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Art therapy with adult bone marrow transplant patients in isolation: A pilot study
Abstract
Psycho-social interventions for cancer patients in isolation for bone marrow transplant (BMT) have been advocated in the recent literature. It is not clear what type of interventions would be most appropriate. This study was conducted at Memorial Sloan-Kettering Cancer Center (MSKCC), with three aims. (1) To test the feasibility of introducing art therapy as a supportive intervention for adult BMT patients in isolation. Nine patients were seen in art therapy sessions twice a week while in isolation, and were helped to develop free personal images. The three art therapists used the same art therapy program as a model. (2) To assess how patients would use the program. Forty-two images were made by the nine patients during the art therapy sessions. A thematic analysis of the images showed that the patients used art therapy effectively in three ways: (a) to strengthen their positive feelings, (b) to alleviate their distress, and (c) to clarify their existential/spiritual issues. (3) The third aim was to identify which patients would most benefit from art therapy. Our results suggest that the non-verbal metaphorical modality of art therapy may be especially beneficial for patients who need to deal with emotional conflicts, and with feelings about life and death, in a safe setting.
... BMT is commonly used in cancer treatment for patients with leukaemia, lymphoma, multiple myeloma and neuroblastoma (National Cancer Institute 2010). Patients going through this procedure are in isolation for long periods of time and may be vulnerable to physical and psychosocial distress (Gabriel et al. 2001;Mische Lawson et al. 2012b). Some common physical side effects are pain, nausea and vomiting. ...
... Some common physical side effects are pain, nausea and vomiting. Patients may also experience psychosocial side effects of BMT including depression, anger and decreased self-esteem (Gabriel et al. 2001). ...
... Art therapy is a complementary therapy used in cancer care and rehabilitation in some medical settings (Wood et al. 2011). Art therapy is a form of psychotherapy where the relationship with the therapist is a contributing factor in the artistic process (Gabriel et al. 2001;Reynolds & Prior 2006). Emerging research of art therapy suggests that it may be an effective intervention for cancer patients (Gabriel et al. 2001;Wood et al. 2011). ...
The majority of research on understanding the illness focuses on analysing the written or verbal content. Thematic analysis of images is a novel qualitative approach that can enhance knowledge of the experience of illness. This study used thematic analysis to examine 171 tiles painted by patients through the Tiles of Hope programme in an outpatient blood and marrow transplant unit. Major themes identified in this study were Faith, Hope, Positive Attitude, Nature and Social Support. These themes provided a better understanding of patients' perceptions in relation to their experience with illness through the art-making process.
© 2015 John Wiley & Sons Ltd.
... Bildterapi som komplementär metod vid omvårdnaden av cancerpatienter har tillämpats både i Sverige och i övriga världen under de senaste decennierna. Gabriel et al (2001) och Nainis et al (2006) är några av dem som i vetenskapliga studier undersökt bildterapins effekter i detta sammanhang. ...
... Enligt Edith Kramer (1975) kan bildterapin bidra till att stödja jaget, skapa en starkare identitetskänsla och bygga upp en inre styrka som gör det möjligt att klara yttre påfrestningar utan att använda sig av försvarsmekanismer (a a). Många patienter ställs inför existentiella frågor i samband med sjukdomsdebuten (Gabriel, 2001). Funderingar såsom vem man egentligen är, vad för sorts liv man levt samt meningen med livet förekommer ofta, likaså huruvida det finns ett liv efter detta (a a). ...
... Även lindring av fysiska symtom såsom smärta har studerats, bland annat av Nainis et al (2006). En pilotstudie bland benmärgstransplanterade vuxna patienter visade att bildterapi kunde hjälpa dessa patienter att återvinna ett positivt tänkande och lösa känslomässiga konflikter (Gabriel et al, 2001). ...
... Die erste Veröffentlichung von Luzzatto, Gabriel und Kollegen beinhaltet die erste Studie zur Creative Journey als Gruppenintervention (Luzzatto, 1997;Luzzatto & Gabriel, 2000). In einer zweiten Studie kommt die Intervention im Einzelsetting zum Einsatz (Luzzatto et al., 2001). Die Datenerhebung beider Publikationen durch Interviews und Darstellung der Ergebnisse in Fallstudien ist vergleichbar mit der hier vorliegenden Studie. ...
... In der zweiten Studie kommt die Creative Journey im Einzelsetting während Knochenmarktransplantationen zum Einsatz. 42 der entstandenen Bilder wurden analysiert und drei Bildthemen zugeordnet (Luzzatto et al., 2001) dem Ausdruck positiver Gefühle, dem Ausdruck belastender Gefühle und der Thematisierung existenzieller und spiritueller Inhalte. ...
Zusammenfassung. In der Onkologie ist die psychosoziale Belastung der betreuten Patienten aufgrund der potentiell lebensbedrohlichen Erkrankung erheblich. Wahrend der akuten Behandlung wird der Einfluss auf die eigene Lebensgestaltung eingeschrankt wahrgenommen und sollte thematisiert werden. Es wurde eine kunsttherapeutische Intervention, die KSKT®, speziell fur den klinisch-onkologischen Behandlungskontext entwickelt. Ziel der vorgestellten Studie ist die Identifizierung und Beschreibung der Wirkung der KSKT® aus Patientenperspektive. Daten aus Leitfaden gestutzten Interviews, die zu drei Messzeitpunkten erhoben wurden (n = 5; vor der Intervention (VDI, T 0) direkt nach der Intervention (NDI, T 1) und nach drei Monaten (NDI 2, T 2), wurden mit Hilfe der Qualitativen Inhaltsanalyse (nach Mayring 2002, 2008b) ausgewertet. Aus dem umfangreichen Datenmaterial liessen sich insgesamt sechs Kategorien ermitteln. Die Sinnhaftigkeit der Erkrankung (Kat. 1) war eine der drei meistgenannten Kategorien. Diese wurde...
... B lood and marrow transplantation (BMT) can have positive effects on blood and marrow cancers, but it often results in adverse side effects, creating the need for alternative therapies (Carlson & Bultz, 2008;Gabriel et al., 2001;Nainis et al., 2006). The basis of BMT involves transplanting stem cells, which are intended to replace and destroy diseased cells to produce healthy blood-producing cells (Leukemia and Lymphoma Society, 2013). ...
... According to the Leukemia and Lymphoma Society (2013), to decrease the risk of infection, precautions are taken, including patient isolation, limited contact with children, certain dietary precautions, hand hygiene, and personal protective equipment. Required precautions to prevent infections may create feelings of isolation because of physical and social barriers (Gabriel et al., 2001;Mosher et al., 2009). ...
Purpose/Objectives: To understand the benefits of making art and listening to music and whether those activities may be beneficial for reducing symptoms associated with blood and marrow transplantation.
Design: A randomized, three-group, pre-/post-pilot design.
Setting: Outpatient Blood and Marrow Transplant Clinic at the University of Kansas Cancer Center in Kansas City.
Sample: 39 adults aged from 22–74 years receiving blood and marrow transplantations.
Methods: Participants were randomly assigned to one of three groups: (a) art making, (b) diversional music (comparison), or (c) control (usual treatment). The Therapy-Related Symptoms Checklist was used to assess the patients’ self-reported symptoms related to treatment. The Spielberger State-Trait Anxiety Index was used to measure self-reported anxiety symptoms. Vital signs were obtained pre- and postintervention to measure physiologic stress.
Main Research Variables: Therapy-related symptoms, state anxiety, and physiologic distress.
Findings: Of the 39 participants, 14 were randomized to the control group, 14 to the art group, and 11 to the diversional music group. No significant differences in age, gender, ethnicity, or diagnosis existed between groups. No statistical differences were found between groups on all measures following the intervention.
