Florida State University Libraries Electronic Theses, Treatises and Dissertations The Graduate School 2012 Art Therapy to Improve the Relationship Between Caregivers and Spouses with Alzheimer's Disease Nola K. Freeman Follow this and additional works at the FSU Digital Library. For more information, please contact [email protected] THE FLORIDA STATE UNIVERSITY COLLEGE OF VISUAL ARTS, THEATRE, AND DANCE ART THERAPY TO IMPROVE THE RELATIONSHIP BETWEEN CAREGIVERS AND SPOUSES WITH ALZHEIMER’S DISEASE By NOLA K. FREEMAN A Thesis submitted to the Department of Art Education in partial fulfillment of the requirements for the degree of Master of Science Degree Awarded: Summer Semester, 2012 Nola K Freeman defended this thesis on June 27, 2012. The members of the supervisory committee were: Marcia Rosal Professor Directing Thesis David Gussak Committee Member Tom Anderson Committee Member The Graduate School has verified and approved the above-named committee members, and certifies that the thesis has been approved in accordance with university requirements. ii This thesis is dedicated to my grandmother, Nina F. Cohen, with love. iii ACKNOWLEDGEMENTS I would like to acknowledge my parents for being my biggest supporters. I would also like to acknowledge my professors at Florida State University, Dr. David Gussak, Dr. Marcia Rosal, and Dr. Carolyn Brown Treadon for teaching me to value research. I would like to give a special thank Dr. Marcia Rosal for serving as the chair of my committee and guiding me through the thesis process. Additionally, I am very grateful to the couples that participated in the study. iv TABLE OF CONTENTS List of Tables ................................................................................................................................ vii List of Figures .............................................................................................................................. viii Abstract ............................................................................................................................................x 1. INTRODUCTION ......................................................................................................................1 Purpose ...........................................................................................................................1 Justification ....................................................................................................................2 Research Statement and Hypothesis ..............................................................................3 Definition of Terms........................................................................................................3 Brief Overview...............................................................................................................5 Summary ........................................................................................................................5 2. LITERATURE REVIEW ...........................................................................................................7 Alzheimer’s Disease ......................................................................................................7 Art Therapy and Alzheimer’s Disease .........................................................................10 The Caregiving Relationship .......................................................................................11 Theories of Treatment ..................................................................................................14 Art Therapy with Couples ............................................................................................17 Importance of Art Therapy Services ............................................................................19 Conclusion ...................................................................................................................20 3. METHOD .................................................................................................................................21 Research Design...........................................................................................................21 Participants ...................................................................................................................22 Instrumentation ............................................................................................................22 Procedure .....................................................................................................................23 Internal Validity ...........................................................................................................25 External Validity ..........................................................................................................25 Data Analysis ...............................................................................................................25 Limitations/Implications ..............................................................................................26 Conclusion ...................................................................................................................26 4. RESULTS .................................................................................................................................28 Qualitative Analysis of Case I .....................................................................................28 v Quantitative Analysis of Case I ...................................................................................44 Quantitative and Qualitative Relationship in Case I ....................................................48 Case I Conclusion ........................................................................................................49 Analysis of Case II .......................................................................................................50 Case II Conclusion .......................................................................................................66 Case I and Case II Joint Analysis ................................................................................66 Conclusion ...................................................................................................................71 5. SUMMARY AND CONCLUSIONS .......................................................................................73 Method .........................................................................................................................73 Results ..........................................................................................................................73 Limitations ...................................................................................................................75 Findings as Related to Literature .................................................................................75 Clinical and Research Implications .............................................................................76 Conclusion ...................................................................................................................79 APPENDIX A- INSTITUTIONAL REVIEW BOARD (IRB) APPROVAL LETTER ...............81 APPENDIX B-LETTER OF SUPPORT .......................................................................................83 APPENDIX C- CAREGIVER CONSENT FORM .......................................................................84 APPENDIX D-COMPETENT PARTICPANT CONSENT FORM .............................................86 APPENDIX E-POWER OF ATTORNEY CONSENT FORM.....................................................88 APPENDIX F- ASSENT FORM ...................................................................................................90 APPENDIX G- ART THERAPY CONSENT FORM ..................................................................91 APPENDIX H- THE MUTUALITY SCALE OF THE FAMILY CARE INVENTORY ............92 APPENDIX I- DAILY LOG OF POSITIVE INTERACTIONS ..................................................93 REFERENCES ..............................................................................................................................94 BIOGRAPHICAL SKETCH .........................................................................................................97 vi LIST OF TABLES Table 1. Case I Log of Positive Interactions Categorized by Theme ...........................................43 Table 2. Case I Mean Values of Baseline and Intervention Periods .............................................46 Table 3. Case II Log of Positive Interactions Categorized by Theme ..........................................64 vii LIST OF FIGURES Figure 4.1. Drawing 1, scribble chase with L as leader. ...............................................................30 Figure 4.2. Drawing 2, collaborative drawing created from scribble chase .................................31 Figure 4.3. Drawing 3, collaborative still life ...............................................................................31 Figure 4.4. Salt dough pounded by L ............................................................................................34 Figure 4.5. L’s line and circle created using salt dough ...............................................................34 Figure 4.6. L and M’s collaborative volcano using salt dough .....................................................35 Figure 4.7. L and M’s collaborative rabbit using salt dough ........................................................35