specific hospital setting and therapy facility, in addition to create a general feeling of familiarity between the staff. This same attempt is made at the Children’s Cancer Association and Doernbecher Children’s Hospitals facilities, but field observations weren’t conducted due to their strict no observation policy.
3 to 5 interviews happened with both Music Rx and also the Ponzio Creative Arts Therapy Program’s creative arts therapy staffs and program coordinators. The background music Rx staff was interviewed via email and also the Ponzio Creative Arts Therapy Staff were interviewed via email and follow-ups were conducted personally at The Children’s Hospital. Medical personnel at both hospitals were contacted regarding their potential involvement within the study and just one medical employee responded to the invitation.
A job interview was conducted with this particular medical employee who worked in the Children’s Hospital included in the Centre for Cancer and Blood Disorders’ nursing team via email along with a follow-up interview happened over the telephone. Potential participants for that formal procedure were chosen randomly. No specific gender, ethnicity, religious or economic background was targeted. The recruitment process for that formal interviews involved a recruitment letter detailing the research, as well as a consent form to be signed by each participant. Once proper consent had been administered, formal interviews were conducted in 2 ways. If at all possible, members of the medical staff, art therapy staff and program coordinators were interviewed via e-mail. A summary of questions was submitted electronically towards the medical staff , expressive arts therapists and this program coordinators.
People who preferred to not be interviewed via email received the option to become interviewed inside a face-to-face manner or through the telephone and people wishing to remain anonymous were offered pseudonyms. Additionally, interviewees received a chance to browse the transcriptions if they made a decision to do so around the original consent form. Data analysis Once data was collected in the literature review, document analysis, field research and formal interviews, the information was coded. Coding ended initially by both cases study site and ended up being be split into the three topical areas recognized by the initial overview of the literature: the reason why for implementing art as therapy, the various types of creative arts therapy methods utilized in the field and also the ways in which expressive art therapies specifically affect pediatric oncology patients as well as their families.
Potential risks and advantages of the study It’s recognized that personal issues may arise due to the interview process and participation because of the sensitive nature of the study. Throughout creative arts therapy sessions and also the formal procedure, the program and medical staffs might have potentially discussed their feelings and thoughts about the program these were involved with as well as their workplace. In this discussion interviewees may have experienced minimal social risk by feeling nervousness or anxiety at the idea of the utilization of participants’ names, titles and opinions within this final published research document. The interviewees might not have felt confident with their colleagues, supervisors, and institution having the ability to read their personal viewpoint. However, each medical staff and inventive arts therapy employee was inspired to consent towards the use of their name and title within the research project and was handed the option to stay anonymous. However, it is the goal of those programs the participants are participating with to assist, “transform the hospital environment…to assisted in the relief of fear, anxiety and pain”.
Using art to facilitate conversation for that purposes of these studies project, may also have led to numerous good things about all those involved. Conversation about expressive arts therapies might have potentially helped hospital administrators, medical staff, and inventive arts therapists to understand the pros and cons of offering an innovative arts therapy program, in addition to find out precisely what resources were required to offer similar programming. Additionally, this research helps to stimulate a larger general awareness regarding the subject of creative arts therapy and just how it intersects using the field of drugs and arts administration. Delimitations The core of the research includes a comparative example with the Music Rx Program provided by the Children’s Cancer Association at Doernbecher and Legacy Emanuel Children’s Hospitals in Portland, Oregon along with the Ponzio Creative Arts Therapy Program in the Children’s Hospital in Denver, Colorado. These specific sites were chosen for his or her location due to their close proximity towards the researcher.
Additionally, both of these sites were of particular interest towards the research topic. By limiting the study to two vastly different programs, it had been the hope from the researcher it would become apparent which strategies and approaches were working and that have been not working for that field of creative arts therapy in pediatric oncology. Furthermore, approaching the study from a two case perspective had the possibility to help those thinking about starting a course to figure out what type of program would fit best inside their specific treatment setting. Limitations Having previously caused the child life department inside a pediatric hospital so that as a camp counselor in a summer camp for cancer patients, the researcher brought certain biases for this study. The researcher wholeheartedly believes that creative arts therapy programs might help children to handle illness, treatment and hospitalization, which it is essential for those children’s hospitals to provide this kind of programming. Definitions Medical terminology and ideas were not directly analyzed because of the researcher’s limited knowledge in this region. However, it was not the main focus of the research topic and also, since there is a large pre-existing body of literature coping with medical terminology, this weakness is minimal.
