Development and evaluation of the effectiveness of family-based art therapy on children’s coping with cancer

Document Type : Original Article

Authors

1 Ph.D. student in health psychology, Department of Psychology and education, University of Tehran, Tehran, Iran

2 Professor in department of psychology, faculty of Psychology and education, University of Tehran, Tehran, Iran

3 Assistant professor in hematology & oncology department, Faculty of pediatrics, Tehran University of Medical Sciences, Tehran, Iran

4 Assistant professor in department of psychology, Faculty of humanities, Tarbiat Modares University, Tehran, Iran

Abstract

The present study was conducted to develop a family-based art therapy method adjusted to hospital condition, and evaluate its effectiveness on the children’s coping with cancer. The present research is a single-subject study (A-B) as a kind of experimental research. The statistical population of the study consisted of all children aged 9-14 years old admitted to Children Medical Center (CMC) from November 2018 to February 2019 that among them, five children were selected by purposeful sampling. Each child accompanied with her/his mother received eight family-based art therapy sessions. The tools of the present study were Checklist of Bio-Psycho-Social Expressions of Incompatibility in Hospital-BPSEIH (Purrezaian, Besharat, Koochakzadeh, & Farahani, 2019) and Children’s Coping Strategies Checklist-revision 1 (Ayers & Sandler, 1999). Research data were analyzed using specific charts and tables for single-subject designs. In addition, the effect size (ES) and the reliable change index (RCI) were also reported. The findings showed that family-based art therapy reduced the expressions of incompatibility and avoidance strategy (P < 0/05) on the one hand, and increased support seeking strategy (P<0/05) on the other, significantly. According to the findings, it can be concluded that family-based art therapy can reduce the incompatibility of children with cancer in hospital and change their coping strategies. Therefore, this method can be considered as one of the useful and practical psychotherapies in the hospital especially for children with cancer.

