The Effectiveness of Art Therapy Incorporating Technology for Older Adult Patients in Hospice Care.

Kang, Ju Hyun. (2016). (Submitted in partial fulfillment of the requirements for the degree of Master of Professional Studies in Art Therapy)

In the field of mental health and art therapy, there is lack of outcome-based research with an older adult population who suffers from declining physical and cognitive functioning as well as people with End-of-Life issues. A person’s ability to be independent is dependent on his or her overall health, mobility, and ability to complete the activities of daily living. Computer devices have been developed to support independent living and aging-with-choice. Dealing with end-of-life issues, hospice patients who have terminal illness need to maintain their quality of life by gaining empowerment. Through this qualitative study, art therapy intervention was facilitated using technology in terms of providing physiological accessibility in order to be able to gain a sense of control and achievement by art making. To view the effects of using technology with this population, the research made comparisons between the sessions which used traditional art materials (colored pencils) and those which used advanced technology (a tablet computer). By analyzing the participants' artworks as well as observing their subjective and objective responses during the sessions that art therapy took place, the results of the four case vignettes demonstrated that when they incorporated a tablet to draw a picture, they appeared to have more engagement (time investment), intention and integration (composition and color coordination), playfulness and satisfaction (verbal reports). It was observed that technology allowed the participants to receive choices that are accessible. However, each case shows findings specific to particular clients and situations. The significance of individualization for each client’s need is raised.
Keywords: hospice care, quality-of-life, technology-based, older adult art therapy

