Reducing burnout for end-of-life care workers: Art Therapy based supervision hospice: art in supervision

Theme: Art Therapy: Connecting Visual Expression & HealingThe Conference proceedings' website is located at http://www.xcdsystem.com/aata2013/proceedings/prof133.htmlCare of the dying and the bereaved can be a psychological, emotional, and spiritual burden to professional caregivers that can lead to compassion fatigue or burnout (Swetz, Harrington, Matsuyama, Shanafelt & Lyckholm, 2009). One way to prevent burnout is through the intentional offering of supervision that emphasizes awareness of and attention to emotional responses to work while promoting autonomy, support and meaning-making (Pereira, Fonseca, & Carvalho, 2011), especially when compared to supervision that solely focuses on knowledge acquisition and clinical skills (Sardiwalla, VandenBerg & Esterhuyse, 2007). Including art making in supervision allows for increased emotional reflection (Franklin, 1999). Studies with end-of-life care workers have proven its benefits in reducing burnout …postprin

Conceptualizing international art therapy education standards

Art therapy programs developing around the world need an educational framework to ensure that graduates have a knowledge base and set of skills consistent with peers in other countries. Currently there are many independent education standards offered by art therapy associations in the United Kingdom, United States, Canada, Australia and New Zealand, as well as two international associations. Synthesizing these requirements reveals 12 content areas that may constitute the core of art therapy education. Even within these standards, programs developing around the world need to consider local values related to health, art, therapy and education in order to establish globally relevant and locally meaningful art therapy training programs-Hong Kong and India are offered as examples of how to adapt education standards to cultural expectations. © 2012 Elsevier Inc.postprin

Medical Student Mandala Making for Holistic Well-Being

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Art-making in a family medicine clerkship: how does it affect medical student empathy?

Background: To provide patient-centred holistic care, doctors must possess good interpersonal and empathic skills. Medical schools traditionally adopt a skills-based approach to such training but creative engagement with the arts has also been effective. A novel arts-based approach may help medical students develop empathic understanding of patients and thus contribute to medical students’ transformative process into compassionate doctors. This study aimed to evaluate the impact of an arts-making workshop on medical student empathy. Methods: This was a mixed-method quantitative-qualitative study. In the 2011-12 academic year, all 161 third year medical students at the University of Hong Kong were randomly allocated into either an arts-making workshop or a problem-solving workshop during the Family Medicine clerkship according to a centrally-set timetable. Students in the arts-making workshop wrote a poem, created artwork and completed a reflective essay while students in the conventional workshop problem-solved clinical cases and wrote a case commentary. All students who agreed to participate in the study completed a measure of empathy for medical students, the Jefferson Scale of Empathy (JSE) (student version), at the start and end of the clerkship. Quantitative data analysis: Paired t-test and repeated measures ANOVA was used to compare the change within and between groups respectively. Qualitative data analysis: Two researchers independently chose representational narratives based on criteria adapted from art therapy. The final 20 works were agreed upon by consensus and thematically analysed using a grounded theory approach. Results: The level of empathy declined in both groups over time, but with no statistically significant differences between groups. For JSE items relating to emotional influence on medical decision making, participants in the arts-making workshop changed more than those in the problem-solving workshop. From the qualitative data, students perceived benefits in arts-making, and gained understanding in relation to self, patients, pain and suffering, and the role of the doctor. Conclusions: Though quantitative findings showed little difference in empathy between groups, arts-making workshop participants gained empathic understanding in four different thematic areas. This workshop also seemed to promote greater self-awareness which may help medical students recognize the potential for emotions to sway judgment. Future art workshops should focus on emotional awareness and regulation.  published_or_final_versio

Art Therapy ethical practice and multicultural/diversity competence

The Conference proceedings' website is located at http://www.xcdsystem.com/aata2013/proceedings/prof108.htmlTheme: Art Therapy: Connecting Visual Expression & HealingThe United States Census (2010) confirms a shift from a nation that is primarily White, from Western European backgrounds, to a country in which the majority of residents are from visible racial ethnic, and non-English speaking backgrounds (D’Andrea & Arrendondo, 2002). Consequently, this shift implies art therapists will be challenged to become expert in culturally congruent treatment. The American Art Therapy Association’s Ethical Principles for Art Therapists (2011) Section 6.0 serves …postprin

Holistic interventions to trauma management for teachers following disaster: Expressive arts and Integrated Body-mind-spirit approaches

