Hats and Values

Hello again. I hope you had a lovely weekend! Mine started with great news on Saturday morning that Ms. Endreson was feeling much better and I had a whole day of art therapy ahead of me. 

We started the morning with a quick group session. There were a number of new patients, so we decided to have everyone get to know each other as much as they could. With a group of about 5 or 6 patients gathered around a few tables (some patients tend to join the group and leave within seconds...we don't take it personally though), we paired up again and conducted mini interviews. I had a lovely conversation with two older women. However, they both had severe dementia. One confessed that she loved to chat and proceeded to spill out stories that never connected in any way. My heart sank a little when she told me she had "the disease that makes you forget everything" but couldn't remember the name. When I reminded her of "Alzheimers" she seemed to snap back into a more conscious state and began to tear up, fully aware of her disease and ultimate condition. I think we both had a bit of a reality check in that short moment.

After group, I was a bit more familiar with the patients and Ms. Endreson and I decided that they all deserved a fun, crafty activity to get their weekend started: paper hats! I was inspired by my past weekend at the Scottsdale Arts Festival and eagerly told Ms. Endreson about the crafts we do there. I've volunteered at the festival for the past several years in the kid's section making paper hats. I was quite convinced the Bridges patients would enjoy a similar activity. Confused about the paper hats? Enjoy these entertaining pictures of me in the past and this year at the festival:

My brother seems so skeptical...But those hats though 

Shameless selfie? Yes.

Anywho, Ms. Endreson and I substituted newspaper for the brown paper you see in the pictures. Our art therapy session began with only a few patients but a couple more wandered in after a while. As always, we had a bunch of materials available so patients could do whatever they pleased if the project didn't interest them. A couple patients decided to wander in and paint/draw pictures, while the others created and decorated their hats. One patient painted sailboats all over his hat, while another added gold bedazzle to hers. Ms. Endreson and I got as involved as we could and helped the patients add color with acrylic paint. I shared a lovely moment with one of the patients as he painted the rim of his hat blue, all the while explaining to me how he used to paint engine parts and refurbish mechanics. As lunch time rolled around, our art table looked like this:

We made boat hats like the red one you see in this picture as well as big sun-hats

After lunch, we did not have any formal group or art sessions scheduled, but we figured we would give the patients an "open studio." We figured some might want to keep working on their hats and turned on the TV in the art room to the UofA basketball game. The TV ploy brought in a few patients who began to fiddle with the art supplies after a while. I was particularly excited about one patient with severe Schizophrenia who came in and drew picture after picture for a good 45 minutes. He usually can't sit still for more than a few minutes, so when he kept asking me for pieces of paper to draw guitars and what he described as "spaceships" I was happy to supply them. 

As the patients worked on their projects, I took a seat at the same table and put some finishing touches on the value game. Ms. Endreson and I were actually able to sit down with one of the patients that day and observe as she sorted the cards. I was absolutely thrilled with what I saw and took a bunch of notes on the mini case study. In fact, I was so excited that I decided that the entire experience deserves its own post. You can expect to see it sometime tomorrow. 

Until then! 

Tia 

A Slower Start

Hello All!

One of the techs at Bridges today greeted me with a "TGIF" but I was only able to quietly reply with a little laugh because it in fact did not feel like a Friday to me. Today was my first day of SRP in Tucson for the week. (If you're new and not aware of my schedule, I spend two days in Tucson each week, eight hours a day in St. Mary's Hospital).

So, needless to say, I was fresh and awake for a day of work today. Unfortunately though, my mentor, Ms. Endreson, greeted me this morning with the news that she was feeling a bit under the weather. Around 9:30 she told me she was going to have to go home and rest. So I was left in the art room at Bridges. Just me, myself, and art supplies...I suppose I'm pretty used to that.

Anyway, I figured I would use this post to give you all a couple visuals. I wasn't able to do any group work today, but I got some work done on that special game. So for your viewing pleasure here is a lovely panoramic of the art room we usually work in:

Yes, there is exercise equipment in the corner. No, we do not use it for our art activities. 

And this is a sneak peak at the game I've been working on: 

The Value Game 

To explain a bit, the game is meant to give patients an opportunity to organize their values. Each little white card in the picture (there are 100 in total) has a value name printed on it. The values range from very deep things, such as acceptance and openness, the more superficial, such as attractiveness and wealth. But I suppose it's really not up to me to decide which ones are deep or not...