Alders, A., Beck, L. Allen, P., & Mosinski, B. (2011). Technology in art therapy: Ethical challenges. Journal of the American Art Therapy Association, 28(4), 165-170.
American Art Therapy Association (2013). Ethical principles for art therapists. American Art Therapy Association.
Boger, J., & Mihailidis, A. (2011). The future of intelligent assistive technologies for cognition: Devices under development to support independent living and aging-with-choice. Neurorehabilitation, 28, 271-280.
Cahill, S., Begley, E., Faulkner, J. P., & Hagen, I. (2007). “It gives me a sense of independence” - Findings from Ireland on the use and usefulness of assistive technology for people with dementia. Technology and Disability, 19, p. 133-142.
Camic, P. (1999). Expanding treatment possibilities for chronic pain through the expressive arts. In Malchiodi, C. (Eds.), Medical art therapy with adults (p.43-62). London & Philadelphia: Jessica Kingsley Publishers.
Cohen, G. D., Perlstein, S., Chapline, J., Kelly, J., Firth, K. M., & Simmens, S. (2006). The impact of professionally conducted cultural programs on the physical health, mental health, and social functioning of older adults. The Gerontologist, 46(6), 726-734.
Cornwell, B., Laumann, E., & Schumm. L. (2008). The Social Connectedness of Older Adults: A National Profile. American Sociology Review, 73(2), p.185-203.
Erikson, E. (1950). Childhood and society. New York: Norton.
Evans, S. (2012). Using computer technology in expressive arts therapy practice: A proposal for increased use. Journal of Creativity in Mental Health, 7: 49-63.
Gawande, A. (2014). Being mortal: Medicine and what matters in the end. New York, NY: Metropolitan Books.
Goldman, L. (2004). Art therapy and alzheimer’s disease: My mother's art. In Magniant, R. (Eds), Art therapy with older adults: A sourcebook (p.201-223). Springfield, Illinois: Charles C Thomas Publisher.
Guest, S. (2012). Ronald Dworkin. Stanford, Calif: Stanford Law Books.
Harlan, J. (1990). Beyond the patient to the person aspects of autonomous functioning in individuals with mild to moderate dementia. The American Journal of Art Therapy, 28(4), pp. 99-106.
Hiltebrand, E. (1999). Coping with cancer through image manipulation. In Malchiodi, C. (Eds.), Medical art therapy with adults (p.113-136). London & Philadelphia: Jessica Kingsley Publishers.
Jonson, H. & Magnusson, J. A. (2001). A new age of old age? Gerotranscendence and the re-enchantment of aging. Journal of Aging Studies, 15, p.317-331.
Keller, S. E., Shiflett, S. C., Schleifer, S. J., & Bartlett, J. A. (1994). Stress, immunity, and health. In R. Glaser & J. K. Kiecolt-Glaser (Eds.), Handbook of Human Stress and Immunity (pp. 217-244). San Diego, CA: Academic Press.
Kerr, C. W., Donnelly, J. P., Wright, S. T., Kuszczak, S. M., Banas, A., Grant, P. C., & Luczkiewicz, D. L. (2014). End-of-life dreams and visions: A longitudinal study of hospice patients’ experiences. Journal of Palliative Medicine, 17(3), 296-303.
Kubler-Ross, E. (1969). On death and dying. New York: Macmillan.
Lee, Yunhwan. (2000). The predictive value of self assessed general, physical, and mental health on functional decline and mortality in older adults. Journal of Epidemiology & Community Health, 54:123-129.
Lockenhoff, C. E. & Carstensen, L. L. (2004). Socioemotional selectivity theory, aging, and health: The increasingly delicate balance between regulating emotions and making tough choices. Journal of Personality, 72(6), p.1395-1424. Blackwell Publishing.
Malchiodi, C. (1999). Medical art therapy with adults. London & Philadelphia: Jessica Kingsley Publishers.
Malchiodi, C. (2000). Art therapy & computer technology: A virtual studio of possibilities. London & Philadelphia: Jessica Kingsley Publishers.
Mather, M., & Carstensen, L. (2005). Aging and motivated cognition: The positivity effect in attention and memory. Trends in Cognitive Science, 9, 496–502.
McNiff, S. (2000). Computers as virtual studios. In Malchiodi, C. (Eds.), Art therapy & computer technology: A virtual studio of possibilities (p.86-99). London & Philadelphia: Jessica Kingsley Publishers.
Mihailidis, A., Blunsden, S., Boger, J., Brandi, R., Zutis, K., Young, L., & Hoey, J. (2010). Towards the development of a technology for art therapy and dementia: Definition of needs and design constraints. The Arts in Psychotherapy, 37(4), p. 293-300.
Miller, C. (2014, January 10). iPad is an artist’s canvas for David Hockney. The New York Times. Retrieved from
Moon, C. (2010). Materials & media in art therapy: Critical understanding of diverse artistic vocabularies. London: Routledge.
Pennebaker, J. W., Kiecolt-Glaser, J. K., & Glaser, R. (1988). Disclosure of trauma and immune function: Health implications for psychotherapy. Journal of Consulting and Clinical Psychology, 56, 239-245.
Penninx, B., Deeg, D., van Eijk, J., Beekman, A., & Guralnik, J. (2000). Changes in depression and physical decline in older adults: a longitudinal perspective. Journal of Affective Disorders, 61(1-2), p.1-12.
Perrin, A. (2015). Social media usage: 2005-2015. 65% of adults now use social networking sites - a nearly tenfold jump in the past decade. Pew Research Center. Retrieved from
Piaget, J. (1963). The Psychology of Intelligence. Totowa, New Jersey: Littlefield Adams.
Pike, A. A. (2013). The effect of art therapy on cognitive performance among ethnically diverse older adults. Journal of the American Art Therapy Association, 30(4), pp. 159-168.
Read, S., Braam, A. W., Lyyra, T., & Deeg, D. (2014). Do negative life events promote gerotranscendence in the second half of life? Aging & Mental Health, 18(1), p.117-124.
Safrai, M. B. (2013). Art therapy in hospice: A catalyst for insight and healing. Journal of the American Art Therapy Association, 30(3), 122-129.
Stephenson, R. C. (2013). Promoting wellbeing and gerotranscendence through an art therapy program for older adults. Journal of the American Art Therapy Association, 30(4), 151-158.
Stephenson, R.C. (2015). Color my words: How art therapy creates new pathways of communication. In L. Carozza (Ed.) Communication and aging: Creative approaches to improving the quality of life (pp. 247-267). San Diego, CA: Plural Publishing, Inc.
Taylor, J. B. (2008). My Stroke of Insight: A Brain Scientist's Personal Journey. NY: Penguin.
Thomas, G. (1995). Art therapy and practice in palliative care. European Journal of Palliative Care, 2(3), 120-121.
Thong, S. (2007). Redefining the tools of art therapy. Journal of the American Art Therapy Association, 24(2), 52-58.
Thorsen, K. (1998). The paradoxes of gerotranscendence: The theory of gerotranscendence in a cultural gerontological and post-modernist perspective. Norwegian Journal of Epidemiology, 8(2), p.165-176.
Tornstam, L. (1989). Gero-transcendence: A meta-theoretical reformulation of the disengagement theory. Aging, 1, p.55-63.
Tornstam, L. (1994) Gerotranscendence - A theoretical and empirical exploration. In Thomas, L. E. & Eisenhandler, S. A. (Eds.), Ageing and the Religious Dimension (p.203–225).Westport: Greenwood.
United States Census Bureau. (2014). An aging nation: The older population in the United States Retrieved from
Wald, J. (2003). Clinical art therapy with older adults. In Malchiodi, C. (Eds.), Handbook of art therapy (p.294-307). London: The Guilford Press.
Wang, J. (2011). A structural model of the bio-psycho-socio-spiritual factors influencing the development towards gerotranscendence in a sample of institutionalized elders. Journal of Advanced Nursing (p.2628-2636). Blackwell Publishing Ltd.
Weisberg, N., & Wilder, R. (1988). Expressive arts with elders. London & Philadelphia: Jessica Kingsley Publishers.