Girija Kaimal

Emerging Adulthood and the Perception of Parental Depression

Few studies have examined children’s perceptions of parental depression. This study was a qualitative analysis of the changes in the perception of parental depression between the ages of 17 and 19 years. Archived interview narratives of 16 respondents from a longitudinal, preventive intervention study of depression in families were analyzed. The respondents were purposefully selected to represent both genders as well as higher and lower levels of family adversity. The perceptions of parental depression were found to fall into three categories: self-oriented perspectives (resistance and negativity), ambivalent perspectives, and, other-oriented perspectives (acceptance and compassion). Over time, respondents from the high-adversity families showed shifts from self-orientation to other-orientation, whereas the perspectives of respondents from low-adversity families remained unchanged. Some respondents with depression in both parents and/or siblings revealed changes in perception toward one parent but no change toward other family members with depression.

Assessing parental attitudes toward genetic testing for childhood hearing loss: Before and after genetic consultation

We report on the development of a Genetic Attitude Assessment Tool (GAAT) to measure parental attitudes in contemplating genetic testing for childhood hearing loss, and to examine the differences in assessments made before and after genetic counseling. The GAAT tool was administered to a convenient sample of 119 parents of children with bilateral sensorineural hearing loss. The respondents completed the survey either before (n = 77) or after (n = 42) genetic counseling. Exploratory Factor Analysis was applied to identify and quantify the underlying psychosocial structure. Our results showed the validated 54‐item GAAT instrument contains six subscales: (1) “test intention,” (2) “beliefs in non‐genetic causes of hearing loss,” (3) “deferral of decision to undergo genetic testing,” (4) “appropriate use of genetic testing results,” (5) “beliefs in the benefits,” and (6) “concerns about stigma.” The respondents who answered the survey after genetic counseling had higher “test intention” (P = 0.017) and endorsed to a greater extent “beliefs in the benefits” (P < 0.001). They believed to a lesser extent that childhood hearing loss was due to “non‐genetic causes” (P < 0.001) and were less inclined to prefer “decision deferral” (P = 0.031). Respondents who themselves had a hearing loss expressed a significantly weaker belief in “non‐genetic causes” of hearing loss (P < 0.0001). In conclusion the validated GAAT instrument is responsive to changes in parental attitudes after genetic counseling. The GAAT may be used to monitor parental attitudes serially, to further understand how parental attitudes change from pre genetic counseling, post genetic counseling, to post test result disclosure.

Active-duty military service members’ visual representations of PTSD and TBI in masks

ABSTRACT Active-duty military service members have a significant risk of sustaining physical and psychological trauma resulting in traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD). Within an interdisciplinary treatment approach at the National Intrepid Center of Excellence, service members participated in mask making during art therapy sessions. This study presents an analysis of the mask-making experiences of service members (n = 370) with persistent symptoms from combat- and mission-related TBI, PTSD, and other concurrent mood issues. Data sources included mask images and therapist notes collected over a five-year period. The data were coded and analyzed using grounded theory methods. Findings indicated that mask making offered visual representations of the self related to individual personhood, relationships, community, and society. Imagery themes referenced the injury, relational supports/losses, identity transitions/questions, cultural metaphors, existential reflections, and conflicted sense of self. These visual insights provided an increased understanding of the experiences of service members, facilitating their recovery.

Free art-making in an art therapy open studio: changes in affect and self-efficacy

Abstract Background: This study investigated the impact of visual art-making on self-reported positive and negative affect and perceived self-efficacy. Study participants included 39 healthy adults aged 18 to 59 years, including 33 women and 6 men. Methods: The study used a mixed methods quasi-experimental (pre–post measurements, no control group) design. The study involved 45 minutes of individual art-making in an open studio format facilitated by an art therapist. Participants completed questionnaires including the Positive and Negative Affect Schedule and General Self-Efficacy Scale, before and after the art-making session. At the end of the session, participants provided brief comments about their art-making experience and a narrative summary of their artwork. Results: Results indicate that free art-making in this context significantly lowered negative affect and improved positive affect and self-efficacy. Improved affect was also moderately correlated with improved self-efficacy. There was no difference between groups based on prior experience with art-making, gender, age, or race/ethnicity. Content themes from the participants’ artwork were very diverse including references to nature, people, activities, memories, and abstract explorations of colors and shapes. Discussion/Implications: These preliminary findings indicate the benefits of a brief studio-based art therapy free art-making session on the psychological states of affect and self-efficacy for health adults.