But what do little cards with values on them have to do with art therapy? Well the twist I have added to the game is a visual counterpart to each value card. I've spent a huge amount of time hunting down visual representations of all 100 values. Ms. Endreson and I are curious to see what a difference these visuals will make. When asked to place each value under a category, either "Very Important To Me" or "Not Very Important To Me," will the patients rank the white cards with words the same way they rank the pictures? What extra layer of importance will a certain value have when a patient sees it in picture form? There are a number of questions I am so anxious to have answered soon. I'll keep you all updated. 

I have a feeling this activity will be really interesting to see used with the geriatric patients as well because 1. it requires very little effort on the patient's side and 2. can easily bring up memories and/or stories that these patients tend to love to share. 

I spent the rest of my day in the hospital reading a bunch of art therapy articles. (The hospital cafeteria is a surprisingly good place for me to focus...maybe it's all the chatting of the nurses that's strangely calming). One of the articles I found particularly fascinating was "Art Therapy With a Hemodialysis Patient: A Case Analysis" by Miki Nishida and Jane Strobino. The abstract of the report can be read below: 

Art therapy has been used to support the coping skills of patients with various medical illness. The purpose of this case study was to examine  the usefulness of art therapy in promoting communication and positive sense of well-being in a hemodialysis patient. The participant was a 57-year-old  Caucasian female who had been treated with hemodialysis for the past 3 years. Two art therapy sessions per week were provided for 4 weeks. The participant was able to express enjoyment with her artistic expressions and challenge herself to learn something new. Following completion of art therapy, the participant indicated a feeling of accomplishment and an increased sense of control and self-confidence. Although these results cannot be generalized, they are worthy of further investigation. Thus, application of art therapy with other hemodialysis patients is recommended. 

The article went into incredible detail about each session of therapy the patient went through and I loved the way all the data was presented. Not only did I recognize a number of similarities between this study and the Bridges sessions, but I also got several examples of what to look for in an individual art therapy session, something I hope to be able to do soon at Bridges. We will have to see what the future holds! 

Until next time, 

Tia 

What makes you a super hero?

Hello all! (Just so you all know, I had this whole post written and accidentally deleted it ugh!...so I apologize for any lack of quality in this second version)

So I switched my days to Wednesday and Thursday this week. I'm going to try to cover two days in one post. The journey down to Tucson was, again, very boring. But the work I got to do at Bridges made it all worth it.

Wednesday was a rather slow day. I arrived at Bridges at 9am to find that five patients had been discharged the night before and there were only four left on the unit. Needless to say, it was a rather quiet day at Bridges.

But despite the apparent lack of energy, Ms. Endreson greeted me and asked me to accompany her to a meeting with the nurses, occupational therapist, supervisor, and head nurse practitioner on the unit. For future reference, they call these meetings "staffing." I listened closely as Betty, the nurse practitioner, meticulously reviewed the needs of the current four patients.

One of the things I really liked hearing in staffing was Betty's suggestion to use cognitive tests to measure patient progress. It was something I was looking into before, in an attempt to collect some sort of quantitative data, so I was excited when Betty coincidentally mentioned some of the same tests that I had found. This one, the MoCA, is one I think is most promising:

No...MoCA does not have anything to do with mocha coffee, unfortunately. Or the Museum of Contemporary Art, for that matter. 

I learned that there are actually several versions of the MoCA, so I hope to be able to use them as a sort of pre-test and post-test for art therapy sessions, either group or individual. Who knows, I might not see any notable results. But I figured it's worth a shot!

After staffing, I took a few hours to sit in Ms. Endreson's office and work on the super secret game (shh it's still not quite done). We then grabbed a quick lunch and headed back to Bridges to end the day with a group session and, finally, an art session.

Only three patients joined us for the group session at the North end of the unit. Inspired by NPR StoryCorps  , we focused on memories and conversation during group. We went around our small circle and asked each other questions:

"Who has been the most kind to you in your life?"

"What are some funny stories your friends/family tell about you?"

"Do you have any regrets?"

