Art Therapy Research Articles

Indicated Stress Prevention Addressing Adolescents with High Stress Levels Based on Principles of Acceptance and Commitment Therapy: A Randomized Controlled Trial

Introduction: Stress affects many adolescents and is associated with physical and mental health symptoms that can have a negative impact on normative development. However, there are very few evidence-based, specific treatment approaches. The aim of the study was to investigate an eight-session group intervention using components of Acceptance and Commitment Therapy (ACT) enriched with elements of CBT (psychoeducation, problem solving) and art therapy, compared to a waitlist control (WLC) group, regarding its efficacy in reducing stress and associated symptoms. Methods: We conducted a randomized controlled trial in eight cohorts. Eligible participants were 13–18 years old with elevated stress levels. Via block-randomization (n = 70), participants were allocated to receive ACT (n = 38) or WLC (n = 32) and subsequent ACT. We used a multimodal assessment (self-reports, interviews, ecological momentary assessment, physiological markers) before treatment (T1), after the training of the ACT group (T2) and after subsequent training in the WLC group (T3). Primary outcome was perceived stress at T2 assessed with the Perceived Stress Scale. The trial was preregistered at the German Clinical Trials Register (ID: DRKS00012778). Results: Results showed significantly lower levels of perceived stress in the ACT group at T2, illustrating superiority of ACT compared to WLC with a medium to large effect size (d = 0.77). Furthermore, the training was effective in the reduction of symptoms of school burnout and physical symptoms associated with stress. Conclusion: Indicated prevention, especially when based on the principles of ACT and CBT, seems efficient in significantly decreasing stress in adolescents with increased stress.

Making meaning of one's own life story in words and images: A narrative case report of personal recovery from personality disorder through the interventions "An Empowering Story" and art therapy.

Understanding and processing life experiences are essential in the treatment of personality disorders to promote personal recovery and psychological wellbeing. In this qualitative case report, drafted in co-creation between the client, clinical psychologist, and art therapist, individual treatment consisted of two psychotherapeutic interventions, "An Empowering Story" and life-story-focused art therapy, in 12 parallel sessions for 24 weeks. Hilda, 68 years of age, had been diagnosed with an unspecified personality disorder and various traits of borderline personality disorder. She experienced emotional exhaustion following long-term mental health problems rooted in a traumatic early childhood. This affected her ability to manage her emotions and social relations, resulting in the sense that her life had no meaning. Hilda was invited to reconstruct her life experiences, divided into the past, turning point, and present/future, in a written and a painted life story. This allowed for the integration of traumatic as well as positive memories, enhanced self-compassion, and meaning making. She developed self-reflection and integration of internal conflicts leading to a better emotional balance and self-understanding. Art therapy emphasizes bottom-up regulatory processes, while narrative psychology supports top-down regulatory processes. The combined approach effectively integrated bottom-up, experiential, sensory experiences with top-down, cognitive emotion-regulation processes. The results suggest that psychotherapeutic interventions involving a multi-pronged, complementary, and thus more holistic approach can support personal recovery in personality disorders.

Art therapy is associated with a reduction in restrictive practices on an inpatient child and adolescent mental health unit

Background The elimination of restrictive practices, such as seclusion and restraint, is a major aim of mental health services globally. The role of art therapy, a predominantly non-verbal mode of creative expression, is under-explored in this context. This research aimed to determine whether art therapy service provision was associated with a reduction in restrictive practices on an acute inpatient child and adolescent mental health services (CAMHS) unit. Methods The rate (events per 1,000 occupied bed days), frequency (percent of admitted care episodes with incident), duration, and number of incidents of restrictive practices occurring between July 2015 and December 2021 were analysed relative to art therapy service provision. The rate, frequency and number of incidents of intramuscular injected (IM) sedation, oral PRN (as-needed medication) use, and absconding incidents occurring in conjunction with an episode of seclusion or restraint were also analysed. Results The rate, frequency, duration, and total number of incidents of seclusion, the frequency and total number of incidents of physical restraint, and the rate, frequency and total number of incidents of IM sedation showed a statistically significant reduction during phases of art therapy service provision. Conclusions Art therapy service provision is associated with a reduction in restrictive practices in inpatient CAMHS.

