Case Study: Using Art Therapy for a Client with Chronic Illness

DEFINITION OF CHRONIC ILLNESS

Illness can be defined into two primary categories of impact:

1. Acute – typically infectious diseases, treated with a specific protocol and expected to occur over a predictable and brief period of time.
2. Chronic – often the result of an accumulation of lifestyle choices, typically involves multiple treatment methods that are not as specific, and occurs over an unpredictable length of time.

With acute illness, individuals are usually diagnosed based on easily identifiable symptoms that are related to specific causes. However, chronic illness can often manifest as a consequence of multiple causes with a variety of symptoms that may not present as clearly until the individual is experiencing the illness at a more advanced stage.

Acute illnesses typically have a known cure, however, chronic illness may often be resistant to treatment and may also be an enduring illness that stays with an individual for the rest of their life.

It’s clear to see from the above definitions that while acute illness may negatively impact an individual and create psychological distress, individuals can often rely on known treatments and outcomes of their illness with an understanding that they will one day be ‘cured’ of their illness.

With chronic illness, psychological distress is more pervasive and enduring and this long term experience can severely impact an individual’s life. In a significant amount of cases, chronic illness can become a permanent disability there individuals have to adapt to a new limitation on physical activities they used to undertake. This can have an impact on the individual’s mental wellbeing as they learn to accept the change in their physical wellbeing.

Often, those who suffer from chronic illness are coping with demanding physical problems. Because of these demands, the prospect of addressing emotional problems can be secondary in terms of priority. It’s most certainly the case that addressing immediate physical problems can itself provide immediate emotional relief to feelings of distress and anxiety.

However, the cumulative effect of chronic illness results in psychological issues that can no longer be ignored. As time progresses and the body habituates to chronic illness, individuals can often develop new beliefs about pain and physical wellbeing. This may impact their beliefs about asking for emotional help and support and their ability to undertake any old activities they may have previously enjoyed.

IMPACT OF CHRONIC ILLNESS

One of the most significant effects of chronic illness on an individual is through the impact on self-identity. The individual is often confronted with many life changes to their normal routine and way of doing things. In many cases an individual experiences a loss in previously enjoyed physical activities which also includes social interaction with family and friends.

Individuals may also have their job and career prospects limited by a chronic illness which can further impact feelings of autonomy, independence, and self-worth. In the case of children, chronic illness may impact their social development due to possible limited interactions with peers. They may also feel isolated from current friendships as they become more and more excluded from peer social circles.

HOW ART THERAPY CAN HELP WITH CHRONIC ILLNESS

People who are suffering from a chronic illness face a multitude of psychological issues to deal with that cross the lines of both physical and emotional experiences.

Sufferers of chronic illness have to develop strategies to meet the increasing stress that chronic illness brings. Chronic illness sufferers also have to learn to develop coping skills for physical pain as well as learning to adapt to a new way of living due to the limitations and restrictions that a chronic illness may create.

Art therapy can help sufferers of chronic illness to develop coping strategies that enable the client to engage in their physical treatment and meet the psychological demands that arise for the client. This includes maintaining a level of motivation and a positive mindset that will enable the client to actively engage in treatment.

Additionally, art therapy can also help a client develop disengagement coping strategies that can help them detach from the difficult and enduring parts of a chronic illness.

Other areas that art therapy can help clients with include:

• Emotional regulation
• Problem-solving skills to adapt to physical limitations
• Relaxation skills
• Expressing physical suffering
• Coping with frustrations
• Maintaining a sense of identity
• Developing acceptance
• Decreasing anxiety around physical pain and difficult medical procedures
• Altered body image
• Anger
• Denial
• Fatigue
• Fear of the future
• Lack of motivation
• Physical tension

One of the most important areas of chronic illness that art therapy can assist with is in helping the individual to reframe the intersection of emotions and physical pain. For many people with a chronic illness, pain and physical discomfort is an inevitable experience. Art therapy can help people explore their relationship to pain and physical discomfort, especially in reference to personal relationships, support, and engaging in activities.