Overview of the Literature
Art as therapy Elinor Ulman, the Bulletin of Art Therapy’s first editor in 1961, defined art therapy by stating, “Anything that’s to be called art therapy must genuinely partake of both art and therapy”. Ulman further defined this term by defining all of its component parts; she defined art as, “a way to discover both self and also the world, and also to establish a relation between your two” and the term therapy was understood to be, “procedures designed to assist favorable alterations in personality or perhaps in living which will outlast the session itself”. Leading scholars after Ulman’s time have contended that art treatments are a form of non-verbal communication that provides patients an innovative outlet for self expression (Bertoia, 1993; Murray & Howard, 2002; Prager, 1993; Rubin, 1984; Savins, 2002; Sundaram, 1995). Riseberg, Kolstad, Bremmes, Holte, Wist, Mella, Klepp, Wilsgaard and Cassileth described art therapy further like a “complementary” or “alternative” therapy; one which applies an unconventional approach using the intent of managing symptoms and improving one’s standard of living.
In addition, the British Association of Art Therapists created their own definition for that term, which describes art therapy as: …a type of therapy where the making from the visual images in the existence of a qualified art therapist contributes for the externalization of feelings and thoughts which may otherwise remain unexpressed. The pictures may have a diagnostic in addition to therapeutic function, for the reason that they provide the individual and the therapist having a visible record from the session, and provide indicators for more treatment. Art therapists may use the transference – that’s, the feelings in the past that are projected to the therapist within the session. Such feelings are often contained through the art work, which enables resolution to occur indirectly if required.
With so many circulating variations from the definition of art therapy, it might be difficult to comprehend the differences and similarities in between each one. Thus, it might be vital to appear back to the origins from the term. The word “art therapy” is related to Adrian Hill, who, in 1942, “painted his way via a tedious convalescence inside a tuberculosis sanatorium”. Throughout his hospitalization, Hill discovered that the act of creating art through painting, fully engaged his body and mind, which released a “creative energy” that allowed him to “build up a powerful defence against his misfortunes”. Margaret Naumburg, the “mother of art therapy” adopted Hill’s term and began utilizing it as a way to describe her use patients inside a psychiatric hospital. Naumburg helped the formal field to emerge through her belief that art would be a form of “symbolic speech” which allows the unconscious to speak through the procedure for making art, permitting, “a means of both diagnosis and therapy, requiring verbalization and insight too art expression”.
Based on Edwards , to understand historical and current practices of art therapy, both Hill’s definition and Naumburg’s definition should be studied because Hill’s approach advocated for that use of “art as therapy” and Naumburg’s approach supported using “art in therapy”. From all of these two definitions, art therapy has traveled down two similar branches of thought “art as therapy and art psychotherapy”. Art as therapy stresses the “healing potential of art” and art psychotherapy underscores “the need for the therapeutic relationship established between your art therapist, the customer and the artwork.
When attemping to make feeling of how healing occurs due to creative arts therapy methods, there’s two branches of conflicting thought. One branch shows that the benefits of art therapy would be the direct consequence of the “creative process itself,” and also the other specifies that it’s due to the “relationship established between client and therapist”. Today, many art therapists think that neither the artwork, nor the connection between the client and art therapist is much more important compared to other; rather the significance is placed upon a “triangular relationship” where the 3 components: artwork, client, and art therapist interact to offer the desired recovery process or therapeutic effect. Within an art therapy session, triangulation is very important because “the interaction between your client as well as their artwork, or between your client and also the art therapist, might be in the foreground or background” at different points during the art therapy session. The thought of triangulation is of significance in hospital offered creative arts therapy programs for pediatric oncology patients because many patients function not have the correct medical knowledge required to fully comprehend their illness and therefore are further limited because of “immaturity”. For these patients, this might very well be the very first time they have heard terms for example cancer, tumor, chemotherapy, and perhaps even the word death.
