Poster Presentation: no. SPP-P8.29Conference Theme: Enhancing Health - 協作同心‧醫澤社群published_or_final_versio

Chan, F

Cheng, CCY

Ho, AHY

Potash, JS

Wang, X

HKU Scholars Hub

Title Art Therapy Approach to Burnout Reduction for Hospice andPalliative Care WorkersAuthor(s) Potash, JS; Chan, F; Cheng, CCY; Wang, X; Ho, AHYCitation The 2012 Hospital Authority Convention, Hong Kong, 7-8 May2012.Issued Date 2012URL http://hdl.handle.net/10722/149319Rights Creative Commons: Attribution 3.0 Hong Kong LicenseArt Therapy Approach to Burnout Reduction for Hospice and Palliative Care WorkersPOTASH Jordan S., PhD, ATR-BC, LCAT (1)CHAN Faye, MSocSc, BSN, RN, FT (2)         CHENG Carol, RSW, BSocSc, MSocSc, CT (2)WANG Xiao Lu, PhD (1)                             HO Andy H. Y., MSocSc, MFT, FT (1)(1) Centre on Behavioral Health, The University of Hong Kong                        (2) Society for the Promotion of Hospice CarePROCEDURES AND EXAMPLESParticipants in the art therapy based supervision group met for 6 weeks in 3 hour sessions (total of 18 hours).  The foci of the 6 sessions were:Self-care and Stress Management1. Mandalasart in the form of the mandala (circle) for self-care2. Symbols of  Stressart to represent stress and then to transform it“ From drawing, I found I had separated my life as 3 parts…I found I need more self time which is the least part in the circle.Purple: silence, starry night, it is a time for myselfGreen: my job, peaceful but had burden, any way out?Orange: my church, my faith walking along the large, large word”“Feeling calm, peace but with tangled lines”“Tangled lines transform to a flower bed.  Iris grows everywhere”Case Sharing and Clinical Skills3. Meaningful Client Interactionsart to represent client interaction that demonstrated practitioner strength4. Challenging Client Interactionsart to represent client interaction that was challenging for the practitioner“Stone is stable and is not easy to be moved away.  No matter what the weather is, the stone will still be there, comforting it.  The stone enjoys environment where it is placed, with flowers, grasses, mountains all around.  Stone is like me who can insist and comfort with different challenges and difficulties.”“Challenges just like big waves. Shake me, flow me, frightened me. I could not say I enjoy it,  but I know challenges bring me golden rain. Wisdom like gold.Golden rain strengthens my golden boat.”Grief  and Bereavement5. Symbols of  Griefart to represent client related death-related encounter6. Finding Meaningart to demonstrate meaning in one’s professional role“To me [death and dying is]…1. Inevitable and natural process2. We all take turn. One by one3. Separation with the ‘earthly matters’4. Reunion with the ‘ancestor’Great impact initially, but then lower impact”“For myself work/job sometimes is just like a huge mountain, I need to climb up with effort but it always make me feel bright, good and light.”INTRODUCTIONHospice and palliative care workers are at a high risk for job burnout due to the intensive emotional labor of their jobs. Supervision or employee assistance programs can reduce this risk (Kravits, McAllister-Black, Grant & Kirk, 2010; Pereira, Fonseca, & Carvalho, 2011; Swetz, Harrington, Matsuyama, Shanafelt & Lyckholm, 2009).  One particularly encouraging strategy in this area has been  the incorporation of art therapy (Brooks, Bradt, Eyre, Hunt and Dileo, 2010; Italia, Favara-Scacco, Di Cataldo & Russo, 2008; Nainis, 2005). The art therapy approach to burnout reduction aims to enhance self-awareness, increase ability of emotional expression and regulation, promote professional relationships and facilitate meaning making processes.OBJECTIVESArt therapy based supervision with hospice and palliative care workers would: • lower incidences of burnout  • increase perception of professional efficacy • facilitate opportunities for self-care and building professional relationships.RESULTSThe study is at the pilot stage and data collection is on-going (expected completion of June 2012). This presentation only reports on the findings from the pre and post tests of the first art therapy based supervision group compared with the first control group 21 participants completed the art therapy based supervision23 participated in the control group.Quantitative DataPaired T-test was used to examine the data.Maslach Burnout Inventory - General SurveyFor the control group, both core dimensions