This annotated bibliography examines three sources that explore using creative expression to help families struggling with a terminally ill loved one. The first source discusses how palliative care provides limited support for family distress. The second summarizes a study finding creative expression helped young adult cancer survivors cope through increased understanding and social benefits. The third recommends play therapy to facilitate healthy family communication in counseling, as play can create new communication patterns. Overall, the sources suggest creative activities like art, music, and play therapy should be part of palliative care to address non-verbal family distress.

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Running Head: Annotated Bibliography
Turning Non-verbal Distress Between Family Members into Creative Expression to Stimulate
Healthy Communication Within Palliative Care Environments: An Annotated Bibliography
Stephanie Templeton
College of Central Florida

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Running Head: Annotated Bibliography
Abstract
Research question: Should there be a therapeutic creativity protocol in place to help
families who are struggling to come to terms with having a terminally ill loved one?
To answer this question, this bibliography summarizes three Research Journals
found within the LINCC library database. The first source sheds light on the issues
regarding insufficient coping practices provided for families with loved ones under
Palliative Care. The second source explains how a research study conducted on young-
adult cancer survivors yielded positive personal and social coping results. The last article
communicates the benefits of recuperation when utilizing play therapy within a family-
centered counseling session. Nevertheless, the combination of these three sources
demonstrates creative expression as an effective therapeutic method. Accordingly, play
therapy can address non-verbal distress between family members; thus, art therapy, music
therapy, and play therapy should be employed as healing tools among other Palliative
Care interventions.

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Running Head: Annotated Bibliography
The authors of this article articulate how palliative care guides contain limited distress
interventions for families. First, they discuss distress conceptualized as a multi-dimensional
construct, which shifts from a unitary to a systemic construct. Furthermore, two types of distress
are established: non-interactive depictions of distress and communicative distress. Finally, the
authors, conclude with an urgent need for research that can serve to define and alleviate distress
in the families of palliative care patients. “Psychosocial interventions adopting a systemic
approach may provide a cogent model to improve the psychosocial care of families in palliative
care” (Carolan, Smith, and Forbat, 2015).
Carolan, M. C., Smith, A., Forbat, L. (2015). Conceptualising Psychological Distress in Families
in Palliative Care: Findings from a Systematic Review. Palliative Medicine, 29(7), pp. 605-632.
This article synthesizes a study on cancer survivors conducted by Green, A.R., and
Young, R. A. The study focuses on the impacts of Creative expression on young, adult-aged
cancer patients. The results yielded positive effects on coping ability, which include: increased
self-understanding, respect for art as a separate entity, renegotiating control, healing experience,
changing one’s environment, and emotional expression. Moreover, the social benefits of creative
expression on these cancer patients promoted personal growth and meaning-making. Through
creative expression, they shared experiences non-verbally. Additionally, the cancer patients
managed to communicate and understand emotions repressed beneath the surface level.
Therefore, Green and Young concluded that Creative expression furthers phenomenological
understanding.

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Running Head: Annotated Bibliography
Green, A. R., & Young, R. A. (2015). The lived experience of visual creative expression for
young adult cancer survivors. European Journal of Cancer Care, 24, 695-706.
According to a conclusion by Wehrman and Field, play-based strategies such as puppets,
dolls, expressive arts, and role play are effective methods to help facilitate healthy family
communication in the healing process. In family-based counseling, counselors should be
knowledgeable in multiple facets of play-based activities from supplies for play to Multicultural
Considerations and Parent Resistance. The article explains, parents may believe play is a
distraction from more important issues, and feel uncomfortable engaging in play. Since the use
of play-based activities can potentially create new communication and relational patterns among
all family members, counselors are urged to encourage therapeutic expression. “. . . if structured
effectively, play therapy can result in progress and success for the entire family” (Wehrman &
Field, 2013).
Wehrman, J. D., & Field, J. E. (2013). Play-Based Activities in Family Counseling. American
Journal Of Family Therapy, 41(4), 341-352. doi:10.1080/01926187.2012.704838

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Running Head: Annotated Bibliography
References:
Carolan, M. C., Smith, A., Forbat, L. (2015). Conceptualising Psychological Distress in
Families in Palliative Care: Findings from a Systematic Review. Palliative Medicine,
29(7), pp. 605-632.
Green, A. R., & Young, R. A. (2015). The lived experience of visual creative expression for
young adult cancer survivors. European Journal of Cancer Care, 24, 695-706.
Wehrman, J. D., & Field, J. E. (2013). Play-Based Activities in Family Counseling.
American Journal Of Family Therapy, 41(4), 341-352.
doi:10.1080/01926187.2012.704838