Conclusions: Although the results of the current study did not indicate significant differences, healthcare professionals may still consider creative therapies as a viable option for patients within hospital or outpatient clinics because they do not require specialty training or costly resources, and they may be an enjoyable activity to occupy time for patients and caregivers.
Implications for Nursing: Art making and music listening are safe and desirable for patients undergoing blood and marrow transplantation in an outpatient clinic. Nurses might consider partnering with therapists to offer these creative therapies as diversion during treatment.
... Die hier vorliegenden Ergebnisse werden durch andere Studien bestätigt, die mit Krebspatienten durch geführt wurden. Danach kommt es durch KT zu einer Verbesserung von Fatigue, Depression, Angstzuständen [2,16,24] und zu positiverer Krankheitsakzeptanz und einer Verbesserung des emotionalen Wohlbefindens [4,6,17]. Außerdem wird auf einen Anstieg der LQ verwie sen [15,17,24]. ...
... Außerdem wird auf einen Anstieg der LQ verwie sen [15,17,24]. Auch kognitive Elemente wie Situations klärung und das Überdenken der Perspektive werden erwähnt [6]. ...
Background: The aim of this randomized controlled trial was to analyze the impact of creative arts therapy (CAT) on quality of life (QoL) in patients with multiple sclerosis (MS) during inpatient rehabilitation. Material and Methods: Out of 69 MS patients, 37 were randomized to an intervention group with group arts therapy sessions 2/week, whereas 32 patients served as control group. All participants took part in an evaluated coping program (REMUS). At three time points (start and end of rehabilitation and after 6 months), evaluated questionnaires dealing with QoL, depression, self-efficacy and fatigue were presented: HALEMS, ADS-L, MSSeS and WEIMuS. Furthermore, a qualitative assessment took place. Results: In both groups, mood, social behavior, self-efficacy, and fatigue improved after inpatient rehabilitation, but the increase of mood, social functions, and fatigue was significant only in CAT. There was also a major positive difference between the two groups concerning subjective well-being (physical and emotional), flexibility, disposition for alteration, and changing of behavior. Conclusions: Creative arts therapy improves QoL in MS, with particular effects on mood, self-efficacy, social behavior and fatigue. It may also have influence on the creation of coping strategies. This needs to be determined in further studies.
... Expressive art therapies offer an alternative to the reliance on verbal communication in traditional therapies. These therapies are increasingly in use, for example, to reduce isolation (Gabriel et al., 2001), to create meaning from illness (Romanoff & Thompson, 2006), to facilitate emotional expression and help patients cope more effectively (Borgmann, 2002) and to improve quality of life (Svensk et al., 2009). Medical art therapy, a specialized expressive therapy for those who are physically ill, has been employed similarly to reduce isolation and help patients cope (Malchiodi, 1993), to reduce stress during hospitalization (Breslow, 1993) and to clarify existential/spiritual issues (Gabriel et al., 2001). ...
... These therapies are increasingly in use, for example, to reduce isolation (Gabriel et al., 2001), to create meaning from illness (Romanoff & Thompson, 2006), to facilitate emotional expression and help patients cope more effectively (Borgmann, 2002) and to improve quality of life (Svensk et al., 2009). Medical art therapy, a specialized expressive therapy for those who are physically ill, has been employed similarly to reduce isolation and help patients cope (Malchiodi, 1993), to reduce stress during hospitalization (Breslow, 1993) and to clarify existential/spiritual issues (Gabriel et al., 2001). Gottheil and Groth-Marnat (2011) explored the concept of spirituality by inviting 25 participants to view images with spiritual content and to tell stories that revolved around spiritual themes. ...
Background: This exploratory study investigated the spiritual use of visual images of artwork to facilitate conversation with hospitalized patients regarding their experiences of illness and hospitalization, with the aim of improving patients' coping and well-being. Methods: Qualitative in-depth interviews were conducted with patients (n = 20), who were asked to examine a selection of paintings and to choose one to discuss with the interviewer. Results: Ninety percent of participants found the experience to be positive. Thematic analysis of patients' descriptions of their reactions to the paintings reveals multiple beneficial dimensions of spirituality during the illness experience. The findings suggest that the use of images can facilitate conversation and enhance well-being in hospitalized patients. Conclusions: Using narrative images may be a useful spiritual modality for working with hospitalized patients.
... Die hier vorliegenden Ergebnisse werden durch andere Studien bestätigt, die mit Krebspatienten durch geführt wurden. Danach kommt es durch KT zu einer Verbesserung von Fatigue, Depression, Angstzuständen [2,16,24] und zu positiverer Krankheitsakzeptanz und einer Verbesserung des emotionalen Wohlbefindens [4,6,17]. Außerdem wird auf einen Anstieg der LQ verwie sen [15,17,24]. ...
... Außerdem wird auf einen Anstieg der LQ verwie sen [15,17,24]. Auch kognitive Elemente wie Situations klärung und das Überdenken der Perspektive werden erwähnt [6]. ...
... Second, the papers by Öster and colleagues (2006, 2007) and Svensk and colleagues (2009) are piecemeal publications of the effects of a single intervention on different outcomes: coping (Öster et al., 2006, 2007) and quality of life (Svensk et al., 2009), and thus should not be considered as independent contributions to the effects of visual arts interventions on cancer patients' symptoms. Third, a considerable amount of the studies included in these reviews are pilot studies examining the feasibility of interventions on very few participants (Ando et al., 2013;Grulke et al., 2006;Puig et al., 2006), are not actually randomized controlled trials (De Feudis et al., 2021;Geue et al., 2013;Wiswell et al., 2019), or are not even experimental studies (Collie et al., 2006;Gabriel et al., 2001;Visser & Hoog, 2008). It is, therefore, misleading to present them as definitively supporting the conclusion that these art interventions are effective at reducing cancer-and cancer treatment-related symptoms. ...
Can art improve health and wellbeing? The rapidly growing art therapy literature claims that there is solid evidence that engaging with art ameliorates mental and physical disorders and increases wellbeing. This claim is used to justify numerous arts-based clinical interventions and health policies, so it deserves thorough scrutiny. Here we show that the evidence cited in favor of the efficacy of art therapy interventions is conceptually and methodologically flawed. Conceptually, experiments investigating the effects of arts-based interventions on health do not include appropriate tests nor control conditions that would allow demonstrating that the putative effects actually owe to the healing power of art: (i) they fail to define what art is, making it impossible to compare the effect of "art" and "non-art" stimuli and activities on health and wellbeing; (ii) they fail to demonstrate that "art" stimuli and activities elicit a distinct class of "art" experiences that modulate the mechanistic causes of disorders; (iii) and they fail to include causal manipulations of physiological processes believed to be mechanisms of action that could prove that art-induced processes affect the etiology of disorders. Methodologically, most studies cited as proof for the efficacy of art therapy lacked such common clinical trial procedures as defining the therapeutic agent, randomizing group assignment, controlling for patient or researcher allegiance, controlling for the effects of other concurrent interventions and medications, comparing art-based interventions to other kinds of interventions, or conducting and reporting statistical analyses appropriately. We conclude that there is no compelling evidence that art objects and activities can induce physiological changes to the human nervous system that result in health improvements and wellbeing. We discuss why proponents of art therapy have neglected these problems and the ethical implications for patients who are treated using art therapy.
... and social needs, while focusing on psychosocial aspects and their emotional growth and development [5]. Art therapy is a clinical intervention based on the conviction that the creative process involved in art therapy can help to heal patients, to improve their life, to enhance their self-awareness (and that of their family members), to cope with symptoms, and to adapt to a situation full of stress and shocks [13]. Art therapy helps to reduce the physical pain of patients and provide them with an opportunity to express their unstable emotions, so that they can relieve tension and feel well-being when going through spiritual and emotional hardship [14]. ...
Purpose:
In this study, the researchers closely investigated the psychosocial problems faced by terminal cancer patients and their family members in hospice palliative care units.
