The Art of Play

There often are young children in the art room, 2 to 4 year olds who like to play as well as do art. The interaction and storytelling that results is often very rich and has been a wonderful way to engage and connect with these younger patients. Themes of creating havoc and destruction and then finding ways to rescue and repair are played out over and over. Art materials like model magic are used to create rescue ropes, quicksand or mud. Dominoes, blocks and Legos are used to build walls, towers and castles and figures such as knights on horses, dragons and dinosaurs are the characters that play out the story line. The stories vary but the theme often remains consistent…the bad guys create trouble and the hero rescues those in need, and often these roles are interchangeable. The figures fall or are “pushed off a cliff” over and over, and they are rescued in various ways. As the rescue story ensues, it often ends with the rescued figures being repaired, nurtured and cared for.

This age group uses play as their work and these scenarios help them to address the issues they are facing such as loss of control, injury, fear related to treatment, as well as their desire and knowledge about providing support and tender care. Directing the story and being in control of the outcome provides a means for control of that world and an opportunity to address their struggles and strengths through the metaphor of play.

A Day for the Kids: Those in Treatment and their Siblings

Throughout the year Life with Cancer provides day long programs for children being treated for cancer and their siblings–those who are between 5 and 12 years old. This day combines education, art therapy, medical play, discussion and various additional programs from the community. These have included: yoga, music making, musical performances, storytelling, movement, therapeutic dogs and horses, and recreational games and activities. The goal of the day is to bring kids together who have similar experiences–either because they are in treatment or because they are dealing with the illness and treatment of a sibling. At one point, the kids in treatment break into a separate group from their siblings; this allows for the siblings to talk about their experiences without their ill brothers and sisters partaking in the conversation. It is a chance for the siblings to share with peers who are going through similar experiences and understand their perspective. Often these children share similar feelings and ways of coping, and enjoy the chance to relate to each other in a way that other peers might not be able to.

The experiences of the children in treatment are often better understood than that of the siblings. Providing support to the patient is generally–and logically–the primary focus, as treatment is extremely difficult and sometimes traumatizing. Due to the severity of the illness and the challenge of treatment, the primary focus of doctors, therapists and medical teams is inevitably–and necessarily–on that child. However, the  journey that the siblings go through is also incredibly challenging. They often experience a myriad of feelings, along with many changes at home. These children are often impacted by the shifts in the emotional makeup of their families. There are many changes over which they have no control and siblings, in turn, often feel left out, forgotten, jealous and angry about the toll that cancer has taken on their lives. They are also scared and worried about their ill brother or sister. Giving voice to these feelings and this journey seems extremely important, and these days provide an opportunity for these experiences to be expressed in an arena where these feelings are validated and supported by staff and by peers.

As a group, the brothers and sisters of cancer patients are free to share their thoughts and true feelings related to their experiences. Some siblings are especially open and clear about how disenfranchised they feel. Although there may not be a lot that can be done to shift the focus off of their brother or sister in treatment, they often find some relief and satisfaction in being with like-minded children, sharing their feelings, and having them validated. The opportunity to speak in confidence, free of their siblings or other family members, provides an opportunity to speak the truth and name the many feelings they have that may be considered unacceptable or unkind.

"I feel left out, for all the attention is on Natalie."

“I feel left out, for all the attention is on Natalie.”

Siblings hold a significant place in the journey and the puzzle pieces represent their part in their families experiences. These pieces also provide a vehicle through which many of their thoughts and feelings are expressed in an open and supportive environment.

Kid and Sib puzzle-3

My Life Has Changed Since You Were Diagnosed with Cancer.

Working with children and teens who have a family member with cancer is an important aspect of my work at Inova Life with Cancer. Through individual work and support groups, children in particular have an opportunity to address and better understand the changes they experience as their family member; (often a parent) undergoes a variety of treatments for cancer including chemotherapy, radiation and /or surgery. This can be a confusing, scary, isolating and maddening time. Through the support group children learn about the various treatments for cancer, the equipment used and the subsequent common side effects. They also learn about and explore the feelings they are having. Through creating art and discussion children share what they have experienced and also prepare for what may be coming as their family member’s treatment progresses. They often discuss the many ways life has changed and continues to change during this time frame.

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Children generally become more open as the group sessions progress often because they are meeting other children who have similar experiences and feelings. There tends to be some relief in learning that theirs is not the only family going through this. One exercise often incorporated into the group is a list of how their lives have changed since their family member’s diagnosis and treatment. The list incorporates home and family, school, friends and neighbors. The children may add to this list throughout the 6 weeks of group or complete it in 1 session. Either way, it reveals a great deal about their experience and provides a very rich opportunity for sharing, expressing and validation. Children see in a very concrete way how many of these experiences are shared by the other kids. It doesn’t change what is happening but hopefully they come away with a deeper understanding of what they are going through and their feelings and reactions. As they become more attuned to how they are feeling they also learn productive ways to cope. Ultimately they have an opportunity to see that they are not alone and support is there when they want it.

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All Around The World

The multi cultural nature of the Washington DC area is well represented in the Inova clinic. Many of the children who come to the clinic for treatment and their families come from all over the world and they introduce many interesting customs, traditions, beliefs, faiths and languages. Despite the many differences we observe from family to family and within the various ethnicities, there are important similarities that are most apparent. The primary connection being that each family has a child that is being treated for cancer but there are other threads that are woven through this tapestry. Threads that reflect the love, concern and care each family has for their own child and how that is so often extended to the other children, teens, siblings and parents. Personal stories, guidance and support are shared and the boundaries that often separate people such as faith, language, style of dress or socioeconomic status all blur and important and meaningful connections are made. The children and teens support one another in a way no one else can and parents support each other as they share stories, suggestions and ideas that can make the journey easier and more bearable. These connections are beyond words or description and are witnessed every day.

