Facilitating a support group specifically for patients with a brain tumor and their caregivers comes with many challenges and rewards. Our skills as facilitators for these types of support groups are often challenged as these patients may have unique cognitive, visual and attention deficits. Connecting patients to caregivers who understand the unique issues that come with this population can be very helpful in their ability to cope.

In my last submission to the AOSW Navigator (October, 2016), I discussed the Brain Tumor Support group created at Cone Health Cancer Center to meet the needs of this patient population and their caregivers. Through facilitating this group, new insight has been gained and commonalities identified that could benefit from additional research and discussion.

A support group of this nature comes with many challenges. The patients who participated in the Brain Tumor Support group brought various unique and individual needs that impacted their ability to participate in the group. They wanted to attend, but they often had limitations that needed to be accommodated in order for them to benefit from the group. They had various visual, speech, cognitive and physical limitations. It became imperative to find ways to have patients and caregivers interact and express emotions while addressing these limitations.

We conducted a literature review to find options and ideas to address these needs. Little research has been done in the area of group process with patients with a brain tumor and their caregivers. We brainstormed ideas, attempted to adapt previous group activities to address patient limitations and tried various processes in the group. Through observing group process, we found that adapting creative art activities provided a common ground and a deeper connection for these patients and their caregivers. These creative activities led to meaningful interactions between caregivers and their loved ones.

We did another literature search on creative interventions with adults who had cancer. In general, this literature search had some results. Archer, Buxton and Sheffield (2014) found evidence that creative psychological interventions provide benefits to adult patients with cancer and can impact anxiety, depression, quality of life, coping, stress and anger. Consequently, we decided to continue to use creative art activities in our group. Various activities were attempted and most were successful.

• One activity was a simple poetry writing activity. Facilitators assisted and transcribed the words of patients who had vision or writing limitations. Patients were captivated by the result of their creative words once read out loud to the rest of the group.
• Another very simple activity used pictures from magazines. Facilitators pulled pages out of magazines and laid them on the table. Group participants chose the ones that “spoke to them” and then shared with the group why they chose those pictures.
• Various brief coloring activities with prompts were often found to be successful.
• Facilitators found simple, short, adapted art activities had the most likelihood that both patients and caregivers would participate fully.
• Flexibility, creativity and strong general group process skills have been key in this group. Having a co-facilitator available to help prepare group activities, jump in at challenging moments and debrief after group were very necessary and led to the success of this group.

Through the observation of group process and literature review, it has become evident to us that additional research needs to be conducted in the area of art activities with patients with cancer, specifically with patients impacted by a brain tumor. Our Brain SIG hopes to meet at the conference next year in order to provide time for networking and educating each other.