Methods:
The investigators conducted four sessions of art therapy intervention programs for the terminal cancer patients and their family members, carried out in-depth interviews about the influence of the cancer experience on their family function and quality of life, and analyzed their experiences using grounded theory methodology.
Results:
After providing autonomous written informed consent, six pairs of terminally ill cancer patients and their family members, accounting for a total of 17 participants with the inclusion of additional family members who took part sporadically, took part in the art therapy intervention and interviews. The raw data, in the form of verbatim records, were analyzed according to the procedures of grounded theory (open, axial, and selective coding). Through these processes, a total of 154 concepts, 56 subcategories, and 13 categories were identified. Families were classified into four types according to their family function, quality of life, and attitude toward death. Though the art therapy intervention, patients and their family members experienced three stages over time.
Conclusion:
This research focused on essential aspects of the family relationships and the art therapy experiences of terminal cancer patients and their family members through an art therapy intervention in the context of hospice palliative care. Based on these observations, the researchers constructed a theoretical rationale for art therapy interventions delivered to patients and their family members in the process of hospice palliative care.
... L'auteur constate que cette technique permet aux enfants à la fois de maintenir leurs défenses psychiques au regard de la maladie et de l'isolement et d'exprimer leur angoisse et leur désespoir. Gabriel et al. [30] ont expérimenté un programme structuré d'art-thérapie appelé The Creative Journey. Les auteurs concluent que le dispositif est profitable aux patients, leur permettant de renforcer leurs sentiments positifs, de soulager leur détresse et de clarifier leurs questionnements existentiels et spirituels. ...
Les auteures présentent la littérature anglophone et francophone sur 1/ les conséquences psychologiques d’une hospitalisation en secteur protégé. 2/ les dispositifs de soutien psychologique. Ce recensement participe d’un projet de recherche-action dont l’objectif est double. Explorer le vécu des patients qui subissent une telle expérience extrême. Leur offrir un dispositif de soutien psychologique aux trois temps de la maladie : hospitalisation, sortie du secteur protégé, retour au domicile.
Mots clefs
Isolement, hématologie, impact psychologique, dispositifs d’accompagnement
... Despite advances in the treatment, the patients have to accept the risks of suffering and death. The secondary effects of chemotherapy treatment and/or radiotherapy (nausea, vomiting, pain, mucositis, alopecia, etc), combined with the long period in isolation, and the separation from the relatives, tend to influence the mood (Gabriel et al., 2001;Mosher, Redd, Rini, Burkhalter, & DuHamel, 2009;Wettergren, Sprangers, Björkholm, & Langins-Eklöf, 2008;Watson , James-Roberts & Ashley, 2006;Wettergren, Sprangers, Björkholm, & Langins-Eklöf, 2008). 4,5,6,7,8) . ...
The aim of this work has been to determine the repercussions a psycho-oncological program has on patients who need to undergo a haematopoietic stem cell transplantation (HPT). We have studied two groups, an intervention group (n=21), formed with patients that have gone through the program of psycho-oncologic preparation previous to the transplant, and a control group (n=15), without psychological intervention. The program consists of four sessions: analysis and handling of the information, coping skills, management of stress, and preparation for the isolation. The results show that patients who receive the psychological intervention. appear to obtain minor levels in anxiety and depression and has a more adaptive perception of the passage of time and a more positive mood with more activity than the control group. However, such differences are not significant in the perception of the physical symptomatology as the amount of time in isolation increases.
... Art therapy helps patients with a malignant disease express experiences that are hard or impossible to put into words and is suitable for patients with various diagnoses, ages and levels of education (1,7,8,9). Review of the literature showed the significant effect of this type of psychotherapy, despite the heterogeneity in samples and study designs (1,10,11,12,13,14,15,16 behavior while increasing the sense of control (17,18,19). Surveys carried out by an interdisciplinary research team demonstrated statistically significant reductions in cancer symptoms with a lower score in depression, anxiety, somatic and general symptoms for the therapy group compared to the control group (20). ...
Aims: Art therapy as supportive-expressive therapy is gaining increasing importance in psycho-oncology. The aim of this paper is to describe the experience of participating in art therapy of a patient with breast cancer and to review the literature regarding the effectiveness of art therapy during breast cancer treatment. Methods: The participant undergoing medical treatment for breast cancer was treated at the Clinical Hospital Centre Zagreb, at the Department of Psychological Medicine. A therapeutic approach was used to analyze the patient's data. Review of the literature in the field of art therapy in psycho-oncology was done, with a particular focus on the approach to patients with breast cancer. Results: Studies have found that breast cancer diagnosis has a large impact on the emotional, cognitive and social functioning of women. It is important to develop strategies to strengthen coping mechanisms in women with breast cancer and help them express often-repressed emotions. The main point of supportive-expressive therapy includes mourning the losses that cancer brings and adapting to a changed body image. Expression in art gives emotions a form and a color instead of just the physical or psychological symptoms. Conclusion: The literature and this case show that art therapy has a lasting effect on a large spectrum of symptoms related to breast cancer and its consequences as well as on self-knowledge and self-realization of the patient. Therefore, art therapy can be used as a highly effective approach to provide breast cancer patients with better quality of life and psychological support while giving them freedom to express themselves and add meaning to their days. © 2017 Croatian Academy for Medical Sciences. All rights reserved.
... Despite advances in the treatment, the patients have to accept the risks of suffering and death. The secondary effects of chemotherapy treatment and/or radiotherapy (nausea, vomiting, pain, mucositis, alopecia, etc), combined with the long period in isolation, and the separation from the relatives, tend to influence the mood (Gabriel et al., 2001;Mosher, Redd, Rini, Burkhalter, & DuHamel, 2009;Wettergren, Sprangers, Björkholm, & Langins-Eklöf, 2008;Watson , James-Roberts & Ashley, 2006;Wettergren, Sprangers, Björkholm, & Langins-Eklöf, 2008). 4,5,6,7,8) . ...
Efectos del entrenamiento en habilidades de comunicación en la expresión de emociones y locus de control en pacientes de trasplante de precursores hematopoyéticos (TPH)
Soledad de Linares-Fernández [1] ; Mª Nieves Pérez-Marfil [2] ; Francisco Cruz-Quintana [2] ; Antonio Romero-Aguilar [1] ; Lucía Moratalla-López [1] ; Elisa López-Fernández [1]
[1] Hospital Universitario Virgen de las Nieves
[2] Universidad de Granada
Localización: Revista argentina de clínica psicológica, ISSN 0327-6716, Vol. 27, Nº. 1 (Enero de 2018), 2018, págs. 14-23
Idioma: español
Títulos paralelos:
Effects of training in communication skills in the expression of emotions and locus of control in patients of haematopoietic stem cell transplantation (HSCT)
Resumen
Español
El TPH supone un periodo de aislamiento en el que se puede experimentar un gran malestar debido a los efectos secundarios, al riesgo de complicaciones y a la separación socio-familiar. El objetivo de este trabajo ha sido comprobar el efecto del entrenamiento en comunicación emocional medido a través de los cambios en locus de control y en niveles de supresión emocional. Participaron dos grupos de pacientes, uno que realizó un programa de intervención psicooncológica (n = 22) y otro que realizó además un módulo adicional de habilidades de comunicación (n= 26). Los resultados mostraron que el entrenamiento en comunicación aumentaba los beneficios del programa psicológico pre-trasplante. El grupo que recibió el módulo adicional aumentó su Locus de Control Interno y la expresión emocional, en comparación con el grupo de intervención estándar.
English
The HSCT requires a period of isolation in which great discomfort due the side effects, risk of complications and separation from family and social relationships, can be experienced. The aim was to determine the effect of training on emotional communication measured through changes in locus of control and in levels of emotional suppression. We had two groups of patients, one performed a program of pycho-oncological intervention (n = 22) and the other performed the same program plus an additional module in communication (n = 26). The results showed that the training in communication increased the benefits of the psychological program pre-transplant. The group that received the additional module improved the internal locus control and the emotional expression of anger, worry and sadness.
