Scrapbooking as an Intervention to Enhance Coping in Individuals Experiencing Grief and Loss

Abstract

Engaging in grief rituals is one way to help individuals cope with loss during traumatic and transitional events (Castle & Phillips, 2003). Creating scrapbooks that incorporate personal, symbolic objects is one activity that has been highly ranked as a preferred grief ritual in individuals dealing with loss (Castle & Phillips, 2003). Scrapbooks can serve as a catalyst for communication and discussion between individuals and their families, as well as provide an opportunity to connect and share with peers (McCarthy & Sebaugh, 2011). The use of scrapbooks may be particularly beneficial for individuals who have difficulty expressing their feelings with words (Karns, 2002), or for children who are unable to verbalize their feelings (Williams & Lent, 2008). This brief literature review examined the benefits associated with scrapbooking for individuals experiencing grief and loss. A knowledge translation plan offering suggestions for incorporating findings into recreational therapy practice is also provided.

Full text

Therapeutic Recreation Journal Vol. l, No. 2 • pp. 181–185 • 20 16
Student Research
Keywords: bereavement; coping; grief; loss; memory book; scrapbook
Search Terms: bereavement group AND scrapbook AND coping; bereavement
AND scrapbook or memory book AND cope; grief AND memory book AND coping
Years: 2003–2015
Databases: Academic Search Premier, Ageline, CINAHL, ERIC, Medline, PsychAr-
ticles, PubMed, SageJournals, Social Work Abstracts
Number of Articles Reviewed: 6
181
Joanna King is a graduate student in the MS in Recreation erapy program at Temple University. Brooke
Prout is a graduate student in the MS in Recreation erapy program at Temple University. Amanda Stuhl is
a student in the accelerated BS/MS program in Recreation erapy at Temple University. Rhonda Nelson is an
Associate Professor in the Department of Rehabilitation Sciences at Temple University, and Program Director
for the erapeutic Recreation Program. Please send correspondence to Joanna King, jlking@temple.edu.
Scrapbooking as an Intervention to Enhance
Coping in Individuals Experiencing
Grief and Loss
Joanna King
Brooke Prout
Amanda Stuhl
Rhonda Nelson
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182 Scrapbooking, Grief, Loss, and Coping
Summary of Research Findings
Individuals can experience grief and
loss in a multitude of ways, and the wide
range of emotions that accompany these
experiences can be challenging for many.
Engaging in grief rituals is one way to
help individuals cope with loss during
traumatic and transitional events (Castle
& Phillips, 2003). Creating scrapbooks
that incorporate personal, symbolic ob-
jects is one activity that has been highly
ranked as a preferred grief ritual in indi-
viduals dealing with loss (Castle & Phil-
lips, 2003). Scrapbooks can serve as a
catalyst for communication and discus-
sion between individuals and their fami-
lies, as well as provide an opportunity to
connect and share with peers (McCarthy
& Sebaugh, 2011). e use of scrapbooks
may be particularly benecial for indi-
viduals who have diculty expressing
their feelings with words (Karns, 2002),
or for children who are unable to verbal-
ize their feelings (Williams & Lent, 2008).
e following six-article literature review
examined the benets associated with
scrapbooking for individuals experienc-
ing grief and loss.
Within the articles reviewed, a vari-
ety of scrapbooking interventions were
described. Some interventions were
delivered one on one (Allen et al., 2008;
Karns, 2002; Williams & Lent, 2008),
while others were oered as part of a
bereavement support group for friends,
family, and caregivers (Kohut, 2011;
McCarthy & Sebaugh, 2011). Programs
were implemented on a one-time basis
(Karns, 2002, Williams & Lent, 2008),
as part of three- or four-week interven-
tions (Allen et al., 2008; Kohut, 2011), or
as part of an ongoing biweekly program
(McCarthy & Sebaugh, 2011). Individu-
als who took part in these interventions
included older adults who had chronic,
life-limiting illnesses (Allen et al., 2008),
children and adults who had experi-
enced a traumatic or transitional event
(Karns, 2002), individuals (children and
adults) who had experienced the death
of a loved one (Castle & Phillips, 2003;
Kohut, 2011; Williams & Lent, 2008), in-
dividuals aected by a downturn in the
economy (Kohut, 2011), and caregiv-
ers whose family members were dealing
with chronic or terminal illnesses (Allen
et al., 2008; McCarthy & Sebaugh, 2011).
Aer engaging in scrapbooking
sessions, individuals experienced de-
creases in stress, depressive symptoms,
and physical symptoms such as pain
and diculty breathing (Allen et al.,
2008). ere were noted increases in
conversation and religious feelings (Al-
len et al., 2008), as well as an enhanced
sense of identity, social connectedness,
and independence (Karns, 2002). Other
participants reported greater feelings of
family bonding, love, strength, support,
and pride (McCarthy & Sebaugh, 2011).
Most importantly, scrapbooking was
found to be meaningful in terms of help-
ing individuals cope with loss (Castle &
Phillips, 2003; Kohut, 2011; McCarthy &
Sebaugh, 2011).
When scrapbooking activities were
structured as part of a support group, in-
dividuals specically beneted from the
supportive environment, in which they
could openly share and connect with
others in similar situations (Kohut, 2011;
McCarthy & Sebaugh, 2011; Williams
& Lent, 2008). For many of the partici-
pants, scrapbooking was identied as an
activity that provided a creative emo-
tional outlet (Karns, 2002; Kohut, 2011;
Williams & Lent, 2008), a way to gain
closure, and a tool to help adjust to new
situations (Karns, 2002).
Since this is a relatively new area of
research, some ndings are limited due
to design structure (case studies) (Karns,

