Art Therapy for Individuals with Cancer
Malinda Ann Hill

AGE RANGE, CHARACTERISTICS & TREATMENT SETTING
The special population I have chosen to work would be young adults, ages 21-30, with cancer. This would be a short term art therapy group that would provide emotional support to these individuals. The treatment setting would most likely be an out-patient setting. The treatment goal would be to help each individual learn to cope with the psychological and emotional issues related to the disease.

SPECIAL CONSIDERATIONS, NEEDS & COURSE OF TREATMENT
Individuals fighting cancer must deal with physical discomfort and pain on a daily basis. Therefore, appropriate and flexible weekly goals are extremely important. Art therapy interventions should be specifically designed to integrate the physical problems and emotional concerns that these clients must deal with on a daily basis. Coping and problem solving skills should be addressed though individual imagery and group discussion.

Each session should begin with a warm-up, relaxation exercise. It is important that individuals with cancer learn how to relax their muscles. The art therapist can guide the group in a guided imagery in order to achieve this bodily relaxation before each art therapy session begins.

This group would meet once a week for eight to ten consecutive weeks. Since this is an intensive, time-limited experience, group members must be committed to attend each session. However, it should be expected that attendance may vary due to complications of each individual's illness and course of treatment.

Session length for group sharing should be approximately 90 minutes to 2 hours, depending on the number of participants and their physical stamina. Ideally, groups should include between six to eight members, in order to encourage intimacy and insight.

ART THERAPY DIRECTIVES, GOALS & ISSUES
The overall goal of the art therapy group is to provide support and a safe place for problem solving and mutual understanding. Ultimately, the art therapy processes should help participants move from isolation to connection, from powerlessness to personal empowerment, and from denial to hope. This group also becomes a safe place to explore feelings of anger, loss, and fear.

Group members should be encouraged to find ways to cope with their feelings and issues associated with their disease. Through the art process, group members can be nurtured by the colorful media and the creative opportunity for self-expression and sharing with others. The artwork produced allows an opportunity for group support and also serves as a safe outlet to express overwhelming emotions.

As with any group, an initial goal is to help facilitate cohesion among the group members by creating a place for safe self-expression. For young adults with cancer, the group should be a source of immediate support and acceptance, against the uncertainty and vulnerability of the disease.

An early directive in such a group may be "draw symbols or choose collage pictures as a way to introduce yourself to the group." Another similar directive that could be used is "trace your hand and then decorate it to symbolize yourself." After the artworks are completed, the group members would spend time discussing their images with the group. This type of directive can help clients express their individuality creatively, as well as facilitate sharing and understanding among the participants.

When faced with a potentially fatal illness, hope can be the individual's reason for continuing to endure the daily struggles with chemotherapy or radiation treatments. In an art therapy group, the imagery can serve as a potent reflection of self-empowerment, helping individuals to facilitate self-nurturance and personal control. One art therapy directive that could help reach this goal is "draw three or four images to show ways you help yourself feel better."

A group mural can allow members a chance to symbolically give something to, and receive something from, the other participants. When used as part of the last session, the mural can help group members deal with good-byes and the issue of loss on a positive and personal note.

A very powerful directive that can be used to end the group is a three-part directive given as follows: (1) draw or use collage to create a symbol of yourself; (2) cut out the symbol and place it on the group paper; (3) take a turn visually connecting with the artwork of others as a way of saying good-bye. This art task can help facilitated the giving and receiving an support and helped the members reach closure though a very meaningful visual "good-bye."

CONCLUSION
Group art therapy provides the patient with an empathic community where mutual concerns, needs and fears can be explored. This support system encourages communication and awareness. Art therapy allows individuals with cancer to use their creativity to help themselves to cope with their physical illness. In a group setting, the art therapist can encourage these individuals to explore their issues concerning the cancer through visual expression and group discussion. When group members share their artworks with others, they find that they are understood and supported by others. Exploring their personal imagery in the group can help clients individually find inventive ways to cope with their pain and encourage their own healing.