Lacking the knowledge of an illness and undergoing the correct course of treatment may cause anxiety and confusion amongst pediatric patients. Creative arts therapies can help patients to know their medical situation by assisting to minimize this confused feeling, shedding light around the reality from the patient’s situation in a manner that encourages a deeper feeling of clarity and self-understanding. Approaching art therapy triangularly permits the patient’s relationship using their artwork to take precedence when necessary, but also enables the relationship between patient and art therapist to become of greater importance when it’s desirable. Triangulation occurs since the relationship between patient and art therapist is essential to the medical explanation from the illness/treatment process as well as in the overall facilitation of communication. The patient’s artwork is really a way in which the individual demonstrates their knowledge of the illness and offers an outlet for expression which could promote healing to start. Creative arts therapy methods Creative arts therapies are therapies where the arts would be the main activity of therapy sessions and therefore are used to facilitate conversation in this manner, that healing in most its forms is promoted. Based on one scholar, creative arts therapies, “in their most enlightened and liberating forms are indicating a brand new vision of art in society which implies the restoration of the ancient and archetypal integration from the creative process with healing”.
The expressive or creative arts therapies include, art, drama, dance movement, music, and poetry/creative writing therapies. Creative arts therapy sessions could be conducted with an individual or group basis and programs can be found in a variety of locations including: hospitals, rehabilitative facilities, clinics, mental health centres, hospice programs, schools, daycare centres, shelters, halfway houses, prisons, correctional facilities, drug abuse treatment centres, businesses, senior centres, nursing facilities, community centres, and practices (American Art Therapy Association, n.d.; American Dance Therapy Association, n.d.; American Music Therapy Association, 1999; Betts, n.d.; Malchiodi, 2005; National Association for Drama Therapy, n.d.; National Association for Poetry Therapy, 2006; Payne, 1993; Rubin, 1998).
This explores the different creative art therapies: art therapy, drama therapy, dance movement therapy, music therapy, and poetry/creative writing therapy, investigates the similarities and differences in between each of the creative arts therapies, and examines the diverse methods and methods used in the various creative arts therapies. Art therapy methods Based on the American Art Therapy Association , “Art treatments are an established mental health profession that utilizes the creative procedure for art making to enhance and boost the physical emotional and mental well-being of individuals of ages” by integrating, “…the fields of human development, visual art…and the creative process with types of counselling and psychotherapy”. Art therapy practices are implemented as a way of providing assessment and treatment, for individuals who may be looking for, “reconciling emotional conflicts, fostering self-awareness, developing social skills, managing behaviour, solving problems, reducing anxiety, aiding reality orientation, and increasing self-esteem” (Betts, n.d., Art Therapy section, para. 2). To be able to engage patients in art therapy, therapists must start by choosing a skill making technique (drawing, painting, sculpture and/or other artistic representations), followed by the particular tools and materials required for the chosen medium.
Art making materials may include anything from pencils, crayons and finger paint to paper maché, felt and clay. One could reason that these art making techniques and materials seem ordinary, something anyone would use when choosing to create visual art. However, you should remember that the therapist specifically chooses how to overcome the art making guided with a set of predetermined goals according to their client’s needs and talents. For example, a skill therapist wouldn’t choose sculpting with clay for any patient having a respiratory illness since the particles might lead to difficulties within the patient’s ability to breathe. Additionally, a pediatric oncology patient inside a bone marrow transplant unit is held in an extremely sterile environment, forcing a skill therapist to supply completely new supplies towards the patient. Before a skill therapy session can happen, art therapists consider factors for example their patient’s health, physical mobility, and also the desired outcome or goal of every therapy session.
Generally, while preparing to do an art therapy session, the therapist must make important decisions concerning the materials to become utilized, that have implications for that kinds of processes/outcomes the therapist is pursuing with the patient. Pencils permit the patient to produce permanent or impermanent marks inside a range of gray tones which are considered to be “noncommittal when compared to feeling qualities related to most colors”. Pens and markers are usually thought of as through an “aggressive potential” and force the individual to make more decisive decisions concerning the permanence of the items they put around the drawing surface. While materials like crayons and pastels allow someone to draw in color, which could reflect human emotion, mood and feeling.
Much like drawing, painting like a medium provides a wide variety of materials to paint with: watercolors, tempera, oils, acrylics, finger paints or gouache to mention a few. Based on Robbins and Sibley , “watercolor demands a willingness to become spontaneous; oil provides a more predetermined and exacting challenge”, which makes it extremely important to have an art therapist to find the appropriate painting materials which are most suitable for patient’s needs. When offering painting materials for an art therapy patient, it is essential for an art therapist to see how the patient approaches and applies the types of materials to the canvas.
