Altered Book-Making for Children and Adolescents Affected by Traumatic Loss

108 Pages·2015·1.44 MB·English

Florida State University Libraries
Electronic Theses, Treatises and Dissertations The Graduate School
2015
Altered Book-Making for Children and
Adolescents Affected by Traumatic Loss
Erin Huntley
Follow this and additional works at the FSU Digital Library. For more information, please contact [email protected]
FLORIDA STATE UNIVERSITY
COLLEGE OF FINE ARTS

ALTERED BOOK-MAKING FOR CHILDREN AND ADOLESCENTS
AFFECTED BY TRAUMATIC LOSS

By
ERIN HUNTLEY

A Thesis submitted to the
Department of Art Education
in partial fulfillment of the
requirements for the degree of
Master of Science

2015
Erin Huntley defended this thesis on June 30, 2015.
The members of the supervisory committee were:

David Gussak
Professor Directing Thesis

Marcia Rosal
Committee Member

Theresa Van Lith
Committee Member

The Graduate School has verified and approved the above-named committee members, and
certifies that the thesis has been approved in accordance with university requirements.

ii
ACKNOWLEDGMENTS
Foremost, I’d like to give great thanks to the chair of my thesis committee, David Gussak, for
your guidance and insight. I am truly grateful for your dedication, time, and continued support
throughout this process.
I owe great appreciation as well to my thesis committee members, Marcia Rosal and Theresa
Van Lith, for your input and enthusiasm.
I would also like to thank Tamari Miller of New Hope for Kids— from the very start, your help
and belief in this research endeavor was essential.
Lastly, thank you to my friends and family whom supported me every step of the way— I would
not have completed this journey without you. Your encouragement, assistance, and
encouragement is limitless.
Thank you all for joining me on this adventure.

iii
TABLE OF CONTENTS
List of Tables ................................................................................................................................ vii
List of Figures .............................................................................................................................. viii
Abstract .......................................................................................................................................... ix

1. INTRODUCTION ......................................................................................................................1

Purpose and Justification.............................................................................................................2
Hypothesis ...................................................................................................................................2
Definition of Terms .....................................................................................................................3
Study Overview ...........................................................................................................................4
Conclusion ..................................................................................................................................5

2. LITERATURE REVIEW............................................................................................................6

Major Symptom Responses.........................................................................................................9
Post-Traumatic Stress Disorder (PTSD) ...................................................................................9
Traumatic and Complicated Grief ..........................................................................................11
Depression and Suicidal Tendencies ......................................................................................12
Common Treatments .................................................................................................................14
Trauma-Focused Cognitive-Behavioral Therapy ...................................................................15
Traumatic Grief Cognitive Behavioral Therapy .....................................................................16
Narrative Approaches .............................................................................................................17
Art Therapy as a Treatment Modality .......................................................................................18
Conclusion .................................................................................................................................21

3. METHOD ..................................................................................................................................22

Hypothesis .................................................................................................................................22
Research Design ........................................................................................................................23
iv
Participants ................................................................................................................................23
Treatment Protocol ....................................................................................................................24
Measures ...................................................................................................................................26
Procedures .................................................................................................................................28
Data Analysis ............................................................................................................................29
Summary ...................................................................................................................................30

4. RESULTS ..................................................................................................................................31

Demographics ............................................................................................................................31
Quantitative Results ..................................................................................................................32
Variable Data ..........................................................................................................................34
Youth Participants ............................................................................................................34
Parents/Guardians .............................................................................................................42
Qualitative Results ....................................................................................................................43
Theme 1: The Narrative of Life and Death ............................................................................44
Theme 2: Integrating Safety and Trauma in Grief .................................................................47
Theme 3: Compartmentalization, Avoidance, and Dissociation ............................................51
Theme 4: Support Systems .....................................................................................................53
Theme 5: Identifying “Grief” ................................................................................................54
Theme 6: Establishing Trust and Control ...............................................................................59
Conclusion .................................................................................................................................62

5. DISCUSSION ............................................................................................................................64