of job burnout — exhaustion and cynical attitudes towards meaning in work — increased after the training program. The increase in cynicism almost reached a statistical significance (p = 0.053). On the contrary, participants in the art therapy based supervision  — showed a marginally significant decrease in exhaustion (p = 0.074). Moreover, this group also experienced a significant positive change in professional self-efficacy (p < 0.05). Five Factor Mindfulness QuestionnaireSimilar results were found with regard to mindfulness. Participants in the control group showed significantly lower levels of abilities to describe their thoughts and feelings (p < 0.01), as well as, not reacting to them (p < 0.05) . Participants in the art therapy based supervision showed a significant increase in their abilities to observe their thoughts and feelings (p < 0.05). Qualitative DataReflective writings and group discussion revealed that the art-making processes helped participants reconnect with themselves and colleagues, while gaining more understanding and new perspectives of challenging experiences at work. METHODOLOGYWe examined the efficacy of the art therapy based supervision group with social workers, nurses, doctors, chaplains and volunteers who work in hospice and palliative care settings.  A standard supervision group of the same length and course topics served as a control group. Participants selected which supervision group to attend.  All participants completed the Maslach Burnout Inventory - General Survey (Maslach, Jackson & Leiter, 1996) and Five Factor Mindfulness Questionnaire (Baer, Smith, Hopkins, Krietemeyer, & Toney, 2006) at pre, post and 1 month intervals. DISCUSSIONThe study showed preliminary evidence for the efficacy of art therapy based supervision on job burnout.  The results imply that participants might have gained a better sense of control of their thoughts and feelings, which might have contributed to their increased level of professional self-efficacy and reduction of exhaustion. Further, the group allowed for increased self-awareness, discovery of creative potential and forming connections with colleagues.REFERENCESBaer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J. & Toney, L.  (2006).  Using self-report assessment methods to explore facets of mindfulness.  Assessment, 13 (1), 27-45.Brooks, D. M., Bradt, J., Eyre, L., Hunt, A. & Dileo, C.  (2010).  Creative approaches for reducing burnout in medical personnel.  The Arts in Psychotherapy, 37 (3), 255-263.Italia, S., Favara-Scacco, C., Di Cataldo, A. & Russo, G.  (2008).  Evaluation and art therapy treatment of the burnout syndrome in oncology units.  Psycho-Oncology, 17 (7), 676-680.Kravits, K., McAllister-Black, R., Grant, M. & Kirk, C.  (2010).  Self-care strategies for nurses: A psycho-educational intervention for stress reduction and the prevention of burnout.  Applied Nursing Research, 23 (3), 130-138.Maslach, C., Jackson, S. E., & Leiter, M. P. (1996). The Maslach Burnout Inventory (3rd ed.). Palo Alto, CA: Consulting Psychologists Press.Nainis, N. A.  (2005).  Art therapy with an oncology care team.  Art Therapy: Journal of the American Art Therapy Association, 22 (3), 150-154.Pereira, S. M., Fonseca, A. M. & Carvalho, A. S.  (2011).  Burnout in palliative care: A systematic review.  Nursing Ethics, 18 (3), 317-326.Swetz, K. M., Harrington, S. E. Matsuyama, R. K., Shanafelt, T. D. & Lyckholm, L. J. (2009).  Strategies for avoiding burnout in hospice and palliative medicine: Peer advice for physicians on achieving longevity and fulfillment.  Journal of Palliative Medicine, 12 (9), 773-777.ACKNOWLEDGEMENTSThis project was funded through the Drs. Richard Charles and  Esther Yewpick Lee Charitable Foundation.  Gratitude to Joyce Sing for assisting in data analysis. 262728293031Pre PostBurnout (Exhaustion & Cynicism)Control Intervention16.51717.51818.51919.52020.5Pre PostSelf-EfficacyControl Intervention2424.52525.52626.52727.528Pre PostDescribeThoughts & FeelingsControl Intervention1919.52020.52121.52222.52323.5Pre PostNonreactionControl Intervention23242526272829Pre PostObserve Thoughts & FeelingsControl Intervention

Art Therapy Approach to Burnout Reduction for Hospice and Palliative Care Workers

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Art Therapy Approach to Burnout Reduction for Hospice and Palliative Care Workers

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