Art therapists focus on how slowly or quickly someone works and if the paint is used thickly or thinly because they can be indicators from the patient’s mood and/or frame of mind. Sculpture is a vital art therapy method since it allows patients to produce in a 3d space using materials like pipe cleaners, clay, modeling dough, wire, string, paper maché, and cardboard. Rubin suggests that, “clay can stimulate feelings of disgust in addition to feelings of enjoyment; it can seem cold and unyielding, in addition to soft and manipulable”.
However, Seiden points out that modeling or sculpting having a material like clay allows someone to turn a malleable material into something permanent by firing or baking; this method increases the object’s value in a way that it is proportional to the patient’s self confidence. Some art therapists would rather use puppets since it offers patients a secure environment by which they can express their feelings and emotions indirectly (Rubin, 1984; Savins, 2002; Sundaram, 1995). Other art therapists discover the use of metaphor may enable someone “to talk about stuff that are complex and never easily described.
Finding image in words, play or drawing could be comforting – a means of feeling understood and connected. Metaphors and pictures reach an element of the brain that words alone cannot”. When conducting art therapy sessions with children, researchers claim that combining art and play can facilitate the therapeutic processes because play is central to some child’s emotional, physical, and social development. With your a wide variety of media, mediums, and procedures to choose from, it’s imperative that the art therapist selects art making materials by which, “the challenge of materials equals the level of skill of the artist”. Rubin suggests that art therapists often lean toward simple materials and procedures because the more unstructured the medium is, “…the more an individual may project upon it. Since all art therapists aspire to evoke personally meaningful creations, it might make sense they would not desire to impose by any means on the patient’s own natural imagery”. With that said, it becomes apparent that it’s extremely important for art therapists to find the art making activity and art making materials with extreme thoughtfulness, the individual and therapeutic goal or outcome should be at the center of the decision.
Drama therapy methods Much like art therapists, drama therapists apply the humanities (in the case drama, instead of the visual arts) to therapy sessions to have individualized therapy. The nation’s Association for Drama Therapy describes drama therapy to be both, “active and experiential” (What’s Drama Therapy section, para. 2). Approaching treatments are this manner allows someone, “to tell their story to resolve a problem, acquire a catharsis, extend the depth and breadth of inner experience, understand this is of images, and strengthen a chance to observe personal roles while increasing flexibility between roles”.
Based on Landy, drama treatments are centered around the thought of helping individuals to find a balance between opposition by playing roles that contradict one another, “such as those of the victim and also the survivor”. In order to achieve this understanding inside a drama therapy session, a drama therapist may apply a number of methods including: theatre games, storytelling, improvisation, role play, performance, dramatic ritual, sociodrama, and psychodrama.
Theater games or as Landy refers for them “dramatic play”, are considered to become the first and simplest step in drama therapy. Dramatic play is a vital place to begin since it helps to foster, “…spontaneity and interaction inside a group, and frequently form the grounds for other group work”. Playing theatre games works as a warm-up activity allowing participants being comfortable with those around them helping to build some trust inside the group. Drama games really are a typical instructional progression for dramatic learning, however in the demonstration of drama therapy, a drama therapist is very thoughtful about which games have been in keeping with their specific therapeutic goals. After dramatic play, a drama therapist may change to a method referred to as “scenework”.
Scenework encourages the participants to utilize pre-existing works of fiction within an improvisational manner. This process offers a more introspective method for the participants because once they have worked with the story or play, they discuss their thoughts, feelings, reactions, and therefore are encouraged to discover the parallels between your fictional work as well as their own life and also the world around them. Scenework prepares the participants for the following step in drama therapy, referred to as “role play”. Role play is a technique that is “used to operate on changing behaviours or introducing new ones”. The participants ought to act out actual life situations and also to “…examine specific problems or issues within their lives for example losing employment, expressing disappointment to some friend, or completing an unfinished conversation having a parent”. Participants may execute a role using their own perspective, but more to the point, are expected to do something out the role from the antagonist too; an approach that can help patients to know multiple viewpoints, varied reactions, and also to brainstorm possible methods to the problem available.