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Art Therapy Approach to Burnout Reduction for Hospice and Palliative Care Workers

Poster Presentation: no. SPP-P8.29Conference Theme: Enhancing Health - 協作同心‧醫澤社群published_or_final_versio

Engaging ethical decision making in Art Therapy practice

The Conference proceedings' website is located at http://www.xcdsystem.com/aata2013/proceedings/prof134.htmlTheme: Art Therapy: Connecting Visual Expression & HealingAlthough increasingly associated with professional protection from liability, at their core ethical principles are meant to guide professionals in their work, describe minimal standards of practice and promote critical reflection. While all professional associations have their own ethical codes, what they have in common are basic pillars related to upholding autonomy, nonmaleficence, beneficience, justice and fidelity (Welfel, 1998). Knowing how to best practice these ideals in the regular course of art therapy can be confusing and uncertain. Unlike other mental health professionals, art therapists must constantly determine where art making and images factor into ethical practice. Whereas an art therapist uncertain of …postprin

Exploring the genetics of lithium response in bipolar disorders

Background: Lithium (Li) remains the treatment of choice for bipolar disorders (BP). Its mood-stabilizing effects help reduce the long-term burden of mania, depression and suicide risk in patients with BP. It also has been shown to have beneficial effects on disease-associated conditions, including sleep and cardiovascular disorders. However, the individual responses to Li treatment vary within and between diagnostic subtypes of BP (e.g. BP-I and BP-II) according to the clinical presentation. Moreover, long-term Li treatment has been linked to adverse side-effects that are a cause of concern and non-adherence, including the risk of developing chronic medical conditions such as thyroid and renal disease. In recent years, studies by the Consortium on Lithium Genetics (ConLiGen) have uncovered a number of genetic factors that contribute to the variability in Li treatment response in patients with BP. Here, we leveraged the ConLiGen cohort (N = 2064) to investigate the genetic basis of Li effects in BP. For this, we studied how Li response and linked genes associate with the psychiatric symptoms and polygenic load for medical comorbidities, placing particular emphasis on identifying differences between BP-I and BP-II. Results: We found that clinical response to Li treatment, measured with the Alda scale, was associated with a diminished burden of mania, depression, substance and alcohol abuse, psychosis and suicidal ideation in patients with BP-I and, in patients with BP-II, of depression only. Our genetic analyses showed that a stronger clinical response to Li was modestly related to lower polygenic load for diabetes and hypertension in BP-I but not BP-II. Moreover, our results suggested that a number of genes that have been previously linked to Li response variability in BP differentially relate to the psychiatric symptomatology, particularly to the numbers of manic and depressive episodes, and to the polygenic load for comorbid conditions, including diabetes, hypertension and hypothyroidism. Conclusions: Taken together, our findings suggest that the effects of Li on symptomatology and comorbidity in BP are partially modulated by common genetic factors, with differential effects between BP-I and BP-II

Immunogenetics of lithium response and psychiatric phenotypes in patients with bipolar disorder

The link between bipolar disorder (BP) and immune dysfunction remains controversial. While epidemiological studies have long suggested an association, recent research has found only limited evidence of such a relationship. To clarify this, we performed an exploratory study of the contributions of immune-relevant genetic factors to the response to lithium (Li) treatment and the clinical presentation of BP. First, we assessed the association of a large collection of immune-related genes (4925) with Li response, defined by the Retrospective Assessment of the Lithium Response Phenotype Scale (Alda scale), and clinical characteristics in patients with BP from the International Consortium on Lithium Genetics (ConLi+Gen, N = 2374). Second, we calculated here previously published polygenic scores (PGSs) for immune-related traits and evaluated their associations with Li response and clinical features. Overall, we observed relatively weak associations (p < 1 × 10−4) with BP phenotypes within immune-related genes. Network and functional enrichment analyses of the top findings from the association analyses of Li response variables showed an overrepresentation of pathways participating in cell adhesion and intercellular communication. These appeared to converge on the well-known Li-induced inhibition of GSK-3β. Association analyses of age-at-onset, number of mood episodes, and presence of psychosis, substance abuse and/or suicidal ideation suggested modest contributions of genes such as RTN4, XKR4, NRXN1, NRG1/3 and GRK5 to disease characteristics. PGS analyses returned weak associations (p < 0.05) between inflammation markers and the studied BP phenotypes. Our results suggest a modest relationship between immunity and clinical features in BP. More research is needed to assess the potential therapeutic relevance