... Art may provide a useful bridge for communication and expression of psychosocial concerns within a therapeutic relationship wherein participants use a choice of visual art materials in an expressive manner to facilitate insight, increase self-agency and promote wellbeing. [9][10][11] Art in various forms has been used as an intervention to offer support to cancer patients at different stages of their illness. 6 In general, results have indicated a reduction in anxiety, stress, depression and physical symptoms, a general enhancement in quality of life and global health, and an increase in energy and positive disposition. ...
Review question/objective:
How does art contribute as a psychotherapeutic tool in making sense of the cancer experience? What is the meaningfulness of integrating art (as either creator or consumer) for patients throughout the cancer experience?
... Previous research reported feelings of anger emerging as a part of expression (Singh 2011), thus it is possible this theme did not reach redundancy. Previous research suggests multiple art therapy sessions are necessary for patients to strengthen positive feelings, alleviate distress and clarify spiritual issues (Gabriel et al. 2001). It is possible that more than 1 h of art-making is needed to move beyond positive expression. ...
Patients with various forms of cancer receiving blood and marrow transplant (BMT) treatment at an outpatient clinic develop chemotherapy-related symptoms and an increased desire to use complementary and alternative medicine in order to address these symptoms. Art-making offers an inexpensive way to pass time and relieve symptoms during long hours in treatment. Twenty-one BMT patients painted a tile and participated in research. Researchers used semi-structured interviews to understand patients' experiences with art-making. Interviews were recorded, transcribed and coded independently by researchers who met to agree on themes. Ten themes emerged from the data including, meaningful activity (32.2%), expression (18.7%), passing time (13.2%), BMT process (12.1%), social outlet (8.1%), therapy-related symptoms (7.3%), negative aspects of painting (5.9%) and encouragement to paint (2.6%). The results of this study revealed that art-making experience can provide patients a meaningful activity during treatment and an outlet to express their feelings.
... Yet, despite the prevalence of spiritual CAM and the assertions of many health care practitioners regarding the beneficial effects of CAM, the efficacy of such treatments remains unknown. An examination of re-search on the efficacy of religious and spiritual CAM in cancer patients is rife with anecdotal articles and case studies (Cohen & Walco, 1999;Gabriel et al., 2001;Sitzman, 1999). Although the case study approach is useful in many respects, it is not conducive to demonstrating the efficacy of spiritual CAM because case studies often contain few or no reliable measures of improvement, nor do they typically include an intentional intervention on the part of the researcher. ...
In addition to biomedical forms of treatment, many cancer patients have elected to use complementary and alternative medicine (CAM) of a spiritual or religious nature. However, the effectiveness of such spiritual and religious interventions is uncertain. Using a meta-analytic approach, the present study synthesized available treatment-outcome studies on spiritual and religious interventions for cancer patients to determine the efficacy of such interventions. Effect sizes were calculated for three types of outcome measures: biological, psychological, and spiritual. The authors found that nondrug spiritual and religious interventions produced small to moderate effect sizes for treatment versus control comparisons and small effect sizes for pre- versus posttreatment comparisons. Studies that used psychedelic drugs to promote spiritual experiences produced large effect sizes for both treatment versus control and pre- versus posttreatment comparisons. Finally, they found that, overall, treatment versus control comparisons produced larger effect sizes than did pre- versus posttreatment comparisons. Limitations of the studies discussed in the present meta-analysis included the lack of control groups, randomization, and a large number of participants. The results suggest that there is a shortage of sufficiently detailed, high-quality treatment outcome studies examining the efficacy of spiritual and religious interventions for oncology patients.
... Creative therapies for cancer patients are generally intended to integrate physical, emotional, and spiritual care by facilitating creative ways for patients to respond to their cancer experience (Feuerstein, 2007). There are a number of descriptions of programs in the literature, ranging from visual arts (Gabriel et al., 2001), music therapy (Trauger-Query, 602721Q HRXXX10.1177/1049732315602721Qualitative Health ResearchButler et al. ...
This research describes a community dance project for people affected by cancer, which was led by a trained community dancer over 10 movement workshops and three performances. Using a qualitative descriptive approach, the research explored the experiences of a convenience sample of 8 participants out of the original group of 17 individuals who took part in the community dance. The research was participatory and the researchers were involved in workshops and performances as members of the group who also had family members with cancer. The findings indicate the motivation of the dancers to continue in spite of hardship, their sense of pride in being part of something that was larger than themselves, the way the dance permitted them to embody a sense of courage, and finally, in performing, how they managed to share something that genuinely moved an audience.
... Diese Einzelfallstudie verdeutlichte den Veränderungsprozess mittels systematischer qualitativer Auswertungen der Bilder. Gabriel und Kollegen [5] wandten bei neun knochenmarktransplantierten Patienten, die sich in Isolation befanden, das manualisierte Kunsttherapieprogramm "The Creative Journey" an [12]. Literatur ...
Die Diagnose Krebs stellt für jeden Menschen eine schwerwiegende Belastung dar, die mit gravierenden Veränderungen durch die Erkrankung und Behandlung einhergeht. Kunsttherapeutische Angebote bieten die Möglichkeit, die Krankheitsverarbeitung auf kreative Art und Weise zu unterstützen. In einer aktuellen Studie wird der Einfluss einer kunstpädagogischen Intervention auf das psychische Befinden, die Lebensqualität und die Krankheitsverarbeitung an einer hämato-onkologischen Patientengruppe kontrolliert untersucht. Ziel des ambulanten künstlerischen Nachsorgeangebotes ist die Gestaltung eines individuellen Buchobjektes, in dem sich die Teilnehmer mit sich selbst und der Krebserkrankung auseinandersetzen. Die Intervention spricht Patienten unterschiedlichen Alters an, wobei mehr Frauen als Männer teilnehmen. Eine erhöhte psychische Belastung der Teilnehmer vor Kursbeginn wurde festgestellt. Fundierte Aussagen zur Wirkung der Intervention können aufgrund der laufenden Datenerhebung noch nicht getroffen werden. Die starke psychische Belastung der teilnehmenden Patienten sowie der oftmals geäußerte Wunsch nach einer Fortführung des Kursangebotes unterstreichen jedoch bereits zum aktuellen Projektzeitpunkt die Notwendigkeit von evaluierten psychoonkologischen Angeboten im ambulanten Kontext.
Summary
To be diagnosed with cancer can be an incisive exposure for everyone as it accompanies serious changes caused by the disease and its treatment. Hence art therapeutical offers give the opportunity to support coping with the disease in a creative way. A current study investigates the effect of art therapy intervention on the patients‘ psychological distress, the quality of life and coping with the disease. Therefore a group of haematological patients which are attending an outpatient art course are being investigated. In this intervention participants create their individual book wherein they deal with themselves and their disease. This intervention is addressed to people of different age, whereas more women than man take part. Before the program began an increased anxiety of the participants has been asserted. Due to the ongoing data acquisition profounded statements regarding the effects of the interventions can not be made yet. However, the need of evaluated offers for cancer patients in an outpatient care has been shown already. The major psychological distress of the patients participating and their request for a continuation of art therapy courses support this fact.
... Art therapy has been used as a significant support tool for people with all kinds of diseases, including cancer [2][3][4]. It is an effective psychosocial tool to cancer patients at different stages in the course of their illness, especially during isolation for bone marrow transplantation [5,6], during radiotherapy treatment [7], and after treatment [8,9]. Evidence suggests that art therapy can increase selfesteem, gain a sense of control, reduce stress and anxiety, enhance cognitive functioning, and improve a person's quality of life by becoming more expressive and livelier through creating art and reflecting on the art products and psychological and emotional processes [10][11][12]. ...