King, Prout, Stuhl, and Nelson 183
2008; Kohut, 2011), and the inclusion of
individuals who were already receiving
other supports (Castle & Phillips, 2011).
Additionally, while some programs in-
cluded diverse participants (Kohut, 2011;
McCarthy & Sebaugh, 2011), two focused
exclusively on children or youth (Karns,
2002; Williams & Lent, 2008) while an-
other only included participants 60 years
and older (Allen et al., 2008). Details on
race and culture were not always provid-
ed, but one study predominantly includ-
ed African American participants (Al-
len et al., 2008). In order to increase the
generalizability of ndings, future studies
should include larger samples that repre-
sent individuals of diverse ages and races.
Research that utilizes control groups and
examines eects over longer periods of
time would also strengthen the evidence
base.
Nonetheless, the current literature
indicates scrapbooking is a normalizing,
supportive, nonthreatening, and mean-
ingful activity for individuals experienc-
ing grief and loss that can help them re-
gain a sense of control in their lives (Allen
et al., 2008; Karns, 2002; Kohut, 2011),
reduce stress (Allen et al., 2008), con-
nect with their feelings (Castle & Phillips,
2003; McCarthy & Sebaugh, 2011; Wil-
liams & Lent, 2008), improve conversa-
tion and interpersonal connections (Al-
len et al., 2008; Castle & Phillips, 2003;
Karns, 2008; Kohut, 2011) and enhance
coping (Kohut, 2011; McCarthy & Se-
baugh, 2011; Williams & Lent, 2008).
Knowledge Translation Plan
Individuals across the lifespan can
experience grief during traumatic or
transitional events. ese events might
include death of a loved one, moving, di-
vorce, illness, disability, hospitalization,
and loss of employment/income amongst
others. Family members who are serving
as caregivers for loved ones may also ex-
perience losses connected with changes
in their family relationships and situa-
tions (Allen et al., 2008). Given the nd-
ings summarized above, and outlined
graphically in Figure 1, recreational ther-
apists should consider using scrapbook-
ing as an intervention to help clients cope
with feelings of grief and loss they may be
experiencing connected with a variety of
life events.
Scrapbooking interventions can be
implemented individually or as part of
a support group in a variety of settings,
including hospitals, community centers,
schools, individuals’ homes, and day pro-
grams. As personal mementos can help
individuals validate relationships and re-
live special memories (Castle & Phillips,
2003), therapists should consider ways
for participants to come to sessions pre-
pared with these items.
During the scrapbooking process,
the recreational therapist should use
leading questions to guide discussions
and encourage participants to express
their thoughts and feelings in creative
ways. e therapist should introduce
participants to each other, explain and
demonstrate the process of scrapbooking,
provide prompts for pages and journaling
(Kohut, 2011), and facilitate the sharing
of scrapbooks among participants. Ad-
ditional sharing can occur with family
members either during or following the
session (Allen et al., 2008; Kohut, 2011).
For participants experiencing diculty
initially coming up with ideas, it may be
helpful to show them examples of previ-
ously assembled scrapbooks. Scrapbooks
are most meaningful, however, when cus-
tomized to each individual. erefore, ev-
erything from photographs and drawings
to poetry and personal mementos can be
included within the scrapbook (Karns,
2002), and the therapist can help partici-

