My Empathy Symposium Talk About My Work in SJOGM Hospital

My name is Lorelee Gobetti, and I am a Master's graduate Creative Arts Therapist - CAT for short. CAT is an emerging complementary therapy that harnesses the power of music, dance/movement, drama, poetry, expressive writing, play, and imagination to promote self-awareness and reparation uniquely to each patient. It's an embodied way of working within the therapeutic relationship.

Historically, this is nothing new, as the arts have played a role across all cultures for their ability to encourage and amplify connection and community.

As a CAT, I facilitate self-expression over artistic outcomes in a secure environment. (You do not need artistic experience to explore CAT as it is relationship-building internally & externally.) It's about developing radical hope and self-acceptance in how you sound, move, make, and experience your world.

I work in respiratory, general, paediatrics, gerontology, hospice, and oncology wards.

My Supervisor, the Senior Music Therapist Giuseppe Reina, talks about his "espresso sessions" philosophy, which underscores the fleeting, often singular nature of our patient encounters.

This art trolley accompanies me wherever I go: I attend ward handover meetings and receive patient referrals from all staff. I specialise in complex or struggling patients, but talk to anyone openly. I can be seen with fabric over my trolley making a cubby, following physio sessions, breathing and making rhythms to co/share regulation. I learnt that, in some cases, the trolley was better left outside the room while I made contact and received consent before bringing it in, because some patients would say "no" even before I spoke, just by looking at the trolley. No is just as welcome as yes. Creating a therapeutic alliance in a hospital can be a delicate dance. The trolley is a fantastic ice breaker in cases like referrals for non-English speaking or patients with poor verbal skills, like young children and people with dementia. I will pull the trolley up close to the patient, open the drawers, and invite them to explore and play with its contents as we communicate and connect through sensing and attuning to each other non-verbally.

Now, I shall share two Case studies with you that highlight CAT as a bridge of empathic support for patients, carers and staff.
Case Study 1: An elderly male patient who was delusional with other comorbidities on admission to the hospital, and now was unable to speak since being hospitalised. (On my arrival, his wife was present.)

I first normalised his confusion in a hospital setting, as you're not at home in your everyday surroundings; I then shared some psychoeducation about the benefits of stimulating the senses to decrease stress and improve brain function. I started pulling things out of my sensory bag and handing them to him. He enjoyed the different textures, smells, sights and sounds.

Next, I produced a piece of A3 paper and put it in front of him and asked him to pick a colour from a caron colour "he said purple" very clearly, and I asked his wife to draw around his hand, and then it was her turn, to which they helped each other to contour her hand inside of his. I wrote their names on the metaphor and showed it to him. His wife said, "It's our 50th wedding anniversary this year. To which he began to speak about his wedding, etc. (He went into details, like not being the favourite son-in-law… Conversation flowed about his life as his wife wept and joined in. As I noticed he was starting to feel fatigued, we ended with me asking what his favourite song was. I found it on YouTube music, and we sat together listening to it until. The doctor arrived; I quickly moved to pack up and get out of the way.

Case Study 2. A 30-year-old man with cerebral palsy and autism/ADHD, recovering from leg and foot surgery, required neurodiversity-affirming approaches. He struggled with routine disruptions, was very difficult and complex for staff to manage, and had an aversion to touching art materials. I started with brief, consistent visits to build trust and gradually learned about his routines, support system, and interests. I progressed to sitting next to him and creating art on his behalf, which got him to help me, for example, assemble the timber dinosaur model kit. He popped the piece out for me. One of the tridactyl wings broke and worked perfectly with the patient having a similar injury, prompting the painting of a black moon boot on the dinosaur. This dinosaur became an object bridge for staff to build rapport with the patient, and he was given his hospital ID band, Terry the Pterodactyl, by the staff.

Another example: I also made a dog out of bits and pieces because he was missing his dog, which fostered humour and empathy among all involved in his care. Our relationship was going from strength to strength through chatting and making things next to him, for him, and about him.

Then, one morning, I had an urgent request to visit him due to a significant meltdown that night, which resulted in him assaulting a nurse early that morning, and the police attended the hospital. I unpacked the events through a painting session using Edith Kramer's "third hand" approach to portrait painting. I put the canvas in front of him on the bed and painted upside down with him, selecting materials, colours, and types of marks. Talking through the image about the event was far less complicated for him than directly discussing what had happened. I started at the neck and asked, "Tell me this black paint story?"

Have any of you ever had your portrait painted? It's deep-looking and sensing to the other by the artist.

He said, "Lighting and thunder", to which I zigzagged around his head, "I was scared and frightened with the wind and rain'. The weather had triggered him! The security guards came, and they were kind and good. The nurse who attended to him early in the morning was someone he didn't know, and she was wearing a mask, which scared him. (I wrote this in his case notes for staff.)

He kept the artwork on his bed for two days, later displaying it in his room. The patient and the artwork continue to talk to each other, promoting ongoing externalisation and realisation. The patient's attachment to the painting demonstrated the therapeutic value of creating objects for self-reflection and understanding. The painting became a communication tool, allowing him to express his experience to staff and fostering their empathy. I also worked with this patient and supported the physios.

My work with this patient reduced escalation, regulated his nervous system, and promoted empathy and holistic care. I received staff feedback and constant gratitude for my work with this and other complex patients. I see the work as moving within the gaps in the hospital setting, providing support for whoever I encounter.

Thank you