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Healing Through Art: Co-Creating Trauma-Informed Spaces

Shean Hinds PGY2

Haorui Sun PGY1, Himabindu Ekanadham Attending Physician, Janani Prasad PGY2, Martha Renn PGY2

New York Presbyterian- Columbia

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Disclosures

We have no actual or potential conflict of interest in relation to this presentation

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Agenda / Goals:

Discuss the process of creating healing spaces
Discussion of trauma-informed care as a concept and as a practice.
Discussion of arts-based and narrative medicine as tools for reflecting and processing individual and shared trauma.
Group based activity
Reflection session

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How do we create healing spaces?

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Healing spaces evoke a sense of cohesion of the mind, body, and spirit. They support healing intention and foster healing relationships.

DuBose J, MacAllister L, Hadi K, Sakallaris B. Exploring the Concept of Healing Spaces. HERD. 2018 Jan;11(1):43-56. doi: 10.1177/1937586716680567. Epub 2016 Dec 18. PMID: 29514569.

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SAMHSA’s definition of individual trauma: “an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being.”

ACE’s

Time goal: 3 mins

Trauma is extremely prevalent, approximately 70% of the world’s population has been exposed to a traumatic life event and approximately 30% has been exposed to 4 or more traumatic events
There is no universal definition of trauma, however, Can occur at any age and to any person - but we must remember our most vulnerable populations are often repeatedly exposed to various forms of trauma.
Experiencing trauma, especially in childhood, increases risk of serious health conditions including chronic lung, liver and heart disease as well as depression and substance use.
One category not included in the above the image is system induced (removal from home, admission to detention/residential facility, multiple placements over a short time) Trauma can occur in the medical setting as well

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Trauma-Informed Care

Art-based therapy

Narrative Medicine:

Tools for responding to individual and shared trauma

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A trauma informed approach acknowledges the prevalence of trauma and aims to provide autonomy and control to patients as they interact with the medical establishment
The goal of a trauma informed approach is to adopt a set of practices that embody the areas listed above

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https://www.youtube.com/watch?v=fWken5DsJcw&ab_channel=CenterforHealthCareStrategies

https://www.traumainformedcare.chcs.org/what-is-trauma-informed-care/

https://www.samhsa.gov/programs

https://store.samhsa.gov/sites/default/files/sma14-4884.pdf

Trauma-informed care seeks to:

Realize the widespread impact of trauma and understand paths for recovery;
Recognize the signs and symptoms of trauma in patients, families, and staff;
Integrate knowledge about trauma into policies, procedures, and practices; and
Actively avoid re-traumatization.

(CDC/SAHMSA)

As humans, we all have biases based on our own unique lived experience. It’s important that we broaden our understanding of trauma and check our biases in order to properly recognize and address trauma in all of its various forms. Events some may not consider traumatic can have a traumatic impact on others.

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Trauma Informed	Non-Trauma Informed

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Art therapy is more specifically mental health care for individuals who have experienced trauma, as opposed to trauma informed care, which is an approach to providing �all healthcare. �
This is a tool that allows patients who have difficulty verbalizing trauma to process & engage with their experiences and can help balance emotional dysregulation �in response to stressors

The next modality of responding to trauma is art therapy
Art therapy is more specifically mental health care for individuals who have experienced trauma, as opposed to trauma informed care, which is an approach to providing all healthcare.
The field integrates literary, performing, and visual arts and design, and other forms of creative expression into a variety of healthcare and community settings to enhance health and well-being in diverse institutional and community contexts
This is a tool that allows patients who have difficulty verbalizing trauma to process and engage with their experiences and can help balance emotional dysregulation in response to stressors
Taking this a step further - this could be a tool that allows healthcare workers to process their chronic traumas experienced by working the medical field

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https://arts.ufl.edu/academics/center-for-arts-in-medicine/about/what-is-arts-in-health/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764181/

https://docs.fntn.ca/VC12761/Handouts/Art%20therapy%20Pp.pdf

https://www.oregon.gov/oha/HSD/BH-Child-Family/Documents/Presentation%20-%20Trauma-Informed%20Care.pdf

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Narrative Medicine

“... the capacity to recognize, absorb, metabolize, interpret, and be moved by stories of illness.” Rita Charon

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Narrative Medicine: Group Read

Narrative Medicine

Trauma for the Patient—and Physician

Abedi, Sarah MD

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Activity

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Show us what healing means to you.

Create a visual representation of a Healing Space.

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Show & Tell

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Wrap up / Reflection

What were some common themes in the group’s healing spaces?
What is missing from these healing spaces?
What did you take away from this exercise for your clinical practice?

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Resources

Find an Art Therapist:

New York State Art Therapy Association https://www.nyarttherapy.org/findanarttherapist
NYC Well: https://nycwell.cityofnewyork.us/en/
Psychology Today: https://www.psychologytoday.com/us

Narrative medicine

Columbia Narrative Medicine: https://narrativemedicine.blog/

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Thank you!