Phylaine Toh shares her journey to becoming an Art Therapist at SGH and helps us understand that art therapy is not about “adult colouring books” or art classes.



1. Were you always an Art Therapist?
   
(From left) Phylaine’s first job as a graphic designer in the advertising field. Before she pursued her Master in Art Therapy, she worked at a bank as a sales manager.


No, I was not! I started out as an Advertising graduate and worked as a graphic designer in an advertising agency. Subsequently, I completed my second Bachelor’s in Marketing, and was a marketing executive for an F&B company (hint: they sell soupy dumplings… haha!). I then worked as a Sales Manager in banking before I pursued my Master in Art Therapy at LaTrobe University in Melbourne, after which I joined SGH as an Art Therapist.  So I went from selling products to supporting patients in their mental health struggles.
 
This is six years ago! Phylaine sets off to study Art Therapy at LaTrobe University!


2. What made you switch careers? And how did becoming an Art Therapist pop into your mind?
 
Phylaine was diagnosed with breast cancer in 2015. 


Mine’s quite a cliché story… long story short, I had rather advanced breast cancer when I was 27. During my treatment, I was frequently hospitalised for side effects from chemotherapy and the nurses showered me with lots of love and care. After completing my treatment, I then wanted to give back to the industry by being a part of it. I volunteered at a school for children with special needs as an Assistant Teacher in their early intervention programme, where I met an Art Therapist for the first time. One of the students always drew himself and his mum with no mouth and his dad with very big hands. The Art Therapist was able to spot and interpret this as a case of family violence. I found it fascinating how the therapist had this deeper layer of interpretation and understanding. And I was inspired to be an Art Therapist!

3. What is art therapy? What type of patient benefits most from Art Therapy?  How does art therapy help the patient?
 

Phylaine working as part of a multi-disciplinary team to treat Eating Disorders.


Art Therapy is a mental health treatment where instead of medicine a trained therapist uses creative activities like drawing, painting or sculpting to help patients express emotions and explore their thoughts. This allows patients to gain insights and tackle underlying issues. It is like using colours and shapes to unravel feelings and understand oneself, just like how putting together pieces of a puzzle helps you to see the bigger picture.

Patients with mental health struggles, including trauma, anxiety, eating disorders and major depression may benefit well from Art Therapy. 

Using a case example, a patient under long-term hospitalisation may feel isolated and perceive that he is losing his sense of self. This affects his mental health. 

As the Art Therapist in the multi-disciplinary team, my role is to help this patient improve his mental health by alleviating his feeling of isolation and improving his sense of self - so that he may be more receptive to treatment. Often when person is not doing well in his mental health, he may experience symptoms such as low mood and low motivation. He may become unmotivated to participate in treatment such as physiotherapy, or may not follow instructions well, for example, fall-prevention tips.
 

This year, Phylaine did her first scientific poster with colleague, Music Therapist Stephanie Chan.


I alleviate his feeling of isolation by providing companionship when we make art together. The choice of art medium is also a critical aspect of his art therapy. Here I will use natural materials such as leaves, branches or rocks to help him to feel closer and more in touch with the outside world. 

To improve his sense of self, I will have conversations with the patient about his art making process and reflections. In the initial stages, I may ask, “Can you use the provided materials to creatively express who you are now? How has this changed you? What was your identity before this?” He might work with a leaf to express that he feels fragile like a dry leaf, empty and on the verge of being broken at the slightest touch.

In later sessions, I may ask him, “Can you make a piece of art that represents how your identity has changed since we started Art Therapy?” If growth had occurred, he may work with soft twigs and express that he may be bent but remains unbroken. 

4. How does art therapy work together with other treatment?

As the cases managed in SGH are acute and complex, the Art Therapist works as part of a multi-disciplinary team. For example, a patient with anxiety would be concurrently seeing a psychiatrist. Subsequently, the patient may consult the Occupational Therapist where they would work on her daily living activities, such as how to schedule a day that is manageable to her.

5. How do you assess that a patient is making progress when undergoing art therapy?

We have measurement scales to track a patient’s progress. For example, if the patient is experiencing difficulties with daily living – such as increased fear of crowded places or a sudden shortness of breath - due to a past traumatic experience, I can use a scale that measures post traumatic stress.  This scale assesses the patient using questions like, “Do you get flashbacks? How often do you have unexpected, unwanted thoughts that make you anxious or uncomfortable?” 

Other than scales, it is also common that a patient’s artwork and art-making process transform during their recovery, like the above case for the long-stay patient. To illustrate with another example, when a patient with anxiety starts Art Therapy, her pictures may appear rigid - a lot of lines, boxing, outlining and erasing. She may also struggle with risks taking or trying new materials. As she gets better, she may start to take risks during art making, or work more with materials that give less control, such as watercolour, as opposed to pencils and markers. I may also observe that she does not have to correct her mistakes as much. 

6. What is one thing you want everyone to know about art therapy?

Art therapy is often misunderstood as “adult colouring books” or art classes. So I advocate for it every chance I get. With the right understanding, colleagues can make more accurate referrals and patients can also request for art therapy.

 

At an outing to a musical this year - Phylaine and her colleagues from the Art Therapy & Music Therapy (ATMT) Unit. (From left) Estelle Ng, Music Therapy Student; Stephanie Chan, Music Therapist; Jeremy Koh, Senior Executive; Phylaine; Lim Mun Moon, Head of Art Therapy & Music Therapy


The Music and Creative Therapy Unit is now called Art Therapy & Music Therapy (ATMT) unit. 

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