Integrating Creative Therapies at Home

What is Creative Therapies? Child Life Recreational Therapy Music Therapy Art Therapy

Why Creative Therapies? Effects of Chronic Illness on Children Physical Emotional Social Cognitive Behavioral Family Infants – attachment, stranger anxiety, lack of dev. appropriate stimulation, pain Toddlers/Preschoolers - Separation from loved ones, regressive behaviors, loss of routine School age – separation from peers, inability to participate in extracurricular activities Teens – dependence on adults, limited role in decision making, isolation from peers, noncompliance with treatment Social – peers, school

Who are Creative Therapies? It’s a TEAM Effort! Creative Therapies is part of a multidisciplinary support team which can include: Physicians PAs RNs NAs/PCTs Behavioral Health Social Work Physical Therapy Occupational Therapy Speech Therapy Pastoral Care Respiratory Therapy Clinical Nutrition Psychology Teachers and School Staff

What is Creative Therapies?- Child Life “Certified Child Life Specialists® provide evidence-based, developmentally appropriate interventions including therapeutic play, preparation and education that reduce fear, anxiety, and pain for infants, children, and youth. Certified Child Life Specialists are educated and trained in the developmental impact of illness and injury. Their role helps improve patient and family care, satisfaction and overall experience.” (Association of Child Life Professionals Infants, children, youth, and families benefit from help coping with the stress and uncertainty of illness, injury and treatment.

What is Creative Therapies? – Child Life Bachelor’s or Master’s degree in Child Life, Psychology, Child Development, Family Studies, or related fields Master’s degree required starting in 2022 Completion of 480 hour internship under direct supervision of Certified Child Life Specialist Professional certification (CCLS) by the Association of Child Life Professionals (ACLP) Armed with a strong background in child development and family systems

What is Creative Therapies? - Child Life Expertise in helping children and their families overcome life’s most challenging events Assist infants, children, youth, and families cope with the stress and uncertainty of illness, injury, and treatment Promote effective coping through play, preparation, education, and self-expression activities Encourage optimum development of children facing a broad range of challenging experiences, particularly those related to healthcare and hospitalization Offer normalization activities to children separated from home, school, family, siblings, peers, etc. Provide emotional support for children and families Educate caregivers, administrators, and the general public about the needs of children under stress  Stressful/challenging events: Difficult or unexpected experiences, such as chronic illness, hospitalization, the death of a loved one, or the aftermath of violent acts or natural disasters   The philosophy and practice of child life will be applicable to any healthcare setting and transferable to other community settings or situations in which the potential for infants, children and youth to cope, learn, and master is placed at risk Emotional support - Give information, support and guidance to parents, siblings, and other family members.

What is Creative Therapies? – Child Life Preparation for medical experiences Developmentally appropriate diagnosis education Non-pharmacological pain management interventions Medical play opportunities Developmental and behavioral assessments Developmental play activities Sibling support Bereavement and grief support Patient and family-centered care advocacy Preparation - i.e. admission diagnostic tests, procedures, treatment, etc.; reduces fear of unknown, gives sense of control to anticipate what will happen and give choices when possible, sense of trust with medical staff, reduces anticipatory anxiety and stress, clarifies misconceptions, familiarization with medical equipment Non pharm - help reduce pain, stress, and anxiety, including distraction, relaxation, and guided imagery techniques Medical play - using real and pretend medical equipment  Play facilitates healing, coping, mastery, self-expression, creativity, achievement, and learning, and is vital to a child’s optimal growth and development. Play is an integral aspect of child life practice with infants, children and youth of all ages.