Once each one of the individuals’ roles continues to be realized, performance or “culminating enactment” promotes a deeper knowledge of the key issues all around the characters. The culminating enactment method allows participants look around the role of the baby as it pertains to the group and as a result, fosters a much better understanding of an individual’s role or devote society. The final method utilized in drama treatments are known as “dramatic ritual”. Dramatic ritual is used as a final part of drama therapy since it functions like a transitional point linking the, “dramatic reality to that particular of everyday reality, from the comfort and support from the therapeutic group up to the more unpredictable social interactions from the outside world”.
Dramatic ritual enables participants to maneuver forward with their former lifestyle by taking what they’ve learned from drama therapy and putting it on to everyday routine. Each of the approaches drama therapy could be approached from different viewpoints and may address individual struggles or situations which are common to each person in the group. In role play for instance, the focus from the therapy session may shift from a fictional world, to that particular of each from the participants’ individualized realities. Nathan and Mirviss refer for this as “psychodrama” since it, “centres on one person’s problems and aims to assist that person reach a deeper knowledge of his/her behaviour and/or an answer of emotional conflicts”. However, the group could use role play in an effort to discuss common problems, feelings and/or behaviours, which is called “sociodrama”.
Both techniques, psychodrama and sociodrama, are essential to drama therapy sessions simply because they encourage participants to determine problems from multiple viewpoints, help participants to understand that certain situations and feelings are typical to all people and encourage a far more constructive method of problem solving. Dance movement therapy methods The nation’s Coalition of Creative Art Therapies Associations asserts that “dance is easily the most fundamental from the arts” because it involves “direct expression with the body”, which makes dance a very expressive and very important vehicle that to practice therapy.
The American Dance Therapy Association further defines dance movement therapy as, “…the psychotherapeutic utilization of movement like a process which furthers the emotional, social, cognitive, and physical integration from the individual”. Movement is a vital means of non-verbal communication since the way in which a person navigates their body through space is really a reflection that’s unique to every individual individual. A common technique dance movement therapists me is called “movement exploration”. Movement exploration applies a progressive problem solving method of teach body control and spatial awareness, in addition to, to improve physical strength and endurance. Movement exploration encourages the study of the, “fundamental patterns of exercise – both locomotor and non-locomotor ”. Participants might be asked to undertake the space as small, big, light, heavy or as silly as you possibly can.
No matter what activity the participants are presented, each movement exploration based activity is grounding through the goals of improving hand-eye coordination, balance, strength, body image, endurance, visual focus, and/or selfconfidence. Inside a dance movement therapy session, a dance movement therapist could also apply a technique known as “mirroring” or “attunement”, the industry technique which allows the therapist and patient and/or patient and patient to speak non-verbally through the use of their bodily movements. The dance movement therapist interprets the participant’s movements and responds similarly by having one participant lead the movements and also the other follow or repeat the movements.
The mirroring or attunement method allows the therapist to help the participant in, “broadening, expanding, and clarifying” both their non-verbal and verbal communication skills. Mirroring or attunement combines using a non-verbal dialogue through movement along with a verbal dialogue through discussion, to create an environment by which both patient and therapist communicate harmoniously. Along with mirroring, dance movement therapists also apply an “integrated developmental approach” by which therapists, “observe developmental phases in movement and help clients sort out developmental blocks, regressions, and delays”.
Understanding of the basic human development process enables dance movement therapists understand the way the body navigates through space and just how the body reacts or communicates in various social situations. Consequently, the knowledge helps therapists to make use of movement in a way that their patients obtain a better knowledge of their own development, that has the ability to yield a much better sense of self-awareness. Lastly, dance movement therapists make use of an approach called “authentic movement” by which one person lays on the floor and moves as though reenacting early life experiences, while someone else watches the procedure as the “witness”. The participant on the ground moves themselves in a way that enables them to to better understand an individual experience felt in their own individual life, as the witness internalizes their movements and interprets their meaning for participants.
The authentic movement method allows those involved to make use of their bodies to communicate dumbfounded, a process which allows them to better comprehend the world around them. Music therapy methods The American Music Therapy Association describes music therapy as, “an established healthcare profession that utilizes music to deal with physical, emotional, cognitive, and social needs of people of all ages. Music therapy raises the quality of life for persons who’re well and meets the requirements of children and adults with disabilities or illnesses” (What’s Music Therapy section, para. 1). Music therapists apply music to therapy sessions both instrumentally and vocally, in a way that allows these phones assess a patient’s emotional, physical, and social state through individual or group therapy sessions.
