Complementary Therapies in the Rehabilitation of Brain Injury

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1 Complementary Therapies in the Rehabilitation of Brain Injury Tori Kline, MA, CBIS Chris Igidbashian, MA, MT-BC Julie Bauer, MOT, OTR/L, CBIS Annawyn Laing, BS, CBIS, E-RYT

2 - Creative Arts Therapies - Intro to the CAT s - Art Therapy - Music Therapy - Mindfulness, Yoga & Meditation - Mindfulness - Yoga Outline

3 Learning Objectives

4 The Creative Arts Therapies (CAT s) Creative Arts Therapists are human service professionals who use arts modalities and creative processes for the purpose of ameliorating disability and illness and optimizing health and wellness. Treatment outcomes include, for example, improving communication and expression, and increasing physical, emotional, cognitive and/or social functioning. -NCCATA, 2015

5 CAT s Include Art therapy Music therapy Dance/ movement therapy Drama therapy Poetry therapy Group psychotherapy/ psychodrama

- Art Therapy (ATx) is a mental health profession in which clients, facilitated by the Art Therapist, use art media, the creative process, and the resulting artwork to explore their feelings,

6 - Art Therapy (ATx) is a mental health profession in which clients, facilitated by the Art Therapist, use art media, the creative process, and the resulting artwork to explore their feelings, reconcile emotional conflicts, foster self-awareness, manage behavior and addictions, develop social skills, improve reality orientation, reduce anxiety, and increase self-esteem. - AATA, 2015 Art Therapy

7 Benefits of Art Therapy -Imagery -Decreased defenses -Objectification -Permanence -Spatial matrix -Self-esteem enhancement -Creative and physical energy (Wadeson, 2010)

Art, Creativity & the Brain Art-making as o an inherently healing process o a mind-body connection o a bilateral process o a bridge between implicit

between creative behavior and activity within/between different brain circuits -Jung, et al.

8 Art, Creativity & the Brain Art-making as o an inherently healing process o a mind-body connection o a bilateral process o a bridge between implicit and explicit o a nonverbal process o a positive coping mechanism o a means to communicate & express oneself o a sublimating process Creativity o Link between creative behavior and activity within/between different brain circuits -Jung, et al., 2010 o Decision-making/ problem solving strengthens the brain and supports plasticity o Creativity utilizes constructs of divergent thinking, fluid intelligence, insight, flow and an open/accepting environment

9 Bilateral/ Annotated Scribble Drawing ATx Experiential

10 Music Therapy What is music therapy? Music Therapy is an established health profession in which music is used within a therapeutic relationship to address the physical, emotional, cognitive and social needs of individuals. - AMTA, 2015

11 Music Therapy What happens in music therapy? Following assessment of client strengths, the qualified music therapist provides the indicated treatment including: o o o o o Playing instruments Singing Moving to music Listening to music Discussing lyrics, drawing parallels between music and life outside music

Benefits of Music Therapy Anxiety and stress reduction Nonpharmacological management of pain and discomfort Positive changes in mood and emotional states Active and

12 Benefits of Music Therapy Anxiety and stress reduction Nonpharmacological management of pain and discomfort Positive changes in mood and emotional states Active and positive patient participation in treatment Improved respiration Lower blood pressure Improved cardiac output Reduced heart rate Relaxed muscle tension - AMTA, 2015

13 Music Therapy Experiential Group Chain Reaction Improvisation

14 Mindfulness, Yoga & Meditation Acceptance Patience Non-judgment Awareness Presence

Roots can be traced back through religion and history for thousands of years Has become more Westernized and mainstream over past 40 years A form of meditation

15 Roots can be traced back through religion and history for thousands of years Has become more Westernized and mainstream over past 40 years A form of meditation Anything can be done mindfully Mindfulness is paying attention in a particular way: on purpose, in the present moment, and non-judgmentally. Jon Kabat-Zinn Mindfulness

