Abstracts

Rationale: Children with chronic illnesses, including epilepsy, tend to have a low self-image, difficulties with peer identity, and a less optimistic view of future functioning. Children with epilepsy feel a strong social stigma and are often reluctant to discuss their disorder with peers. Art therapy is an effective modality to address the emotional and psychological challenges that affect children and adolescents. However, art techniques have been vastly underutilized in epilepsy. In our preliminary study, we asked 105 children with epilepsy to draw a picture of themselves having a seizure (Seizure Drawing Task) (Epilepsy Behav 4:43-56, 2003). Drawing features suggested impaired self-concept and the sense of helplessness and vulnerability. We hypothesized that art therapy focus groups would be an effective way to explore and enhance the self-image of children with epilepsy. Methods: This study used combined neurological evaluation by an epileptologist (CES) with assessment and psychosocial intervention by art therapists (JH, AK). Participants included 14 children with epilepsy, ages 7 to 18. Baseline assessments consisted of checklists and an art assessment battery. Checklists included: Piers-Harris Self-Concept Scale (PHSCS); Child Adjustment to Illness Scale (CATIS); Impact of Childhood Neurological Disability Scale (ICNDS). The art therapy assessment battery included: Seizure Drawing Task (SDT), Levick Emotional and Cognitive Art Therapy Assessment (LECATA) screen for cognitive and emotional development; and Formal Elements Art Therapy Scale (FEATS). After screening, children attended a series of four 1-1/2 hour art therapy groups. Each session included a different discussion topic and art activity designed to facilitate positive adjustment to epilepsy. The CATIS was re-administered at the conclusion of the last art therapy session. Results: All baseline scores were within the normal range. No correlation was found between PHSCS, CATIS, and ICNDS. Pre-CATIS scores were higher than those reported for children with epilepsy in other studies. No measurable correlation was found between checklists and the art therapy assessments. There was no change in CATIS scores before versus after art therapy groups. A trend was seen between the Seizure Drawing Task score and the LECATA average score. Despite these negative quantitative measures, there was marked enthusiasm among participants regarding the bonding and social aspects of the groups. Conclusions: The trend in correlation between the Seizure Drawing Task body score and LECATA screen confirms the findings of our previous study. Although there was no change in pre- and post-CATIS scores, anecdotal information from participants and their parents, and data from the art therapy sessions indicate that participants’ self-esteem and adjustment were enhanced by their participation in the art therapy groups. Our findings suggest that art therapy focus groups are useful for improving the self-concept of children with epilepsy.