The little girl slowly walks up to the table wearing a hospital gown and a princess tiara, her IV bag and pole close behind her. At the table, children are making colorful shapes with modeling clay and cookie cutters, and nearby, dollops of paint on paper plates stand vigil around tiny easels. The children are smiling, as if they’ve forgotten that they’re in the middle of a hospital, or at least pushed this fact to the back of their minds for now as they work with an art therapist.
The Emily Cooper Welty Expressive Therapy Center at Akron Children’s Hospital is a place of healing, where visual art and music converge as therapy for these young patients. The two-year-old center — adorned with vibrant calming colors, mosaics depicting characters from nursery rhymes and skylights that fill the room with natural light — is a relatively new concept in the patient experience but one that hospital staff, administration and patients can hang their hat on as an effective method of treatment.
“The connection between arts and biology is there,” says Dr. Sarah Friebert, director of pediatric palliative care at Akron Children’s Hospital, and the driving force behind establishment of the Expressive Therapy Center. “There are a number of studies out there that show there is actual connection with the immune system and how well we fight infection when we’re relaxed, when we’re engaged in something that’s tapping into our creativity. We see it in terms of reduced anxiety, reduced pain, increased ability to cope and increased feelings of self-efficacy for children and families. And that’s particularly important for children who have a chronic disease and who are very ill, who are out of control of what’s happening to them most of the time.”
“Hospitalized children are dealing with a wide range of different feelings,” says Mary Kohut, art therapy coordinator at Akron Children’s Hospital. “There might be a sense of worry, or maybe they’re feeling lonely. Just the fear itself of why they’re here and the unknown of their being diagnosed with something they don’t understand. These children are also away from their normal routines and support groups, too. It’s a difficult place to be in. Art therapy provides a sense of control for these kids.”
Kohut, who leads art classes at the center, along with conducting bedside visits throughout the hospital, considers this a “dream job.” She adds: “I really like working with the kids. I’m very passionate about art, but I felt like art therapy was a better fit for myself.”
She says she sees patients develop a greater awareness of themselves and better methods of communication with family members.
Friebert’s seen the effectiveness of the arts and healing throughout her career, especially with her experience in hospice work. “It was a long road from idea to conception, but we had a great group of people from the very beginning who were as excited about it as I was,” she adds. “We approached it through an interdisciplinary team of folks from all different areas of the hospital who contributed their ideas.”
The center’s function as a catalyst for creativity is underscored by its unique design, which Friebert attributes to an innovative architectural team. She describes it as “a very colorful and open creative space where kids have the license and supplies to do whatever it is that makes them happy.”
She adds: “Some people are interested in drawing, others are interesting in writing, others are interested in pottery, and what we’ve tried to do is set up a menu of opportunities, many of which employ community artists, through grants we have available.”
Art therapy also is a way for these young people to leave a creative legacy behind. The Expressive Therapy Center is hosting an open house May 22, from 4 to 7 p.m., where patient and family artwork will be on display, as well as performance and literary artwork.
A legitimate form of therapy Therapies like art and music are being taken more seriously than ever before, even in a clinical setting, as visual and performing art can relax patients, decrease depression and lower stress levels, as well as giving these children a sense of control over their lives.
“We know that healing is more than curing disease and that medicine and therapeutic treatments that the medical profession provides only goes so far,” says Friebert. “And we find that people, by being able to be in touch with that greater sense of who they are, can bring that healing power to any clinical situation. The process of being engaged in something pulls at parts of our brain and parts of our immune system that help us battle chronic illnesses and even acute situations. It’s part of who we are as human beings to be creative, and very often in the medical environment, we lose sight of that.”
Indeed, humans have used the arts as a form of healing for thousands of years. Legendary writers, visual artists and musicians have long used their muse to battle against mental and physical illness. Music and art tap into a primal place in the brain, which, logically, could also control a person’s biological well-being.
A musical home visit Ryan Hunt, 28, has severe cerebral palsy and is nonverbal and confined to a wheelchair. He requires around-the-clock care.
His days are fairly routine, but when music therapist Sarah Tobias stops by for his sessions, Ryan’s face lights up with pure joy. Tobias sings songs to him that are catchy, repetitious and positive, like “You Are My Sunshine,” and “Take Me Out the Ballgame,” and Ryan laughs, smiles and attempts to sing along. Tobias’ unique therapy session even involves interaction, as she pre-records vocal lines on a hand-held recorder, which Ryan then presses when prompted.
