Abstract Background/Aims Severe anxiety around medical procedures such as blood tests can significantly affect engagement in care for adolescents with rheumatological conditions. Collaborative, non-pharmacological approaches help young people manage procedural distress and build confidence. This case study describes the joint work of a Teapot Trust Art Therapist, Clinical Nurse Specialist, and Healthcare Assistant supporting a 17-year-old young person with needle phobia and vasovagal syncope. As the young person approached transition to adult rheumatology—where gas and air would not be available—they aimed to develop strategies to undergo blood tests without vomiting or fainting. Following an initial assessment, the young person engaged in eight fortnightly art therapy sessions, coordinated with the Clinical Nurse Specialist and clinic visits supported by a Healthcare Assistant. The young person’s therapeutic goals were to develop coping strategies for blood tests and explore feelings about transition to adult services. Methods Sessions combined creative exploration, psychoeducation, and graded exposure. The young person used medical materials (cannulas, syringes) in artmaking, including syringe painting, to desensitise triggers. Breathing exercises were practised through mark-making, replicating gas and air rhythms. Sensory grounding using the five senses and visual imagery supported self-regulation, which the young person practised at home with parental support. The Art Therapist, Clinical Nurse Specialist, and Healthcare Assistant collaborated through shared planning, progress reviews, and a final clinic session where the young person successfully tolerated venepuncture without gas and air. Results The young person progressed from requiring gas and air for blood tests to tolerating venepuncture without it, using co-developed breathing and grounding strategies to prevent fainting. Conclusion This collaborative intervention between an Art Therapist, Clinical Nurse Specialist, and Healthcare Assistant enabled the young person to explore fears creatively, understand physiological responses, and build coping strategies. Joint planning and graded exposure supported procedural confidence, reduced vasovagal responses, and informed transition readiness. An integrated approach provided a safe, empowering space for self-regulation and emotional processing, demonstrating the value of multidisciplinary, non-pharmacological approaches in paediatric rheumatology. We acknowledge the valuable input of the nursing team on Ward 1C at the Royal Hospital for Children, Glasgow, and the commitment of the young person and parent, whose hard work made this case study possible. Disclosure P. Watts: None. A. Fell: None. S. Callan: Corporate appointments; Trustee for Teapot Trust.
Watts et al. (Wed,) studied this question.
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