The informal interviews were a great lead into our art therapy project later that day. We chose collage, a material that requires much less effort and is much less intimidating, since we noted the slow feeling about the unit. The "rules" were to create a three part piece, depicting your past, present, and future. One patient followed the project guidelines, but the other two were much less involved. One simply collected small cut-outs of cats, while another flipped through car magazines. So, I figured I would share my collage, just to get some color up in here: 

I threw this together rather quickly. It's certainly not my best work. 

Thursday was much livelier and more productive. Five new patients were admitted, leaving us with a total of nine patients on the unit. I got to sit in on three group sessions: an early morning group with Ms. Endreson, Cassie's Reminiscence group, and the art therapy group. 

The morning group was quite similar to Wednesday's group, but served as more of an icebreaker for the new patients. Six patients sat around a circle with Ms. Endreson and I and we all paired up. We conducted mini interviews and asked each other three questions: Who are you? Where are you from? What would help you? After the interviews, each pair introduced each other to the group. It was a lovely start to the day. 

Cassie's  reminiscence group was the most popular event of the day. The discussion was based on ideas of strength. Cassie, Randy (the unit supervisor), and I joined eight other patients in the day room. One patient, who had been very reluctant to join any groups previously, even took a seat with us. I was really pleased with the turn out. We began by naming our favorite super heroes, from our childhood or just in general. As we went around the circle, patients named characters like Superman, Mighty Mouse, The Lone Ranger, and even Napoleon. Cassie quickly transitioned to asking the patients "What makes you a super hero?" 

The patients, forced to consider their strengths, listed traits such as patience, persistence, and organization. We ended on a positive note and headed into art therapy with ideas of strength on our minds. During a short break between groups, I hurried into the art room with Ms. Endreson, to peruse bunches of magazines and cut our images of "strength." Eventually, the activity table was covered with images of men working out, ballerinas, hawks, soldiers, rock climbers, and just about anything you could think of. We hoped the images would help kickstart any reluctant newbies. Often times, a visual stimulus is all a patient needs to get started. 

Six patients joined us to create collages of their perceptions of strength. However, like always, the "rules" were broken. After a while, the collage images on the table were joined by colored pencils, markers, and stencils. We decided to give the patents freedom to create whatever they liked. And they did. One patient created a strikingly evocative portrait, while another created a campaign poster of some sort. 

We started out the session with classical music playing in the background, but about half way through, a patient got up to change the radio to "Tainted Love" by Soft Cell, which (if you haven't heard) sounds like this:

How's that for an art therapy vibe? It was a great way to end the day. The entire session took on a very cozy, homey feeling towards the end. The patients got quite invested in their work and I could tell they got something out of it.

Anyway. I had a wonderful time in Tuscon this past week. Next week is spring break for me, so I will be working on that secret game and reading a bunch of art therapy articles. Get excited!

Until next time,
Tia

An Explanation

Hi all,

So I've been reading a lot of papers and articles about art therapy these past couple days and they've all been filled with a ton of statistics and data. As much as the artsy side of me would like to stray away from these cold numbers and labels, the sciency side of me realizes that a good research project has some sort of order to it.

So I want to share with you all a chart that Ms. Endreson gave to me a few weeks ago. It was created by Sharon Sousa, the Associate Dean at the College of Nursing at the University of Massachusetts, Dartmouth. I went ahead and embellished it a bit with some colors to show you how it relates to the work we do at Bridges.

Patients are admitted to Bridges when they are in the red zone of the chart and are discharged when they are somewhere around the green zone (some characteristic vary from person to person). When I observe group and art therapy sessions, I pay particular attention to the social skills category as well as patients' facial expressions, speech, and interest in others.

I hope this helps a bit to explain what exactly I'm thinking about and what goals we're trying to reach. I'll try to keep a healthy balance of fun artwork pictures and helpful charts in the future.

Tia

Nobody Understands _______ About Me

Hello all!

So it turns out I didn't have to pee in a cup for that drug screening. Instead, I sat in the Carondelet Associate and Wellness office with a thermometer-like thingy in my mouth until it collected enough saliva. It was a great start to the day...

Anyway, all bodily fluid discussion aside, Friday was another busy day at Bridges. Three patients were scheduled to discharge and towards the end of the day we had another admit. But despite the hectic atmosphere, group session and art therapy were quite productive.

