Abstract
To overcome barriers that prevent women with breast cancer from attending support groups, innovative formats and modes of delivery both need to be considered. The present study was part of an interdisciplinary program of research in which researchers from counseling psychology, psycho-oncology, nursing, computer science, and fine arts have explored art making as an innovative format and telehealth as a mode of delivery. For this study, we conducted focus groups and interviews with 25 people with expertise about breast cancer, art, art therapy, and distance delivery of mental health services to generate guidelines for distance art-based psychosocial support services to women with breast cancer. A qualitative analysis of the focus group and interview data yielded guidelines for developers and facilitators of distance art groups for women with breast cancer pertaining to (a) emotional expression, (b) emotional support, (c) emotional safety, and (d) accommodating individual differences, plus special considerations for art therapy groups. Further research is needed pertaining to the use of computers, involvement of art therapists, and screening out vulnerable clients.
Similar content being viewed by others
References
Anand SA, Anand VK (1997) Art therapy with laryngectomy patients. Art Ther 14:109–117
Andersen BL, Farrar WB, Golden-Kreutz DM, Glaser R, Emery CF, Crespin TR, Shapiro CL, Carson WE III (2004) Psychological, behavioral, and immune changes after a psychological intervention: a clinical trial. J Clin Oncol 22:3561–3580
Angell K, Kreshka MA, McCoy R, Donnelly P, Turner-Cobb JM, Graddy K, Kraemer HC, Koopman C (2003) Psychosocial intervention for rural women with breast cancer: the Sierra–Stanford partnership. J Gen Intern Med 18:499–507
Baider L, Peretz T, Hadani PE, Koch U (2001) Psychological intervention in cancer patients: a randomized study. Gen Hosp Psych 23:272–277
Baron P (1989) Fighting cancer with images. In: Wadeson H, Durkin J (eds) Advances in art therapy. Wiley, New York, pp 148–168
Bloom JW (1998) The ethical practice of webcounselling. Br J Guid Couns 26:53–59
Borgman E (2002) Art therapy with three women diagnosed with cancer. Arts Psychother 29:245–251
Cameron LD, Booth RJ, Schlatter M, Ziginskas D, Harman JE, Benson SRC (2005) Cognitive and affective determinants of decisions to attend a group psychosocial support program for women with breast cancer. Psychosom Med 67:584–589
Classen C, Koopman C, Angell K, Spiegel D (1996) Coping styles associated with psychological adjustment to advanced breast cancer. Health Psychol 15:434–437
Classen C, Butler LD, Koopman C, Miller E, DiMiceli S, Giese-Davis J, Fobair P, Carlson RW, Kraemer HC, Spiegel D (2001) Supportive–expressive group therapy and distress in patients with metastatic breast cancer: a randomized clinical intervention trial. Arch Gen Psychiatry 58:494–501
Collie K (2004) Interpersonal communication in behavioral telehealth: what can we learn from other fields? In: Bloom J, Walz G (eds) Cybercounseling and cyberlearning: an encore. American Counseling Association, Alexandria, pp 345–365
Collie K, Cubranic D (2002) Computer-supported distance art therapy: a focus on traumatic illness. In: Resnick H, Sade P (eds) Human services technology: innovation in practice and education. Haworth, Binghamton, pp 155–171
Collie K, Cubranic D, Booth K (1998) Participatory design of a system for computer-supported distance art therapy. In: Proceedings of the participatory design conference 1998. Computer Professionals for Social Responsibility, Seattle, pp 29–36
Collie K, Cubranic D, Long B (2002) Audiographic communication for distance counselling: a feasibility study. Br J Guid Couns 30:269–284
Collie K, Bottorff JL, Long BC (2006) A narrative view of art making by women with breast cancer. J Health Psychol (in press)
Curran VR, Church JG (1999) A study of rural women's satisfaction with a breast cancer self-help network. J Telemed Telecare 5:47–54
Dreifuss-Kattan E (1990) Cancer stories: creativity and self-repair. Analytic, Hillsdale
Eakin EG, Strycker LA (2001) Awareness and barriers to use of cancer support and information resources by HMO patients with breast, prostate, or colon cancer: patient and provider perspectives. Psychooncology 10:103–113
