1. Integrating Creative Therapies at Home

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

3. 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

4. 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

5. 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.

6. 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

7. 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.

8. 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.

9. 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

10. 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

11. 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)

12. 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)

13. 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

14. 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

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

16. Where are Creative Therapies? – Recreational Therapy

17. 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

18. 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)

19. 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)

20. 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

21. 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

22. 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

23. 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

24. 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)

25. 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.

26. 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

27. 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)

28. 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

29. 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”

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

31. 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

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

33. 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.

34. 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

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

36. Questions? Sarah Miedel, MS, CCLS, LBS smi@the-institute.org
Jesse Solomon, MS, APA Specialist
Haley Welsh, MT-BC
Denise Esposto, MS, CCLS