Amee Le presented on applying principles of mindfulness and art therapy for individuals with brain injuries. The presentation discussed research showing benefits of mindfulness-based interventions for reducing depression and improving quality of life after brain injury. It also described a mindfulness-based art therapy group protocol used at CHIRS involving mindfulness meditation, guided art activities, and group discussion. The goals were to help participants practice self-awareness, find meaning through creative expression, and enhance self-acceptance through social support. Emerging themes from the art included life, love, and the journey of accepting a brain injury.

1. 1
Mindful Art Workshop:
Principles and Applications
of Mindfulness and Art Therapy
Presenter:
Amee Le, OT Reg (Ont.)
Community Head Injury Resource Services of Toronto (CHIRS)
CAOT Lunch & Learn
June 10, 2014
L’Association canadienne des ergothérapeutesCanadian Association of Occupational Therapists

2. Agenda
• Mindfulness & Brain
Injury Research
• Mindful Art Workshop
Group Protocol &
Themes
• Art Showcase
• Emerging Themes
• Key Take Away Points
• Contact Information
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3. Learning Objectives
1. Appreciate the value of using mindfulness for
persons with cognitive impairments.
2. Be familiar with how mindfulness and art therapy
can be combined into an effective clinical program.
3. Be inspired to consider these useful tools in your
current programs and adding them to your
treatment toolbox.
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4. Mindfulness & Traumatic Brain Injury
Bedard, M., Felteau, M., Marshall, S., Cullen, N., Gibbons, C., Dubois, S., Maxwell, H.,
Mazmanian, D., Weaver, B., Rees, L., Gainer, R., Klein, R., Moustgaard, A. (2013).
Mindfulness-Based cognitive therapy reduces symptoms of depression in people with a
traumatic brain injury: Results from a randomized controlled trial. Journal of Head Trauma
Rehabilitation, Lippincott Williams & Wilkins
Azulay, J., Smart, C., Mott, T., Cicerone, K., (2013) A Pilot Study Examining the effects of
Mindfulness-Based Stress Reduction on Symptoms of Chronic Mild Traumatic Brain
Injury/Postconcussive Syndrome. Journal of Head Trauma Rehabilitation, Lippincott
Williams & Wilkins
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5. Mindfulness & Brain Injury
• 10 weeks group protocol
• Bedard: Mindfulness based cognitive therapy
(MBCT) by Segal et al. (2002)
– Reduction in depression
– Maintained at the 3 months follow-up
– Approaching statistical significance p=0.029
• Azulay: Mindfulness based stress reduction (MBSR)
by Jon Kabat-Zinn (2009)
– Perceived quality of life scale p=0.003
– Perceived self-efficacy scale p=0.001 especially in management of cognitive,
emotional symptoms
– Statistically significance aspects of working memory and regulation of
attention p=0.01
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6. A Randomized Controlled Trial of
Mindfulness Based Art Therapy (MBAT)
Monti, D.A., Peterson, C., Kunkel, E.J.S., Hauck, W.W., Pequignot, E., Rhodes, L., & Brainard, G.C.
(2006). A randomized, controlled trial of mindfulness-based art therapy (MBAT) for women with
cancer. Psycho-Oncology, 15, 363-373.
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7. A Randomized Controlled Trial of
Mindfulness Based Art Therapy (MBAT)
• Cancer patients within the Philadelphia region
• n=111 women with 93 completing both pre/post measurements
• Exclusion criteria: terminal, concurrent psychiatric diagnosis of
major mood disorder, psychotic disorder or significant cognitive
deficits
• 8 weeks MBAT psychosocial group or wait list control group
• MBAT group demonstrated decreased in symptoms of distress
(Symptoms Checklist-90-R)
• Improved in key aspects of health related quality of life (Medical
Outcomes Study Short–Form Health Survey)
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8. Mindfulness Based Art Therapy (MBAT)
Group Protocol
• Eight consecutive weekly meetings
• Two and a half hours long
• Sessions are standardized in format using a manual
• Mindful Meditation includes: body scan meditation, sitting
meditation, gentle Hatha yoga, walking meditation
• Art Activity includes: drawing (coloured pencil, marker, pastel,
watercolor crayon, paint), collage, open studio
• Home assignment: practice mindful meditation for 6 days a week
for 30 minutes by using guided audiotape
• Recommendations for reading to support Mindfulness curriculum
were offered
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9. Goals of Mindfulness Based Art Therapy (MBAT)
• Goal of the MBAT program is to facilitate a sense of control by
recognizing that each person has a choice to view their illness as is,
or alter their relationship to aspects of the illness
• Goal is accomplished by:
1. Mindfulness: Learning self awareness through practicing and experiencing
mindfulness practices
2. Art: Creative expression of internal thoughts and emotions through art
therapy
3. Group Therapy: Enhancing self-acceptance through verbal and non-verbal
bonding and social support in a group structure
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10. MINDFUL ART WORKSHOP
Is a therapeutic workshop for clients with an
acquired brain injury.
The program teaches clients to use principles of
Mindfulness & Meditation
and Art Therapy
to carve eraser stamps and create prints.
Please visit us at: www.mindfulartabi.com 10

