Art therapy
Art therapy is a form of expressive therapy that uses art materials, such as paints, chalk and markers. Art therapy combines traditional psychotherapeutic theories and techniques with an understanding of the psychological aspects of the creative process, especially the affective properties of the different art materials. As is also the case for other forms of expressive therapy, research into the effectiveness of art therapy has not been conducted with sufficient detail or quality to support claims of its clinical effectiveness in treating any form of mental disorder.
As a mental health profession, art therapy is employed in many clinical settings with diverse populations. Art therapy can be found in non-clinical settings as well as in art studios and in workshops that focus on creativity development. Closely related in practice to marriage and family therapists and mental health counselling, practitioners of art therapy throughout the US are licensed as MFTs, LPCs, or LPCCs and hold either registration or board certification as an art. Practitioners of art therapy work with children, adolescents, and adults and provide services to individuals, couples, families, groups, and communities.
According to the American Art Therapy Association, art therapy is based on the belief that the creative process of art is both healing and life-enhancing. The American Medical Association and Health Professions Network state that practitioners of art therapy use drawing, painting, and other art processes to assess and treat clients with emotional, cognitive, physical, and/or developmental needs and disorders, though neither of these professional medical organizations endorse the practice of art therapy, nor do they suggest that art therapy is an effective means to treat mental disorders.
Using their skills in evaluation and psychotherapy, practitioners of art therapy choose materials and interventions appropriate to their clients’ needs and design sessions to achieve therapeutic goals and objectives. They use the creative process to help their clients increase insight and judgment, cope better with stress, work through traumatic experiences, increase cognitive abilities, have better relationships with family and friends, and to just be able to enjoy the life-affirming pleasures of the creative experience. Depending on the state, province, or country, the term 'art therapist' may be reserved for those that are professionals trained in both art and therapy and hold a master's degree in art therapy or a related field such as counselling or marriage and family therapy with an emphasis in art therapy. Other professionals, such as mental health counsellors, social workers, psychologists, and play therapists apply art therapy methods to treatment. Many practitioners of art therapy in the US are licensed in one of the following fields: creative arts therapy, art therapy, professional counselling, mental health counselling, or marriage and family therapy.
Practitioners of art therapy have generated many specific definitions of art therapy, but most of them fall into one of two general categories. The first involves a belief in the inherent healing power of the creative process of art making. This view embraces the idea that the process of making art is therapeutic; this process is sometimes referred to as art as therapy. Art making is seen as an opportunity to express oneself imaginatively, authentically, and spontaneously, an experience that, over time, can lead to personal fulfilment, emotional reparation, and recovery (Malchiodi, 2006).
The second definition of art therapy is based on the idea that art is a means of symbolic communication. This approach, often referred to as art psychotherapy, emphasizes the products - drawings, paintings, and other art expressions--as helpful in communicating issues, emotions, and conflicts. The art image becomes significant in enhancing verbal exchange between the person and the therapist and in achieving insight; resolving conflicts; solving problems; and formulating new perceptions that in turn lead to positive changes, growth, and healing. In reality, art as therapy and art psychotherapy are used together in varying degrees. In other words, practitioners of art therapy feel that both the idea that art making can be a healing process and that art products communicate information relevant to therapy are important (Malchiodi, 2006).
Purpose of Art Therapy
The purpose of art therapy is much the same as in any other psychotherapeutic modality: to improve or maintain mental health and emotional well-being. But whereas some of the other expressive therapies utilize the performing arts for expressive purposes, art therapy generally utilizes drawing, painting, sculpture, photography, and other forms of visual art expression. For that reason practitioners of art therapy are trained to recognize the non-verbal symbols and metaphors that are communicated within the creative process, symbols and metaphors that might be difficult to express in words or in other modalities. By helping their clients to discover what underlying thoughts and feelings are being communicated in the artwork and what it means to them, it is hoped that clients will not only gain insight and judgment, but perhaps develop a better understanding of themselves and the way they relate to the people around them.
What Does a Typical Art Therapy Session Look Like?
Malchiodi (2006) provides an example of what an art therapy session involves and how it is different from an art class. "In most art therapy sessions, the focus is on your inner experience--your feelings, perceptions, and imagination. While art therapy may involve learning skills or art techniques, the emphasis is generally first on developing and expressing images that come from inside the person, rather than those he or she sees in the outside world. And while some traditional art classes may ask you to paint or draw from your imagination, in art therapy, your inner world of images, feelings, thoughts, and ideas are always of primary importance to the experience.
