SCMP – Art of hearts

PUBLISHED : Wednesday, 01 February, 2006, 12:00am
UPDATED : Wednesday, 01 February, 2006, 12:00am

STANDING FIRM IN the face of a roaring tiger isn’t easy, but there are rich rewards for the victims of child abuse who use this new virtual technology to cope with trauma.

In one of City University’s science labs, Sun (not his real name) navigates his way through a world of virtual reality. The 11-year-old is a victim of child abuse and is trying this new therapy that blends art with interactive technology.

‘I [said] it was good to have him here – he looked surprised,’ says Julia Byrne, president of the Hong Kong Association of Art Therapists. ‘Validating his worth should be a new concept for him.’

Smart Ambience Therapy (SAT) is a $1.4 million programme developed by a group of scientists at City University in conjunction with local art therapists, and Sun is one of nine child-abuse victims testing the treatment.

From an early age, Sun was emotionally abused by his parents, who were too busy to provide proper care. He became aggressive, both at home and at school. He neglected his personal hygiene and lacked discipline. His parents sent him to live with his grandparents, but things didn’t improve. They lacked patience, were prone to losing their temper and often resorted to violence. Sun’s father eventually sought help from a social worker, who referred him to Byrne – and she put him through SAT.

Byrne says art therapy offers children an outlet to express their feelings and can pave the way for them to overcome behavioural and emotional difficulties and learn vital emotional skills.

In traditional art therapy, patients produce images that reflect their feelings and the process can be cathartic. Through SAT, virtual reality brings the art to life. Patients can interact with their environment, form relationships with the characters within it and learn valuable lessons along the way.

‘Traditionally, the client makes the image,’ says Byrne, a 10 year-veteran of art therapy whose collaboration with local art therapists has extended to workshops and courses, in addition to clinical treatment. ‘But now the client gets into the image and interacts with the elements – the body is more actively involved.’

The likes of throwing paint at a wall is encouraged because it allows children to take positive risks. SAT uses a technology called Body Brush, which is funded by the government’s Innovation and Technology Fund. Body Brush captures and translates a patient’s body motions and gestures into visual forms and movements. This allows the child to interact with the machine to create a variety of visual forms and space.

Champions of art therapy include hospitals in the public health system – Tai Po and Queen Mary, for example – and social groups such as the YWCA and Sheng Kung Hui. But development of the treatment has been hampered by limited public resources and the fact that there are just four professional art therapists in Hong Kong.

Because of this, it’s difficult to quantify the effectiveness of art therapy, not to mention assess its cost-effectiveness.

City University’s chair professor in computer science and head of the SAT project, Horace Ip Ho-shing, wants further collaboration on the therapy and more research to enable SAT to benefit more people. ‘We could design more SAT games so that it could help people with depression, trauma, bereavement, learning difficulties and autism,’ says Ip.

Money remains the main issue. The SAT team wants to promote the programme to welfare centres around Hong Kong, but each computer costs at least $500,000.

William Fan Tak-wing, senior medical officer at Castle Peak Hospital, says Body Brush could improve body co-ordination among the physically handicapped.

‘If they see their own movements being translated as an image on to a screen, it can stimulate them to use that part of their body,’ Fan says. ‘They can then improve their muscle control.’

It could also be used to treat phobias. ‘If a victim has phobia [about] a certain type of animal, he can slowly master skills to confront it in virtual reality,’ he says. ‘The client feels safe because he knows it’s not real.’

Byrne has slowly transformed Sun from an aggressive child with little confidence into one with higher self esteem and a greater sense of self control and ability to express himself.

Much of this has come from playing the SAT games. The tiger in a wooden box is part of a programme called Face the Threat, which teaches assertiveness in the face of an aggressor.

The SAT team shows Sun how to challenge the perceived threat and once he achieves this he’s rewarded by being transformed from the box into a grassland, a much nicer environment designed by himself (patients are given images from which to choose).

‘[The grassland enables them to see] they can do their own things to make changes in their lives,’ says Byrne. ‘They can internalise this ability. In traditional therapy, this change has to be imagined.’

A Heart Man encourages the child to cultivate feelings of love. Waving the arm activates the process, sending out hearts to a moon icon that smiles more and more as it receives the hearts. Sun’s initial reaction to this game is negative.

When asked to whom he wants to offer love, he says, ‘no one’. But after a while he changes his mind.

‘[He slowly] shared that he wanted to offer hearts to his mother,’ Bryne says.

The last stage of the therapy entails creating a safe place, so the patient can learn the feeling of security.

The children design the environment themselves, with Sun picking trees, flowers, shells and a swing. This is important because it’s an active movement towards creating something that’s positive. Sun told Bryne he enjoyed being in the middle of the island, surrounded by trees.

‘He felt safe there. It was apparent how he began to internalise a sense of safety,’ she says. ‘At the end, he also expressed his desire to live with his parents and make a healthy future.’

A senior social work practitioner at the Hong Kong Family Welfare Society, Shirley Tang Tsang Kar-yee, has put her patients through the therapy and she is happy with the results.

However, she’s quick to point out that SAT is not a panacea. Parenting skills must be improved, too. She suggests Sun’s parents go through training provided by the society on how to raise children and allow their relationship with him to be reviewed.

Sun’s parents have resumed their roles as full-time father and mother and are making plans to live with their son.

And Tang says Sun has changed for the better. For a start, he has stopped lying about his true feelings.

‘Because of the physical abuse, he lost trust in people,’ says Tang. ‘He’s now become more reasonable and is willing to communicate with others. He understands the SAT team is supportive, but he too has to play a part in helping himself.’