Medical Art Therapy

Art therapy is a psychotherapy where free expression through art materials is used and works as a stress-relieving activity or to help the therapist in finding a diagnosis. Medical art therapy is used specifically for people who are undergoing aggressive medical treatment, are physically ill, or are experiencing trauma to the body. In children who have cancer, art therapy can be especially beneficial. Often, children do not understand what is happening to them or why it is happening to them, and they become very scared. This can also place stress on the parents, who want to console their child but do not know how to do so. Luckily, the use of art therapy in the medical setting can help not only the child undergoing treatment, but also the patient’s

family and medical team.
Children often have a hard time communicating what they are feeling due to many reasons. They could be too young and not have the vocabulary for the situation they are in; they are trying to protect their parents from their feelings, or relationships are “strained by anger, fatigue, and feelings that are too emotionally charged to be said with words” (Councill, “Art Therapy with Pediatric Cancer Patients” 86-87). Art therapy can allow children to express themselves and learn about the environment that surrounds them while also helping them communicate their feelings, whether they are consciously doing so or not. Art therapy is also one of the only therapies that allows individuals to become “actively involved in treatment through the process of art making and through the creation of a tangible product” (Malchiodi 16). Children with cancer were found to “have significantly more internalizing behavioural problems and somatic complaints (Tsai et al. 625). The making of art helps alleviate the feeling of helplessness and lack of control. The selection of the subject the child is to draw is an important consideration and should be meaningful to the activity. The more involved children become in the art activity, “the more they identify with what they are doing, the more they are actively using their senses, the more the project is really their own, the more meaningful it is” (Lowenfield and Brittain 247). Artistic expression also provides a way for the child to practice and prepare for medical procedures. The art therapist can have the child depict what they think the procedure is going to be like and through this the therapist can see how the child perceives medical intervention. After depicting the procedure and talking it through with the art therapist, the child often has a sense of mastery over the procedure, helping them become less frightened. Children may also benefit by turning medical supplies such as masks, gloves, or various tubes into artwork.
Picture
When the art therapist is included as part of the medical team (doctors, nurses, anesthesiologists), they can help make diagnoses that the medical team might overlook, due to the nature of the problem. They can also help the medical team determine whether a child is faking a certain symptom. For example, Tracy Councill (“Medical Art Therapy with Children”, 2012) was called to work with a 7-year-old leukemia patient, who was experiencing out-of-place seizures as a reaction to one of her new medications. These seizures included repetitive motions and verbalizations, however, they started spontaneously and ended without any intervention on behalf of the medical team. The medical team was under the impression that the child was pretending to have these seizures just to get attention. When Councill began working with the child, she asked the child to draw self-directed pictures (meaning the child chose what she was going to draw without any help from the therapist), because she knew that the child’s ability to self-organize would help Councill see what was happening in the child’s mind.
Picture
In the picture shown above, the patient drew an opera singer with a mouth wide open, occupying center stage.

The child gave a story about the picture: “…the singer had been kidnapped and held captive deep in the woods. She was singing as loudly as she could so her lover would come and rescue her” (Councill, “Medical Art Therapy with Children”, 227). With the picture and the story that the patient gave, Councill could determine that the child was not faking her seizures, and her picture showed a cry for help. Through the artwork, the patient was subconsciously trying to tell the medical team that she needed and wanted their help. After further research into the medicine the child was taking, doctors found that the seizures were a rare side effect and, upon switching the medicine, the seizures stopped. Medical art therapists who are integrated into the treatment team are also able to help parents’ understanding of medical information, by communicating in non-medical

terms.
The diagnosis of a serious illness or injury can be a devastating blow to the young patient and his or her family’s fundamental sense of trust and well-being. Working with the child and family as part of the treatment milieu, the art therapist can provide a nonthreatening opportunity to give support and build an alliance between the family members and the family and treatment team. Families often have the unspoken rule of prohibiting emotional expression. This can cause a build-up of stress which can, in turn, cause more health problems for all family members. Art therapy could allow the family members to express their emotions without the fear of causing pain to other members of the family. Family members also often have guilt, saying things like “If Only It Could Be Me” (Koch, 1985). Art therapy makes the clinic or hospital a more comfortable environment as this mother says: “Art therapy makes coming to the clinic like sitting around the kitchen table. It is so comfortable and normal. I can talk to other moms, and my son feels much less stressed” (Councill, “Medical Art Therapy with Children”, 237).
During the first six months of a child’s cancer diagnosis, parents experience a worse health related quality of life (HrQoL) and greater parenting stress. Studies have shown that it is often common for parents and siblings to have their own medical challenges during the cancer diagnosis of their loved one. Fathers often experience “alcoholism, extramarital affairs, and exacerbation of kidney stones and disk problems to the extent that surgery was required” (Koch, 66). Mothers, on the other hand, often attempt suicide, have gallstones that require surgery, allergic reactions requiring medical intervention, and miscarriages. If the parents were to have access to an art therapist during this trying time, these medical risks could be lessened due to the fact that art therapy gives them a safe place to release and discuss emotions, and to lower their stress levels. Even after the cancer is gone, parents are often still stressed: “She kept getting black and blue on her knees. I kept telling myself, you’re panicking. She’s been playing unusually hard. It’s not the leukemia; it’s the kid…Your mind tends to right away say, Oh my God” (Koch, 65-66).
Siblings of pediatric cancer patients are often more socially isolated than the patients, particularly in terms of expressing their emotions to their parents.

During a cancer diagnosis, siblings often have these medical issues: “hepatitis requiring hospitalizations, multiple knee injuries requiring multiple surgeries, emotional symptoms requiring psychiatric care, fighting and other disruptive behaviour at school, and a death resulting from an automobile accident” (Koch, 67). Siblings, especially younger ones, also have the fear of contracting a life-threatening illness and dying, and are also forced to mature faster due to their sibling’s illness. Similar to the parents, having access to an art therapist could reduce these risks. Especially with children who are not getting the attention they may need from their parents, art therapy gives them a safe place to be a child and get much needed attention from the therapist. Another helpful situation would be doing family art therapy, so that the parents are aware of how the sibling is feeling. Siblings often feel that because their parents are giving their brother or sister more attention, that the brother or sister’s life is more important than theirs. Art therapy would be able to help these children understand that their sibling’s life is not more important than theirs and help explain while the parents may seem to be giving a bit more attention to the ill child, the parents still love and care for

them.
It is easy to see how art therapy is beneficial to every member of a cancer stricken family. Siblings would benefit from art therapy, since not all their needs are being met, and they may feel alone because their parents are preoccupied with the sick child. Art therapy can help parents be aware of all of their children’s feelings as well as their own, and it can help the stricken child better understand and express their feelings about what is happening to them. Currently, there are only 16 notable medical art therapy programs in the United States, two of which are specifically at children’s hospitals. Because of the value of art therapy in treating children with cancer and those children’s families, every hospital that treats children with cancer should implement an art therapy program or have a medical art therapist on staff to help comfort the patient and his or her family in their time of need.