Dialoguing With Images: An Expressive Arts Method for Health Research.

Despite the increasing integration of arts-based methods within qualitative research, few expressive arts methods have been studied to understand their process, rationale and impact on the inquiry process. We conducted a grounded theory study on family experiences of paediatric HSCT where we simultaneously adapted and studied a 'dialoguing with images' (DI) expressive arts process as method. Fifteen family members participated in two interviews, drew an image and were guided through the DI method. We articulate the social process shared by researchers, participants and the images as they co-constructed knowledge through the DI method. The four distinct phases of the method include: 1) containing the imaginative space within an outer and inner frame, 2) creating an embodied image: image work is an expressive, generative process, 3) a shared, participatory aesthetic interpretation and 4) crystallizing stories of illness. The findings are grounded in expressive arts theory and philosophy, hermeneutics and analytical art psychotherapy theory.

Falling Down the Rabbit Hole: Child and Family Experiences of Pediatric Hematopoietic Stem Cell Transplant.

Pediatric hematopoietic stem cell transplant (HSCT) is an intensive treatment that can be life-threatening. All family members experience distress. We conducted a grounded theory study using a family systems-expressive arts framework to develop a theoretical understanding of the family experience of HSCT. Six families (15 family members) participated in two interviews, drew an image, and were guided through a "dialoguing with images" process. Participants did not always perceive HSCT as an experience they had lived as a family and were surprised to hear other family members' experiences. While one mother drew, she suddenly understood it was not only her ill child, but the entire family who had "fallen down the rabbit hole." The family experience of HSCT is described across (a) the pre-HSCT trajectory, (b) family fragmentation (hospitalization), and (c) family reintegration. We identified a critical need for targeted family intervention during the transition into HSCT, throughout and following hospitalization.

Living in the in-between: families caring for a child with a progressive neurodegenerative illness.

Medical advances in recent years have led to an increased life span for children with progressive, neurodegenerative illnesses. The purpose of this hermeneutic inquiry was to explore the experience of families caring for their child at home. In-depth, audiorecorded interviews with six families (13 interviews) living in western Canada were transcribed and analyzed. The illness journey was revealed to be complex and unpredictable. We discovered many metaphors that spoke to the child's/family's life and explored the paradox of duality, such as holding both joy and sorrow, and containing both suffering and love. We outline implications for policy development within the area of respite care and coordination of services for families. The voices of families must be a vital component to influence and guide education and service development within the emerging specialty of pediatric palliative care.