ART-THERAPY IN THE REHABILITATION OF ADOLESCENTS WITH SPINAL-CORD INJURIES - A CASE-STUDY

This case study highlights the usefulness of art as a therapeutic moda lity in the rehabilitation of adolescents with quadriplegia. It often is difficult to engage adolescents in verbal psychotherapy. Art therap y is shown to be an effective alternative means of self-expression tha t serves as a catalyst for adjustment. Drawings and clinical material from the therapy of a 13-year-old girl with quadriplegia resulting fro m spinal cord injury are presented. Themes of disturbed body image, is olation, and concern over control are evident in her work. The signifi cance of these otherwise unexpressed inner conflicts is discussed in t he context of her overall progress in rehabilitation. Adolescents with quadriplegia present unique emotional problems during rehabilitation. They frequently exhibit denial (Geller and Greydanus, 1979; Gordon, 1 987), which makes traditional forms of psychotherapy difficult. Furthe rmore, they may project anger over the disability onto the staff of th e rehabilitation facility, preventing the formation of a therapeutic a lliance. In addition to the general adjustment difficulties experience d by people with spinal cord injuries, adolescents often have developm entally congruent concerns regarding autonomy, control, and body image which may be difficult for them to articulate. Art therapy is based o n the concept that defense mechanisms commonly used in speech are not readily transferable to drawings (Labarca, 1979). Some clients are abl e to express their inner conflicts through art; thus the therapy provi des a forum in which emotions can be revealed. Art therapy has been us ed successfully in health care settings to treat adolescents, includin g oncology patients (O'Neill, 1989; Walker, 1989) and anorectic patien ts (Wolf, Willmuth, Gazda, & Watkins, 1985). However, there has been n o documented study of its use with adolescents who have spinal cord in juries. In this case study, a brief introduction to the patient will b e followed by a discussion of her artwork, a series of drawings render ed in individual psychotherapy sessions over a period of several month s during an inpatient rehabilitation stay.