The inpatient playroom at the Children’s Hospital of the King’s Daughters in Norfolk is filled with toys. It’s a colorful refuge for children being treated at CHKD for everything from cardiac to kidney disease. One wall is filled with kids’ artwork, and another is all windows. Between surgeries and tests, kids of all ages come here to play and try to pretend that life is normal.

Twice a week, two smiling women enter the playroom, pushing a big plastic cart filled with art and music supplies.

As the children gather around, the women help the kids choose an activity. Do you like art or music? What kind of music? Which instrument would you like to play? Would you rather paint or draw?

As the children begin working on projects, Leigh Ann Dickinson, an art therapist, and Leslie Magee, a music therapist, talk to them about their feelings and what the art means to them. This helps the children heal mentally, physically, and emotionally, the women say. And while the kids immerse themselves in music and art, they find a way to escape the hospital setting, if only for a moment.

“It’s not just the product,” said Leigh Ann, who’s in her early 50s. “It is the process that is very healing.” She and Leslie, 30, are part of the Hospital School Program, a partnership between Norfolk Public Schools and CHKD. Their work with these special children is heartwarming.

CREATIVE OUTLET

Recently three boys ages 7 to 15 waited for the therapists in the playroom. Two of them had cancer and would be in and out of the hospital for a while. After joining the boys around a table, the therapists played a Rascal Flatts song and then talked about the song with them—how it made them feel.

Leslie gave them copies of the lyrics, but with words missing, and together they came up with their own words to the song. When they were done, Leslie played it for them, singing their words.

“It’s really powerful for kids to hear their words sung back to them,” she said.

The next day, the boys recorded the song, singing along and playing the guitar, and Leslie burned it onto a CD they could share with their friends. Leigh Ann helped them design the cover. One of the boys drew a cancer ribbon but with multiple colors to represent all diseases, and the other boy drew a lion because they named their song “Rawr.” They layered the two images one on top of the other, with the lion’s head coming through the ribbon, to decorate the front of their CD.

“I’m not teaching them with the goal of making music,” Leslie said. “I’m teaching them with the goal of social interaction or emotional expression or aesthetic expression, giving them a creative outlet.”

EMOTIONAL CHALLENGES

Art is a part of every child’s learning, whether it’s at home or at school. The process of creating art helps children develop positive attitudes, build confidence, control behavior, and sharpen problem-solving skills. Art therapy goes a step further. It is creating art to achieve a non-artistic goal, using the process to help with physical, mental, or emotional health issues.

Mary Roberts, an art therapist in private practice and also art therapy program director at Eastern Virginia Medical School, says art therapy is an important therapeutic tool.

“The art therapist is trained to make clinical decisions about how and what art media is going to help the client or a patient be able to work through those emotional challenges,” she explained.

When children are more stressed than normal, art therapy can help, Mary said. When stress starts to impact daily functioning, engagement in activities, school or relationships, art therapy is useful to help discover an underlying cause behind a child’s problem behavior, such as a traumatic experience. Art therapy can also be used to help a child build confidence by joining in a group art project.

NEW WAYS OF COPING

Just as a doctor will give a patient a prescription for an illness, an art therapist devises a treatment plan for each individual patient.

“There’s no recipe book for art therapy,” Mary said. When a new patient comes in, she assesses him or her using a series of drawings to better understand the patient’s challenges and opportunities for growth. Together they come up with goals and a treatment plan for achieving them.

Therapy takes on many forms, and children often use their own imagination, symbols, and metaphors to solve problems. “When it comes to difficult situations or trauma that they need to work through, the art process can help them do that in metaphors and stories verses having to relive,” Mary said. She might use painting or clay to help children express something that’s troubling them and guide them into putting anxiety into something else besides their behavior.

In one particular case, Mary was able to help a teenage boy with obsessive-compulsive disorder identify and control his thoughts. “By participating in art therapy, he could draw out those obsessive thoughts and get them outside of himself, identify new ways of coping, and therefore he would not act on them,” she said.

SECRETS IN A BOX

At CHKD, Leslie and Leigh Ann assess patients more informally. They get a feel for what a child is interested in and whether she prefers music or art. Either way, they want to know what the child will enjoy.

“If they don’t enjoy it, it’s not going to work,” Leslie said.

If a child is going through physical therapy, Leslie might use music to practice actual physical strength. For example, she might lay a drum on the floor and let the patient kick it to help expand range of motion in the child’s leg. “Kids are motivated by rhythm and by music,” she said. “When they’re able to focus on that, they don’t even realize that they’re in a physical therapy session.”

Leslie often asks the children to sing a few songs while they are standing in physical therapy, which helps them take their mind off their physical challenges and focus on something else. If they’re stressed, she’ll help them relax by playing music for them and teaching them deep- breathing techniques.

In group sessions, she might let children take turns leading a drum circle, where they decide how soft or loud or fast or slow they want to play. The patients are in control.

“It’s their session,” Leigh Ann said. “It’s about what they can gain from that session to reduce their stress, increase self awareness, achieve insight.”

Sometimes Leigh Ann brings boxes for the children to play with. “A lot of times they need to put secrets into something,” she said. “We’ll make boxes that they can put secrets in or things that are bothering them, and they take them out when they’re ready. It empowers them to bring it out when they want to.”

A CHILD’S STORY

It is important for parents to be able to recognize when their child is experiencing stress that may meet the level of needing art therapy, Mary said. But even at home, parents can help their children communicate through art. Using art or music to express angry feelings can be a healthy outlet, for example.

Parents should be curious about their children’s artwork, according to the Virginia Art Therapy Association, and ask them about it without interpreting it. Children should have the freedom to tell you what they drew, not what you think they drew.

“Focus on your child’s process rather than their final product,” the website advises. “For instance, try saying ‘I love the way you blended those colors!’ or ‘The feathers on your bird are so detailed’ rather than ‘It’s a really pretty painting.’”

Leslie’s best advice for parents is to listen to their kids. She suggests kids be given choices in the kinds of music they listen to, and when it comes to art, let them choose the materials. Then let them communicate through art and listen to their stories.

“I love letting a child’s story unfold through their expression,” Leigh Ann said, “and being a part of that with them.”

CHKD
EVMS Art Therapy Program
Virginia Art Therapy Association
American Art Therapy Association

Jessica Wilde is a freelance journalist who lives in Hampton