Brief, structured, group art therapy for women with breast and/or gynaecological cancer

Abstract

ABSTRACT Background This paper describes a structured group approach for women vulnerable to psychological distress following treatment for breast and/or gynaecological cancer. Aims Set in Hong Kong, the aim was to develop and pilot a brief art therapy intervention sensitive to local concerns and the specific needs of service-users. Methods A mixed methods study was developed and piloted in two phases over six-years in collaboration with female service-users recovering from breast and/or gynaecological cancer treatment. Key therapeutic goals and core themes were identified in phase 1 leading to the piloting of a six-session structured intervention with six groups in phase 2. This was evaluated using qualitative and quantitative methods: through service-user feedback and reflections; informal feedback captured through the art therapy process; and pre and post assessment of emotional distress (Distress Thermometer) and mental wellness (C-SWEMWBS). Results A consistent six-session structure was developed addressing four therapeutic goals: stress release and relaxation; amelioration of psychological and emotional distress; exploration of self-image; promotion of self-acceptance and awareness. Six core themes relating to loss and readjustment were established through the art therapy process. Participants experienced statistically significant reductions in psychological distress and increased mental well-being. Conclusion A new brief, structured, group art therapy approach was developed for women recovering from breast and/or gynaecological cancer treatment. Implications for practice/policy/future research The study contributes to the evidence base for the efficacy of art therapy in psycho-oncology and highlights the importance of service-user involvement in the design of a tailored, culturally sensitive, intervention responsive to local concerns. Plain-language summary This paper describes a brief art therapy group approach for women in recovery from treatment for breast and/or gynaecological cancer who are finding it difficult to adjust to changes in their bodies and the way they see themselves in the world. The aim of the project was to explore the use of a participatory approach to develop and test a brief art therapy intervention designed to meet the specific needs of such women. The project took place in Hong Kong, in a community cancer service offering support with the emotional impact of a cancer diagnosis and treatment. The theme-based group model was developed in two phases over six years in collaboration with female participants, all of whom were over the age of eighteen and had received treatment for breast and/or gynaecological cancer in the previous two years. Four therapeutic goals were identified: relaxation, reduction of emotional distress; exploration of feelings about oneself in the world, and awareness and acceptance of various aspects of oneself and one’s situation. Common issues relating to feelings of loss and difficulties adjusting to bodily changes led to the further identification of six core themes. These were creatively explored through the art therapy process leading to the development of a consistent six-session structure. The themed group approach was evaluated through service-user feedback and reflections, informal feedback during the art therapy process, and established measurement tools for assessing emotional distress and mental wellness. Results suggest an overall reduction in emotional distress with improvements in mental wellbeing. This contributes to the evidence base for the efficacy of art therapy in cancer care. Positive outcomes also reflect the participants’ involvement in the design of a culturally sensitive intervention responsive to local needs.