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EXPRESSIVE ARTS THERAPY IN AN OPEN SPACE ENVIRONMENT AT THE PEDIATRIC WARD CHILDREN SCHOOL
Shaare Zedek Medical Center Jerusalem
Asnat Weinfeld MA EXAT
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The Arch of Arts in Health International Conference
Haifa, Israel March 17-19, 2013
Child Population
Ages 3-21
Short term hospitalization or long term due to chronic disease
Children are entitled to school during hospitalization according to to Free Education Law for Sick Children on behalf of the Ministry of Education - 2001
Diverse and heterogeneous population: Jewish and Arab (Muslim and Christian), ultra-Orthodox and secular, and children from the Palestinian Territories
Socioeconomic diversity: from large, poor families, as well as from affluent families
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Open space setting Ideal and classic therapeutic space
Lack of walls A safe and intimate room
Time and space varies Fixed time and place
Noisy and full of stimuli Quiet and without interference
EXA Therapist comes to the client Client comes to the therapist
EXA Therapist adjusts to the medical area Custom space for arts therapy
Acute physical condition is the first priority Priority to emotional issues
Expressive Arts Therapy in an Open Space Environment
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The child’s willingness to
participate
A " therapeutic bubble"
created by both therapist and
client
Cooperation of the medical
staff in maintaining minimal
intervention during the session
Giving emotional
interpretation to the child’s
art, dialogue and behavior
What are the necessary conditions for EXAT in the open space enviroment ?
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Therapeutic open space – a new working model
It requires a complete new set of therapeutic principles, techniques and approaches:
Mobile equipment
Children that cannot move from their medical treatment area must have EXAT come to them
A “therapeutic bubble” held by therapist and client together replaces walls and doors
Creating a boundary between the therapeutic focal point in a session and the surrounding medical activity
Time session and duration varies
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Mobile equipment
Medical equipment cart becomes a portable art studio
The art supplies are familiar to children from their normative lives outside hospital walls
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EXAT comes to the client
The therapist is responsible to assess whether a meeting is appropriate and to what extent to offer services without being intrusive or aggressive
The child’s decision whether or not to accept art therapy gives him a sense of control in his otherwise disempowering hospital experience
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The “therapeutic bubble” becomes a replacement for walls and doors
A unique physical presence is required from the therapist : Limit reaction to noises,
sounds, sights and smells Refer only to the EXAT
session events Avoid conversations with
others during the session as much as possible
The child is an active partner in achieving privacy
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Creating a boundary between the therapeutic
experience and the medical reality Behavioral codes differ
from those regularly expected in a medical environment: mess and noise are allowed
Legitimacy to express emotions in sublimated way
Contact with an adult in the hospital based on the child's strength and abilities as opposed to contact associated with pain or discomfort Proprietary Information of Asnat Weinfeld © 2013
Session time and duration varies
The therapist must be aware of the child’s physical abilities and limitations during the EXAT encounter
Attention to physical distress in order to alarm the medical staff if necessary
The therapist displays empathy
to the child and conveys an understanding of the difficulties the child faces in dealing with the disease
Being flexible & providing EXAT
at irregular times supports the child, medical staff, parents and the medical process
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Some of the EXAT sessions themes in the open space environment
Medical procedures processing Identifying with others in a similar situation
Coping with anxiety, anger and frustration
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Final Word
Clearly, EXAT is of substantial importance despite the extreme conditions at
the hospital, as these children would not be receiving therapy otherwise
Open space conditions are appropriate and often more effective in the
hospital environment
The processing work done achieves similar results to conventional therapy
There are advantages to open space EXAT practice, such as legitimizing the
expression of emotions in public and regaining a measure of control
Therapeutic open space is a new working model and a portion of it was
presented here
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Thanks
Mrs. Helena Bogopolsky – Music therapist
Mrs. Sara Shoshany – Principal and of the Pediatric Ward Children School - Shaare Zedek Medical Center Jerusalem
The entire staff of Pediatric Ward Children School
The hospitalized children and their families
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