Keywords


Abdulah, D. M., & Abdulla, B. M. O. (2018). Effectiveness of group art therapy on quality of life in paediatric patients with cancer: A randomized controlled trial. Complementary Therapies in Medicine. 41, 180-185.
Aguilar, B. A. (2017). The efficacy of art therapy in pediatric oncology patients: an integrative literature review. Journal of Pediatric Nursing. 36, 173-178.
Alberts, N. M., Gagnon, M. M., & Stinson, J. N. (2018). Chronic pain in survivors of childhood cancer: a developmental model of pain across the cancer trajectory. Pain. 159(10), 1916-1927.
Arpaci, T., Toruner, E. K., & Altay, N. (2018). Assessment of nutritional problems in pediatric patients with cancer and the information needs of their parents: a parental perspective. Asia-Pacific Journal of Oncology Nursing. 5(2), 231.
Ayers, T. S., Sandler, I. N., West, S. G., & Roosa, M. W. (1996). A dispositional and situational assessment of children’s coping: Testing alternative models of coping. Journal of Personality. 64(4), 923-958.
Berger, A. M., Mitchell, S. A., Jacobsen, P. B., & Pirl, W. F. (2015). Screening, evaluation, and management of cancer‐related fatigue: Ready for implementation to practice? CA: a Cancer Journal for Clinicians. 65(3), 190-211.
Berger, A. M., Mooney, K., Alvarez-Perez, A., Breitbart, W. S., Carpenter, K. M., Cella, D., . . . Escalante, C. P. (2015). Cancer-related fatigue, version 2015/2. Journal of the National Comprehensive Cancer Network. 13(8), 1012-1039.
Bevan, R., Grantham-Hill, S., Bowen, R., Clayton, E., Grice, H., Venditti, H. C., . . . Hill, C. M. (2019). Sleep quality and noise: comparisons between hospital and home settings. Archives of Disease in Childhood. 104(2), 147-151.
Camisasca, E., Caravita, Simona C. S., Milani, L., & Di Blasio, P. (2012). The children’s coping strategies checklist-revision 1: a validation study in the Italian population. Testing, Psychometrics, Methodology in Applied Psychology. 19(3), 197-218.
Chilton, G., & Wilkinson, R. (2016). Positive art therapy. In J. A. Rubin (Ed.), Approaches to art therapy: Theory and technique (3rd ed., pp. 249–267). New York: Routledge.
Colorectal cancer facts & figures. (2017). In. American Cancer Society: American Cancer Society Atlanta, GA.
Damasco-Ávila, E., Velasco-Hidalgo, L., Zapata-Tarrés, M., Cárdenas-Cardos, R., & Rivera-Luna, R. (2019). Feeding difficulties and eating disorders in pediatric patients with cancer. Boletin medico del Hospital Infantil de Mexico. 76(3), 113-119.
de Boo, Gerly M., & Wicherts, Jelte M. (2009). Assessing cognitive and behavioral coping strategies in children. Cognitive Therapy Research. 33(1), 1-20.
Dean, M., & Landis, H. (2017). Creative arts-based approaches with adolescent groups. In C. Haen & S. Aronson (Eds.), Handbook of child and adolescent group therapy: A practitioner’s reference (pp. 124-136). New York: Routledge.
Dekker, J., & de Groot, V. (2018). Psychological adjustment to chronic disease and rehabilitation–an exploration. Disability and Rehabilitation. 40(1), 116-120.
Gast, D. L. (2010). Single subject research methodology in behavioral sciences. New York and London: Routledge.
Good, D. A. (2016). Adult Art Therapy: Four Decades, Ages 20–60 Years. In D. E. Gussak & M. L. Rosal (Eds.). The Wiley Handbook of Art Therapy (pp. 262-271). UK: John Wiley & Sons.
Gussak, D., & Rosal, M. L. (2016). The Wiley handbook of art therapy. UK: John Wiley & Sons.
Haen, C., & Webb, N. B. (2019). Creative Arts-based Group Therapy with Adolescents: Theory and Practice. New York: Routledge.
Ho, K. Y., Lam, K. K. W., Chung, J. O. K., Xia, W., Cheung, A. T., Ho, L. K., . . . LI, H. C. W. (2019). Systematic review of the effectiveness of complementary and alternative medicine on nausea and vomiting in children with cancer: a study protocol. BMJ open. 9(10), e031834.
Hogan, S. (2015). Art therapy theories: A critical introduction. New York: Routledge.
Kelley, E. (2017). A Narrative Approach to Art Therapy for Life Review as a Means to Increase Mood in an Elder Community. (Master of Arts in Art Therapy), Indiana University.
Khodabakhshi Koolaee, A., Vazifehdar, R., Bahari, F., Akbari, M. E. (2016). Impact of painting therapy on aggression and anxiety of children with cancer. Caspian Journal of Pediatrics. 2(2), 135-41.
Lane, K. J. (2018). Building Coping Skills, Emotional Regulation, and Insight in Preadolescent Girls: An Expressive Art Therapy Program Developmental Model. Capella University.
Lee, S., Narendran, G., Tomfohr‐Madsen, L., & Schulte, F. (2017). A systematic review of sleep in hospitalized pediatric cancer patients. Psycho‐Oncology. 26(8), 1059-1069.
Malchiodi, C. A., & Crenshaw, D. A. (2015). Creative arts and play therapy for attachment problems. New York: The Guilford Press.
Malchiodi, C. A., & Crenshaw, D. A. (2017). Art therapy approaches to facilitate verbal expression. In Malchiodi, C. A., & Crenshaw, D. A. (Eds.), What to do when children clam up in psychotherapy: Interventions to facilitate communication (pp. 197-216). New York: The Guilford Press.
Metzl, E., Morrell, M., & Field, A. (2016). A Pilot Outcome Study of Art Therapy and Music Therapy with Hospitalized Children (Étude pilote des résultats de l'art-thérapie et de la musicothérapie auprès d'enfants hospitalisés). Canadian Art Therapy Association Journal. 29(1), 3-11.
Nasif, J. (2015). The emotional impact of chronic illness. Journal of Psychology & Clinical Psychiatry. 3(6), 177-180.
Nunes, M. D. R., Nascimento, L. C., Fernandes, A. M., Batalha, L., De Campos, C., Gonçalves, A., . . . Jacob, E. (2019). Pain, sleep patterns and health‐related quality of life in paediatric patients with cancer. European Journal of Cancer Care. 28(4), e13029.
Rosal, M. (2016). Cognitive-behavioral art therapy revisited. In D. E. Gussak & M. L. Rosal (Eds.). The Wiley Handbook of Art Therapy (pp. 68-76). UK: John Wiley & Sons.
Rosen, M., Pitre, R., & Johnson, D. R. (2016). Developmental transformations art therapy: An embodied, interactional approach. Art Therapy. 33(4), 195-202.
Sobol, B., & Howie, P. (2016). Family Art Therapy. In J. A. Rubin (Ed.), Approaches to art therapy: Theory and technique (3rd ed., pp. 397–417). New York: Routledge.
Supportive, P., & Board, P. C. E. (2019). Adjustment to cancer: anxiety and distress (PDQ®). In PDQ Cancer Information Summaries [Internet]: National Cancer Institute (US).
Tahmasebi, Z., Maghsoudi, J., & Talakoub, S. (2017). The effect of painting on depression in children with cancer undergoing chemotherapy. Iranian Journal of Nursing and Midwifery Research. 22(2), 102-105.
Tutelman, P. R., Chambers, C. T., Stinson, J. N., Parker, J. A., Fernandez, C. V., Witteman, H. O., . . . Jibb, L. A. (2018). Pain in Children with Cancer. The Clinical Journal of Pain. 34(3), 198-206.
Twycross, A., Parker, R., Williams, A., & Gibson, F. (2015). Cancer-related pain and pain management: sources, prevalence, and the experiences of children and parents. Journal of Pediatric Oncology Nursing. 32(6), 369-384.