Art therapy as support for children with leukemia during painful procedures

Background. Children with leukemia undergopainful procedures such as lumbar punctureand bone marrow aspiration. To overcome pain,certain units offer total anesthesia; others offergeneric support; others offer no preparation atall. Since September, 1997, we have providedleukemic children with art therapy (AT), anonverbal and creative modality that developscoping skills. Our goal is to prevent anxiety andfear during painful interventions as well asprolonged emotional distress. Procedure. Wetreated 32 children aged 2±14 years. The modesof AT before, during, and after the punctureswere as follows: clinical dialogue to calmchildren and help them cope with painfulprocedures; visual imagination to activate alternativethought processes and decrease theattention towards overwhelming reality andraise the peripheral sensitivity gate; medicalplay to clarify illness, eliminate doubts, and offercontrol over threatening reality; structureddrawing to contain anxiety by offering astructured, predictable reality (the drawing) thatwas controllable by children; free drawing toallow children to externalize confusion andfears; and dramatization to help children acceptand reconcile themselves to body changes.Results. Children hospitalized before September,1997, exhibited resistance and anxietyduring and after painful procedures. By contrast,children provided with AT from the ®rsthospitalization exhibited collaborative behavior.They or their parents asked for AT whenthe intervention had to be repeated. Parentsdeclared themselves better able to managethe painful procedures when AT was offered.Conclusions. AT was shown to be a usefulintervention that can prevent permanent traumaand support children and parents during intrusiveinterventions.