A művészet és a hit kapcsolódási lehetőségei büntetés-végrehajtási keretek között

Aim: The penitentiary organisation gives an important role to drama education, prison theatre and the combination of religion and faith with art therapy programmes in order to combat the harms of forced detention in prisons and to reintegrate prisoners into society. The aim of this study is to present the progress made in implementing the above and the art therapy programmes planned for 2024.Methodology: As a practising prison specialist and head of the Incarceration Affairs Service of the Hungarian Prison Service Headquarters, the author has an insight into the range of art therapy programmes offered to prisoners and their practical implementation. During his career, he has been involved in the creation and implementation of several such programmes, both as an implementer and as a supervisor. In preparing this study, he has drawn on his personal experience as well as on the available literature on the subject.Findings: The prison population is very open to different kinds of artistic programmes, and they actively and creatively participate in their implementation. Drama-based theatre programmes, combined with elements of religion and faith, can be clearly integrated into the range of programmes to prepare prisoners for release, sometimes with elements of reparation.Value: Art programmes in prison environments not only help prisoners to reintegrate after release, develop their personality, skills and competences, but are also suitable for sensitising society and reducing prejudices and antipathy towards prisoners.

Effects of expressive arts therapy on cognitive function and depression among older adults with MCI in Taiwan

ABSTRACT Older adults with mild cognitive impairment (MCI) are at increased risk of progression to dementia. Whether it is feasible to engage this population in expressive arts therapy and yield effects on cognition and depression for older adults with MCI remained unclear. The aim of this study examined the effects of expressive arts therapy on the cognitive function and depression levels of older adults with MCI in day care centers in Taiwan. A quasi-experimental design was conducted in a sample of day care centers older adults with MCI. A total of 88 participants with MCI were assigned to the intervention or comparison group. The intervention groups participated in an expressive arts therapy for 12 weeks in addition to their daily activities. Data were collected at the baseline point and immediately after post-intervention. Generalized estimating equations were used to examine the effect of the intervention on the outcomes. At week 12, findings indicated that the intervention group had significant improvement in cognitive function and depression over time than the comparison group. These findings provide evidence for the feasibility and efficacy of expressive arts therapy intervention in older adults with MCI.

Comparison of Viral Load, CD4 and Hematological Parameters Amongst HIV, Patients on Tenofovir and Zidovudine-Based ARV Therapy in Nasarawa State, Nigeria

HIV is a global public health concern and people diagnosed with HIV are treated with Antiretroviral therapy. Until 2017, Tenofovir and Zidovudine-based ART were the two major first line drugs for PLHIVs in Nasarawa Nigeria. This study aims to compare the HIV viral load suppression amongst patients on these two ART combinations in Nasarawa State, Nigeria. The study was conducted in three (3) secondary health facilities in Nasarawa State using one hundred subjects selected randomly from the three facilities comprising 50 HIV Sero-positive individuals on Tenofovir-based ART and 50 HIV sero-positive individuals on Zidovudine-based ART. Ethylene diamine Tetra Acetic (EDTA) blood specimen was obtained from each study participant for Full blood count (FBC) using haematology auto-analyser (Sysmex K21N), CD4 count using Partec Cyflow Counter II and HIV viral load analysis using real-time polymerase chain reaction. The demographic data of study participants shows that more females (72) were involved in the study making up 64% of the subjects on Tenofovir and 80% of those on Zidovuine and most of the subjects were within the ages of 26-35years. There was no significant difference (p=0.666) in the viral load of the subjects on any of the regimen. The red blood cells count (RBC) and platelet counts were significantly different (p<0.0001) amongst the subjects on the two ART regimen whereas CD4 count, white blood cells count, lymphocytes count, granulocytes count and Packed cell volume (PCV) were not significantly different within the two groups. Age affected some of the haematological parameters (granulocytes, PCV, RBCs and platelets) within the two groups at different ages. Sex only affected the PCV and granulocytes of subjects within the two different groups (p=0.0069), occupation, knowledge about HIV/AIDS disease and care, duration of ART treatment and year of initial diagnosis of HIV did not affect the haematological and immunological parameters of subjects on the two ART regimen. Conclusively, there is no significant difference in the virologic and immunological response of patients on the two ART therapy but some haematological parameters of subjects on Zidovudine were statistically different from those on Tenofovir.

