Art and Creativity in the Field of Occupational Therapy

A Qualitative Experimental Proposal to Measure the Interest and Effect of Art

as a Rehabilitative Instrument

Unless otherwise indicated, all images included in this lecture were created by Allison Blakeley © Kent State University 2006

Introduction “Patients First” is the motto of the Cleveland Clinic in Cleveland, Ohio. Are

our patients first? Are their interests in rehabilitative needs accurately met? Do modern Occupational Therapy (OT) tactics provide the care they need physically and mentally?

Present literature conducts the profitable essentials art in OT can provide to our patients physically and mentally. How are art’s effects measured for insurance and our patient’s occupational (return to work) purposes?

Current studies exhibit vast and profitable outcomes but lack to measure it against modern scientific methods of treatment.

Present research conveys rehabilitative practices among OTs who use or are interested in creativity. However, it lacks an outside opinion and the opportunity to be analyzed by those in the profession who lack knowledge about the field of art or may oppose its practice due to lack of information.

There is scarce material on this topic conducted in America versus those that have been implemented and studied in the United Kingdom and Australia. The focus of this proposal is to address these questions and conduct research that is a stepping stone to serve our patients by meeting their needs physically and mentally through the tools of art and creativity.

History of Art in America: The Science of Art and the Art of Science“Imagination is more important than knowledge.”-Albert Einstein

Art was introduced into the classrooms of America due to the industrial and scientific advances being developed in England. Art was the key to the future in architecture, mechanics, and technology.

Leonardo daVinci was more of a scientist than an artist and Albert Einstein considered himself to be an artist as well as a scientist. Their work and discoveries left us with a legacy of proof that art and science can coexist in a harmonious and profitable relationship.

Art effects all areas of the brain. It develops the parts of our brains that process logic information as well as help us to be imaginative in order for us to puzzle together conclusions. It allows us to exercise our physical and mental abilities and strengthen our disabilities.

If this is true, why has art and creativity lacked recognition or a correlation in the field of modern medicine specifically in the field of therapy where it’s potential can be used profitably for our patients?

Background of Art in Occupational Therapy

The foundation and heart of Occupational Therapy is creativity and art. It was the first of many to be used as a therapeutic tool.

The essence of craft and art was used because of their abilities to create goals and improve the mechanics of mobility.

According to Lloyd & Papas (1999), art and creativity’s ties date back to the 1950’s. In the 1960’s, art was challenged among assessments portrayed in the company of Azia Battery. This assessment entailed using visual productions of artwork through the use of drawings, clay, and paintings in order to analyze and treat potential levels of rehabilitation as well as disabilities or diseases.

Art lost accreditation because the tools used possess very little technology. However, in today’s modern health world it would be a cost effective approach.

Schmid (2004), expresses that art allows the essentials of the professionals to think outside the box and be analytical to address the unique characteristics of each individual patient.

Background of Art in Occupational Therapy

Research conducted in Australia by McEneany, McKenna, & Summerville (2002), conveyed only 5% of occupational therapists, conducted from a sample of 147 participants, used art and creativity for the rehabilitation needs of their clients

In Contrast, studies developed by Lim, Morris, & Craik, (2007) conveyed among 16 activities, arts and crafts were the top choice of therapy for rehabilitation among patients.

Background of Art in Occupational Therapy: The Statistics

Research Schmid (2004) vs. Williams & Paterson (2009)› Schmid (2004) conducted a phenomenological design

gathering data through conversation among three OTs with an average age of 41.3 years and 18 years of experience in rehabilitation, mental health, an hospice facilities in which they felt art and creativity provided “learning by doing” and allowed professionals to think outside the box and be analytical to address the unique characteristics of each individual patient.

› Williams & Paterson (2009) proposed OTs felt the modern health care model of rehabilitative practices limits any potential interest in the use of creativity in the profession and discourages the pedagogical thoughts of art as a means of practical therapy.

Background of Art in Occupational Therapy: The Statistics

Statistics from a research study conducted by Symons, Clark, Williams, Hansen, & Orpin (2011), with a sample of nine individuals with a mean age of 52.6 years, conveyed from the testimonies of the patients that implementation of art provided by the OT and art teacher allowed them to regain hand coordination as well as endurance by having something interesting and active to keep their attention from the fact they were even immersed in therapy.

Similar results were conveyed among eight

participants among the ages of 20-59 in study by Griffiths (2008), in which findings concluded that self-confidence, a sense of purpose, and exploration of potential rehabilitative opportunities mentally and physically resulted from the engaging challenges the artistic methods provided among the OT sessions.

Art shows progress in Rehabilitation through Imagery

Strokes display evidence of fine motor skills rehabilitated or obtained through the use of art

Vast strokes show arm extension capabilities as well as intricate gestures displayed by dots

Pinching gestures conveyed through process of picking up and sprinkling sand.

Craft and art according to Pollanen (2009), can actually be a tool that tracks adjustments in the client’s “physiological, psychological, perceptual, and behavioral states” of the mind and body.

The Question of the Big Picture…Does art and creativity in the modern medical world of Occupational Therapy exhibit effective levels of physical rehabilitation that are applicable to the patient’s everyday needs of mobility and mental health?

Research Proposal: Method A Qualitative Experimental Randomized

Controlled Trial through patient observations and interviews will be the method of choice to focus on a random sample of patients in outpatient rehabilitation using art to develop the motor and mobility skills of their upper extremities.› Currently research has yet to attempt to compare and contrast the

modern methods of OT to the foundational practices of the field.› It is important we have the ability to measure the patient’s mental

and physical rehabilitative needs and how they are assessed among each form of treatment in the field.

