Frances Hodgkins Saint Joseph’s College of Maine Monday, October 18, 2010

Georges Braque: Compotier, bouteille et verre, 1912 Photograph by Sharon Mollerus, Creative Commons licensed

Scientific studies tell us that art heals by changing a person's physiology and attitude. The body's physiology changes from one of stress to one of deep relaxation, from one of fear to one of creativity and inspiration. Art and music put a person in a different brain wave pattern, art and music affect a person's autonomic nervous system, their hormonal balance and their brain neurotransmitters.

(Samuels, 2000)

Venus of Willendorf Material: Oolitic limestone Created:22,000 B.C.E– 21,000 B.C.E. Discovered 1908 near Willendorf, by Josef Szombathy Present location: Naturhistorisches Museum, Vienna, Austria (Wikipedia, 2010)

“Art therapy is the therapeutic use of art making, within a professional relationship, by people who experience illness, trauma or challenges in living, and by people who seek personal development.” (American Art Therapy Association, 2010)

Visual expression has been used for healing throughout history, but art therapy did not emerge as a distinct profession until the 1940s.

As a result, the profession of art therapy grew into an effective and important method of communication, assessment, and treatment with children and adults in a variety of settings. Currently, the field of art therapy has gained attention in healthcare facilities throughout the United States and within psychiatry, psychology, counseling, education, and the arts. Photo: Unknown

Art therapy is the therapeutic use of art making, within a professional

relationship, by people who experience illness, trauma or

challenges in living, and by people who seek personal development. Through creating art and reflecting on the art products and processes, people can

increase awareness of self and others cope with symptoms, stress and traumatic experiences; enhance

cognitive abilities; and enjoy the life-affirming pleasures of making art.

(American Art Therapy Association, 2010)

Photo: Frances Hodgkins, 2010 Dale Chihuly ART Glass Instillation at Cheekwood Botanical Gardens, TN

(Ghose, 2010)

Photo: Frances Hodgkins RN, PMHN-BC, 2009

Key Words: Art Therapy, Holistic Nursing Creativeness

Holistic Art Facilitation and Holistic Art Coaching

Searching the CINAHL and Expanded Nursing and Allied Health Database, reveals 4 records from 2004 until 2010. Only one of those records explicitly mentioned Holistic Nursing. “Arts in Healthcare: A New Paradigm for Holistic Nursing Practice”.

Bringing creativity into health care has opened up a new dimension in nursing. Creative interventions have been shown to shorten hospital stays and reduce the patient's need for pain medication. In response to these benefits, many major medical centers around the world have instituted arts in health care programs. Arts in Medicine is one such program that serves hundreds of patients. It was established by a nurse at the University of Florida and is directly tied to nursing care. Programs like this provide clinical models for nurses who want to integrate the arts into their health care practice. This article presents these models and discusses ways that nurses can easily implement creative interventions into their practice. (Lane, 2006)

To understand nursing as a discipline and a distinct field of study is to honor it within a context of art, the humanities, and expanding views of science…

Caring Science seeks to combine science with the humanities and arts. The intersections between art and science help reveal what is beyond the confines and contingencies of the visible world, to “see” that which is deeper, glimpsing the human spirit, the human soul, its beauty and loveliness, whatever its shape or form. (Watson 2008 p.19,20)

Holistic Art Facilitation and Holisitic Art Coaching

Holistic Art Facilitation: Grounded in Caring Science

Media: Brown Kraft paper Ink Markers Stickers Artists: Patients and Nurses of the Micheal E. DeBakey VA Medical Center, 2009 Facilitator: Frances Hodgkins RN, PMHN-BC

What Art Therapists do is not the same as an Holistic Art Facilitator. Art Therapists have advanced degrees in Art Therapy and have to be certified in art and psychotherapy. Holistic Art Facilitation does not need an advanced degree. Although background knowledge in art and art techniques is necessary.

“one that facilitates; especially : one that helps to bring about an outcome (as learning, productivity, or communication) by providing indirect or unobtrusive assistance, guidance, or supervision”. (Merriam Webster, 2010)

Nurses in any setting, who have a penchant and a passion for art can facilitate an art program. The process is to assist the client with calming their nervous systems and revealing inner emotional states of being, guided by the Caritas Theory.

Jean Watson’s 10 Caritas Processes

1. Embrace altruistic values and Practice loving kindness with self and others.

2. Instill faith and hope and honor others. 3. Be sensitive to self and others by nurturing individual beliefs and

practices. 4. Develop helping – trusting- caring relationships. 5. Promote and accept positive and negative feelings as you authentically

listen to another’s story. 6. Use creative scientific problem-solving methods for caring decision

making. 7. Share teaching and learning that addresses the individual needs and

comprehension styles. 8. Create a healing environment for the physical and spiritual self which

respects human dignity. 9. Assist with basic physical, emotional, and spiritual human needs. 10. Open to mystery and Allow miracles to enter.

(Watson, 2009)

Holistic Art Facilitation and Coaching is alive and well at the

Acute Recovery Treatment Center in the Houston VA.