Art Therapist-Facilitated Open Studio Versus Coloring: Differences in Outcomes of Affect, Stress, Creative Agency, and Self-Efficacy (Studio ouvert animé par un art-thérapeute versus coloriage : différences de résultats sur l'affect, le stress, l'agentivité créatrice et l'efficacité personnelle)

ABSTRACT Background: Coloring books for adults have become a ubiquitous presence in retail outlets worldwide and in the visual cultural landscape. The goal of this study was to determine differences in outcomes between art therapist-facilitated open studio and individual coloring. Methods: The study used a within-subjects experimental design. Healthy adult participants (aged 19–67 years) were invited to engage in one session each of individual coloring, and open studio facilitated by an art therapist. A total of 36 participants enrolled in the study; 29 completed pre- and post-surveys for both conditions. Outcomes measured included positive and negative affect, perceived stress, self-efficacy, and creative agency. Results: The art therapist-facilitated open studio condition resulted in superior improvements in positive affect, creative agency, and self-efficacy compared to the coloring condition. Both conditions resulted in lowered stress and reduced negative affect. Discussion and implications: The results indicated that coloring might have therapeutic benefits on distress; however, only the art therapist-facilitated open studio session showed significant improvements in self-efficacy, self-perceptions of creativity, and positive mood. Art therapists might consider using the phenomenon of coloring as a doorway to art therapy and more spontaneous creative and self-expression for transformative change. Future studies should seek to identify the unique mechanism of change through which art therapist-facilitated art making explains the shifts in positive affect, creative agency, and self-efficacy.

Crafting, health and wellbeing: findings from the survey of public participation in the arts and considerations for art therapists

Abstract This brief report presents a review of the literature on health implications of crafting practices, as well as secondary analysis of data from the National Endowment for the Arts’ Survey of Public Participation in the Arts. The secondary data analysis focuses on trends in crafting practices in the United States. The findings indicate a greater prevalence of craft-based practices compared with fine arts media, as well as, distinct differences in arts participation based on gender, ethnicity and income levels. Using these data sources, implications for craft-based expressive practices as a therapeutic tool in art therapy practice are discussed.

‘Master My Demons’: art therapy montage paintings by active-duty military service members with traumatic brain injury and post-traumatic stress

This study involved a thematic analysis of montage paintings and of related clinical records of 240 active-duty military service members collected during their art therapy treatment for traumatic brain injury and underlying psychological health concerns, including post-traumatic stress, at the National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA. Congruent with other research findings, the qualitative analyses of this study suggest that the group art therapy experiences fostered improvement in interpersonal relatedness, hopefulness and gratification for the service members in treatment, aiding in externalisation, progressive exposure and construction of a trauma narrative imperative for recovery. The mixed media nature of the montage painting supported the expression of a range of postcombat symptoms. Results from this study highlighted the complexity of military culture, necessitating a broader scope of analyses for how art therapy helps service members express and communicate their challenges to care providers, peers and family as well as regulate emotion in the short and long term.

Observational study of associations between visual imagery and measures of depression, anxiety and post-traumatic stress among active-duty military service members with traumatic brain injury at the Walter Reed National Military Medical Center

Objectives The study aimed tocompare recurring themes in the artistic expression of military service members (SMs) with post-traumatic stress disorder (PTSD), traumatic brain injury and psychological health (PH) conditions with measurable psychiatric diagnoses. Affective symptoms and struggles related to verbally expressing information can limit communication in individuals with symptoms of PTSD and deployment-related health conditions. Visual self-expression through art therapy is an alternative way for SMs with PTSD and other PH conditions to communicate their lived experiences. This study offers the first systematic examination of the associations between visual self-expression and standardised clinical self-report measures. Design Observational study of correlations between clinical symptoms of post-traumatic stress, depression and anxiety and visual themes in mask imagery. Setting The National Intrepid Center of Excellence at the Walter Reed National Military Medical Center, Bethesda, Maryland, USA. Participants Active-duty military SMs (n=370) with a history of traumatic brain injury, post-traumatic stress symptoms and related PH conditions. Intervention The masks used for analysis were created by the SMs during art therapy sessions in week 1 of a 4-week integrative treatment programme. Primary outcomes Associations between scores on the PTSD Checklist–Military, Patient Health Questionnaire-9 and Generalized Anxiety Disorder 7-item scale on visual themes in depictions of aspects of individual identity (psychological injury, military symbols, military identity and visual metaphors). Results Visual and clinical data comparisons indicate that SMs who depicted psychological injury had higher scores for post-traumatic stress and depression. The depiction of military unit identity, nature metaphors, sociocultural metaphors, and cultural and historical characters was associated with lower post-traumatic stress, depression and anxiety scores. Colour-related symbolism and fragmented military symbols were associated with higher anxiety, depression and post-traumatic stress scores. Conclusions Emergent patterns of resilience and risk embedded in the use of images created by the participants could provide valuable information for patients, clinicians and caregivers.

Facilitative Leadership: A Framework for the Creative Arts Therapies.

ABSTRACT We propose a leadership framework for the creative art therapies (CATs) as a means to affect the sociopolitical contexts of our clinical and scholarly practices. The new model of facilitative leadership includes 3 aspects: developing the self, developing others, and envisioning a creative and just future.

Evolving Identities: The Person(al), the Profession(al), and the Artist(ic)

Abstract In this viewpoint, the author shares some experiences of living in the United States for the past 16 years and explores the uses of art and narratives in uncovering bias, illustrating lived experience, and informing research enterprises. In addition, contradictions, vulnerabilities, and complexities that underlie evolving constructions of culture, diversity, and identity beyond simple storylines and categorizations are highlighted.