ADDITIONAL RESOURCES

If you’re looking for additional resources to help supplement this content about chronic illness and art therapy, we sell many products in our store that can be used to help clients address the various aspects of coping with a chronic illness. These include:

• Art Therapy Guidebook – Developing Mindfulness
• Art Therapy Guidebook – Developing Motivation
• Art Therapy Guidebook – Developing Resilience
• Art Therapy Guidebook – Developing the Self

You may also want to read some of our previous blog posts to read more case studies that are related to clients who may have a chronic illness:

• 10 Art Therapy Exercises for Anxiety
• Case Study: Using Art Therapy for a Client with Anger
• Case Study: Using Art Therapy for a Client with Anxiety (GAD)
• Case Study: Using Art Therapy for a Client with Depression
• Case Study: Using Art Therapy for a Client with Fatigue
• Case Study: Using Art Therapy for a Client with Identity Issues
• The Benefits of Art Therapy for Cancer Patients
• What is Medical Art Therapy

• Name: Samuel
• Age: 57
• Summary of sessions to date: Samuel had started to attend group art therapy sessions as part of his rehabilitation treatment through the local hospital. Samuel was attending this 3rd session of an 8 week program.

Samuel had a workplace accident that injured his back. Samuel had been off work for 9 months and was still experiencing daily pain. Overall his pain levels had decreased however, they now felt a part of Samuel’s everyday life. He seemed to have a daily routine that focused entirely around this pain and injury.

Samuel was feeling the loss of his past life when he enjoyed activities in life including his garden and car restoration work.

Before introducing an art therapy exercise in a group or individual therapy setting, it can be useful to undertake a short mindfulness meditation exercise with your client. This can involve deep breathing or undertaking a physical awareness check-in where the client can attend to any feelings of discomfort, and release any physical tension that may be held in advance of the therapy session.

Mindfulness meditation can help participants in the present moment to engage in the art therapy activity.

This exercise focuses on understanding the meaning that clients attribute to their abilities. While some clients may not be able to participate in activities they did when they were not chronically ill, they can develop new activities that may suit their current physical state that hold just as much meaning to the client.

The purpose of this exercise is to extract the meaning that is important to your client.

INSTRUCTIONS:

• Ask your client to bring to mind an activity or hobby they participated in before they were ill. This should be something that the client previously viewed as important and gave meaning to themselves.
• Ask your client to reflect on the specific meaning that the activity held for them.
• You may want to ask your client some specific questions to prompt your client to explore the meaning:
  • Did this activity make your client feel strong?
  • Did this activity make your client feel competent?
  • Did this activity make your client feel intelligent?
  • Did this activity make your client feel less stressed?
  • Did this activity make your client feel creative?
  • Did this activity make your client feel mentally or physically challenged?
  • Did this activity make your client feel adventurous?
  • Did this activity make your client feel inspired?
  • Did this activity make your client feel they were having fun?
  • Did this activity make your client feel connected to other people (social inclusion)?
• As your client reflects on the meaning that the activity represents for them, ask them to create an artwork to reflect this meaning. They may want to use colours, shapes, and patterns to reflect the specific meaning of this activity.
• Discuss with your client the importance of meaning in the activities that we do. This may help your client understand that while the old activity may have been enjoyable, the benefits that the activity provided can be felt in establishing new activities that the client can undertake with any current physical limitations they may have with chronic pain.
• Discuss with your client the possibility of finding new activities to enjoy if they are physically limited to continue with old activities that they previously participated in.

Samuel reflected on his previous car restoration activity. He felt that car restoration gave him the feeling of accomplishment in turning something old into something new. Samuel felt challenged by car restoration and enjoyed the challenge of problem-solving difficult parts of the restoration process. Samuel also felt a sense of pride in the methods he had created to sourcing supplies that he needed for his restoration projects.

After the exercise, Samuel gained insight into specific meaning that his hobby of car restoration had given him. Samuel could also see that it wasn’t necessarily the physical work of restoring that delivered all of the benefits he received. Samuel could see that some of the research and problem-solving components of car restoration gave him purpose and interest in his hobby.

After further discussion with his art therapist, Samuel was interested in exploring how he could continue to be involved in car restoration projects in the future by mentoring other car restorers. He also was going to approach his local car enthusiast club about contributing articles to their newsletter about car restoration and the methods he had used in his process. Samuel felt positive about exploring these new avenues while remaining connected to his love of car restoration.

This case study represents a snapshot of the client’s progress in treatment. The exercise in this article could be used as written or as a guide for new and original tasks developed by the Art Therapist. Responsibility for treatment resides with the individual therapist who understands their clients specific needs. The art therapy exercise should not be viewed as a pre-defined directive on how to treat a client that presents with a specific range of problems.This art therapy exercise will help build a database of knowledge to draw upon when helping your client. Art Therapy is associated with psychotherapy techniques, however each therapist often approaches therapy with their own foundation of psychological interventions, whether it be psychotherapy, CBT, DBT or other methods.