Frances Hodgkins, RN,PMHN-BC is responsible for the art related milieu. She is a registered nurse with a passion for the process of

making art as a recovery process. Picture: Example of collective art process.

Media: Kraft paper, stickers, colored ink markers Work done by patients and nurses over a 2 week period in September 2009

Photo: Frances Hodgkins 2009

The foundations of Holistic Nursing and Holistic Art Facilitation have the basic tenet of

(American Holistic Nurses Association,

2007, p. 1)

celebrates the fundamentals of holism in the process of creating. The process of creation is healing for the body, mind, and soul.

Embracing values, instilling hope and honor, being sensitive, promoting positive and negative feelings. All of these holistic ideals are evident in a facilitated art class. Developing relationships, teaching, and creating healing environments is also encased in a facilitated art class the participants are encouraged to express their feelings. Nothing is ever “wrong.” It is only an expression of the complexity of your life and your current situation. Nurses can assist with the bio-psycho-social needs and also allow miracles to enter.

Nursing theorist Jean Watson’s 10 Caritas Processes embrace art and artistic expression as an important avenue to

(Watson J. , 2008, p. 285)

Processing the making of art in the client population fosters a safety net of risk, as many people have not tried to make art or have forgotten that they had creative urges in the past. It is the use of creative ways to help people channel energy in positive ways.

A “safety net of risk” involves a deep breath. “Mixing a color, picking up a brush, applying emotions to the canvas…it will not hurt… Risk is Safe in Art.”

Said to Holistic Art Class in 2010 by Frances Hodgkins RN, PMHN-BC

Requires extensive education in art, psychotherapy, and the therapeutic modalities. Is recognized as a distinct discipline by state boards of licensure and has their own association.

Art Therapists are counselors and therapists that are able to analyze art work that the person has produced.

Has no formalized educational requirements. Requires fundamental knowledge of coaching and facilitation, recovery principles, and art and art materials.

Is not designed to psychoanalyze the art produced, is designed to help the client see into their own lives by working in self-made art.

I developed the Facilitated Art process in 2009 to decrease boredom and increase patient self-awareness. Many of my patients are war-time veterans with poly-substance abuse and emotional issues. Many have problems with thought

disorders and like most institutions

we couldn’t afford an Art Therapist.

I Learned:

There are two things in life that people share.

Art and Music.

Photo: Frances Hodgkins , 2010 Artist: Reggie Williams, veteran US Army Media: Acrylics applied by airbrush and hand to wall

Art and Music are universal to all of my warriors and staff. No matter the age, the cultural background, the mental or spiritual challenges or the step in their personal growth, the language of art and music is universal.

is a direct outcome of my work with art process in an inpatient psychiatric unit, and as a result of my studies in holistic nursing at St. Josephs College of Maine.

Historically, Art Modalities have been used with patients who are in extreme states of illness such as long-term developmental disabilities, cancer, and psychiatric patients. Oftentimes, art and art modalities are used with children. (American Art Therapy Association, 2010)

The introduction of a novel holistic method to bring art into a medical center through nurse-centered delivery is not unique as indicated by the Shands Medical Center in Florida, and the Cleveland Clinic, but it certainly is emerging as an important factor in the patient experience in healthcare. (Shands Medical Center, 2010) (Cleveland Clinic, 2010)

Health conditions indicated for use of Art in the medical environment includes all types of healthcare maladies, but more importantly, warrants the use of these modalities to maintain a state of wellness, and a state of wholeness.

The studies in Holistic Nursing is what spurned me to develop this modality more fully. My research has revealed facilitated art is not fully developed. As a result I plan to develop this as a holistic guided modality for nurses.

will provide clients with creative artistic nursing interventions based on assessments of the professional nurse according to the needs of the client.

AHNA states that Art Therapy is “an intervention most frequently used”, however Art Therapy is actually an individual discipline that has it’s own set of standards. (American Holistic Nurses Association, 2007, p. 84)

Unless a holistic nurse is educated in Art Therapy, I believe that the use of the wording “Art Therapy” within the AHNA document is erroneous and infringes on the Art Therapy practitioner. Art Therapy is a distinct mental health discipline.

Holistic Art Facilitation and Holistic Art Coaching

The Holistic Art Facilitator Program will adhere to the Holistic Nursing Scope and Standards of Practice.

Holistic Art Facilitation and Holistic Art Coaching

Applying Leadership Research Collaboration Ethics Collegiality Professional Practice Evaluation

Coordination of Care Health Teaching Quality of Practice Education Consultation Evaluation

Assessment Diagnosis or Health Issues Outcome Identification Planning Implementation Evaluation

(American Holistic Nurses Association, 2007)

The Holistic Nurse Artist will be able to assist clients in a therapeutic setting.

