Healing Arts: Patients Respond to Expressive Therapy

Last year, the 13-bed Pediatric Psychiatry Department at Cleveland Clinic’s Fairview Hospital enhanced its expressive therapy programming. Michele Laffin, MSN, RN, nurse manager of the department, and Mackenzie Varkula, DO, medical director, carefully examined the unit’s programming, then added two mental health workers as well as expressive therapists, including one music therapist and two art therapists. (The department already had one art therapist.)

“A lot of kids express themselves through those mediums, so we thought targeting kids through music and art would be really helpful,” explains Laffin.

Using music and art to manage symptoms

Nurses on the pediatric psychiatry unit at Fairview Hospital, a regional hospital west of Cleveland, struggled to reach a patient with pervasive development delays until the unit’s new music therapist stepped in. “Because of poor communication skills, he had difficulty expressing himself,” says Laffin. “The music therapist used drums with him, and it has really helped the patient manage his anxiety.”

The music therapist visits the unit, which serves children ages five through 17, two to three days a week. She leads the patients in creative activities, such as encouraging them to write poetry about their feelings then turn the poems into songs. The art therapists work with patients as needed, incorporating clay, drawing and painting into sessions. A nurse on the unit also teaches a weekly yoga class. The overall goal is to reach patients in whatever way works best for them.

Combining expressive therapy with other programming

Expressive therapy complements the department’s pyschoeducational programming, which is led by three mental health workers. The group sessions, which last approximately 45 minutes, provide a method of sharing in a peer-supported, non-threatening environment. The programming has been modified to focus on current trends affecting the pediatric and adolescent psychiatric patient population, such as cutting and bullying, says Laffin. During group sessions, patients develop coping skills and learn to manage symptoms (such as anger) and communicate effectively.

All of the healthcare professionals work together to treat patients on the unit, whose average length of stay is three to four days. Two to three nurses work on each shift and are supported by the expressive therapists, mental health workers and licensed clinicians. In addition, a Cleveland public school teacher provides lessons to patients during the school year.

While no data currently exists to measure the effectiveness of the programmatic enhancements, Dr. Varkula and Laffin are considering ways to collect such information. In the meantime, anecdotal evidence suggests the improvements are working. “I’ve heard from the nursing staff, physicians and some families that they really support and appreciate the structure that’s been put in place,” says Laffin.

Music and art are more than fun pastimes on Fairview Hospital’s Pediatric Psychiatric Unit: They are helping patients heal.