16 Mindfulness......as a therapeutic intervention: Low lights, avoid fluorescent lights Soft music, different types for different people and situations Being comfortable with moments of silence Reviewing key concepts Orientation to session plan Provide visual example and repetition of instructions for activities Break activity down into small steps Guided activities, structured reflection

Yoga Ancient Art of Healing that is minimally 5,000 years old Biggest misconception is that you have to be limber and flexible to participate in yoga Yoga not only consists of stretching postures,

17 Yoga Ancient Art of Healing that is minimally 5,000 years old Biggest misconception is that you have to be limber and flexible to participate in yoga Yoga not only consists of stretching postures, but is a complete philosophy that includes overall psychological and physical wellness Yoga and Meditation have scientifically been proven to calm the mind, reduce cortisol levels and assist an individual in finding balance in one s life through self awareness Is a great activity to add to one s daily life, even if you only have 12 seconds

18 Sleep Cortisol levels, hormones Stress Management Coping Skills Attention Self Awareness Pain Management Breath Control Socialization/community Memory/learning Self-Regulation Emotional Regulation Problem solving Mental Flexibility Benefits of Mindfulness/Yoga

19 Mindfulness/Yoga Experiential Guided Chair Yoga, followed by Mindfulness Meditation Wrap-Up

20 Questions?

21 References AATA, 2015 NCCATA, 2015 Wadeson, 2010 Azulay J, Smart C, Tasha M, Cicerone K, Caplan B, Bogner J. A pilot study examining the effect of Mindfulness-Based Stress Reduction symptoms of chronic mild traumatic brain injury/postconcussive syndrome. Journal of Head Trauma Rehabilitation. 2013;28(4): doi: /HTR.0b013e318250ebda Davis DM, Hayes JA. What are the benefits of mindfulness? Psychotherapy. 2011;48(2): Emerson D, Sharma R, Chaudhry S, Turner J. Yoga therapy in practice trauma-sensitive yoga: Principles, practice, and research. International Journal of Yoga Therapy. 2009;19: Hartfiel N, Havenhand J, Khalsa SB, Clarke G, Krayer A. The effectiveness of yoga for the improvement of well-being and resilience to stress in the workplace. Scand J Work Environ Health. 2011;37(1):70 76 Johansson B, Bjuhr L, Ronnback L. Mindfulness Based Stress Reduction (MBSR) improves long term mental fatigue after stroke and brain injury. Brain Injury. 2012; Kirkwood G, Rampes H, Tuffrey V, Richardson J, Pilkington K. Yoga for anxiety: a systematic review of the research evidence. British Journal of Sports Medicine. 2005;39(12): Kuboy, M. Impact of traumatic brain injury on mindfulness in veterans who have PTSD. Master of Social Work Clinical Research Papers. 2015;Paper Sharma R, Gupta N, Bijlani RL. Effect of yoga based lifestyle intervention on subjective well-being. Indian J Physiology Pharmacology. 2008;52(2): Ulrichsen KM, Westlye LT, Kaufmann T, Dørum ES, Kolskår KK, Richard G, Alnæs D, Arneberg TJ and Nordvik JE (2016). Clinical utility of mindfulness training in the treatment of fatigue after stroke, traumatic brain injury and multiple sclerosis: A systematic literature review and meta-analysis. Front. Psychol. 7:912. doi: /fpsyg

Mindfulness. Mandakini Sadhir, MD Assistant Professor Division of Adolescent Medicine Department of Pediatrics UK HealthCare

Mindfulness. Mandakini Sadhir, MD Assistant Professor Division of Adolescent Medicine Department of Pediatrics UK HealthCare Mindfulness Calligraphy by Thich Nhat Hanh Mandakini Sadhir, MD Assistant Professor Division of Adolescent Medicine Department of Pediatrics UK HealthCare Adolescence Marked by pubertal growth, psychosocial