Art therapy/occupational and play therapy: plastic expressiveness as a means of reducing loneliness, anxiety, sadness – research carried out during the period 2008-2022 with the theme: creation in / with elements from nature at the placement center

IntroductionOccupational therapy - which also includes art therapy - is an activity/test with a purpose, it involves coordination between the sensory, motor, cognitive, and psychosocial systems of the individual. “Sciences recognize the role of observation in research… All artists who practice art therapy are based on their own artistic activity and present a common recurring feature: they are always in line with “essential pragmatism”. (McNIFF, Shaun, Trust the process: an artist’s guide to letting go. Creative ability. Psychological aspects. Self-actualization (Psychology). Artist-Psychology, Shambhala Publication, Boston, 1998, p. 78)ObjectivesWe seek to find new development solutions through stimulation, creativity, catharsis, and socialization to be authentic, spontaneous, feel fulfilled, emotionally balanced, and transformed, with the aim of fulfilling one’s social role through contact with human and environmental factors. (Emilia Chirilă, ART THERA PY IN EMOTIONAL DISORDERS OF CHILDREN AND ADOLESCENTS, printed edition 2018) ISBN 978-973-0-27683-1)MethodsThrough the graphic gesture, the child expresses various issues related to his feelings, like the search for his identity, the generated anxieties, the family and professional environment, and the situations of neglect and abuse. (MALCHIODI, Cathy A, Handbook of Art Therapy, The Guilford Press, New York and London, 2003, p. 157).ResultsThe following reactions can be identified: aggression, frustration, dominance tendency, low self-esteem, fraternal rivalry, hopelessness, sadness, compensation mechanisms, self-defense, other significant psycho-traumatic aspects. The disappearance of frustrations and negative feelings due to the disinterest of parents who do not visit the beneficiaries was achieved by gaining authority over the environment and by improving pre-existing skills. emotional disorders of children and adolescents” - Journal of Neurology and Psychiatry of Children and Adolescents from Romania - 2012 - vol. 15 - no. 3- p 121-136 - ISSN (printed): 2068-8040)Image:Image 2:Image 3:ConclusionsThrough the creative process and symbolic communication, associated with narration and imitation, we realize the development of outstanding and hidden abilities, we develop new ways of communication, new ways of self-expression, and new ways of seeing things, to increase the ability to face existential problems.(2018 Emilia Chirilă - Art therapy in emotional disorders of children and adolescents: “Festina lente - Hurry slowly!” Harmonizing the rhythm with those around us ,print edition, ISBN 978-973-0-27683)Disclosure of InterestNone Declared

The effect of painting-based art therapy on teacher-child relationship, aggression and social interactions of children with autism spectrum disorder

The purpose of this applied research was to determine the effectiveness of painting-based art therapy on the teacher-child relationship, aggression and social interactions of children with mild autism spectrum disorder. The current research was conducted using a semi-experimental method of pre-test-post-test type with a control group. The statistical population of the research included all the children with autism disorder of the second April Autism Center in Tehran, 30 of whom were selected by the available sampling method and were randomly assigned to two experimental and control groups. To collect information, Nielson's Aggression Questionnaire (2000), Pianta's Teacher-Child Interaction Questionnaire (1992), and the Autism Scale Questionnaire in the Social Interactions Subscale (1993) were used, and Martin's art therapy educational package (2009) was used for therapeutic intervention. became Collected data was analyzed using SPSS-27 software and analysis of variance test. The findings showed that art therapy based on painting has a significant effect on the teacher-child relationship, aggression and social interactions of children with autism spectrum disorder (p<0.5). The child-teacher has reduced children's aggression.

The employment of art therapy to develop empathy and foster wellbeing for junior doctors in a palliative medicine rotation - a qualitative exploratory study on acceptability

