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Sewing Dolls and Pillows

Running Stich

For clients with developmental disabilities, an important goal of art therapy is to foster successful art making experiences they can subsequently feel proud of. I am flexible during 1:1 or group art therapy sessions, allowing the clients to choose what they would like to work on, while keeping my ears and eyes open for any suggestions they may have for art projects they would like to work on in the future. So, when a client happened to mention how she used to watch her mother sew dolls when she was a child, I asked her (and later the group) if they’d like to begin a sewing project. The group, which is mainly young females in their early 20s, enthusiastically replied “yes”- especially after they began to see some of the projects their peers were working on.

Materials:

– Felt (rectangular pieces of various colors) – felt is good because when you cut it, it doesn’t fray
– Embroidery floss (sometimes split in half to make it more like regular thread)
– Sewing needles
– Plastic sewing needles
– Hand held hole puncher 1/8″
– Yarn
– Buttons
– Scissors
– Pipe cleaners
– Fabric Glue
– Fluff/Stuffing

Directives:

I am hoping that in the future I’ll have some photos to put alongside this post, which may help following my instructions a little easier.

– Clients chose which they would like to work on; a pillow or a doll.

– If the client does not have the fine motor skills to use a regular sewing needle (for example if the client has cerebral palsy), or if the client may become self injurious with the needle, I offered to punch small holes along the edge of the felt so that they could sew using a plastic needle and thread.

– For clients that were comfortable using a needle, I reviewed threading and how to make a running stitch, practicing on a test piece of felt.

Pillows

– Clients making a pillow chose 2 pieces of rectangular felt. They were asked if they wanted to embroider a design on their pillow. If they said yes, I asked them to draw an outline on one piece of felt using a dark colored pencil. Then, using the running stitch (or an embroidery stitch) the client sewed along the outline they created. After the design is complete, the client can begin sewing their 2 pieces of fabric together into a pillow. Remind the clients to leave one side unsewn so that the pillow can be stuffed and sewn closed.

Dolls

– For clients making a doll, I begin by asking them to make a sketch of what they would like their doll to look like.

-Many DD clients have low frustration tolerance, and difficulty cutting accurately. Since one of the goals is to make this project successful, I suggest the therapist cut the shapes needed for the head, body, arms and legs for the client, allowing the client to focus on the task of sewing and stuffing. This helps the project to be less overwhelming for some. However, higher functioning clients (especially adolescents who are trying to master separation and individuation) may ask that the therapist not help. In this case, respect the client’s wishes, while reminding them that you are there if they have any questions.

– Most clients opt to begin with the head. I have multicultural skin toned felt, which is great for the head, hands and feet. I precut 2 circles for the client, in the color of their choice, to be sewn together as the head. However, before the sewing begins, I suggested to the clients that they may want to work on the face, for example, by sewing on buttons for eyes or gluing yarn for a mouth. Once the face is completed, the 2 round felt pieces can be sewn together, again, leaving an unsewn part to stuff the fluff into and then close. Hair can be added by gluing pieces of yarn on the finished head with some fabric glue.

– While the client works on the head, the therapist can cut 2 pieces of felt intended to be the body according to what the client has drawn in their sketch. This may be a simple shape, such as a triangle or rectangle, or it may be more complex, like a dress that has a neck, shoulders and arms. They may want to choose felt of a different color so they body looks like clothes. Again, the client will sew the 2 pieces of felt together, leaving an unsewn part to stuff. Before the stuffing takes place, the client may want to add a pipe cleaner (folded into a “w” shape) into the body, so that it acts like a spine- holding the doll in place. Once the pipe cleaner is inserted, the client can stuff and close.

– For simplicity’s sake, I opted to not have 3 dimensional arms and feet, but rather cut one piece of felt into the hands and legs of the doll.

– The client can now sew the head to the body, as well as the arms and legs.

Tip– For the pillows/dolls made by clients who did not sew their piece well enough to last (it looks like it will fall apart), the therapist may ask if the client would like some extra reinforcing sewing to be done by the therapist so the pieces will last longer. While many DD clients are excellent sewers, some are not. Helping to support the longevity of a project that the clients intend to keep over the long term because they are proud of their piece, can be validating to the client and demonstrate that their work, ideas and creativity is valued.

Observations

This is an ongoing project, so there will be no doubt more information about this directive to come. In any case, here are some interesting dynamics that have surfaced so far with the individuals participating in group art therapy 4x per week (sessions are voluntarily attended, so many do not participate as much as this). All information shared is in generalities to protect the identities of the clients.

– As the group members sewed, almost immediately a discussion began about mom’s. It seems that many of these clients were taught to sew by their mothers or maternal figures, and the act of sewing itself evoked strong memories of their mothers.

– Many of the clients who chose to create a doll are in the process of working through body image issues. Doll making may open another avenue of exploring such issues with the therapist.

– The participants are proud of their work, and proud that they were able to remember or learn new skills.

– Many clients remarked on how relaxing hand sewing is, and wanted to create more than one piece.

– Some clients wanted to use their own fabric, for example from old clothes, to make their pieces. In many of these instances the fabric used were from clothes that have meaning to the client. For example, one client saved a hospital robe from a involuntary psychiatric hospitalization, and used this robe to make a pillow as a reminder to herself that she does not want to be involuntarily hospitalized again.

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Art Show

I recently organized an art show at Redwood Place (for staff and clients only), where the masks discussed in a previous post were featured. The art show took place at lunch time during a special barbq. The masks were hung all around the dinning room, and underneath each mask was a personal explanation or story, as well as the client’s first name to go along with their respective mask. In total, there were about 25 masks featured.