The Participants .........................................................................................................................65
Kristine ...................................................................................................................................65
Natalie ....................................................................................................................................68
Amanda ..................................................................................................................................70
Darron .....................................................................................................................................74
Limitations .................................................................................................................................75
v
Limited Sessions .....................................................................................................................75
Limited Sample ......................................................................................................................76
Acquiring the Tests ................................................................................................................77
Suggestions for Future Research ...............................................................................................77
Treatment Duration ................................................................................................................78
Population and Demographic .................................................................................................78
Parent/Guardian Involvement .................................................................................................79
Recommendation for Art Therapists .........................................................................................79
Conclusion .................................................................................................................................81

APPENDICES ...............................................................................................................................84

A. INSTITUTIONAL REVIEW BOARD (IRB) APPROVAL LETTER ....................................84
B. CONSENT FORM ....................................................................................................................86
C. ASSENT FORM AGES 6-11....................................................................................................88
D. ASSENT FORM AGES 12-18 .................................................................................................89
E. POST-RESEARCH SURVEY ..................................................................................................91
References ......................................................................................................................................92

Biographical Sketch .......................................................................................................................97

vi
LIST OF TABLES
Table 1. Overall Pre-tests and Post-tests........................................................................................33
Table 2. Pre-Test and Post-test Variable Scores: Kristine .............................................................35
Table 3. Pre-Test and Post-test Variable Scores: Natalie ..............................................................35
Table 4. Pre-Test and Post-test Variable Scores: Amanda ............................................................35
Table 5. Pre-Test and Post-test Variable Scores: Darron ..............................................................35
Table 6. Youth Participant Variable Point Differences From Pre- to Post-Test ............................36
Table 7. t-Test, youth participant “Intrusion” Scores ....................................................................36
Table 8. t-Test youth participant “Avoidance” Scores ..................................................................37
Table 9. t-Test youth participant “Negative Cognition/Mood” Scores..........................................39
Table 10. t-Test youth participant “Arousal/Reactivity” Scores ...................................................40
Table 11. Youth Participant “Dissociation” Point Differences from Pre- to Post-test ..................41
Table 12. Parent/Guardian Pre- and Post-test Variable Scores ......................................................42
Table 13. Parent/Guardian Point Difference of Variables from Pre- to Post-test ..........................43
Table 14. Parent/Guardian Pre- and Post-test “Dissociation” Scores ............................................43

vii
LIST OF FIGURES
Figure 1. Overall Pre-tests and Post-tests ......................................................................................33
Figure 2. Pre-test Variable Comparison .........................................................................................40
Figure 3. Post-test Variable Comparison .......................................................................................41
Figure 4. “Response Piece” completed by Amanda ......................................................................45
Figure 5. “Safety and Comfort Pages” ...........................................................................................48
Figure 6. “Trauma Collage” ...........................................................................................................50
Figure 7. “Response Piece”............................................................................................................52
Figure 8. “Emotions of Grief” .......................................................................................................56
Figure 9. “Clay Grief Characters” .................................................................................................57
Figure 10. “Grief Character Settings” ............................................................................................59
Figure 11. “Outsides”.....................................................................................................................60
Figure 12. “Altered Book Covers”.................................................................................................62

viii
ABSTRACT
This research study sought to test the effectiveness of using art therapy, specifically altered
book-making, to decrease traumatic grief symptoms in children and adolescents. The study
hypothesized that altered book-making with children and adolescents, who had experienced
traumatic loss, would be effective in decreasing traumatic grief symptoms. The six-week/six-
session treatment design used a single group pre/post-test, utilizing the UCLA PTSD-RI and an
open-ended post-research survey. The population involved in the research were children and
adolescents who had experienced the death of a family member through traumatic means, such
as homicide or suicide, within the past five years. Four participants began the study, and three
participant, completed both pre and post-test. The overall outcome of the study supported the
researcher’s hypothesis— participants reported increased understanding of grief responses,
emotion identification, and self-reflection. Through altered book-making, participants also
reported a decrease in anger, trauma symptoms and dissociation.

ix