BackgroundThe interdisciplinary realm of medical humanities explores narratives and experiences that can enhance medical education for physicians through perspective-taking and reflective practice. However, there is a gap in comprehension regarding its appropriateness at the postgraduate level, especially when utilising art therapists as faculty. This study aims to assess the acceptability of an innovative art therapy-focused educational initiative among junior doctors during a palliative care rotation, with the goal of cultivating empathy and promoting well-being.MethodsA qualitative research project was conducted at the Division of Supportive and Palliative Care (DSPC) in the National Cancer Centre Singapore (NCCS). The study involved the recruitment of junior doctors who had successfully completed a three-month palliative care rotation program, spanning from January 2020 to April 2021. In a single small-group session lasting 1.5 h, with 3 to 4 participants each time, the individuals participated in activities such as collage making, group reflection, and sharing of artistic creations. These sessions were facilitated by an accredited art therapist and a clinical psychologist, focusing on themes related to empathy and wellbeing. To assess the acceptability of the program, two individual interviews were conducted three months apart with each participant. An independent research assistant utilised a semi-structured question guide that considered affective attitude, burden, perceived effectiveness, coherence, and self-efficacy. Thematic analysis of the transcribed data was then employed to scrutinise the participants’ experiences.ResultsA total of 20 individual interviews were completed with 11 participants. The three themes identified were lack of pre-existing knowledge of the humanities, promotors, and barriers to program acceptability.ConclusionsThe participants have mixed perceptions of the program’s acceptability. While all completed the program in its entirety, the acceptability of the program is impeded by wider systemic factors such as service and manpower needs. It is vital to address these structural limitations as failing to do so risks skewing current ambivalence towards outright rejection of future endeavours to integrate humanities programs into medical education.

ZETGENERATION – SMILE, EMPATHY, THERAPY. THE OPPORTUNITIES OF ART AND EDUCATION REGARDING DEPRESSION AMONG GENERATION Z PREADOLESCENTS

Concurrent global events such as political changes, natural disasters, climatic changes, protests, wars, and pandemics are factors that help with defining a generation. What are the characteristics of Generation Z and what are the problems its members face? Preadolescence is a period during which individuals strongly feel the need to reflect deeply on what is happening to them. Several questions arise: “Who am I? Am I a normal person? Am I a competent person? Am I worthy of being loved?”; “How do I manage my emotions (e.g. fear, anger, and sadness)?”. Anxiety and depression disorders are two of the most common issues that arise during adolescence. The project ZETgeneration - Smile, Empathy, Therapy aims to facilitate access to culture for generation Z preadolescents affected by depression disorders, with the help of art and therapy. This is achieved through four contemporary art productions based on interviews and questionnaires conducted with 300 children from Iași. This article, an interdisciplinary perspective between art, education and mental health, explores how cinema, theater, and art therapy can prevent depression and encourage conversations between adults and children on topics related to mental health.

Anxiety disorders and Quality of life: The Role of Occupational Therapy

Introduction Anxiety disorders represent the most common mental illnesses, which are listed among the ten most important causes of disability worldwide. According to DSM-5, they are defined as “disorders that share characteristics of excessive fear and anxiety and related behavioral disorders”. Patients exhibit low levels of quality of life. Their daily routine is affected negatively. However, Occupational Therapy has been proven to play a crucial role in their treatment, improving quality of life through the involvement in occupations.ObjectivesTo highlight the contribution of Occupational Therapy in ameliorating the quality of life in anxiety disorders.MethodsA review of 50 articles -from 2013 to 2023- on PubMed and Google Scholar, regarding the beneficial impact of Occupational Therapy in the Anxiety Disorders’ treatment.Results Occupational Therapists can intervene in many negatively affected -by the disease- life domains such as: Activities of Daily Living, Education, Work, Play, Social Interaction and Sleep. The most effective Occupational Therapy methods are based on the cognitive behavioral approach and include: Psychoeducation, Relaxation techniques, Social skills training and Systematic desensitization.Other methods involve training in Activities of Daily Living such as feeding, maintaining good personal hygiene, and using public transport. Furthermore, Art Therapy (visual arts, use of clay) has been shown to reduce feelings of anxiety, while promoting creativity and enhancing self-esteem.ConclusionsAdditional research is needed regarding the effectiveness of Occupational Therapy in improving the quality of life for patients suffering from Anxiety Disorders. The important “take home message” is that the amelioration of the patients’ quality of life should be the main goal of the therapeutic intervention and not a secondary result of it.Disclosure of InterestNone Declared

Applications of art therapy/occupational therapy in neuropsychic disorders: raw art objectives: stimulation, creativity, catharsis, socialization

