P41 Art therapy and rheumatology: using a collaborative approach to address the emotional needs of a child with Marfan syndrome

Abstract

Abstract Background 1:1 art therapy sessions have been offered to rheumatology patients at the Royal Hospital for Children, Glasgow since 2012, supported by the Teapot Trust. A relationship is established between child and Therapist, allowing safe exploration of difficult issues. We describe a new way of collaborative working to include input from other professionals within therapy sessions. Methods A 10 year-old girl was referred to art therapy by the consultant rheumatologist to help her process an existing diagnosis of Marfan syndrome. She displayed intense anger towards her family, lost all confidence socialising and became extremely distressed when having medical examinations. The child identified anger towards her family was because she perceived a lack of honesty about her condition making her feel worried she would die, which in turn prevented her from socialising. The child noticed she became distressed when clinicians didn’t ask permission to examine her. It was apparent that the child needed a joined up approach with the art therapist and consultant rheumatologist collaborating to communicate the child’s views to all professionals involved, which at times involved the consultant rheumatologist joining art therapy sessions. The child identified her own goals for art therapy: Not saying mean things when I’m angry and think of other ways to express my anger Get my confidence back Progress in therapy was measured using Goal Based Outcomes and Psychlops Outcome Measurement Tools allowing the child to report on her own progress. Results Through Goal Based Outcomes, she communicated her anger ‘was getting better’ and she felt confident enough ‘to go on a trampoline’. Family sessions were used to help the child speak honestly with her parents about her diagnosis and prognosis. Having her consultant rheumatologist at sessions enabled her to ask questions like ‘why do I have this,’ ‘will I die’ and ‘can I go on roller coasters.’ Through Psychlops, she communicated her anger was related to feeling embarrassed and exposed during examinations. The art therapist supported the child to explore her body boundaries and to create rules clinicians should follow when examining her. The consultant rheumatologist shared these rules with the rheumatology MDT. The MDT encouraged the child to create a poster to be displayed in the paediatric outpatient clinic, which raised her confidence. At subsequent medical examinations she has been able to communicate her wishes to clinicians instead of becoming distressed. The child is also socialising more and can communicate her feelings at home without becoming angry. Conclusion This collaborative approach supported the child to process her diagnosis by creating a safe and honest space for her feelings to be explored whilst reducing barriers to engaging with clinicians. We have since used this methodology with other members of the rheumatology MDT. Conflicts of Interest The authors declare no conflicts of interest.