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Foster Care Youth Who Have Experienced Childhood Trauma Benefit More From Expressive Art Therapy Than Foster Care Youth Who Only Participate in Traditional Counseling

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According to the Code of Federal Regulation, under title 45, foster care is defined as a “24 hour substitute care for children outside their own homes.” It is a child protective service available across the country, within rural and urban cities. This protective service is comprised of billions of dollars and thousands of professionals helping struggling parents and vulnerable children

According to the 2016 Adoption and Foster Care Analysis and Reporting System (AFCARS), some circumstances where a child or adolescent is pulled out of a home and placed into the system include neglect, physical, and sexual abuse.

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Creative arts therapy is a widespread approach in the treatment of child post trauma disorders. It includes different modalities of art, music, dance and drama in combination with other approaches to psychotherapy and counselling, such as psychodynamic, cognitive, developmental, systems, and narrative therapy. The use of art therapy practise varies and can be described on a continuum, ranging from using arts as an adjunct in verbal psychotherapy to art engagement without verbal analysis, and several gradations in between. Creative arts therapies used as a primary form of therapy requires graduate-level training in one or more modalities. Creative arts is also used by counsellors or other qualitied mental health professionals in facilitating different stages in psychotherapy. When using creative arts in this way as an adjunct, the key is to understand the various treatment goals and to carefully select creative arts activities that can support this process. Mental health professionals can be offered training in applying creative arts activities in psychotherapy, but at all times it is important to avoid challenging ethical boundaries by going beyond what someone was trained to do. Therefore, another explanation for our programme evaluation results may be that the circumstances of ongoing adversity are impeding the potential therapeutic benefits of the intervention. We also noticed that most trauma treatment studies in a developing context have focused solely on PTSD and internalizing symptoms as outcome measures. Perhaps other outcomes such as externalizing responses, but also resilience, self-confidence, and social support could be more relevant in a setting of poverty, hardships and crime and should be an essential focus in future studies.

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The idea that creative expression can make a powerful contribution to the healing process has been embraced in many different cultures. Throughout recorded history, people have used pictures, stories, dances, and chants as healing rituals (Rockwood-Lane M, 1994)

There has been much philosophical and anecdotal discussion about the benefits of art and healing, but less empirical research exists in the literature. In fact, although arts therapy has been used clinically for more than a century and has been recognized as a profession since 1991, much of the published work is theoretical in nature, with little discussion of specific outcomes. Only in recent years have systematic and controlled studies examined the therapeutic effects and benefits of the arts and healing. Nevertheless, we have seen positive outcomes for the potential of using art to promote healing in our 4 primary areas of focus. This article is not meant to be a comprehensive review of all of the literature available (other authors have provided comprehensive overviews in areas such as music therapy and expressive writing). Instead, it represents a sampling of the many potential benefits of art in enhancing health and wellness. With respect to research methodology, the qualitative data focused on the meaning-making process of the arts and healing, and examples were provided of how art-based programs can contribute to wellness. Qualitative studies that report individual and unique results through rich descriptions and data could complement the use of quantitative methods (Monti DA, Peterson C, 2006). Both are needed to understand creative engagement and health effects among generalized populations with unique individual differences.

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In the long run, research on the application of group expressive arts therapy with children and adolescents who have been traumatized appears to be limited in comparison to other fields in the helping profession, despite the enormous benefits it can offer the population. Agreeable, creative techniques should be used both for research purposes, with the intent of better understanding children's experience directly from children, and as a therapeutic intervention

More documented research with larger and diverse sample sizes is recommended in an effort to validate, strengthen, and obtain the due recognition the field deserves.

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Kreitzer M, Snyder M. Healing the heart: integrating complementary therapies and healing practices into the care of cardiovascular patients. Prog Cardiovasc Nurs 2002;17(2):73–80

Ulrich R, Lunden O, Eltinge J. Effects of exposure to nature and abstract pictures on patients recovering from open heart surgery. J Soc Psychophysiol Res 1993;30:7

Rockwood-Lane M, Graham-Pole J. Development of an art program on a bone marrow transplant unit. Cancer Nurs 1994;17(3):185–192

Tusek DO, Cwynar R, Cosgrove DM. Effect of guided imagery on length of stay, pain and anxiety in cardiac surgery patients. J Cardiovasc Manag 1999;10(2):22–28

Monti DA, Peterson C, Shakin Kunkel E, et al. A randomized, controlled trial of mindfulness-based art therapy (MBAT) for women with cancer. Psychooncology 2006

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