Background: Art therapy is a form of psychotherapy that is facilitated by professional art therapists. Through the process of art-making, the development of therapeutic relationships, and the application of psychological theory, art therapy offers an integrative approach to supporting healing across a wide range of palliative care settings. Its emphasis on sensory and symbolic – rather than linguistic – expression promotes the exploration of complex emotions that may be difficult to address through other modes of therapy. Despite a consistent internal vernacular and a growing evidence base (van Lith, 2018), the field of art therapy lacks a standardized collaborative workflow or a common-language scope of practice that easily translates across fields, limiting opportunities for integration within palliative care programs.

Methods: In this study, we piloted a standardized documentation protocol, developed by an interdisciplinary taskforce (which included licensed art therapists, a social worker, an administrative clinical director, and medical physicians). The documentation tool was designed to communicate clinically relevant information from outpatient art therapy group sessions at Mount Sinai Beth Israel Hospital in New York, NY, while identifying common art therapy assessments and interventions that may contribute to the development of art therapy practice definitions.

Results: Our interdisciplinary documentation initiative was implemented during 18 outpatient group art therapy sessions over six months. The most frequently logged art therapy interventions included the use of reflective summary (14.5% of logged interventions), creation of holding space (11.7%), facilitation of client-to-client support (11.0%), ritual engagement (11.0%), counseling (9.7%), and the use of containment (9.7%). Grouped analysis showed that insight-development (38.6%) and social-relational (35.9%) interventions were recorded more often than art-making (25.5%) interventions. The most frequently logged art therapy assessments included assessments of client response (88.9% of sessions) and mental status examinations (72.2%).

Discussion: The growing role of art therapy within palliative care programs necessitates a rethinking of how art therapists communicate and collaborate with other members of the palliative interdisciplinary team. Our study demonstrates an innovative model of interdisciplinary communication between outpatient art therapy programs and medical team members, while identifying preliminary components of the art therapy scope of practice that may contribute to future quality improvement initiatives aimed at elevating standards of care for patients across a wider range of palliative care settings.

References:

Van Lith T, Bullock L. Do Art Therapists Use Vernacular? How Art Therapists Communicate Their Scope of Practice. Art Therapy. 2018;35(4):176-83.

Author

Ian B. Kwok, MD
Resident Physician
Mount Sinai Beth Israel Hospital
281 1st Avenue
New York, NY 10009