Specifically, music therapists center therapy sessions on “conceptual development”, “body image and the body awareness”, “gross and fine motor skills”, “tactile discrimination”, “auditory memory”, “auditory sequencing”, and “socializing”. Music therapists can do this by making use of various methods, including everything from song conntacting lyric discussion to performance. Based on a music therapist’s specific goals for any therapy session, a number of methods does apply to the situation, including “improvisation” (Bunt & Hoskyns, 2002; Forinash, 2005; Nathan & Mirviss, 1998).
Based on Bunt and Hoskyns improvisation may be the, “action product in our musical imagination and intuition, or ‘intuition in action’”. Improvisation like a process can happen on an individual level whenever a person comprises music on their own or on the group level when music is made in a collaborative environment. A music therapist may choose improvisation like a method guided by their goal of, “providing nonverbal communication; promoting self-expression; exploring relationships; enhancing intimacy; acquiring group skills; encouraging creativity; spontaneity, and playfulness; stimulating the senses; and developing cognitive skills”. Additionally, music therapists may apply the technique of a “recreative experience”, which inspires the use of a pre-existing composition of music.
The recreative experience allows the individual and art therapist to operate together to do, interpret, or reproduce a musical piece, using the possibility of enhancing the patient increase their attention span and memory, in addition to promote sensorimotor development. Much like the recreative experience, a “receptive experience” encourages using a pre-existing body of music, but takes it a measure further by permitting a patient to reply to the music via another talent. The patient learns live or recorded music and could respond to the piece through drawing or poetry, this process aids in relaxation, stimulation, and promotes receptivity. Along with using pre-existing compositions, music therapists also encourage their sufferers to write their very own music.
This process is known as a “composition experience”. Composition experience includes writing lyrics, music or perhaps a combination of the 2 and is thought to promote organization skills, problem solving strategies and self-reliance. When combined, the techniques of improvisation, recreative experience, receptive experience, and composition experience help those involved with music therapy to, “promote wellness, manage stress, alleviate pain, express feelings, enhance memory, improve communication and promote physical rehabilitation”.
Poetry/creative writing therapy methods Poetry therapy and inventive writing therapy will also be known through the term bibliotherapy, where the word “biblio” is understood to be, “books and, by extension, literature” and also the definition of the word therapy is, “to serve or help medically”. Together, the terms poetry therapy, creative writing therapy, and bibliotherapy are understood to be the, “intentional use of the written and spoken word” to advertise “growth and healing”. Poetry therapists do that by embracing “all forms literature and also the language arts”, in a manner that unites an appreciation of words along with a “passion for improving the lives of others” and themselves.
Poetry therapists use stories, fables, fairytales, myths, chants, along with other forms of poetry, “to help their customers discover the truth that belongs to them existence, boost their creative and problem-solving abilities, communicate and relate easier to others, and go through the healing properties of beauty”. Poetry or creative writing therapy methods include analyzing pre-existing texts which, “provoke and evoke self-understanding” in addition to, the creation of original works which, “promote clients’ self-discovery via their very own creative self-expression”. These poetry therapy methods are applied for a poetry therapy session to evolve through each one of the four main poetry therapy stages: “recognition”, “examination”, “juxtaposition” and “application to self”.
“Recognition” provides the patient time for you to take in the literary work and take into account the meaning, “examination” allows someone to explore and analyze the written text, “juxtaposition” permits various patients or participants to check and contrast their reactions towards the literature and also the last stage, “application towards the self” encourages the individual to apply their very own life experiences towards the work in such a manner that they learn something about themselves and/or the planet around them. Poetry therapy, like several of the creative art therapies, is lead with a trained therapist who applies their understanding of the arts and therapy, to have specific therapeutic goals or outcomes. Poetry therapy concentrates on the individual or self; an issue that separates it from traditional writing workshops, that are centered on the merits from the specific literary work.
Based on Gorelick , poetry therapy offers, “a mirror, a disguise, a bridge. Poetry is continuity, it’s change. It’s large in the smallness. It embraces and transcends conflict; it’s both/and rather than either/or. Poetry is individual and communal. It’s thought and action. Its wordplay makes masks and penetrates disguises and invites intimacy”. Poetry or creative writing therapy offers patients a getaway to another time or place, in a way that encourages thought and discussion concerning the literary work’s relevance or irrelevance to their personal world, environment and/or individual life.