... Les applications de l'art thérapie à médiation picturale (dessins, peintures, collages, modelage) ont été étudiées en onco-pédiatrie [27 28], pour les patients en isolement [29,30], durant la période de traitement par chimiothérapie et/ou radiothérapie [31,32], pour les patients en réhabilitation [33,34], pour les personnes en soins palliatifs [35,36], ainsi que dans le cadre des mesures de soutien pour le personnel soignant [37]. Les applications de la musicothérapie active et réceptive ont été étudiées en cancérologie aiguë pour différents groupes d'âge, à savoir chez les enfants [38][39][40], les adolescents [41][42], les adultes [43,44]. ...
... Au cours des dix dernières années, les études ont porté sur des populations de plus en plus diversifiées. Les applications de l'art thérapie à médiation picturale (dessins, peintures, collages , modelage) ont été étudiées en onco-pédiatrie [27 28], pour les patients en isolement [29,30] , durant la période de traitement par chimiothérapie et/ou radio- thérapie [31,32], pour les patients en réhabilitation [33, 34], pour les personnes en soins palliatifs [35, 36], ainsi que dans le cadre des mesures de soutien pour le personnel soignant [37] . Les applications de la musicothérapie active et réceptive ont été étudiées en cancérologie aiguë pour différents groupes d'âge, à savoir chez les enfants383940, les adolescents4142, les adultes [43,44]. ...
... Gabriel et al. (25) , en un estudio cualitativo piloto de las temáticas analizadas en los trabajos artísticos de 9 pacientes (4 mujeres y 5 varones) hospitalizados por transplante de médula y que recibieron dos sesiones semanales de arteterapia de una hora durante toda la duración del ingreso, reportan efectos como refuerzo de los pensamientos positivos, resolución de conflictos emocionales causantes de distrés y profundización en la toma de conciencia de las cuestiones espirituales y existenciales así como facilitación de la comunicación con los familiares y amigos. ...
Art and in particular visual arts are an integral part of cultures, giving expression to thoughts, feelings, desires and values. Throughout natural evolution they survived in the human conscience, contributing to develop a wide sense of well-being; and as a remedy to partially compensate unhappiness, such as illness and suffering. In modern times, art therapy has arisen from these fundamental premises and establishes the intervention based on the therapeutic value the intrinsic creative art process may confer to the person in crisis.Numerous benefits from art therapy have been documented in cancer, such as the expression of emotions, specially giving voice to feelings hard to express. It increases relaxation and communication, contributes to reduce pain, allows bearing of stressing experiences, promotes self-control feelings and increases self-esteem. It helps develop a greater understanding about the personal situation, contributing to adaptation and the finding of meaning to what is being lived. In other words, it promotes post-traumatic growth.A literature review of the main art therapy studies at different stages of the oncological disease trajectory is provided. The benefits of art therapy are thoroughly discussed from a palliative care perspective, as well as benefits in bereavement and healthcare personnel burnout prevention. Artwork created by patients is presented to illustrate the therapeutic value in the clinical field of cancer.
Hope's role in the care of adolescents and young adults (AYAs) who have advanced cancer (AC) is not well understood. This study aimed to conceptualize the essence of hope among AYAs who have AC based on their lived experiences and illustrate hope through verbal and artistic depictions of the AYA's lived experiences. Fifteen AYAs, aged 12 to 21 years, diagnosed with AC completed two semistructured interviews to share their lived experiences of hope perspectives in the form of a descriptive narrative and a creative-art outcome. Participants who chose to draw pictures narrated the conceptual meanings based on elements of each picture. A board-certified art therapist performed a post hoc analysis of the drawings and participants' verbatim descriptions of their meanings. Five of the 15 AYA participants created drawings depicting their lived experiences of hope. The artistic process of mapping their cancer journey revealed distinct views of hope through nature landscapes and metaphors. Participants provided titles for their drawings such as "Over the Rainbow," "Growth in the Valley," and "The Light at the End of the Tunnel." The pictures embodied the AYAs' thoughts, perceptions, and lived experiences related to hope and its role during their cancer journey. Drawing is one simple art form that can facilitate an AYA's expression of well-being (including hope) beyond what may be verbally articulated. Creative art should be further researched as a screening tool to assess how AYAs with AC cope with an uncertain future and psychological and/or existential distress symptoms.
This study aimed to investigate the feasibility of facilitating four sessions of art therapy intervention with a primary focus on implementation and acceptability. The exploratory aim was on assessing the impact of art therapy on self-reported outcomes on anxiety and mood among 5 individuals (aged 18+ years) hospitalized for burn injuries and to understand their perceptions of engagement with art therapy. A convergent mixed methods small N design was adopted wherein both quantitative and qualitative data are gathered and then integrated, and an individual served as his/her own control when assessed before and after art therapy. Anxiety was assessed using Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety short-form of the emotional distress bank, and mood was assessed using the Positive and Negative Affect Schedule (PANAS). There was a statistically significant decrease in anxiety scores and negative mood scale. Positive mood scale scores tended to improve after art therapy though were not statistically significant. Thematic analysis of qualitative data indicates that art therapy improves a) symptom management, b) facilitates emotional expression and c) insight, d) brings out symbolic and metaphorical representations, and e) allows tactile and sensory exploration of art media. This study demonstrated that art therapy can be successfully implemented with acute burn patients and can have promising psychosocial benefits. More research in needed to determine the impact and effectiveness of art therapy with burn patients, in ways that is meaningful to the patients.
The term “complementary and alternative medicine” (CAM) refers to the broad range of health systems, modalities, and practices that are not part of the conventional and politically dominant health system [1, 2]. We would also suggest that “integrative medicine” incorporates conventional medical approaches with evidence-based complementary approaches for an individualized care program designed to optimize human health and well-being. Several practices that are considered part of integrative medicine approaches in the United States include complex traditional health systems from other cultures, such as traditional Chinese medicine, as well as components of these systems that are practiced as distinct entities, such as acupuncture [3]. The originally named National Center for Complementary and Alternative Medicine (NCCAM) categorized CAM in the following domains: whole medical systems such as homeopathy and Ayurveda; mind-body medicine such as meditation and art therapy; biologically based practices such as herbs and dietary supplements; manipulative and body-based practices such as chiropractic and massage; and energy medicine such as biofield therapies and magnets [4]. But as above, even NIH has recognized the importance of integrating CAM with conventional medicine and now calls the NCCAM the National Center for Complementary and Integrative Health.
Psychological correlates of cancer incidence, progression, and quality-of-life difficulties have been well-documented in the literature; however, recent developments in psychoneuroimmunology (PNI) may provide further confirmation for the relationship between psychological factors and cancer. In this chapter, we review the current literature on how psychosocial factors (e.g., depression, marital support) and physiological processes (e.g., glucocorticoids) impact cancer incidence and progression. We then explore cutting-edge research on the biological mechanisms (e.g., bioenergetic health) that may explain quality-of-life difficulties among cancer survivors. Finally, we review studies that use biomarkers (e.g., pro-inflammatory cytokines) to evaluate the effectiveness of psychosocial intervention strategies.
Many patients with cancer face existential challenges struggling to find mental respite from their illness and a space for processing and transforming difficult thoughts and concerns. Research has shown that providing a room for cancer patients’ own creative expression can foster healing processes and mental well-being. Using theories of Donald W. Winnicott and liminality as a theoretical lens, we aim to show how a group of 40 cancer patients participating in a rehabilitation program have experiences of transition through art therapy. 33 women and seven men (within the age span of 31–76 years), across all disease stages and types of cancer, participated in a five-day rehabilitative program, addressing different existential themes (e.g., death, hope, love). On the last day of the course, we performed focus group interviews to explore the participants’ perceived significance of the art therapy among other course elements. The analysis led to three main processes of transition: a) engaging in a new creative realization or refusing to do so, b) therapeutic change, and c) reintegration: contemplation and peace. We show how the participants’ experiences can be understood as a space of reflection on new patterns of life. The use of art therapy as an extended part of a rehabilitation care contributes to positive processes of “corrective emotional experiences” and to transformation of crisis by fostering patient expression, especially in combination with encounter groups.