Why Creative Therapies? - Child Life The Importance of Stress-Point Coping…Why? Refocuses senses away from intense or painful medical experience Uses developmentally appropriate materials to reduce distress Gives acceptable and developmentally appropriate choices Helps teach positive coping skills Helps promote sense of accomplishment/self-esteem Can improve cooperation with medical staff Refocus – on another sensory outlet DAP materials – used in anxiety provoking situations especially ones that are medically related Choices – medical experience can’t be controlled; provides sense of mastery/control; outlet for coping Coping skills – can be implemented in future with or without adult support Self-esteem – overcome stressful situation

Why Creative Therapies - Child Life The Importance of Stress-Point Coping…How? Movies/videos Music/singing Squeeze balls Video games I-pad I Spy books Guided Imagery (directed thoughts and suggestions that guide the mind towards a more relaxed and focused state) Deep breathing without focal point Watching vs. turning head away Verbal Distraction Comfort positioning (child is positioned on or close to caregiver in a safe and secure hold) Pacifier Swaddling Rocking/patting Sound/light-up toys Story and pop-up books Bubbles Pinwheels Party blowers Whistles Kaleidoscopes Puppets Projector/bubble column

What is Creative Therapies? - Recreational Therapy “Recreational Therapy is a treatment service designed to restore, remediate and rehabilitate a person’s level of functioning and independence in life activities, to promote health and wellness as well as reduce or eliminate the activity limitations and restrictions to participation in life situations caused by an illness or disabling condition.” (American Therapeutic Recreation Association)

What is Creative Therapies? - Recreational Therapy Bachelor’s or Master’s Degree in Recreational Therapy Completion of 560 hour internship under direct supervision of Certified Recreational Therapist Professional certification (CTRS) through the National Council for Therapeutic Recreation Certification (NCTRC)

What is Creative Therapies? - Recreational Therapy Purpose is to identify, improve, and enhance the functional abilities and independence through leisure and play Use play, recreation, and leisure activities to improve the physical, cognitive, and social/emotional abilities in children, adolescents, and young adults Aim is to improve a person’s functioning to keep him/her as active, healthy and independent as possible Also known as Therapeutic Recreation

What is Creative Therapies? - Recreational Therapy Goals address: Functional skill development Leisure education Increase independence Reduce effects of illness or injury Provide opportunities for normalization & mastery Decrease stress Increase self esteem Provide developmentally appropriate activities

Where are Creative Therapies? - Recreational Therapy Recreational Therapy can be found in camps, community settings, rehab centers, schools, and hospitals Pictured: The Woodlands Foundation

Where are Creative Therapies? – Recreational Therapy https://www.youtube.com/watch?v=32gZ6rMvShI

Where are Creative Therapies? – Recreational Therapy The Woodlands Foundation is a non-profit organization dedicated to enriching the lives of children and adults with disabilities and chronic illnesses Weekend Retreats Summer Camps Wellness Center Activity Areas: Arts & Crafts Music Nature Cooking Sports Mind, Body, Spirit Swimming

What is Creative Therapies? - Music Therapy Music Therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program.”(American Music Therapy Association)

What is Creative Therapies? – Music Therapy Bachelor’s degree or higher in Music Therapy from AMTA approved program Completion of 1200 hour internship Board certification (MT-BC) by the Certification Board for Music Therapists (CBMT)

What is Creative Therapies? – Music Therapy Reduce fear, stress and grief Promotion of social objectives increased interaction/engagement, verbalization, independence and corporation Promote normalization and well-being Help increase coping skills Provide opportunities for self-expression and creativity Increase self-esteem Enhance relationships Peers, Family and Health care personnel Help increase relaxation and comfort

What is Creative Therapies? – Music Therapy Lyrics analysis and songwriting Recording patient music Interactive music Distraction with musical engagement Provide religious and spiritual music of patient/family Teach patient to play instrument Sing with patient Engage family in music sessions Group sessions

Why Creative Therapies? – Music Therapy Patient loves music Patient/family express interest in music therapy Patient is nonverbal Patient is anxious Patient is dealing with pain Patient needs a creative outlet Family is in need of support Patient has special needs Patient needs extra support

Why Creative Therapies? – Music Therapy Hold On Strong He went to a place that helped people with problems Just a small town boy He was getting somewhere, he was making progress Who doesn’t say ew to bugs They would play music and it helped him with walking He made a mistake It won’t happen again And he was happy that he could walk with some help He hit a tree Left his friends in the dust His helmet was not strapped on He feels grateful because he’s at a place that helps He had a lot of regrets He’s thankful for the people here that helped so much He was feeling dumb But his dad said “things happen and we don’t know why” Don’t give up Hold on strong You can make your life better you can be your old self again if you try hard