11. GOAL
To facilitate acceptance by creating a safe space where
participants can engage in the process of finding meaning
through shared traumatic experiences.
Can’t Stop Tomorrow by Fiona
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12. Process of Achieving the Goal
1. Mindfulness: learn the concepts & practice to get a direct experience
2. Art: creating art is a meaningful activity
• Engaging in the process helps participants to experience a difficult emotion
without over-reacting or over-identifying with the emotions
• This facilities acceptance and decreases “judgment”
• This allows participants to practice different coping strategies in a safe
environment with feedback
• The process encourages participants to find inspiration from within to encourage
internal locus of control
• The activity allows participants to express the mindfulness concepts in a functional
and meaningful way which helps the person to remember the experience
3. Group Therapy: allows participants to share stories in safe
environment which further enhances self-acceptance through verbal
and non-verbal bonding and social support
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13. Group Protocol
1 Introduction & Journaling
2 Breathing Meditation
3 Mindfulness Lesson & Meditation
4 Art Instruction & Meditation
5 Art Class & Group Support
6 Gratitude
Eight consecutive weeks
Two hours long
Mindful Meditation includes:
breathing meditation,
mindfulness meditation, and
yoga movement meditation
Art Activity includes: carving
linoleum or erasers & stamp pads
for printing
Blog: Sharing the blog posts of
the participant’s artwork,
gratitude quotes and mindfulness
themes
No Homework
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14. Gratitude
“I am thankful for my life,
for being alive.
Thankful for all the wonderful people
who have helped me, and continue to help me.
I am thankful for my family and
thankful that I’ve met all of you guys here.
I look forward every Thursday to come here.”
--Roxanne
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15. Mindfulness Themes
Week Theme
1 Judgment + Acceptance = Surprise!
2 Storms, Strengths and Wisdom
3 Keep Going
4 Prints & Patterns
5 The Intelligent Body
6 Black & White Thoughts
7 Wishes & Release
8 Celebration!
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16. week
1/8
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17. Storms, Strength and Wisdom
week
2/8
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18. week
6/8
Black & White Thoughts - Black & White Prints
Survivor by Maria Fond Memories by Inder 18

19. Wishes and Releases
week
7/8
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20. week
8/8
Celebration! Art Exchange
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21. Art Journaling
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22. • Death calling
• Coma
• Surviving
• Anger, frustration, denial
• Mourning
• Perhaps a difficult and arduous
journey
• At times with mixed blessings
• Finding meaning
• Emerging acceptance
• Gratitude
Brain Injury –
A journey with many voices…
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23. Emerging Themes
Life
Love
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24. Applications of Mindfulness,
Art Therapy and Group Dynamics
1. How can you engage clients internal reflections?
 Have you thought about Art Journaling or Photo Journaling?
2. How can you give your clients the experience of relaxation?
 What about using a 5-minute Guided Yoga or Meditation with
your clients?
 Have you tried meditation?
 Have you tried meditating with your clients?
3. How do you encourage clients to speak using positive narratives
and non-violent language?
 Have you tried a Gratitude Exercises or Gratitude Journals?
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25. References
• Azulay, J., Smart, C., Mott, T., Cicerone, K., (2013) A Pilot Study Examining the effects of
Mindfulness-Based Stress Reduction on Symptoms of Chronic Mild Traumatic Brain
Injury/Postconcussive Syndrome. Journal of Head Trauma Rehabilitation, Lippincott Williams &
Wilkins
• Bedard, M., Felteau, M., Marshall, S., Cullen, N., Gibbons, C., Dubois, S., Maxwell, H.,
Mazmanian, D., Weaver, B., Rees, L., Gainer, R., Klein, R., Moustgaard, A. (2013). Mindfulness-
Based cognitive therapy reduces symptoms of depression in people with a traumatic brain
injury: Results from a randomized controlled trial. Journal of Head Trauma Rehabilitation,
Lippincott Williams & Wilkins
• Kabat-Zinn, J. (2009). Full Catastrophe Living: Using the wisdom of your body and mind to face
stress, pain and illness, 15th ed. New York, NY: Random House Inc.
• Monti, D.A., Peterson, C., Kunkel, E.J.S., Hauck, W.W., Pequignot, E., Rhodes, L., & Brainard, G.C.
(2006). A randomized, controlled trial of mindfulness-based art therapy (MBAT) for women
with cancer. Psycho-Oncology, 15, 363-373
• Segal, ZV., Williams, JMG, Teasdale JD. (2002) Mindfulness-Based Cognitive Therapy for
Depression. A new approach to preventing relapse, New York, NY: The Guilford Press, 2002
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27. In an effort to continue to improve our webinars, registrants
will receive an email with a link to a feedback form. We’d
greatly appreciate any feedback you can provide.
To request a certificate of completion, please email
education@caot.ca
*Only those that have registered for this webinar and who
attended the webinar live can request a certificate of
completion.
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L’Association canadienne des ergothérapeutesCanadian Association of Occupational Therapists