IntroductionArt therapy, occupational and play therapy support the idea that man becomes what he is through activity. We accept man in his totality, we oppose the rigid boundaries between “sick” and “healthy”, there is no contradiction between these states, but only an unbroken chain of neighboring nuances, of gradual differences of human life.ObjectivesTherapies based on the visual arts are also used in the discharge of repressed experiences, called in psychoanalytic terms “catharsis”, with the aim of preventing or remedying dysfunctions, facilitating maximum adaptability of the beneficiary, regardless of the degree of handicap. The activities of occupational therapy and ergotherapy has and productive objectives, in accordance with the outstanding, hidden skills, correlated with the current demands on the labor market. Art forms called: “Raw Art” can be practiced.MethodsTraditional crafts and visual arts are reinvented as therapeutic methods. We use pottery and sculptural artistic ceramics with elements from the history of archaic arts connected with contemporary visual arts (pictures, sculpture, graphics, mixed arts and multimedia)ResultsThe creative process and symbolic communication, associated with narration and imitation, develop new ways of communication, new ways of self-expression, new ways of seeing things. Throughout this process, people are more productive, more efficient, focused, calm and self-satisfied. (2014- Emilia Chirilă The role of art therapy in self-knowledge, self-esteem and interpersonal relationships in children with emotional disorders”- THE SECOND WORLD CONGRESS ON RESILIENCE: FROM PERSON TO SOCIETY may 8-10 Timisoara Romania 1139-1145editors: M Tomita, S.Cace – MEDIUMOND- INTERNATIONAL PROCEEDINGS copyright 2014 by MEDIMOND srl 40065 Piamond (Bologna) Italy -Printed May 2014 by Editografica.Bologna Italy - ISBN 978-88-7587)Image:Image 2:Image 3:ConclusionsPeople who do not have a sufficiently developed vocabulary to be able to express themselves feel very good practicing art as a natural means of communication. Discovering the skills of the beneficiary, through the artistic product and the awareness of emotions and feelings open up ways to a more effective non-verbal communication.Disclosure of InterestNone Declared

Impact of Supportive Care Interventions on Quality of Life in Pediatric Hematologic Disorders: Systematic Review and Meta-analysis

Abstract: Supportive care is employed in pediatric hematology to improve children’s quality of life (QoL). This study explores the impact of supportive care modalities on the QoL in pediatric hematologic disorders. Studies were searched from online databases and selected against predetermined eligibility criteria. A random-effects subgroup meta-analysis was conducted to calculate the standardized mean difference (SMD) at 95% confidence interval. Subgroups were based on physical, emotional, familial/social, and scholarly functionalities. Six studies met the requirements for inclusion. The meta-analysis reported a significant change in QoL when comparing initial QoL scores to final QoL scores (SMD −1.11 [−1.54, −0.68], P < 0.00001). When compared to a control standard treatment, the impact of these interventions lacks significance (SMD −0.01 [−0.67, 0.65] [P = 0.97]). Included studies explored interventions such as group creative art therapy, social support, adapted physical activity, and nurse-led interventions (custom). Standard hospital care and supportive care interventions have a relatively similar impact on the QoL of children hematologic patients.

Improving Mental Health of Medical Students through Movement, Art, and Interpersonal Relations

IntroductionBurnout, and symptoms of distress amongst medical students is becoming increasingly common due to the uncertainty of the Hungarian healthcare system. Change itself may be the cause of stress. Since the pandemic, the workload has been growing among health care workers. Anxiety is increasing even for beginner practitioners.ObjectivesOur examination intends to improve the mental health of the students with a variety of methods to help them develop resilience towards everyday stress, such as: 1.increasing body awareness2.exploring the inner drivers of vocations by self-esteem, worth symbols and emblems3.supporting relationships and interpersonalityMethods We had advertised a monthly course in the mailing system of the students of the Semmelweis University (Neptun). Each occasion would go as far as 240 minutes in length. Selection criteria were: guaranteeing participation in the sessions. Any applicant suffering from mental health problems requiring medical attention, or the applicant regularly skipping occasions of the session would lead to his or her getting dismissed. Courses consists of musical aerob movement and receptive art therapy tools (exl. „Self-exhibition”). The aim was to interpret ones identity via images individually. In advance of the first occasion, the applicants were interviewed to talk about themselves their career, mental health and issues, why they want to participate in the sessions. The closing interviews are still in progress. The examination was permitted by the SE-RKEB.Method of examinationQualitative: personal interviews, exploring talks about the artworks (“Self-Exhibition” collage), made during the course.Results 20 individuals started the course and 10 of them finished. The Body and Mind movements (Body Art - fusion of functional and breathing exercises, yoga and therapeutic exercises) has proven to have great importance throughout the session. The prescribed length of it in time was the third of each occasion. The joint analysation and interpretation of various artworks, images, visual narratives, even, the discussion of experiences in form of structured group activities has noticeably helped the interpersonality and social connections being formed for each individual who participated. The homeworks (eg.: Self Exhibition-collage, own worth emblem-collage etc.) and the active conduction of a diary has helped both to achieve results and have more involvement in the group.Image:Image 2:ConclusionsClosing interviews are still in progress.Disclosure of InterestNone Declared

