012. The development of Art Therapy within a Paediatric Rheumatology Service

Abstract

Background: Chronic conditions affecting children have significant impact on both physical health and emotional wellbeing. Psychological support for families is fundamental to holistic care but is under resourced and often not quickly available. Art therapy can help individuals to express themselves, making sense of their thoughts and feelings through both verbal and non-verbal activities. The Teapot Trust was formed in Scotland in 2012 with the aim of providing art therapy to children and families affected by chronic illness, especially rheumatological conditions. The Paediatric Rheumatology team at the Royal Hospital Sick Children in Edinburgh (RHSCE) has worked closely with the Teapot Trust since the outset. Aims: To describe the development of art therapy for patients attending the Paediatric Rheumatology service at RHSCE and to describe the caseload over a recent 12-month period. Methods: Retrospective review of the developing service and caseload. Results: Art therapists employed by the Teapot Trust are seconded to work within the NHS team at RHSCE. Following extensive initial discussions it was agreed to embed the therapists within both the Paediatric Psychology and Liaison Service (PPALS) and Paediatric Rheumatology teams ensuring adequate supervision, support and sharing of information. Members of the Paediatric Rheumatology MDT refer children to the art therapists and the referral is processed through PPALS. Prior to an initial appointment a meeting with the child and family is arranged to discuss what art therapy can provide and an 8-week block (extended as necessary) is offered of one-to-one sessions with an art therapist. Formal assessments (PedsQL and Goal Based Outcomes) are undertaken pre and post therapy. A formal feedback letter is sent to the clinical team, GP and family on completion of therapy. Eighteen children (12 female, 6 male) were seen between March 2016-2017. Age range was 4-18 (median 11) years. Background conditions included JIA (n = 11); JDM (n = 2); linear scleroderma (n = 2); jSLE (n = 1); other (n = 2). Reasons for referral included anxiety; fear of hospital and treatment; mood and behaviour changes; peer relationship difficulties. Waiting time from referral to first appointment was 4-6 weeks. Goals agreed included to feel more confident: to feel less anxious about my illness; to understand my feelings better and to find ways to express myself. Sessions attended ranged from 8-40 (median 14) weeks. Attendance rate was 86%. Eleven patients have completed a course of therapy. Goal based outcomes show trend of improvement. Informal feedback from families has been universally positive. Conclusions: Art therapy complements other psychological therapies offered to families affected by chronic rheumatological conditions. We describe its establishment within our service offering an effective, well-liked and timely intervention. Further work is ongoing to support observations that art therapy reduces anxiety, improves emotional wellbeing and enhances hospital engagement.