Edwards GM (1993) Art therapy with HIV-positive patients: hardiness, creativity and meaning. Arts Psychother 20:325–333
Fawzy FI, Fawzy NW, Hyun CS, Elashoff R, Guthrie D, Fahey JL, Morton DL (1993) Malignant melanoma: effects of an early structured psychiatric intervention, coping, and affective state on recurrence and survival six years later. Arch Gen Psychiatry 50:681–689
Fawzy FI, Canada AL, Fawzy NW (2003) Malignant melanoma: effects of a brief, structured psychiatric intervention on survival and recurrence at 10-year follow-up. Arch Gen Psychiatry 60:100–103
Fish SL (1990) Therapeutic uses of the telephone: crisis intervention vs. traditional therapy. In: Gumpert G, Fish SL (eds) Talking to strangers: mediated therapeutic communication. Ablex, Norwood, pp 154–169
Gabriel B, Bromberg E, Vandenbovenkamp J, Walka P, Kornbluth AB, Luzzatto P (2001) Art therapy with adult bone marrow transplant patients in isolation: a pilot study. Psychooncology 10:114–123
Gotay CC, Wilson ME (1998) Social support and cancer screening in African American, Hispanic, and Native American women. Cancer Pract 6:31–37
Gotay CC, Lau AK (2002) Preferences for psychosocial interventions among newly diagnosed cancer patients from a multiethnic population. J Psychosoc Oncol 20:23–37
Graetz KA, Boyle ES, Kimble CE, Thompson P, Garloch JL (1998) Information sharing in face-to-face, teleconferencing, and electronic chat groups. Small Group Res 29:714–743
Gustafson DH, Hawkins RP, Boberg EW, McTavish F, Owens B, Wise M, Berhe H, Pingree S (2002) CHESS: 10 years of research and development in consumer health informatics for broad populations, including the underserved. Int J Med Inform 65:169–177
Heiney S, McWayne J, Hurley TG, Lamb L, Bryant L, Butler W, Godder K (2003) Efficacy of therapeutic group by telephone for women with breast cancer. Cancer Nurs 26:439–447
Hiltebrand EU (1999) Coping with cancer through image manipulation. In: Malchiodi CA (ed) Medical art therapy with adults. Kingsley, London, pp 113–135
Koopman C, Hermanson K, Diamond S, Angell K, Spiegel D (1998) Social support, life stress, pain and emotional adjustment to advanced breast cancer. Psychooncology 7:101–111
Koopman C, Angell K et al (1999) Workbook–journal significantly reduces posttraumatic stress disorder symptoms among rural women with primary breast cancer. Psychooncology 8(Suppl):43
Kreshka MA (1997) One in eight: women speaking to women. Sierra–Stanford Partnership, Nevada
Krizek C, Roberts C, Ragan R, Ferrara JJ, Lord B (1999) Gender and cancer support group participation. Cancer Pract 7:86–92
Krueger RA (1994) Focus groups: a practical guide to applied research, 2nd edn. Sage, Thousand Islands
Levine EG, Eckhardt J, Targ E (2005) Change in post-traumatic stress symptoms following psychosocial treatment for breast cancer. Psychooncology 14:618–635
Lieberman MA, Golant M, Giese-Davis J, Winzelberg A, Benjamin H, Humphreys K, Kronenwetter C, Russo S, Spiegel D (2003) Electronic support groups for breast carcinoma. Cancer 97:920–925
Long JK (1998) Medical art therapy: using imagery and visual expression in healing. In: Camic PM, Knight SJ (eds) Clinical handbook of health psychology: a practical guide to effective interventions. Hogrefe & Huber, Seattle, pp 523–558
Luzzatto P, Gabriel B (2000) The creative journey: a model for short-term group art therapy with posttreatment cancer patients. Art Ther 17:265–269
Lynn D (1994) Myself resolved: an artist's experience with lymphoma. Meniscus, Philadelphia
Malchiodi CA (1997) Invasive art: art as empowerment for women with breast cancer. In: Hogan S (ed) Feminist approaches to art therapy. Routledge, London, pp 49–64
Malchiodi CA (2003) Using art therapy with medical support groups. In: Malchiodi CA (ed) Art therapy handbook. Guilford, New York, pp 351–361
Michalec B, Van Willigen M, Wilson K, Schreier A, Williams S (2004) The race gap in support group participation by breast cancer survivors: real or artifact? Eval Rev 28:123–143
Miller B (1996) Art therapy with the elderly and the terminally ill. In: Dalley T (ed) Art as therapy: an introduction to the use of art as a therapeutic technique. Routledge, London, pp 127–139