What is Creative Therapies? – Art Therapy “Art therapy is the therapeutic use of art making, within a professional relationship, by people who experience illness, trauma or challenges in living, and by people who seek personal development. Through creating art and reflecting on the art products and processes, people can increase awareness of self and others cope with symptoms, stress and traumatic experiences; enhance cognitive abilities; and enjoy the life-affirming pleasures of making art.” (American Art Therapy Association)

What is Creative Therapies? – Art Therapy Master’s degree in Art Therapy or related field with concentration in Art Therapy Completion of 700 hour internship in school, and 1,000 hours of client experience afterwards. Registered Art Therapist (ATR) by Art Therapy Credentials Board (ATCB) Board certification (ATR-BC) by Art Therapy Credentials Board (ATCB) While advanced training is required to call one’s work art therapy, art therapists value the creative process, and encourage others to do so as well! Becoming a Registered Art Therapist (ATR) requires the completion of qualifying master's level education (including art therapy core curriculum, supervised practicum and internship experiences) and 1,000 hours of post-education supervised clinical experience. Once you are a Registered Art Therapist (ATR), you may apply to become Board Certified (ATR-BC). Board Certification provides:The highest credential you can earn as an art therapist. To earn the ATR-BC, you must pass the national examination, demonstrating comprehensive knowledge of the theories and clinical skills used in art therapy.

What is Creative Therapies? – Art Therapy A better term might be to call it HeART Therapy! “What we need to be taught is not art, but to believe in ourselves , our imagination, our senses, and our hands, to free our bodies and spirits that we may live and work according to our visions.” Florence Cane, The Artist in Each of Us

What is Creative Therapies? – Art Therapy Provide psycho-social care Motivate patients Provide opportunities for normal, creative play Provide opportunities for communication Provide distraction Promote emotional health Supports family members with opportunity to create art Permits expression of feelings that are hard to put into words “Art therapists are professionals trained in both art and therapy. They are knowledgeable about human development, psychological theories, clinical practice, spiritual, multicultural and artistic traditions, and the healing potential of art. They use art in treatment, assessment and research, and provide consultations to allied professionals.” (American Art Therapy Association)

What is Creative Therapies? – Art Therapy Uses a variety of mediums to create (acrylics, watercolor, crayons, markers, medical materials, clay, etc.) Establishes an environment where the person knows their work will not be rejected Directed and non-directed art Experimenting is good and independence is encouraged by reinforcing choices made Permits opportunities for creative play Discusses art work with patients at times, sometimes through storytelling

What is Creative Therapies? – Art Therapy A common misunderstanding about art therapy is that we interpret the art people make, as IF we read it. We do look at art closely, but are not trying to guess what the person is saying. And we pay attention to product: maybe the person tells a story about the art they made, or talks to it, or picks one part to make bigger that helps them communicate something about themselves We pay attention to process: What art media does the person choose? How do they use it? How does it help them develop a sense of.. “I DO or I CAN DO”

Why Creative Therapies? – Art Therapy Art is “once removed” from real life problems. It uses metaphor to work things out.

Why Creative Therapies? – Art Therapy At the same time, it is common to think of art in a visual way... But.... learn to think about art in a tactile way… the art is experienced as the hands and finger tips move over it, it is something that is touched

Why Creative Therapies? – Art Therapy Or think of art as release and relief … the person sets out to express themselves freely

Why Creative Therapies? – Art Therapy And a third level... think of art as speaking back to the person who made it and helping them figure something out.

Why Creative Therapies? – Art Therapy While only properly trained people use art therapy in their work, many professionals can learn to use creativity in their work An excellent resource to come up with ideas for “arting” is the series of books by MaryAnn Kohl 1) First Art: Open-Ended Art Experiences 2) Preschool Art: It’s the Process, not the Product 3) Primary Art : It’s the Process, not the Product

Why Creative Therapies? A child needs……. Play Therapeutic Medical Developmental Recreational

Questions? Sarah Miedel, MS, CCLS, LBS smi@the-institute.org Jesse Solomon, MS, APA Specialist jsolomon@woodlandsfoundation.org Haley Welsh, MT-BC hse@the-institute.org Denise Esposto, MS, CCLS dae10@pitt.edu