Nidhi Chabora, APRN-Rx, BC
2012 APNA Award for Innovation - Individual
To Nidhi Chabora, APRN-Rx, BC, creating art is “worthy of prescription.” After several years of spending her days working as a Nurse Practitioner in Hilo, Hawaii doing medication management paired with some supportive and motivational therapy, she noticed a persistent sense that there was a piece missing. “Clients who responded to medication came in feeling better with reduction of symptoms, but I felt something was missing in their presentation,” she remembers. “There was relief but very few signs of healing: such as high self esteem, solid sense of self, engaging in purposeful activity and enjoying meaningful relationships.”
Chabora wanted to take her patients beyond simple diagnoses and symptoms management “to a sense of wellness and being comfortable with themselves.” She remembered from her experience on locked wards in New Jersey that clients gained a boost in self-esteem by producing art and resolved to research the use of art creation for clients with mental illness further. Through various readings including the book Art as Medicine by Shaun McNiff, she became convinced “that expressive arts was an important step in the healing process” and determined to integrate art creation into her work with her clients.
The question that remained was how to do so in a way that would be most effective for the population she was serving. The answer came to her unexpectedly one day at the gym. “In 2009, NJ Moses came into my life as an answer to my prayers,” she says. “We were at Curves exercising and she came over and introduced herself, saying, ‘I am NJ and I am a social entrepreneur. I am a retired art teacher from Minnesota and am looking for something to do.’” Chabora was thrilled - “Do I have a gig for you!” she responded. The two jumped right in together, exploring various approaches to “marry art and therapeutic themes.” Chabora’s clients were eager to participate as “guinea pigs,” as the two refined their approach. “I have always been a fan of Cognitive Behavior Therapy from my years of working with people with substance use disorders,” Chabora says. “Over the course of the following year the idea of combining CBT with art-making percolated to the surface and evolved naturally into what we have today: Self Discovery through Art.”
Chabora has worked determinedly to make Self Discovery through Art a success. “With no funding for this innovative idea, Nidhi has been known to dumpster dive, beg, pray, and spend her own money on art supplies,” NJ Moses says. Many of the participants have trouble expressing themselves verbally or are illiterate; this program presents them with an alternative and a new way to communicate therapeutically. For two hours each week, adult clients meet for this “ongoing psycho-educational and structured studio art therapy program,” as Chabora puts it. She has broadened the program to connect with and educate the community, inviting local artists to share their techniques in workshops, receiving support from the local Jaycees, and even arranging an exhibit of the participants’ art in a local art gallery.
Chabora describes the Self Discovery through Art program:
This unique program combines two familiar evidence based practices: Cognitive Behavior Therapy (CBT) and Art Therapy to enhance healing and sustain recovery. It is informed by the work of Albert Ellis, Aaron Beck, and David Burns along with art therapists Shaun McNiff, Noah Hass Cohen and Richard Carr. The emphasis of this program is to highlight selected cognitive distortions, explain and draw out awareness of clients’ use of these distortions and the associated feelings and behaviors. The clients are taught to use CBT techniques to challenge the distorted belief and associated emotion and arrive at corrected perceptions that are closer to reality. This is reinforced immediately by making art that clearly illustrates the distortion and then corrects it with new visual images that are closer to fact. The activity helps decrease cognitive-emotive dissonance (“this new way of thinking or doing is strange and alien to me and does not FEEL right”) and facilitates the “integration of limbic bottom up expression (Sympathetic Nervous System) and cortical top down regulation of affect” (Parasympathetic Nervous System) (Noah Hass-Cohen). We also know today that the left brain thinks in words and right brain sees images - this integration is evidenced by the ease with which clients come to the “aha” moments and the reinforcement that happens through experiential learning.
Our clients are discovering that:
They are all artists who are also capable of processing information and choosing their thoughts, feelings and behaviors instead of reacting automatically
They can lose themselves in art making and sublimate hostile emotions into productive endeavor and that communicating through color, line, shape, space, value, texture is a complex way of communicating meaning without using words
They belong to an elite group as their art hangs in art shows in the community and now they can move on to accomplishing other goals they set aside because they were too “sick” to dream.
They are more willing to go with the flow of unanticipated possibilities