A Hero's Journey: Supporting children throughout inpatient psychiatric hospitalization using a therapeutic comic book.

PROBLEM: Art- and narrative-based interventions are an integral component of pediatric inpatient psychiatric care. We describe a novel therapeutic comic book we developed for hospitalized children and young adolescents. METHODS: A Hero's Journey is a 38-page zine that can be freely downloaded and photocopied for distribution. The short booklet is intended to demystify and offer guidance throughout the experience of hospitalization, promote interaction and socialization, provide scaffolding for skill-building, and prepare patients for moving forward after discharge. FINDINGS: The underlying foundations of the booklet include: 1) Theoretical sources (Joseph Campbell's hero's journey; Donald Schön's reflective practice; and the principles of narrative medicine); and 2) Clinical sources (collaborative problem solving; cognitive-behavioral therapy, and trauma-informed care). We articulate how each page relates to the different components, and how individual pages can be used as worksheets for practice of specific skills. We next provide suggestions on how best to use the booklet: from arrival at the emergency room, through inpatient hospitalization, and toward discharge. We also propose ways for staff, caregivers, and any child-facing adult to make use of this clinical resource in support of a patient's recovery and reintegration into their community. CONCLUSIONS: Even though not yet empirically tested, this therapeutic comic book is available for dissemination free of cost. We encourage leaders in nursing and therapeutic recreation to try using this resource in their emergency room and milieu settings.

An Evaluation of the Subjective Experience of Receiving Reiki: Qualitative Results from a Pragmatic Effectiveness Study.

Objectives: The main purpose of this study was to evaluate the subjective experience of Reiki in a large sample. Design: The study design was a single-arm pragmatic effectiveness trial with qualitative questions completed post-Reiki session. Setting: The study took place at private Reiki practices across the United States. Subjects: A total of 99 Reiki practitioners met the inclusion criteria and participated in the study. Reiki practitioners invited each of their Reiki clients to complete a survey before and after the Reiki session. Of the N = 1575 Reiki sessions recorded, N = 1284 qualitative responses were completed (82% of total) and included in the analysis. Interventions: Trained and experienced Reiki masters conducted Reiki sessions in person, with each session lasting between 45 and 90 min. Outcome measures: Participants were asked to describe their experience during the Reiki session. Results: Qualitative analysis revealed eight major themes: (1) deep relaxation and calm (68%), (2) body sensations/somatic experiences (53%), (3) emotions (29%), (4) spiritual or symbolic significance (18%), (5) changes in symptoms (17%), (6) changes in perception (11%), (7) sleep and drowsiness (10%), and (8) changes to breathing (4%). Significantly more males reported feeling relaxed and experiencing time perception changes, whereas more females reported body sensations, emotions, visual perceptions, and spiritual significance. Conclusions: The findings from this study suggest that Reiki can elicit the relaxation response and alter emotions and perception in such a way as to facilitate a transformative subjective healing experience. Future work will analyze these themes as they relate to changes in symptoms and compare the experience of Reiki with other biofield therapies.

Evaluation of adolescent and adult patients treated with the Carriere Motion Class III appliance followed by fixed appliances.

OBJECTIVES: To determine dentoalveolar and skeletal effects produced in mature patients by the Carriere Motion Class III (CM3) appliance followed by fixed appliances. MATERIALS AND METHODS: This retrospective study evaluated 32 patients at three time points: T1 (initial), T2 (removal of CM3), and T3 (posttreatment). Serial cephalograms were traced and digitized, and best-fit regional superimpositions were constructed. Eleven linear and 7 angular variables were measured. The starting forms of the CM3 patients were compared with a sample of untreated subjects with normal occlusions and well-balanced faces. RESULTS: The CM3 phase lasted 6.3 months, followed by a phase of fixed appliances lasting 12.9 months; the total duration of treatment was 19.2 months. Minimal skeletal changes were measured sagittally, with only a slight increase in lower anterior facial height observed during treatment. Most treatment changes were dentoalveolar in nature. Wits appraisal increased 4.0 mm during treatment. The molar relationship improved by 6.0 mm during phase I, a value that rebounded slightly during phase II, resulting in an improvement toward Class I of 4.8 mm. Best-fit regional superimpositions revealed anterior movement of upper molars relative to the maxilla and posterior movement of lower molars relative to the mandible. CONCLUSIONS: The Carriere Motion Class III appliance is an effective and efficient method of resolving occlusal problems in minimally growing Class III patients. Primary treatment effects are dentoalveolar in nature with minimal skeletal alterations.