The Hunt family lives in a spacious home in Cuyahoga Falls that’s been customized to fit Ryan’s needs, with widened hallways, and a bedroom with a functional hospital bed that adjoins a converted bathroom with rails.
With home nurses and adoring parents, Ryan is well provided for, but the highlight of his treatment seems to be the one hour a week that Tobias comes to visit. And home visits are another unique component of the Expressive Therapy Center.
“It’s so beautiful to see how engaged Ryan is with Sarah and how alert and attuned he is to her and the instruments and music,” says Mimi Hunt, Ryan’s mother, who admits, “I sing to him sometimes, but it’s not the same as what Sarah brings with her instruments. She’s so adept at pulling him in. He’s lit up like a neon sign, and when it’s over he’s sound asleep and he’s given it his all. He’ll probably nap for a couple hours.”
She says Ryan’s nurses will tell her that he often giggles and laughs in his sleep after his music therapy sessions. “I believe he’s dreaming about her and about the session, and the music is playing in his mind long after she’s gone.
“It’s been so mesmerizing to watch,” she adds. “He’ll reach out and strum the guitar and be a part of it. I never would have thought my boy would be strumming an instrument. For us, going places can be so cumbersome; the fact that palliative brings this right to our home is an amazing gift.”
Music has long been considered a universal language that connects people from different cultures and even different time periods. And for Ryan, who is unable to communicate through words, the music therapy enables him to form a connection with Sarah and, as Mimi points out, engage in a “language that’s all their own, and the language is wrapped around music.”
She adds: “To me it’s the most amazing therapy because it relies on a communication that so few people ever build and ever become proficient at. How do you hold a conversation with someone who doesn’t have the ability to speak?”
Tobias, music therapy coordinator for the Expressive Therapy Center, uses a number of criteria to pick out the music she plays for patients. “I like songs that are uplifting, that have a good message, and that are positive,” she notes. “When you sing a song over and over it turns into an inner monologue or an inner script. First and foremost, I pick songs that are patients’ preference.”
Tobias says she also works with young patients who have terminal illnesses, and sometimes songwriting is implemented during her sessions. “I find that songwriting is a very powerful tool,” she says. “(Patients) kind of feel isolated or that they’re not in control anymore, and there’s a loss of not being at home and doing what you want to do.”
Expressive therapy challenges Holistic healing approaches like expressive therapy are in no way substitutes for conventional treatment, Friebert stresses, but she sees a more universal acceptance taking hold.
“There’s a growing acceptance of expressive therapy and healing arts throughout the medical community,” she says. “It’s been slow to happen. I think we as physicians and clinicians are suspicious of anything that hasn’t been proven in a typical medical model, which is a randomized, double-blind placebo-controlled study that’s published in The New England Journal of Medicine, but fortunately, partly through consumer engagement and public pressure, we’ve been looking more at things that folks bring to us as ways that they find effective for their own healing. As we know, the arts have been around for thousands and thousands of years. This is not new. And to exclude who we are as creative people from ourselves as healing beings going through illness is really not effective for anyone.”
And as researchers gather more data about the efficacy of art as therapy, medical professionals like Friebert hope that insurers will eventually reimburse this type of treatment.
For now, though, financial hurdles exist. “This is not a reimbursable kind of therapy, so our ability to provide it to every patient and family who needs it is limited by our resources to be able to do that,” Friebert adds. “We hope to get to a day where we have proven that this is such an integrated part of comprehensive health care that every health system finds this available and is able to offer it, and eventually that it’s paid for in a way that conventional therapies are paid for; but that’s not where we are.”
The Emily Cooper Welty Expressive Therapy Center relies on philanthropic support, as well as volunteers from the community. And consumer demand from patients and their families for this type of treatment will further drive the cause to make art therapy more widespread.
“We’re working hard to capture data to make this a replicable model that other health care systems would adopt and want to adopt, and be able to show some hard outcomes and real changes, whether it’s a reduction in pain and symptom management, lower anxiety, improved quality of life or improved coping,” says Friebert.
To find out more about the Emily Cooper Welty Expressive Therapy Center, visit www.akronchildrens.org/cms/expressive-therapy.