Facilitating the use of artistic modalities to:

Increase comfort

Decrease pain

Self-Process feelings

Modulate stress and physical responses to stress

Realize hope

Increase personal identity

Increase self-esteem and self-awareness

Self-Process Spirituality

(This is not an all inclusive list of possibilities)

Holistic Nurse Art Facilitator

The Holistic Art Coach designation is designed for the non-nurse. It encompasses the components of the recovery and utilizes peer support. The 10 essential components of Recovery are:

• Self-Direction

• Individualized and Person-Centered

• Empowerment

• Holistic

• Non-Linear

• Strengths-Based

• Peer Support

• Respect

• Responsibility

• Hope US Department of Health and Human Services,,(2004)

Holistic Art Coaching for Laypersons

The Holistic Art Coaching portion of the program is designed to increase the availability of art within therapeutic and non-therapeutic environments. After a short course in art and art materials, volunteers of hospitals or other unlicensed persons can lead an art process group or an individual session. They do not teach coping skills or perform assessments.

They are grounded in the principles of Recovery.

Holistic Art Coaching for Laypersons

Therefore the inception of Holistic Art Facilitation and Art Coaching is actually more inclusive of what holistic nurses do; who are NOT trained in the mental health discipline of Art Therapy.

Holistic Art Facilitation and Holistic Art Coaching

Holistic Art Facilitation and Holistic Art Coaching

Holistic Art Facilitation and Art Coaching is currently being developed as a holistic modality by Frances Hodgkins RN, PMHN-BC in Houston, Texas.

is envisioned to encompass the assessment and implementation skills of the registered professional nurse and the

aspect is not for registered nurses, but designed for laypersons. Media: Acrylics Airbrush and Hand Painted Mural

Artist: Reggie Williams, Veteran Artist Photo: Frances Hodgkins RN ,PMHN-BC 2010

Holistic Art Facilitation and Holistic Art Coaching are two new emerging modules in holism that can easily evolve into the nursing practice with licensed and unlicensed personnel.

Holistic Art is a Mind-Body Modality.

Holistic Art Facilitation and Coaching is easily learned and taught.

A person does not need to have any prior knowledge of art to reap the healing benefits of Holistic Art Facilitation and Holistic Art Coaching.

Holistic Art

Holistic Art Facilitation and Holistic Art Coaching

Photo: Frances Hodgkins 2010

Media: Stickers on grey wall

Installed in the MEDVAMC Unit 6A

Artist: Frances Hodgkins RN, PMHN-BC

Poster Presentation at 2009 MEDVAMC Nursing Strategic Planning Symposium by Frances Hodgkins RN, PMNH-BC, Principle Investigator

Although Holistic Art Facilitation is not a named and recognized therapy, art has been in therapeutic uses for centuries.

I use the process in the Michael E DeBakey during group sessions and individual sessions.

This presentation suggests that Holistic Art Faciliation be more fully developed within the context of holism and nursing care.

My art modality is grounded in Holistic Nursing and the Caritas Nursing Theory.

• Fully develop the idea with dedicated research to show outcomes.

• Fully develop the Facilitator role and the Coaching role to delineate the responsibilities unique to each.

• Write papers and eventually a book on the fully developed idea.

• Work with AHNA and ANA to proclaim the method as Holistic and meaningful to nursing practice, patient experiences, and as a beneficial way to heal.

Patricia Johanson, environmental artist

American Art Therapy Association. (2010). History of Art Therapy. Retrieved October 18, 2010, from

American Art Therapy Association : http://www.americanarttherapyassociation.org/aata-

history-background.html

American Holistic Nurses Association. (2007). Scope and Standards of Practice. Silver Spring:

Nursebooks.org.

Arts, N. E. (2009). State of the Field Report Arts in Healthcare. Retrieved October 18, 2010, from

Society for Arts in Healthcare: http://thesah.org/template/page.cfm?page_id=604

Cleveland Clinic. (2010). Art and Medicine. Retrieved October 23, 2010, from Cleveland Clinic Arts and

Medicine Institute: http://my.clevelandclinic.org/art/default.aspx

Ghose, T. (2010). Faculty of 1000. Retrieved October 18, 2010, from The Scientist: http://www.the-

scientist.com/blog/display/55663/

Lane, M. (2006). Arts in health care: a new paradigm for holistic nursing practice. Journal of Holistic

Nursing, 24(1), 70-75. Retrieved from CINAHL with Full Text database

Merriam Webster. (2010). facilitator. Retrieved October 23, 2010, from Merriam Webster Dictionary:

http://www.merriam-webster.com/dictionary/facilitator

Samuels, M. (2000). How Art Heals. Retrieved October 23, 2010, from Art As Healing:

http://artashealing.org/ahfw3.htm

Shands Medical Center. (2010). Shands Research. Retrieved October 23, 2010, from Shands Medical

Center for Arts in Medicine: http://shands.org/aim/research.html

US Department of Health and HumanServices, Substance Abuse and Mental Health Services

Administration, Center for Mental Health Services (2004) NationalConsensus Statement on

Mental Health Recovery. http://mentalhealth.samhsa.gov/publications/allpubs/sma05-4129/

Watson, J. (2008). The Philosophy and Science of Caring. Boulder: University Press of Colorado.

Watson, J. (2009). Dr. Jean Watson's Theory of Human Caring. Retrieved October 18, 2010, from

Watson Caring Science Institute:

http://www.watsoncaringscience.org/caring_science/10caritas.html

Wikipedia. (2010, October 10). Retrieved October 23, 2010, from Wikipedia: Venus of Willendorf

The End