184 Scrapbooking, Grief, Loss, and Coping
pants to identify symbolic items that have
signicant personal meaning for inclu-
sion in their scrapbook (Castle & Phillips,
2003).
erapists working with children
need to recognize that those under the
age of seven will respond best to oppor-
tunities to use artistic creation and sym-
bolic play to express their feelings (Wil-
liams & Lent, 2008). Regardless of age,
however, scrapbooking can be used as an
alternative to traditional talk therapy for
individuals, groups, or families to explore
and express emotions (Williams & Lent,
2008). is particular type of reminisc-
ing has been ranked more helpful than
some more traditional forms of counsel-
ing such as attending a bereavement sup-
port group or participating in individual
grief counseling or psychotherapy (Castle
& Phillips, 2003).
When using scrapbooking in a group
setting, therapists should capitalize on
the supportive atmosphere and encour-
age participants to share their books
with each other. is allows individuals
to share their emotions and pain, oen
prompting further sharing and psycho-
logical healing (Kohut, 2011). e ideas,
concerns, and fears expressed in a scrap-
Figure 1. Scrapbooking Intervention to Cope with Feelings of Grief and Loss

King, Prout, Stuhl, and Nelson 185
Figure 1. Scrapbooking Intervention to Cope with Feelings of Grief and Loss
book can facilitate discussion amongst
group members or with counselors, ther-
apists, and other professionals (Karns,
2002).
erapists who have limited time to
work with clients can start them o with
a single scrapbook page (McCarthy & Se-
baugh, 2011) and then encourage partici-
pants to add to their book on their own.
If a caregiver is involved, scrapbooking
can be structured as an activity that the
two individuals do together, as this can
have benets for both parties (Allen et al.,
2008).
Given the limited research in this
area, therapists should also aim to docu-
ment outcomes and record protocols and
session guidelines that can be replicated
by others. is will foster continued
growth of the evidence base since it ap-
pears scrapbooking interventions can be
a creative outlet for diverse individuals
and allow them to nd personal meaning
during a variety of traumatic or transi-
tional events.
References
Allen, R. S., Hilgeman, M. M., Ege, M. A., Shuster, J. L., & Burgio, L. D. (2008). Legacy ac-
tivities as interventions approaching the end of life. Journal of Palliative Medicine, 11(7),
1029–1038.
Castle, J., & Phillips, W. L. (2003). Grief rituals: Aspects that facilitate adjustment to bereave-
ment. Journal of Loss and Trauma, 8(1), 41–71.
Karns, J. T. (2002). Scrapbooking during traumatic and transitional events. Journal of Clinical
Activities, Assignments and Handouts in Psychotherapy Practice, 2(3), 39–47.
Kohut, M. (2011). Making art from memories: Honoring deceased loved ones through a scrap-
booking bereavement group. Art erapy: Journal of the American Art erapy Association,
28(3), 123–131.
McCarthy, P. G., & Sebaugh, J. G. (2011) erapeutic scrapbooking: A technique to promote
positive coping and emotional strength in parents of pediatric oncology patients. Journal of
Psychosocial Oncology, 29(2), 215–230.
Williams, K., & Lent, J. (2008). Scrapbooking as an intervention for grief recovery with children.
Journal of Creativity in Mental Health, 3(4), 455–467.

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