Expressive arts therapies and pediatric oncology The next section analyzes the particular reasons for that the various creative arts therapies: art therapy, drama therapy, dance movement therapy, music therapy, and poetry/creative writing therapy, are put on a pediatric oncology patient’s treatment regimen. Additionally, it examines pre-existing studies that indicate the healing capabilities from the creative arts therapies on a physical and emotional level. Based on Prager , children are cognitively limited within their ability to understand illness and hospitalization due to immaturity and this can frequently cause confusion to happen between fantasy and reality.
An ill child’s immaturity can frequently produce two main kinds of understanding a disease “ the medical version, that is repeated verbatim; and also the private version, that is revealed through art”. Creative arts therapy programs might help pediatric patients to speak their feelings about hospitalization, treatment, and also the disease, in a manner that encourages a deeper understanding helping them to deal with their current condition.
These kinds of programs can provide pediatric oncology patients an optimistic activity to appear forward to when anything else seems to be negative. Oppenheim, Géricot and Hartman conclude that art therapies provide: …children having a creative method to explore their connection with cancer. It’s helped them recognize their value, and provided all of them with a way to express their spontaneity, fantasy, creativity, fear, and sweetness – everything that belong to everything about childhood which the experience of cancer can destroy.
Creative arts therapies especially provide patients having the ability to cope with the emotional and mental stresses associated with cancer. However, current research now suggests that the programs are also found to advertise healing and may help relieve the physical pains and traumas that include the disease and it is treatment process. In her own book Art Therapy: An intro, Judith Rubin describes a study completed in which a researcher asked participants to visualise and draw their T-cells multiplying. Slides from the participants’ blood pre and post the drawing activity established that the art making helped to significantly boost the participants’ number of T-cells. Similarly, Deforia Lane, a united states Cancer Society volunteer used a saliva test to appraise the amount of immunoglobulin A (plays a huge role in the functioning from the immune system) contained in pediatric oncology patients who have been involved with a music therapy program. Her research established that children who received music therapy treatments had higher levels immunoglobulin A, compared to those who didn’t participate in a music therapy program.
Additionally, other music therapy reports say that the act of hearing music alone can increase “blood quantity of a immune agent interleukin-1” (a protein that drives the defense mechanisms) and may help to reduce “blood levels of the stress-related immune antagonist, cortisol”. Rubin describes studies like these, as providing evidentiary support of, “the power of mental and artistic imagery to bolster the human immune system”. As well as the suggested healing capabilities of creative arts therapies, the nation’s Coalition of Creative Art Therapies Associations asserts that creative arts therapies can “make the main difference between chronic pain and comfort” by giving arts experiences that “distract people from pain and facilitate needed relaxation”.
These programs also “promote rehabilitative goals” in addition to “teach cognitive, motor, and everyday living skills”. This assertion is made about the healing qualities of creative arts therapies inside a general manner. However, current creative arts therapy research indicates the reality of this assertion when creative arts therapies are utilized as part of an oncology patient’s treatment. Research findings from the study about art therapy and cancer patients implemented by Northwestern University’s Feinberg Med school, suggest that art therapy may reduce anxiety, depression, drowsiness, pain, and may potentially improve appetites and difficulty breathing.
Similarly, research about dance movement therapy with cancer patients suggests that dance movement therapy will help, “decrease fatigue, improve vigor and tension, and lower anxiety and depression” (Serlin, Classen, Frances, & Angell in Ho, 2005, p. 89). Additionally, music therapy has been discovered to ease the discomfort brought on by the side results of cancer treatments for example chemotherapy, by reduction of the amount of vomiting and nausea. Studies also indicate that music therapy can sort out pain management, lessening anxiety and stress for pediatric oncology patients receiving treatments like bone marrow transplants. Being hospitalized and identified as having cancer can be very frightening and anxiety inducing for the bravest of adults, not to mention for young kids.