For our group session, Ms. Endreson suggested a more interactive "check in" (as opposed to simple conversation). We had each patient fill in the blanks and draw a portrait on this worksheet:

Here are some of the results:

Most patients, again, shared very personal stories with such a simple task. The portraits seemed to be secondary to many of them, but were still a good exercise in self-reflection.

As I drew my portrait, one of the patients commented: "Wow. I wish I could ask you to draw mine for me!" I was of course flattered, but I was even more taken aback by the fact that he had practically guessed the art therapy activity. Ms. Endreson and I exchanged glances as soon as he said it.

The art therapy activity of the day was a paired activity. One person in each pair was to play the role of "master," while the other played "servant" (we didn't exactly say servant, but you know...the person who does the dirty work). The master had to instruct the other partner what to draw and how to draw it. We hoped the activity would help the patients learn to not only cooperate, but to see how other's think and feel.

I worked with a patient who, again, did not speak english very well ( after three Spanish speaking patients, I am beginning to regret my foreign  language choice). But as my partner timidly explained an image for me to draw, I tried my best.

The patient explained to me that this was an image of his church, complete with a parking lot and musicians. 

We switched positions after a while and I tried to explain to him how to draw a rose. It was frustrating for the both of us, to say the least. He did eventually end up with a rose-like thing on his page, but with the combination of the language barrier and my (probably) overly bossy approach, it was a bit of a mess. I'd say we both learned something.

The other patient pairs encountered similar struggles with their pieces. I could sense which patients had more dominant personalities and which patients had more submissive personalities. I hope they realized the same thing.

PS Here's what some of the clay pieces look like from Thursday (the prehistoric fish is in the top right corner). We might add some color in the future!

Until next time,
Tia

Well hey, let's work with clay!

Hello all!

So I headed down to Tucson a day early this week. Tomorrow I finally have to take that dreaded drug test (ew gross peeing in a cup...). But today presented only an exciting adventure in art!

I met Ms. Endreson in the lobby again at 9:30. She greeted me with a bag full of art supplies and a big sketchpad under her arm. I helped her carry the supplies up to Bridges, where I discovered she had completely switched offices. It was a refreshing transition and I was incredibly happy to find this posted in the door window:

It was the perfect artsy/sciency mix to get my morning started

Like on the past Fridays I have spent at Bridges, group therapy and art therapy were not scheduled to start until after lunch. So, after meeting the Thursday techs and nurses (the staff usually changes from day to day), I spent most of my morning in Ms. Endreson's new office. Ms. Endreson and I are currently working on a surprise game for the patients that I am rather excited about. But we're still working out the details, so I'll have to keep it a secret for now. Let's just say I spent a good amount of time over the past couple days and this morning looking through old magazines.

As I perused those old magazines this morning, Kris, the Occupational Therapist at Bridges, stepped into the office to go over the details of her morning group session. She was incredibly enthusiastic about the patients' cooperation and went on to explain her lesson about metronomes and how she showed the patients how to stay calm. Ms. Endreson, Kris, and I all continued the discussion over lunch in the hospital cafeteria and I was left with a positive feeling about the group and art therapy sessions.

Group started around 1 and was led by--instead of Ms. Endreson-- Cassie, a social work intern from ASU. We managed to convince five of the twelve patients in the ward to join us in the 30 minute session. The theme today? Reminiscing.

So, how do you feel about some of these images?

If you're anywhere around my age, you probably don't have many memories of the kinds of things you see above. But the Bridges patients certainly did. I couldn't help but listen intently as three of the older gentleman got into a heated discussion over cars and drive-ins. Through their discussion, I learned a little bit more about each of their personalities.

One patient explained how he remembered bringing dates to the drive-ins when he was a teenager. Another quickly responded that he was always too shy to get a date to bring there in the first place. I loved that a visual stimulus was all they needed to reveal those descriptions of themselves.

After our exciting discussions of pedal pushers and extra big steering wheels, we took a quick break before art therapy. Ms. Endreson and I decided during this time to pursue a case-study sort of approach with one of the patients, which will hopefully involve some one-on-one art therapy sessions in the near future. More to come on that later. Now onto the squishy stuff: clay!