The clients seemed to enjoy walking into the dinning room, and trying to find their mask on the wall. I also observed that many clients needed encouragement to take the time to look at other people’s masks or read the blurbs to go along with the artwork. Some clients had difficulty remembering which mask were theirs, and needed a reminder to patiently look around the room to find their mask.

Several clients whose artwork was featured in the art show chose not to attend, but rather go to lunch at a local grocery store. Once they returned back to the facility, they seemed disappointed that they did not attend, stating that they had forgotten. This made me realize that although the art show was talked about and featured on the monthly calendar, extra reminders may be needed, such as by posting up special flyers around the facility advertising the art show further.

It was also interesting to see the reaction of the staff, who were curious about the masks and their stories. Many staff discussed feeling excited for the art show, where they would see the masks the clients’ artwork. During the exhibit staff members took the time to look carefully at each mask and ask clients questions. I felt that seeing the masks may have helped the staff see another side of the clients that they may have been unaware of previously…at least, that is my hope.

After the exhibit had taken place, I was surprised how many clients (even low functioning clients) asked when the next one would be and expressed interest in knowing what art project will be focused on next. Indeed…that is the question. Lately I’ve been thinking of slowly introducing paint and eventually mono-printing techniques to be done using paint, paper and cafeteria trays. But its summertime, and we have a beautiful garden in the back…maybe some drawing from life outdoors? We’ll see…

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DSM for People with Developmental Disabilities

I recently attended a conference in San Jose hosted by UCLA’s TARJAN Center for Developmental disabilities entitled, Innovative Approaches: Treatment for People with Developmental Disabilities & Psychiatric Disorders. There I discovered that a new DSM specifically tailored to individuals with developmental disabilities is now available. The title is: The Diagnostic Manual- Intellectual Disability (DM-ID): A Textbook of Diagnosis of Mental Disorders in Persons with Intellectual Disability.

I have yet to read it, so I’m not sure exactly what the differences are between this book and the DSM-IV-TR. I’m hoping that one of my administrators will be acquiring it soon for the clinicians at Redwood Place.

I suppose the reason for this text is to help clinicians and psychiatrists tease through the symptom presentation that is found within the dually diagnosed DD and mentally ill population, who often present differently than people without DD. This begs the question: so…when are they going to come out with a DSM specifically geared towards children? As many professionals have noticed, children often present differently than adults, which is not reflected in the current DSM. Perhaps a DSM for children is in the works, and I haven’t heard about it, after all, to me, the DD DSM was a surprise.

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Stress Balls

I first learned how to make a stress ball, using a balloon and flour, when I was working with Jeanette Pailas ATR-BC at the Friends Hospital Eating Disorder Unit in Philadelphia, PA. The purpose of making the stress balls was so that the clients could use the final product itself during times of anxiety, but also the directive may represent a metaphor for eating: filling up a stomach, which is stretchy like a balloon.

I’m presently working with developmentally disabled individuals. They too have difficulties managing their anxiety. One client in particular tends to squeeze his had so hard in a fist, that he causes lesions to his skin with his nails. This inspired me to introduce stress ball making in my art therapy group. I prestructured the group so that there would be only a small number of steps, insuring the success of the clients (an important goal of artx with developmental disabilities).

Here is a break down of how I structured the group:

Materials

– Balloons
– Flour
– The top part of a water bottle (a make-shift funnel)
– Spoons
– Small cups
– Colored pencils

Prestructuring

– Stretch a balloon over the top of a water bottle. Prepare as many balloons and funnels as needed according to the size of your group.
– Prepare several small cups with flour. Each cup should have a plastic spoon in it, making it easy to transfer flour into the funnel. I decided to have a cup of flour per person, but having the clients share with each other can be an option to promote group interaction.

Execution

– Introduce the idea of a stress ball- what it is, what it can be used for. I find it important to remind the clients that balloons can pop…discussing squeezing the stress ball in the palm of their hands vs. digging your nails or twisting the balloons.
– Pass around a pre-made stress ball, so that the clients an see and feel an example of a balloon stress ball.
– Have a quick demonstration about how to make a stress ball. I began by holding up a pre-prepared balloon/funnel and spooning in some flour. I then demonstrated how to use the back of a colored pencil to pack down the flour. I let the group know that if they needed help holding the funnel or packing down the flour, they could ask (I usually have a recovery specialist in group with me. This can be very helpful if there are several clients needing assistance at once).
– Hand out materials.
– As the group began working, I encouraged them to share their techniques- what works to get the flour down and what doesn’t.
– We discussed what situations they themselves might find the stress ball handy.
– When a client felt that he/she had filled up the stress ball enough, I helped them tie off the balloon.

Results

I found that with encouragement the clients were able to successfully work through the frustration of stuffing the flour into the balloon (it takes some persistence). They also tended to be hesitant about getting dirty. Redwood Place unfortunately does not have a designated art room. We tend to use common areas, or a conference room. I also wonder what would happen if the group had the freedom to “get messy”. So far I haven’t introduced paint or clay in the short time I have been working there. In any case, I realized quickly that flour (as long as its not wet) offers easy clean up. You can sweep it off the floor and brush it off your clothes. I therefore demonstrated this fact to the group by pouring some flour on my pants, and brushing them off, like new.

After the group was over, several clients seemed proud of their work. I was surprised, however, that the next day the same clients were asking to make more stress balls. Their peers, who had not joined us for the previous art therapy group, had also seen the stress balls, and wanted to make their own.

Over the next 3 days the art therapy group consisted of making stress balls. Some clients wanted to make a new one because their last one broke. Others wanted two or three- one for their room, one for their pocket. Some wanted to make an extra one for family or friends. All in all, this seemed to be a successful directive that many clients enjoyed and found useful.