Minar VM (1999) Art therapy and cancer: images of the hurter and the healer. In: Malchiodi CA (ed) Medical art therapy with adults. Kingsley, London, pp 242–247
Morgan DL (1993) Future directions for focus groups. In: Morgan D (ed) Successful focus groups: advancing the state of the art. Sage, Newbury Park
Naumburg M (1966) Dynamically oriented art therapy: its principles and practices. Grume & Stratton, New York
Petrie KJ, Fontanilla I, Thomas MG, Booth RJ, Pennebaker JW (2004) Effect of written emotional expression on immune function in patients with human immunodeficiency virus infection: a randomized trial. Psychosom Med 66:272–275
Predeger E (1996) Womanspirit: a journey into healing through art in breast cancer. Adv Nurs Sci 18:48–58
Rutter DR (1987) Communicating by telephone. Pergamon, Oxford
Shaw BR, McTavish F, Hawkins R, Gustafson DH, Pingree S (2000) Experiences of women with breast cancer: exchanging social support over the CHESS computer network. J Health Commun 5:135–159
Sheard T, Maguire P (1999) The effect of psychological interventions on anxiety and depression in cancer patients: results of two meta-analyses. Br J Cancer 80:1770–1780
Sheese BE, Brown EL, Graziano WG (2004) Emotional expression in cyberspace: searching for moderators of the Pennebaker disclosure effect via e-mail. Health Psychol 23(5):457–464
Spiegel D, Classen C (2000) Group therapy for cancer patients: a research-based handbook of psychosocial care. Basic, New York
Spiegel D, Bloom JR, Kraemer HC, Gottheil E (1989) Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet 2:888–891
Spiegel D, Morrow GR, Classen C, Raubertas R, Stott PB, Mudaliar N, Pierce HI, Flynn PJ, Heard L, Riggs G (1999) Group psychotherapy for recently diagnosed breast cancer patients: a multicenter feasibility study. Psychooncology 8:482–493
Sproull L, Keisler S (1991) Computers, networks, and work. Sci Am 265:116–123
Stanton AL, Danoff-Burg S, Cameron CL, Bishop M, Collins CA, Kirk SB, Sworowski LA, Twillman R (2000) Emotionally expressive coping predicts psychological and physical adjustment to breast cancer. J Consult Clin Psychol 68:875–882
Stanton AL, Danoff-Burg S, Sworowski LA, Collins CA, Branstetter AD, Rodriguez-Hanley A, Kirk SB, Austenfeld JL (2002) Randomized, controlled trial of written emotional expression and benefit finding in breast cancer patients. J Clin Oncol 20:4160–4168
Stevens MJ, Duttlinger JE (1998) Correlates of participation in a breast cancer support group. J Psychosom Res 45:263–275
Taylor SE, Falke RL, Shoptaw SJ, Lichtman RR (1986) Social support, support groups, and the cancer patient. J Consult Clin Psychol 54:608–615
Turner-Cobb JM, Sephton SE, Koopman C, Blake-Mortimer J, Spiegel D (2000) Social support and salivary cortisol in women with metastatic breast cancer. Psychosom Med 62:337–345
Walther JB (1996) Computer-mediated communication: impersonal, interpersonal, and hyperpersonal interaction. Commun Res 23:3–43
Walther JB, Anderson JF, Park DW (1994) Interpersonal effects in computer-mediated interaction: a meta-analysis of social and antisocial communication. Commun Res 21:460–487
Weinberg N (1996) Compassion by computers: contrasting the supportiveness of computer-mediated and face-to-face interactions. Comput Hum Serv 13:51–63
Winefield HR, Coventry BJ, Lewis M, Harvey EJ (2003) Attitudes of patients with breast cancer toward support groups. J Psychosoc Oncol 21:39–54
Winzelberg AJ, Classen C, Alpers GW, Roberts H, Koopman C, Adams RE, Ernst H, Dev P, Taylor CB (2003) Evaluation of an internet support group for women with primary breast cancer. Cancer 97:1164–1173
Acknowledgements
We wish to thank our research assistant, Jennifer Wilson, and the 25 people who offered their time and ideas for this study. The research was supported by a Hampton Fund research grant from the University of British Columbia.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Collie, K., Bottorff, J.L., Long, B.C. et al. Distance art groups for women with breast cancer: guidelines and recommendations. Support Care Cancer 14, 849–858 (2006). https://doi.org/10.1007/s00520-005-0012-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00520-005-0012-7