Taken from publications on art therapy from 1989 to 2019, bibliometric characteristics were analysed based on datasets located in the Social Science Citation Index (SSCI) and Science Citation Index Expanded (SCIE). Terms relating to “art therapy”, “art therapies”, “art* therapy”, “art* therapies” were used as keywords to search journal articles as of May 24th, 2020. A total of 935 articles, representing 2,650 authors across 363 journals were scanned. The USA, UK, Germany, Israel, Canada, South Korea, Netherlands, and Italy were eight of the top 14 countries in this field. The top 10 most influential countries and journals were identified by the number of publications, Total Local Citation Score (TLCS), and Total Citations / Total Publications (TC/TP). The top three journals are Arts in Psychotherapy, American Journal of Art Therapy, and Frontiers in Psychology. Three emerging core themes determined from highly-cited articles and keyword co-occurrence are art therapy with cancer patients, art therapy with prison inmates, and art therapy for mental disorders. The “effects of art therapy on trauma” is likely a potential trend of art therapy. The topics on “parental mentalization” (or “mother-child relationship”) and “art-making experiences” (“art-materials”) in the process of art therapy are promising.
Aims
The aim of the present study was to explore: (1) the feasibility of using color and pain drawing to describe pain; (2) the cultural appropriateness of pain body diagram (PBD); and (3) the cultural meaning of colors used in pain expression within one cultural group—the Hmong residing in the United States.
Design
A qualitative-descriptive study.
Methods
Data were collected sequentially in two phases with different Hmong participants from a Midwestern city using (1) focus groups to determine colors used for pain intensity and qualities along with preferences for drawing versus using the PBD; and (2) individual interviews to determine pain-related meanings of colors and cultural appropriateness of PBDs. Interviews were recorded, transcribed, and analyzed using summative and directed content analyses.
Results
Of 67 participants, 73% were female, the average age was 53.7±14.9 years, and 67% received Medicaid. In Phase I, most participants were unable to draw their pain on a blank page and preferred using a PBD. Most could select colors for pain intensity levels, with white and red indicating no pain and severe pain, respectively. In Phase II, white, red, and black had cultural meanings related to pain while colors such as yellow, orange, and blue had personal meanings. All participants perceived the PBD to be culturally appropriate.
Conclusions
The study's findings have implications for how to use colors in pain communication and confirm that PBDs can be used with Hmong patients.
This study investigated the potential role of art therapy as treatment for a child with Crohn’s disease. The subject was a 10-year old boy from a city in Korea, who was diagnosed with Crohn’s disease at the age of nine. A 20-session art therapy program was conducted once a week from April to September 2019, with each session lasting 90 min. Through art therapy, we can understand the experience of Crohn’s disease in a child, observe the psychological changes and treatment compliance that occur, and conduct a case study focusing on the experience and meaning that art therapy has on the child. The qualitative analysis showed that art therapy resolved the experiences associated with the child's traumatic hospital experience and negative feelings regarding the treatment, thus solving the problem of internalization and improving his quality of life. Art therapy improved the conformance of the child with the treatment for Crohn’s disease and helped to maintain his health through voluntary health care.
Background
Hematopoietic stem cell transplantation (HSCT) has become the standard treatment for many diseases, but it is an intense and distinctive experience for patients. HSCT-related mortality is present throughout the whole process of transplantation, from pretransplantation to recovery. Long-term rehabilitation and the uncertain risk of death evoke feelings of vulnerability, helplessness, and intense fear. Zimmermann et al. proposed that spiritual well-being is an important dimension of quality of life and that patients at the end stage of life require spiritual support in addition to physical care, psychological care, and social support. Therefore, the purpose of this review is to examine the role of spirituality in the process of HSCT.MethodA systematic mixed studies review (SMSR) was based on Pluye and Hong’s framework to understand the role of spirituality in patients’ experiences while undergoing HSCT. We use the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement to report the results of integration.ResultsFifteen original qualitative studies, 19 quantitative studies, and one mixed method study were included in the systematic mixed studies review. The evidence from the review revealed the following three themes: the spiritual experiences of HSCT patients, the spiritual coping styles of HSCT patients, and the spiritual need changes brought about by HSCT.DiscussionFew medical institutions currently offer spiritual healing, although HSCT patients with different cultural backgrounds may have different spiritual experiences and spiritual coping styles. Psychotherapists or nurses should be considered to provide spiritual care for patients undergoing HSCT, to help patients cope with disease pressures, promote HSCT patients’ comfort, and improve their quality of life.
Oncology patients experience significant psychological distress in addition to physical symptoms associated with illness. Overwhelming emotions, negative moods, and other forms of psychological stressors are present due to uncertain future. Shock experienced after receiving diagnosis, distress associated with medical decision-making, lack of control over one's environment, and fears related to changes in lifestyle within the course of the illness are a few examples of the challenges faced by patients. Art therapy is a therapeutic treatment modality that accommodates the opportunity for patients to make autonomous decisions, organize and structure these choices, and obtain a sense of control over personal artwork as well as the therapeutic experience. In this paper, the authors explore the literature surrounding the impact of perceived control on psychological distress in oncology patients, the connection between decision-making and perceived control, and the potential for art therapy to increase perceived control through decision-making opportunities for oncology patients.
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.
The psychological effects of medical illness are known to include depression, anxiety, and post-traumatic stress disorder (PTSD), and require appropriate evaluation and management. Since the medically ill are seen in a variety of treatment settings, art therapists will inevitably encounter these patients in their practice and therefore need to be cognizant of the principles of medical art therapy (MAT). This chapter first provides the classification of medical illnesses: medical, surgical, neurological, and palliative care. Art therapists must take appropriate measures and modify the therapeutic intervention in these cases. The goals of MAT differ depending on the patient, illness, treatment setting, and circumstances, and include: decrease isolation and improve socialization; and increase self-confidence through mastery of art materials and processes. The chapter provides a case study of a patient who was able to reconstruct her self-identity through involvement in art therapy and creative work.
Background:
Protective isolation is one of the precautionary measures put in place for neutropenic cancer patients, where patients will be placed in an isolation room during their medical treatment in the hospital. The purpose of this practice is to minimise neutropenic patients from contracting nosocomial infection and the length of stay in the isolation room varies depending on their medical condition. It has been reported in some literature that this group of patients experience social isolation, a wide range of emotions and psychological burdens such as depression and anxiety as a result of staying in the isolation room. Therefore, a systematic review on neutropenic cancer patients' experience in isolation room will add knowledge to the nursing science of providing high quality care for this particular group of patients.
Objectives:
The objectives of this review are to understand neutropenic cancer patients' experiences in the isolation room and their coping mechanisms.
Inclusion criteria:
The participants of interest were adults neutropenic cancer patients aged 18 years old and above.The phenomenon of interest i was the experience of neutropenic cancer patients who were nursed in an isolation room due to chemotherapy induced neutropenia or during the period of haematopoietic stem cell transplant.The studies of interests were are qualitative studies which focus on adult neutropenic cancer patients' experiences in an isolation room.The outcome of interest wai s patients' self reported experiences.
Search strategy:
An initial search to identify keywords was undertaken in MEDLINE and CINAHL. A second search using all identified keywords and index terms across the databases was performed subsequently. The final search included reference lists from included papers for additional studies.
Methodological quality:
Six qualitative papers were included in this review. The papers were qualitative descriptive, phenomenological, qualitative exploratory and grounded theory. All the papers used interview as primary method to collect data except one study which had an additional art making directive method.