The map hangs in the art room and provides a beautiful visual reminder of our world and its size and diversity. Each jewel on the map represents a family that is or has received treatment in our clinic and their country of origin. Parents and children have enjoyed placing a jewel on their country and seeing that it may be the first on the map or quite often that there are others also from that part of the world. Either way the message conveyed is that we are all connected, no matter where you were born, the world although enormous and expansive doesn’t feel so big when it is placed on the wall and our small community is represented there. Clinic world map 006 copy

Piecing It Together: The Art of Group Projects

Group projects are periodically introduced in the Inova pediatric oncology outpatient clinic as a way for patients to work together toward a common goal: to create one piece of art that represents all of the patients that come to clinic every week for treatment. These projects provide a way for patients to connect with one another, even when they don’t see each other at the clinic. Making art with multiple artists creates a sense of mystery. Each artist completes a piece, not knowing how it will contribute to the end result,  and others are added to it until the artwork is whole. The patients and family members know that the piece will hang in the clinic when it is completed for all to enjoy and everyone becomes invested in contributing to this community art piece.


Two multi-panel paintings were created recently;  a 24 panel zebra and a 9 panel butterfly. The images were drawn in black on a series of 4″ white canvas boards and individuals chose the panel they wished to work on. The only direction given was to use one color that was used in neighboring panels, understanding that the color could be incorporated in any way they chose. The intention was to create some continuity between the canvas panels. The butterfly and zebra came to life with each completed canvas. Everyone approached their piece in a different way and it was interesting to watch that process; to note which panel they each chose to work on, the colors they chose to use and the many different ways the canvases were painted.

These projects took some time to complete, but there was anticipation and interest throughout the process–and a sense of belonging and ownership for the many children, teens and adults who had a part in creating the final art piece. Although this work does not have the same therapeutic expression as an individual piece of art, there is power in the connection between those who contributed as they worked to create this piece with people they did not know or may not see any more in clinic due to treatment schedules. There was noticeable delight for some in learning who else had contributed to the butterfly and /or the zebra and for others in knowing that these were both a group collaboration.

There was excitement and surprise when the finished pieces were viewed for the first time. Patients and family members who worked on the butterfly or the zebra were surprised and delighted by what they had created and those who did not participate were excited about the finished piece as well. There continues to be much interest and investment in where the pieces will hang in the clinic and that perfect spot will be chosen soon.

The Greater Good

Our beautiful silk hoop and origami mural at Life With Cancer

Patients and their family members often create art and then leave it in the art room to be completed or displayed. Pieces of origami and an assortment of silk hoops wait to be strung with beads to create a hanging art piece or a mobile. Sometimes interest in one technique or medium is shared by many kids and parents at the same time. This is often the case with both folding origami and painting on silk. When this happens a variety of artists often agree to combine their pieces to create a larger group art piece. Unlike the individual art pieces that reflect each artist personally, these group pieces represent the parts of their lives that they share; specifically the common bond of creating while waiting during weekly visits to the clinic for treatment. These group pieces become a beautiful representation of the collective group and they reflect the combined efforts and inspiration of the all the children, teens and parents who contribute pieces. The art making process helps to provide a different spin on this weekly experience. When the individual pieces join together they reflect the connection, cohesion and support that the children and parents provide to each other during this time. It is moving and beautiful, and it is an honor to witness.

The final piece becomes a legacy of those connections and experiences as well and a means to inspire others to create and explore.

"It is moving and beautiful, and an honor to witness."

I Can’t Tell You But I’ll Show You….

Some children in treatment for cancer really struggle with the all the demands of  treatment, which include weekly finger pokes or a port access, shots and examinations by the doctor, and much more. Many of them cry and scream and let the treatment team know they are mad and don’t like what is happening.

Then there are kids who are incredibly compliant, say little about the treatment process and seem to make the best of a very difficult situation. These kids intrigue me. I always wonder about their experience and what they are not saying out loud. And then they begin to create and many of these quieter children and teens say a great deal about what they’re feeling through the imagery.

These two pictures are by a 9 year old boy who has said very little about his experience with cancer and the intensive treatment. His art work however, is very expressive and has become the vehicle through which he expresses many of the things that he doesn’t say out loud. It seems to be easier for him to express himself through the art; a seemingly natural way for him to convey his feelings about his experiences. When you look closely you begin to understand….


Letting the Art Shine In

The Tracy’s Kids program at Inova Life with Cancer (LWC) is in Fairfax, VA and looks a little different than the other Tracy’s Kids programs. The outpatient clinic where patients come weekly for treatment is separate from Inova’s Hospital for Children at Fairfax Hospital, where children and teens are admitted when hospitalization is necessary. What is similar is that patients have access to art therapy in the outpatient clinic and in the hospital. However, there is another facet to this program that I also find very rewarding, which are the programs offered to families at the Life with Cancer Family Center where anyone impacted by cancer can access services. Through a grant from Tracy’s Kids, individual and group art therapy support is available to any child or teen impacted by cancer, whether they are in treatment or have a family member with cancer.

When patients and families create art at the clinic they often want to hang it on the walls of the art room. Everyone who comes there for the first time is impacted by the breadth and power of this work. It seemed important to share the art with many other people who are touched by cancer and would truly appreciate it. With the permission of the patients, siblings and parents this amazing art work was displayed in an art show at the LWC Family Center during July and August. This show was moving and powerful. The art contained so much color, energy and expression. It touched the hearts of all those who saw it, which I was told over and over again. Creating art is a healing process and it seems it also has a healing quality when it is viewed. Many thanks to all the kids, teens and parents that participated in this Tracy’s Kids program and Let Their Art Shine In at the LWC Family Center!