The art therapy project for today featured crayola air-dry clay. The "rules" were pretty open. Once we had our five patients sitting around the art table, we gave each of them a baseball-sized piece of clay and prompted them with images of animals. After all, it is easier to relate to the simple emotions of animals than the complex emotions of fellow humans, right? But, again, "rules" were broken.

Two out of the five patients created animals, including a seagull, rattlesnake, and an apparently fossilized fish. All three creatures triggered background stories that, although not very profound, still showed an increase in communication. The other three patients created more abstract sculptures, from mini furniture to connected spheres. Right now all the mini masterpieces are drying in the hospital. I can't wait to see the finished products tomorrow. Who knows...we might end up painting them.

After the messy clay, the patients hurried off to wash their hands and get to their dinners. Ms. Endreson and I cleaned up and had a quick review of the day. She gave me a number of articles today that I have already started to dig into. I keep finding more and more things about art therapy that fascinate me. So I am off to read a bit more.

Talk to you soon!
Tia

PS I was more conscious during the drive to Tucson today. So, if you're interested, here are a couple of the songs I listened to during that ever so exciting journey:

A Mural for All

Happy Sunday everyone!

Yesterday, I was able to have a few of the Bridges patients sign waivers to have their art posted on this blog. So, as promised, here are a few of the blind contour portraits they created on Friday. The one in the middle is the one I described in my earlier post:

The one on the left was actually created by Ms. Endreson. Her face isn't that orange in person, I promise! 

I returned to Bridges on Sunday and Ms. Endreson had a task for me to complete right away. Our group sessions that precede art therapy are often meant to provide a "check in" for the patients. We want to know how they are feeling and what is on their minds. So our creative "check in" for Saturday was bumper stickers. You might be thinking: "What? Bumper stickers? What are you talking about, Tia?" But think about it. Bumper stickers often express a certain feeling or belief of the car owner. We wanted to understand what kind of bumper sticker the patients would put on their cars at that moment in time.

So my task at 9am on Saturday was to create the bumper stickers. Ms. Endreson gave me a number of examples and I began to create my own. I started with a slogan that I particularly enjoyed: "Without art, earth is just 'eh.'" From there, I played with a variety of positive and negative feelings with bumper stickers that read: "Just breathe...", "STAY BACK", "You can do it", or "If you can read this, you're TOO CLOSE."

When group started, we laid out each bumper sticker on the floor in the middle of a circle of seven patients. We went around the circle and had each patient pick a single sticker they related to. I found it interesting that two patients selected the sticker that read "My religion is kindness," while another adamantly chose "Keep honking, I'm reloading." There was certainly a range of emotions that morning.

Our group discussion quickly became a conversation of  cooperation and community interaction; patients shared their ideas about what it meant to be assertive and even some suggestions for the ward community. So, while the patients let those thoughts ruminate in their minds during a 15 minute break, Ms. Endreson and I set up a project that matched our discussion: a mural.

On a large sheet of brown paper, we decided to let patients work together to create one large piece of art. Because structure seemed to motivate patients in the past, we then added some "rules" to the game. Each patient was supposed to use a single color (of their choice), no one was allowed to cross out or scratch out the work of another patient, and each artist was supposed to let the music we played guide their hand. But of course, as in previous projects, those rules were easily broken. So here is the finished product:

"And the days float by like water. And one day it's spring again. And this is not the end of the story."

Ms. Endreson and I participated (a lot of the red marks are mine) to provide a bit of motivation once again. We began with only two patients working on the mural, but over the entire session, we had a total of five patients contribute at least a tiny bit. I love that I can still recognize each part of the mural and which patient did them. See that red circle in the bottom right corner? That was done by a patient who was very anxious and wandered about the ward constantly, but stopped into the art room for a few minutes when I held out a red pastel for her (the only way I knew how to communicate with her, as she only spoke Spanish). Art certainly is a universal language.

After a quick vote, the patients titled the mural "Verve." And, after Ms. Enderson and I took it outside to spray it with fixative, we displayed it in the day room, where patients congregate and watch TV every day.

Not only did the mural activity encourage cooperation and conversation among the patients, but it also gave them a great sense of pride. Yet another project success! I can't wait to head back to Tucson on a few days to see that mural hanging on the wall.

Until then!
Tia