부모 사별을 경험한 고등학생의 애도과정에 관한 미술치료 질적 사례연구 - 미술치료사의 반응작업을 중심으로 -

부모 사별을 경험한 고등학생의 애도과정에 관한 미술치료 질적 사례연구 - 미술치료사의 반응작업을 중심으로 -

비자살적 자해행동 청소년의 푸드아트테라피 사례

This study is a case study of the forgiveness experience of food art therapy foradolescents with non-suicidal self-injurious behavior. We would like to examine changesin whether adolescents with non-suicidal self-injurious behavior can reduce or stop theirself-injurious behavior by resolving internalized anger and experiencing forgiveness. Thesubjects of the study were four male students from J High School in K City, and a total of16 sessions were conducted from April to August 2023. Food Art Therapy is a study thatexamined the experience of forgiveness and the effects of growth in adolescents withnon-suicidal self-injurious behavior. Food art therapy had an impact on reducingself-harm behavior by increasing the level of forgiveness experience in adolescents withnon-suicidal self-harm behavior. Therefore, it will be possible to understand theself-harming behavior factors of adolescents with non-suicidal self-harming behavior anduse food art therapy to find ways to prevent adolescent self-harming behavior.

모 사별을 경험한 아동의 상실감 극복을 위한 애도 미술치료 사례연구

모 사별을 경험한 아동의 상실감 극복을 위한 애도 미술치료 사례연구

양극성 장애 여대생의 자기 인식에 관한 인지행동 미술치료 사례연구

양극성 장애 여대생의 자기 인식에 관한 인지행동 미술치료 사례연구

미술치료의 특성이 치료 수용의도에 미치는 영향 연구

With the rapid development of digital technology, societal changes have a significant impact on mental health and behavior, particularly among China's MZ generation. Their unique life experiences and social backgrounds have led to a high concern for mental health and differing preferences for traditional psychological treatments. This study explores the influence of art therapy characteristics on the treatment acceptance intention of the Chinese MZ generation, focusing on non-verbal nature, form diversity, self-expressiveness, and safety. After reviewing relevant literature and analyzing representative cases, a research model and hypotheses are proposed. A questionnaire survey among the MZ generation with experience or acceptance of art therapy collects empirical data. Multiple regression analysis confirms the impact of art therapy's non-verbal nature, self-expressiveness, and safety on treatment acceptance intention (p-values: 0.000, 0.008, 0.000, respectively, all <0.05), indicating a positive effect. However, form diversity (p-value: 0.116) shows no significant impact, leading to the rejection of its hypothesis.

Effectiveness of Art Therapy Intervention to Reduce the Level of Parenting Stress and Negative Emotions of Mothers of Hydrocephalus Patients

Children with developmental disorders such as hydrocephalus require assistance in carrying out daily activities. In previous studies, many have said that it is important to provide attention to mothers who have children with disabilities, but not many have provided direct interventions to reduce stress levels and negative emotions in mothers. This study aims to see the effectiveness of art therapy intervention in reducing stress levels and negative emotions of participants. This study is an experimental study with a one-group pre-test post-test design involving seven mothers who have an age range of 20-40 years, have children with hydrocephalus, and are directly involved in their care. Differences in stress levels and negative emotions were measured using the Perceived Stress Scale-10 (PSS-10) and the Positive and Negative Affect Schedule (PANAS) from. Based on the results of analysis using paired sample t-test, it was found that there were significant differences in maternal stress levels (t=8.910, p=.000), negative emotions (z=-2.032, p=.042) and positive emotions (z=-2.371, p= .018). These results suggest that art therapy intervention can reduce the level of parenting stress and negative emotions, and increase positive emotions in mothers who have children with hydrocephalus.