Being repeatedly poked and prodded, mounted on a machine, losing tufts of hair, and also the constant sense of nausea could be enough to dampen the spirit, something which is much needed in the battle from this terrible disease. Creative arts therapy programs assistance to invigorate a pediatric oncology patient’s spirit by providing therapeutic techniques that promote both physiological and psychological benefits (Abrams, 2001; Betts, n.d.; Dakutis, 1991; H., 2006; Rubin, 1999; Serlin, Classen, Frances, & Angell in Ho, 2005). Creative arts therapies assisted in the healing process by enhancing treatments, in such a way that healing of both body and mind are promoted.
Findings
Example organizations and programs Within the following section, the Children’s Cancer Association’s Music Rx program and also the Children’s Hospital’s Ponzio Creative Arts Therapy Program are generally profiled. This section is definitely the various aspects of these programs such as the organizational backgrounds, mission and goals, program offerings, program participants, volunteers, staff, training, and funding. The Children’s Cancer Association and Music Rx The Children’s Cancer Association is really a not-for-profit organization which was established in 1995 by Cliff and Regina Ellis, in memory of the daughter Alexandra who died after battling cancer for 2 and a half years.
The Children’s Cancer Association was created out of the Ellises need to create a business that would provide families like theirs using the, “resources and support which had been” previously “unavailable or inaccessible” (E. Hoffmann, personal communication, April 24, 2007). The Children’s Cancer Association functions like a support network for all those whose life is directly influenced by pediatric cancer along with other serious illnesses and it is dedicated to offering, “award winning programs, together with information, advocacy and support which help enrich the caliber of life for seriously ill children as well as their families”.
The Ellises have commemorated their daughter’s spirit through their use the Children’s Cancer Association and also have honored Alexandra’s name in most that the organization represents. Alexandra’s memory is the central organization’s operations and this really is evident with the tagline, “When families need support, Alexandra’s there” (Children’s Cancer Association, n.d., About Alexandra section, para. 3). The Children’s Cancer Association’s logo was made from a drawing of the vibrant heart, which Alexandra drew in May of 1995.
By continuing to keep Alexandra’s life in the center of that the Children’s Cancer Association does, the Ellises have discovered a way to turn their negative and sorrowful experience right into a positive experience for other people. The organization includes medical professionals, families, community leaders along with other individuals who are devoted to improving the standard of living of seriously ill children, and every year their efforts reach a large number of children nationwide.
One way that the Children’s Cancer Association has the capacity to reach a lot of children is thru their numerous program offerings. One of these simple programs is called Music Rx. Music Rx is really a unique, unique program that transforms a healthcare facility environment and offers therapeutic music to pediatric patients as well as their families at Doernbecher Children’s Hospital and Legacy Emanuel Children’s Hospital in Portland, Oregon (E. Hoffmann, personal communication, April 24, 2007). The concept to create a music therapy program stemmed from Cliff and Regina Ellis’ numerous hospital stays with Alexandra, where, “…they had brought friends and family into the hospital to experience music. They realized the background music was soothing not only to their family, however the staff along with other children as well”.
Music Rx offers hospitalized children a getaway from the typical hospital environment by giving them with the various tools for musical expression. The Music Rx staff and volunteers are capable of helping their patients deal with cancer along with other serious illnesses and express their opinion of living with the condition through their usage of, “the scientifically proven, therapeutic advantages of music to produce a soothing escape, a method to express anger, joy and frustration along with a way to just be a kid” (Children’s Cancer Association, n.d., Music Rx section, para. 1). By taking part in the creation of music, children express their pain, hopes, fears, happiness, sadness, in addition to, their uneasiness concerning the disease, hospitalization, and course of treatment. Music also provides patients having a distraction, a method to forget about their disease and also to help them seem like a “normal” kid, if perhaps for a few moments. One way in which the Children’s Cancer Association has the capacity to impact a lot of pediatric patients’ lives is as simple as offering a course that is driven by a business with a defined purpose and it is guided with a predetermined group of goals. Based on Emily Hoffmann, the Director of Music Rx, their primary goal is exactly what she describes to be “simple” in nature; Music Rx strives to “bring the benefits of music to honestly ill children as well as their families” (E. Hoffmann, personal communication, April 24, 2007). By giving numerous therapeutic musical experiences for pediatric patients as well as their families at both Doernbecher and Legacy Emanuel Children’s Hospitals, it appears like this “simple” goal, is definitely achieved. However, Music Rx can also be focused on meeting various program sub-goals.