Therapy comes from the Greek word therapeia, which means 'to be attentive to.' This meaning underscores the art therapy process in two ways. In most cases, a skilled professional attends to the individual who is making the art. This person’s guidance is key to the therapeutic process. This supportive relationship is necessary to guide the art-making experience and to help the individual find meaning through it along the way.
The other important aspect in art therapy is the attendance of the individual to his or her own personal process of making art and to giving the art product personal meaning--i.e., finding a story, description, or meaning for the art. Very few therapies depend as much on the active participation of the individual. In art therapy, the practitioner facilitates the person's exploration of both materials and narratives about art products created during a session.
Art-Based Assessments
Practitioners of art therapy and other professionals use art-based assessments to evaluate emotional, cognitive, and developmental conditions. There are also many psychological assessments that utilize artmaking to analyse various types of mental functioning (Betts, 2005). Practitioners of art therapy and other professionals are educated to administer and interpret these assessments, most of which rely on simple directives and a standardised array of art materials (Malchiodi 1998, 2003; Betts, 2005). The first drawing assessment for psychological purposes was created in 1906 by German psychiatrist Fritz Mohr (Malchiodi 1998). In 1926, researcher Florence Goodenough created a drawing test to measure the intelligence in children called the Draw–A–Man Test (Malchiodi 1998). The key to interpreting the Draw-A-Man Test was that the more details a child incorporated into the drawing, the more intelligent they were (Malchiodi, 1998). Goodenough and other researchers realized the test had just as much to do with personality as it did intelligence (Malchiodi, 1998). Several other psychiatric art assessments were created in the 1940s, and have been used ever since (Malchiodi 1998).
Notwithstanding, many practitioners of art therapy eschew diagnostic testing and indeed some writers (Hogan 1997) question the validity of therapists making interpretative assumptions. Below are some examples of art therapy assessments:
The Diagnostic Drawing Series (DDS)
The Diagnostic Drawing Series is an art therapy assessment that is correlated with the diagnosis of major psychiatric disorders (Mills, 2003). The DDS is a three drawing series that is used by mental health professionals around the world (Diagnostic Drawing Series website, 2009). In the first part, subjects are asked to draw any picture using coloured chalk pastels on an 18 x 24 inch piece of paper. Then they are asked to draw a tree in the second part. In the last part of the art interview, subjects are asked to show how they are feeling using lines, shapes, and colours. Research regarding the pictures is generally based on the presence and absence of many elements, such as use of colour, blending, and placement of the images on the paper (Cohen, Hammer, & Singer, 1988).
The Mandala Assessment Research Instrument (MARI)
In this art therapy assessment, a person is asked to select a card from a deck with different mandalas; designs enclosed in a geometric shape, and then must choose a colour from a set of coloured cards (Malchiodi 1998). The person is then asked to draw the mandala from the card they choose with an oil pastel of the colour of their choice (Malchiodi 1998). The artist is then asked to explain if there were any meanings, experiences, or related information related to the mandala they drew (Malchiodi 1998). This test is based on the beliefs of Joan Kellogg, who sees a recurring correlation between the images, pattern and shapes in the mandalas that people draw and the personalities of the artists (Malchiodi 1998). This test assesses and gives clues to a person's psychological progressions and their current psychological condition (Malchiodi 1998). The mandala originates in Buddhism; its connections with spirituality help us to see links with transpersonal art.
House–Tree–Person (HTP)
In this art therapy assessment, the patient is asked to draw three separate images: a house, a tree, and a person (Malchiodi 1998). After the patient has finished the drawings, the therapist asks questions like, "How old is the person in your drawing? What is he or she doing? What is the house made of? What is the weather in this picture?" (Malchiodi 1998). This assessment can be done achromatically (one colour, such as lead pencil) or chromatically (with various coloured markers or pencils). This is a projective assessment and the house, the tree, and person in the drawing represent different aspects of the artist and the way the artist feels about him or herself (Malchiodi 1998).
Road Drawing
In this art therapy assessment and therapeutic intervention, the patient is asked to draw a road. This is a projective assessment used to create a graphic representation of the person's "road of life." The road drawing has the potential to elicit spontaneous imagery that represents the client's origins, the history of his or her process, experiences to date, and intent for the future - even from a single drawing (Hanes, 1995, 1997, 2008). The road's reparative features or its need for "periodic upgrade" can serve as a metaphor for the client's capacity for change and restoration (Hanes, 1995, 1997, 2008).
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