› Randomization will allow a variety of individuals to participate as well as display an array of neurological and muscular difficulties that seemed to be limited in other studies

Research Proposal: Design

Group A: Control Group Group B: Intervention Group

Modern Medical model of health science practices used as a tool of rehabilitation through known tools such as extension exercises with bands or gripping exercises

Random sample of 30 patients who are part of the everyday outpatient rehabilitation program needing therapy treatments for upper extremities

Sample will or may contain an array of neurological or muscular issues

Assessing progress in everyday mobility and functioning will be tested and measured using present instruments such as dexterity devices, dynamometer, and timed tests

Assessment of mental health will be assessed through interviews

Applying Art as the primary rehabilitation tool through use of clay, paint, crayon, or pencil

Random sample of 30 patients interested or curious about art as a rehabilitative medium in the outpatient rehabilitation program needing therapy treatments for upper extremities

Sample will or may contain an array of neurological or muscular issues

Assessing progress will be evaluated by markings in artwork

Assessing progress in everyday mobility and functioning will be tested and measured using present instruments such as dexterity devices, dynamometer, and timed tests.

Assessment of mental health will be assessed through interviews

Data Collection Individual sessions explaining the details of the experiment will be conducted

verbally and textually in order to reassure and obtain their confidentiality and understanding of the study. Participants will sign a consent form verifying their participation and confidentiality.

Three sets of occupational therapists will be constructed in order to accurately measure the effects and outcomes of each patients:

Occupational Therapy Group A› Admitting Treatment through use of Art and Creativity

Occupational Therapy Group B› Admitting Treatment through use of modern tactics of Occupational Therapy

Occupational Therapy Group C› Observing/Interviewing with a semi-structured design

Articulate field notes will be documented in order to address common themes presented from both practices of therapy

Two thirty minute semi-structured interviews with concrete questions will be conducted and voice recorded for producing transcripts for the purpose of analyzing and precision The first one will be administrated after their first therapy session to

evaluate their thoughts and reflection of their condition. The second will be provided to each group to analyze their thoughts and

progress mentally and physically.

› Implementing physical tests in order to confirm legitimate effects of each practice

› Analyzing Medical Records in order to measure medical aspects of rehabilitation

Analyzing the Data Data will be analyzed by Occupational Therapy Group C A third party was constructed specifically for collecting and

analyzing data in order to ensure lack of contamination or influence of opinion when administering or evaluating tests, interviews, physical and mental abilities

Individuals will be identified with numbers in order to track and collect data. 1-30 will represent the control group and 31-60 will represent the intervention group

Portfolios and photographs documenting the progress of the patients work in the intervention group will be obtained for analyzing mobility

Interviews will be analyzed to produce common themes of interest and reflections of mental and physical health needs and goals conveyed by the patients

Tables of inferential statistics will be organized in Excel and then developed into t- test or posttest to organize the effectiveness of each treatment through the use of standardized OT tests of rehabilitation. Instruments will be listed and the effects of each form of treatment will be accurately measured in correlation to the function and range of the patient’s mobility each device exhibits.

Comparing and contrasting creative methods versus modern health practices of OT by analyzing the patient’s progress physically and mentally through the use of interviews, observations, and standardized rehabilitation tests will validate the effectiveness of art as a profitable and tool of interest among OTs and our patients.

Conclusion This study will convey the value and effect of applying the

foundational and fundamental methods of art and creativity in the field of OT as it is measured against the modern practices of the field.

Data collected through interviews, observations, and rehabilitative measurements through standard time tests of mobility will convey the overall mental and physical effectiveness of each of the therapy treatments.

Potential effects using art and creativity in the field of Occupational Therapy will allow us to put “Patients First” by not only assessing their physical disabilities but their mental ones as well.

Conveying creativity’s effectiveness is not only a stepping stone to make rehabilitation practices personable and meaningful to the patients but will also allow OTs to act on their concepts or inventions by thinking outside the box when rehabilitating their clients. Thus, making each practice unique and concrete to the patient’s needs.

The study will reflect the foundation of OT and convey that the science of the field needs creative opportunities and the art of the field needs the knowledge of science.

References Griffiths, S. (2008). The experience of creative activity as a treatment medium. Journal of Mental Health, 17(1),

doi: DOI: 10.1080/09638230701506242

Lim, K., Morris, J., & Craik, C. (2007). Inpatients' perspectives of occupational therapy in acute mental health. Australian Occupational Therapy Journal, 54, 22-32.

Lloyd, C., & Papas, V. (1999). Art as therapy within occupational therapy in mental health settings: a review of the literature. The British Journal of Occupational Therapy, 62(1), 31-35.

McEneany, J., McKenna, K., & Summerville, P. (2002). Australian occupational therapists working in adult physical dysfunction settings: what treatment media do they use?. Australian Occupational Therapy Journal, 49, 115-127.

Pevsner, J. (2002). Leonardo da vinci's contributions to neurosciene. TRENDS in Neurosciences, 2(4), Retrieved from http://tins.trends.com

Pollanen, S. (2009). Craft as context in therapeutic change. The Indian Journal of Occupational Therapy, XLI(2), 43-47.

Radcliff, M. (2008). Absentminded professor or romantic artist?. Journal of Popular Film and Television, 36(2), 64-69.

Schmid, T. (2004). Meanings of creativity within occupational therapy practice. Australian Occupational Therapy Journal, 51, 80-88.

Symons, J., Clark, H., Williams, K., Hansen, E., & Orpin, P. (2011). Visual art in physical rehabilitation: experiences of people with neurological conditions. British Journal of Occupational Therapy, 74(1), 44-52.

Wlliams, S., & Paterson, M. (2009). A phenomenological study of the art of occupational therapy. The Qualitative Report , 14(3), 689-718.