The Recovery Tree

Research and planning

Today on placement I completed a creative arts group based session with a group of stroke survivors in a residential rehab setting. The benefits of engaging with art after having a stroke are becoming increasingly recognised. As discussed within the research by Morris et al (2014) and Beesley et al (2011) participation in art based projects can increase self-esteem, improve mood and therefore have a positive impact on physical recovery. Similarly discussed in this inspiring article Art and Stroke Recovery. Based at the Manchester Royal Infirmary these art group sessions are held every 2 weeks and support stroke survivors in the long term to build their confidence, regain independence and improve quality of life. Art can bring to life old interests/hobbies or inspire individuals to learn new hobbies.

While planning my group, I took my research findings into consideration and thought about the client group I would be working with. I would only be running the group for one morning so my goals and aims are for the very short term. Also taking into account the environment/setting - the clients would only stay there for 6 weeks of intensive rehabilitative therapy, so very short term at this early stage of their road to recovery after stroke. My main aims for the group where to address the individual needs of the clients and to incorporate aspects of their individual therapy programs into the group activity. 

A check list I created highlighting the aims and focus of therapy my group session would cover

I created this form myself as a risk assessment checklist of stroke patients complex individual needs addressed within a group therapy session.

So, I needed to think of some ideas of activities that would address these complex needs! I came across this idea on Pinterest... 'The Tree of Many Colours' and this really inspired me to incorporate this idea into my group. As you may have read in my previous posts, I came up with some weaving project ideas which could then be easily incorporated into the tree based piece of artwork.

...And I adapted it to enable stroke patients to engage in the activity using just one hand (as they usually present with one sided weakness in an upper limb) by using a laminated sheet of paper, some velcro (I love velcro) and a bit of masking tape. What is it they say? Once an OT always an OT?

Why a tree?

I named my project The Recovery Tree. I thought the tree is an amazing symbol to represent stroke and the situations people are going through after stroke. A tree represents the condition. Each branch of the tree represents the carers and loved ones supporting the beautifully unique, patterned 'leaves' which of course represent the stroke survivor. The strong, atmospheric tree represents the condition, which has bought all of these people and connected them together. It also highlights the healing power of 'branching out' and sharing experiences with others that have been affected. A tree with it's ability to re-grow and blossom represents stroke recovery and neuroplasticity of the brain.

The activities.

Being within a group setting and collaborating with others to create a piece of art work addresses the aims and goals within the patients short term therapy programmes. To complete the activities I had planned the patients would need to use; complex concentration skills, skills in following and of course remembering instructions, communicating with others, use a range of sensory mixed media materials to promote sensory recovery, visual scanning as well as involving their affected upper limb, fine motor control, managing fatigue levels and their sitting tolerance... and of course they have to be motivated....Wow.

The fun part of planning.

I love feeling inspired and creating! This placement has enabled me to do both of these things and I am very grateful for the experiences and amazing people I have met along the way. Here I am preparing the tree.

The group.

I gained verbal consent for participation in my group therapy session and 6 clients chose to join in. Each client with their own individual needs in their road to stroke recovery. With the assistance of an OT, a therapy assistant and a student physio, I prepared the room for my session. The clients were seated in a group together instead of the usual groups of separate tables. I presented the clients with a wide variety of art materials and placed them onto the table. I also placed down sheets of paper with different sized circle shapes drawn on to them (Great for visual scanning) and placed down the weaving CD activities. I explained the project and visuals were offered to the hard of hearing clients. I showed them the tree and asked if they could help me decorate it with bright colours.

Some clients chose to weave while others chose to colour in, collage or paint. The group fell silent with the high level of concentration! Weaving with wool sparked some lovely conversations about knitting hobbies amongst individuals. Whereas the activity also promoted conversations about doing new things and new hobbies to aid in recovery. Clients seemed to really enjoy choosing their favourite colours and patterns to decorate their small individual pieces. Some clients required some motivation and guidance during the activity and this worked well.

The clients required some re-assurance as I do find when you mention engaging with art to most people in general they have an anxious reaction claiming "Oh no I can't draw" or "I don't have a creative bone in my body." Well I believe everyone has a creative side hidden within them somewhere... and when you see the finished product I'm sure you will agree. The clients worked so hard and some concentrated for up to 2 hours! Some clients are having to re-train their brain to use their previously non-dominant hand and turn it into their now dominant hand! That is such a difficult thing to do and this activity was really good practice for fine motor control regarding this.

The final product.

After working so hard, the clients returned to their rooms for a well deserved rest and cup of tea after a marathon 2 hour therapy session! The clients reported that they had enjoyed their morning and engaging in something a bit different :) Here's what you've all been waiting for...

The Recovery Tree

A collaborative therapy project by Victoria Jones and participating stroke survivors

Acrylic and mixed media on canvas. 80cm X 80cm.

References

Beesley K, White J. H, Alston M. K, Sweetapple A. L & Pollack M. (2011) 'Art after stroke: the qualitative experience of community dwelling stroke survivors in a group art programme', Disability and rehabilitation, 23-24 pp. 2346-2355.

Health + Culture (2015) Art and Stroke Recovery Available at: http://www.healthandculture.org.uk/programmes-artists/programmes/art-and-stroke-recovery/. Accessed: 5th May 2015.

Morris J. H, Kelly C, Toma M, Kroll T, Joice S, Mead G, Donnan P, Williams B (2014) Feasibility study of the effects of art as a creative engagement intervention during stroke rehabilitation on improvement of psychosocial outcomes: study protocol for a single blind randomised control trial: the ACES study. Open access journal available at: http://www.trialsjournal.com/content/pdf/1745-6215-15-380.pdf. Accessed: 5th May 2015.