Post on 08-Feb-2017
Copyright 2006 Gretchen Graves
Group Art Therapy for Patients With
Traumatic Brain Injuries: A Pilot Study
Thesis Study by Gretchen Graves
Copyright 2006 Gretchen Graves
IntroductionEvery year 70,000-90,000 people in the United States are permanently impaired due to a traumatic brain injury.Survivors often show few physical signs of an injury consequently may not receive appropriate treatment for the impairments that will follow.A wide range of behavioral symptoms may occur as a result of a brain injury.Many cognitive functions are disrupted.
Copyright 2006 Gretchen Graves
And…..Greater need for medical and emotional attention.Life change causes anxiety.
Copyright 2006 Gretchen Graves
Functional Results of Brain InjuryConcentration Idea of abstraction Learning from mistakes Problem solving-unrealistic
Memory Hippo-campal sensitive to damage Short term memory Performance of tasks
Cognition Various functions affected
Perception Fragmented approach to tasks
Copyright 2006 Gretchen Graves
Statement of ProblemIn the past brain-injured patients were considered poor patients for psychotherapy (Ball, 1988).Interventions should be done by persons who are knowledgeable about cognitive disturbances as well as psychotherapy (Prigatano, 1999).Many studies in projective art assessments with brain-injured people, but few or none involving an intervention (Garner, 1996).
Copyright 2006 Gretchen Graves
Why Art TherapyArt allows the use of motor skills, cognitive functions, and psychosocial skills (Poldinger & Krambeck, 1987)Art allows retraining of brain functions and an accumulation of data to document effects (Garner, 1996)Details are more easily remembered when organized into a structured form (Silver, 1978)Offers non-aggravating, activity-centered treatment that will induce personal expression with out raising defenses.
Copyright 2006 Gretchen Graves
Rehabilitation using Art TherapyConcentration Increase in organizational skills Following directions Choice makingMemory Material is comprehended and retained Improve patients self-identity.Cognition Gain insight Sequential steps Much to learnPerception 3D vs. 2D Exploring themes in life
Copyright 2006 Gretchen Graves
Benefits of an Art Therapy Intervention
Reduce behavioral problems-art as an emotional outletFormation of adequate emotional response to injury (depression and anxiety)Increase motivation for rehabilitation (depression)Improve self-identity-hard to achieve due to lack of access to recent memory (short term memory deficit)Aid in reduction of cognitive confusionIncrease socialization through group awarenessIncrease organizational skills
Copyright 2006 Gretchen Graves
Hypothesis of StudyDepression would decrease Anxiety would decrease Stress would decrease Socialization Skills would improve
Copyright 2006 Gretchen Graves
MethodologyPre/Post-Intervention Inventory {Depression Anxiety and Stress Scales (DASS)}Five 1 hour art therapy sessions Six subjects – ages 24 – 71Post-Intervention Interview
Copyright 2006 Gretchen Graves
Art Therapy Tasks Designed for easy executionAllowed for a wide range of expressive potentialDid not include drawing tasks
Copyright 2006 Gretchen Graves
Self-collageSelf-collage
PLATE 2
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PLATE 3
62
Low anxiety taskTrust building exercise
Self- ExpressionSelf-identity
Copyright 2006 Gretchen Graves
Torn Paper CollageTorn Paper Collage
Low anxiety taskSuccess oriented Self-expressionEnhance ability for abstractionEnhance discussion of group
PLATE 6
65
PLATE 5
64
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PrintmakingPrintmakingLow anxiety taskSuccess orientedSelf-expressionEnhance exploration of materialsIncrease concentration and structureConnect cognitive function with emotions
PLATE 9
68
PLATE 11
70
Copyright 2006 Gretchen Graves
3-D animals3-D animalsLow anxiety taskSuccess oriented Self-expression Foster sense of controlIncrease self-esteemFoster group cohesionIncrease awareness of anxiety stress reducing strategies
Copyright 2006 Gretchen Graves
Animal EnvironmentAnimal EnvironmentLow anxietySuccess orientedGroup cohesion
PLATE 15
74
PLATE 16
75
Copyright 2006 Gretchen Graves
Results of DASS
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5
10
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La K L T V R
D-beforeD-AfterA-beforeA-afterS-beforeS-after
4/6 decreased depression (66 % improvement)3/6 decreased anxiety (50 % improvement)5/6 decreased stress (83 % improvement)
Copyright 2006 Gretchen Graves
Subject AScores indicated depression both pre & postSuffered visual impairments due to BIArt was uncomplicated yet gave subject feeling of satisfactionArt upbeat & reflected a happy-go-lucky personalityPlayful & unrealistic
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Subject KPre-depression & anxiety were close to clinical: Post-demonstrated no depression or anxietyVerbal associations to art indicated that patient understood life had changedArt contained much self-expression and memories
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Subject L (injured at age 14)
Pre & post scores indicate great levels of depressionOutline of collage shape of headMany photos in it typical of adolescent images
Copyright 2006 Gretchen Graves
Subject TPre scores indicate clinical levels of depressionPost level scores decreased dramaticallyInterpersonal level increased a great dealAdolescent type art in printmakingTorn paper collage- passive/defiant
Copyright 2006 Gretchen Graves
Subject VScores for depression & anxiety went up from pre to post testDifficulty motivatingDifficulty connecting emotions to art
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Subject RScores pre were low and dropped postSpouse helped with tasks great deal in beginning but towards end of intervention worked more independentlyIncreased confidence & became less hesitant to create
Copyright 2006 Gretchen Graves
Post Intervention InterviewQuestions How did the
participants feel about the art therapy intervention
Feelings about the group and working together
Answers Helped use emotions Relaxed & Calming Got along better with
everyone towards the end of the intervention
Copyright 2006 Gretchen Graves
Ideally…..More meetingsLonger period of timeDifferent time of Day-not when rides might come, etc.Comparison groupSize of groups good
Copyright 2006 Gretchen Graves
ConclusionObjectives were achieved, although not statistically significantTherapeutic art intervention for people with brain injury could be very beneficial:
Help reworking the brain Decreasing anxiety, depression, & stress Increase memory & socialization skills