Data collection:
Data were extracted using standardised data extraction tools from JBI-QARI.
Data synthesis:
Categories were formed based on aggregation from the similar findings with like meaning. The categories were then read and reread to develop two synthesised findings that were presented as declamatory and generalisable statements to guide and inform clinical practice.
Results:
Two syntheses were generated based on the meta-aggregation. The first synthesis was that health care workers need to be aware physical isolation could result in social isolation in patients that made them feel powerless. The second synthesis was that health care workers should encourage patients to use cognitive mechanisms to cope with isolation experiences. Family, friends and nurses should step in to provide help in any form whenever patients need it.
Conclusions:
Isolation room has a negative impact on the neutropenic cancer patients while they are hospitalised. However, they are coping effectively using cognitive mechanisms and receive adequate support externally.Offering patients more options especially having flexibility in their daily routine such as meal times could be a useful intervention to allow them to take some control. Notifying the patient in advance of their time of treatment and involving patients in their treatment care will promote their autonomy. Tracking the patients' coping mechanisms and offering support when necessary will ease the patients' isolation experience.The psychological effects of being cared for in isolation room may undermine the clinical benefits of infection control. Therefore, future research is needed to evaluate the effectiveness of isolation room in preventing neutropenic cancer patients from infection.
Purpose:
To explore patient experiences of engaging in art making or music listening while receiving treatment in a blood and marrow transplant clinic.
Method:
Researchers recruited 25 individuals receiving blood and marrow transplant (BMT) treatment, 12 men and 13 women aged 22 to 74, from a Midwestern outpatient BMT clinic. Participants engaged in a painting activity or listened to music on an iPad using an internet music application for one hour. Researchers interviewed participants after the one-hour activity to gain insight into participants' perceptions of the art making or music listening experience. Interviews were recorded, transcribed verbatim, and independently coded by members of the research team. Researchers met on several occasions to analyse codes and agree on emerging themes.
Results:
Nine themes emerged from the data including, Engaging in Activity, Art and Music in Daily Life, Expression, Engaging with Equipment, Novelty, BMT Process, Activity Process, Social Support, and Living Situation. Participants enjoyed art making and music listening and found the activities beneficial during treatment.
Conclusions:
Participants benefited from art making and music listening because these activities increased the variety of options available during treatment, allowed for self-expression, and could be done alone or with caregivers.
When we really feel unwell, we should seek the advice of a good and scientifically trained doctor. The doctor will examine us, and, if suspicious of a serious illness, we will be requested to undergo various examinations. The tests may finally tell that we have cancer. What to do next? This may seem a silly question, but today in many societies the patient does have choices and the patient’s life rests on what he or she does with this right to choose. What the individual finally decides to do will be his or her prerogative, but we should hope for a well-informed decision. In this decision-making process it is always possible to make mistakes. The problem with cancer is that by the time the patient realises that he/she got it wrong it may be too late. This was the case of Steve Jobs, the founder of the computer company Apple, who was diagnosed with pancreatic cancer but decided to delay conventional therapy in order to pursue other kinds of therapies such as acupuncture, herbal therapy, diet therapy and spiritual exercises. After 9 months of exclusive non-conventional therapies he decided to undergo chemotherapy and surgery, but it was too late. Does Job’s story prove that complementary psychological therapies (CPTs), such as spiritual exercises and meditation, are therefore useless? Not really. In fact, CPTs do have an important role to play in the overall plan to tackle the challenges of cancer, but such a role should be seen as synergistic with that of conventional therapies (surgery, chemotherapy, radiotherapy), especially when a cancer has been already diagnosed. In addition, CPTs can be useful in the prevention of cancer by decreasing the levels of stress, apart from their use as adjuvant therapies throughout the period of conventional treatment. During remission, CPTs may provide some aid in preventing cancer recurrence or at least help individuals to be mentally better prepared to absorb the shock of recurrence of cancer if it does happen.
The use of complementary and alternative medicine (CAM) by cancer survivors is high, particularly among those with psychosocial distress, poor quality of life, culturally based health beliefs, and those who experience health disparities in the mainstream healthcare system. As the number of cancer survivors continues to increase, so does the diversity of the survivorship population, making it increasingly important to understand and address the CAM culture in different survivor groups. Given the known communication barriers between cancer patients and their physicians regarding CAM, it would be useful for oncology providers to have a platform from which to discuss CAM-related issues. It is proposed that mind-body therapies with some basis in evidence could provide such a platform and also serve as a possible means of connecting cancer survivors to psychosocial supportive services. This article reviews a few mind-body therapies that may have particular relevance to cancer survivors, such as hypnosis and meditation practices. A theoretical foundation by which such therapies provide benefit is presented, with particular emphasis on self-regulation.
This study identified decreased distress after art therapy in a proxy pretest study with a convenience sample of 73 patients being treated for cancer. Art therapy outcomes from 4 settings (oncology unit, infusion clinic, individual sessions, and open studio) were measured via the self-report Distress Thermometer, which was collected as part of an ongoing hospital evaluation of the art therapy program. Results indicated decreased patient distress following art therapy, and the art therapy open studio showed the largest mean decrease for stress post-art therapy.
Protective isolation is aimed at preventing infection in neutropenic patients, but it is implemented inconsistently across centres and is supported by recommendations with poor evidence. This review and metasynthesis explored the experiences and the psychological implications of protective isolation in patients with haematological malignancies undergoing bone marrow (BMT) or haematopoietic stem cell transplantation (HSCT). A systematic search of multiple databases for qualitative studies exploring BMT or HSCT patients' experiences of protective isolation was completed. The metasynthesis followed the meta-aggregative method from the Joanna Briggs Institute, with four procedural steps: (1) comprehensive search, (2) quality appraisal, (3) extraction of relevant findings and (4) synthesis of the identified findings. Twenty-six findings were extracted from 11 articles included in the review. The synthesising process yielded seven categories, aggregated into three synthesised findings: (1) isolation is a source of suffering, (2) isolation can lead to relating with oneself and (3) the person does not close the door to the outside world. This metasynthesis sheds light on patients' suffering from being isolated, and the possibility of overcoming this suffering thanks to relationships that patients have with themselves and with the external world. Healthcare providers should reconsider this practise in order to avoid unnecessary patient suffering.
In this chapter, we review a few mind–body therapies relevant to cancer survivors and provide a rationale for considering them as possible complementary interventions, based upon presence of supportive data (albeit non-conclusive), an applicable theoretical framework, and relative safety. It is often stated in the literature that since CAM modalities lack conclusive evidence, they should not be recommended [Hewitt et al. (editors). From cancer patient to cancer survivor: Lost on transition. Institute of Medicine, National Academies Press, 2006]. We propose a modified perspective that also considers the potential benefits of supporting the use of certain mind–body therapies in cancer survivor subgroups, amidst a lack of absolute certainty about efficacy and mechanism of action.
Since ancient times, art has served as a means of communication, rehabilitation, and transformation, and it has been used to gain physical, psychological, and spiritual well-being. Drawing, painting, sculpture, and other artistic forms of communication are important and effective, and over the centuries, cultures have been defined and understood through the art they produced.
It is estimated that 1,596,670 new cancer cases were diagnosed in 2011. Symptoms commonly associated with cancer and cancer treatment include pain, nausea and vomiting, fatigue, insomnia, dyspnea, delirium, anxiety, depression and distress. An important aspect of cancer control is palliative care, which is guided by the principles of symptom relief, integration of psychological and spiritual care into the treatment plan, and promotion of quality of life (QoL). Palliative care is patient-focused, family-centered care delivered by a multidisciplinary team and is indicated early in the course of the illness. Palliative care has a broad mission to reduce symptom burden (in all domains of life), improve QoL, and as a result, reduce suffering. Palliative care provides a supportive environment in which there is collaboration between patients and health care providers to achieve the best possible results for the patient. This collaborative framework can incorporate the patient’s use of non-pharmacological therapies such as relaxation and guided imagery to reduce stress and enhance QoL. Patients diagnosed with cancer are increasingly using non-pharmacologic strategies to address their illness concerns, including pain relief, desire to improve health, and desire to enhance QoL. Many of the non-pharmacological therapies used by patients do not have sufficient evidence to determine efficacy or safety. This chapter provides an overview of some of the most commonly used non-pharmacological therapies with a discussion of the evidence supporting their use and indications of risk of each therapy.
Notes that art therapy with pediatric cancer patients addresses emotional and developmental needs of normal population under extreme stress. Reviews literature on the problems likely to be encountered by pediatric cancer patient and presents case examples to illustrate the emergence of these issues and their management in art therapy. (Author/NB)
Introduction Bone marrow transplantation (BMT) has now be-come a conventional form of therapy, especially for certain hematological and oncological diseases. The life-threatening disease, the hospital admission for bone marrow transplantation to a BMT unit with sin-gle-room treatment under isolation conditions and the treatment itself all put an enormous strain on the emotional balance of the child and the whole family. Therefore, research on the psychosocial aspects of BMT and the psychotherapeutic support of the chil-dren is of growing importance. Complete psychoso-cial support of the affected children and their families should be part of the contemporary standards of a BMT unit. Nevertheless, literature on the psychother-apeutic treatment of bone marrow transplanted chil-dren is still rare. Lane and Graham-Pole (1994) de-scribed their art program at a bone marrow transplant unit. Kuntz et al. (1996) presented a play therapy program with children. Emanuel, Colloms, Mendel-sohn, Muller, and Testa (1990) indicated that psycho-therapeutic work with children in an in-patient setting in the acute phases of a life-threatening disease gen-erally requires specific modifications compared to out-patient psychotherapy. The setting has to be adapted to the hospital situation. Frequency, time and duration of the sessions change depending on the physical condition of the child. The transference is much more complicated and therefore it is important to frame the therapist's relationship with the child in the wider context of the hospital team. The compe-tence of the child should be confirmed, his or her defense mechanisms should be respected and not challenged too boldly. In order to better understand the emotional situa-tion of the affected children and their families, a short recapitulation of the course of a bone marrow trans-plantation follows. After the indication has been es-tablished, the children are subjected to extensive di-agnostic examinations. As a rule, the children often have repeated stays in the hospital over the course of several years or months for diagnostic or therapeutic reasons. Approximately 2 weeks after the renewed diagnostic procedures, the children are admitted to the BMT ward for transplantation. First the so-called con-ditioning is performed, i.e., eradication of the child's own bone marrow by total body irradiation (TBI) and high doses of chemotherapy. About 1 week after this admission to the BMT ward, the transplantation is performed as an intravenous infusion of bone marrow cells via a Hickman catheter. During this time and for about 3 weeks afterwards, the children are treated in a single room under isolation conditions in aseptic sur-roundings. With quite a lot of noise development from the air conditioner, laminar air flow (LAF) is established. It lets air flow to the outside without any turbulence so that dust particles are not whirled around. The water *Michael Günter is affiliated with the Department of Psychiatry and Psychotherapy in Childhood and Adolescence, University of Tübingen, Osianderstr. 14, D 72076 Tübingen, Germany. I thank the colleagues of the University of Tübingen Pediatric Hospital for their cooperation. In particular I would like to thank the art therapist of the BMT ward, Mrs. Steiner, for inspiration and for loaning me her case vignette.
Cancer patients who have completed medical treatment are often left with unresolved psychological issues. The need for a readjustment of self-identity is often emphasized as the core goal of therapy with this patient population. In this article, a model is presented for a 10-week group art therapy program that is currently offered to posttreatment cancer patients at Memorial Sloan-Kettering Cancer Center, New York. The general aim, the framework of the program, and the structure of each workshop are described. The response of the 70 patients who have participated in the program has been very positive. The analysis from the questionnaires completed by each patient at the end of the program indicates some key concepts have emerged.
The principle aim in art therapy is to assist patients towards a better understanding of their situation. A case study shows how the role of the therapist is less that of a teacher and more one of questioning companion. It is hoped that this approach will be increasingly recognized as having a valuable part to play in palliative care.
A literature search reveals that little has been published specifically on art therapy with medically ill, hospitalized children. It also is apparent that interest in this subspecialty is grouping. The author, whose approach is based on phenomenology, describes the strategies used in her practice of art therapy on the pediatric unit of a large, teaching hospital, illustrating them with case material. Assessment rounds made to evaluate which children could benefit from art therapy; the importance of staff communications; and the clinical work itself are discussed. The art materials used and the organization of products are also described. Necessary adaptations for practicing art therapy in the hospital environment are included.
Art therapy as crisis intervention is relatively new in the field of medical trauma care, outside of the psychiatric setting. Art therapy on a trauma unit provides unique opportunities for clinical intervention and field research. This paper presents an art therapy intervention protocol developed for a burn trauma unit over a 10-year period. A research paradigm for assessing artwork and the psychosocial transition from trauma, rationales for art therapy in a medical setting, and documentation are considered. A case study illustrates the ways that art media were used to review, integrate, and express the personal experience of recovery from severe burns.
In recent years there has been an unexpected resurgence of tuberculosis, a disease that was considered to have been conquered earlier in this century. Due to environmental, epidemiological, and behavioral factors, it is reappearing with increasing prevalence and presenting new treatment challenges. Art therapy, which partly originated in tuberculosis sanatoria, again serves to assist patients in coping with their illness and confinement. Case examples illustrate aspects of the disease and related emotions and highlight the potential for such an expressive activity to counter perceived and real isolation.
This article describes a project created as part of the Arts in Medicine program at Shands Hospital at the University of Florida. The overall mission is to identify and develop connections between the creative arts and the healing arts that will improve the physical, mental, emotional, and spiritual health of our community. The immediate aim of this project is to facilitate the development of similar programs on other clinical units and in other hospitals. The key component is the inclusion of professional artists as artists in residence in an intensive care unit setting. Their primary function is to conduct creative arts workshops and to work one on one to facilitate the use of art as a therapeutic intervention with patients, families, and health caregivers. This pilot program is being conducted on the Bone Marrow Transplant Unit and is exploring the links between nurses, physicians, artists, patients, and families in the creative process. The nurse's role has proved to be that of facilitator and advocate, directly incorporating the artist's interactive process into the daily activities of patients and families. The artists have designed and implemented each creative project and acted as consultants in how to incorporate it. The basic assumption is that every individual is a natural artist. We believe that creating opportunities for everyone to explore the possibilities of artistic expression without judgment or criticism can lead to greater self-awareness and self-esteem and can release our innate creative energy. We hypothesize that this energy can be directed as a potent force into our physical, mental, and spiritual healing.
Something Understood: Art Therapy in Cancer Care
- C Connell
Connell C. 1998. Something Understood: Art Therapy
in Cancer Care. Wrexam: London.
Art 6ersus Illness. George Allen & Unwin: London
- A Hill
Hill A. 1945. Art 6ersus Illness. George Allen & Unwin: London.
Psychosocial adaptation of cancer survivors
- A B Kornblith
Kornblith AB. 1998. Psychosocial adaptation of cancer survivors. In Psycho-Oncology, Holland JC et
al. (eds). Oxford University Press: New York; 223-241.
The Creati6e Journey (booklet for cancer patients)
- P Luzzatto
Luzzatto P. 1997. The Creati6e Journey (booklet for
cancer patients). Memorial Sloan-Kettering Cancer
Center: New York.
Pediatric art therapy
- A Prager
Prager A. 1995. Pediatric art therapy. Art Ther 12(1):
14-20.