Although the idea of self-discovery through art is an old
one, the concept of art therapy is relatively new. For years, artists
of all kinds have been growing, learning and expressing themselves through
their respective medias, but only until the last century and a half, have
therapists turned to the arts as a potential tool for healing.
Who is Art Therapy for?
Art therapy is not just for people who are mentally ill, but rather for
children, adolescence and adults who are struggling with personal issues
or just in search of personal growth.
Art Therapy: Two Main Approaches
There are two basic ways in which an art therapist can approach the idea
of art therapy. The first is to be process intensive. In this approach
the art therapist, uses art as a means to help his/her patient(s) to discover
something about him or herself. Art is used as a catharsis, an emotional
journey to which self-actualization and discovery are the end result.
Edith Kramer was the first person to champion this school of thought.
Kramer emphasized the healing qualities of art making, and was concerned
with artistic quality.
The second approach is not to be so concerned with the process of making
the art, but with what the person is consciously or unconsciously expressing
through their art. Margaret Naumburg believed that this was the best way
to utilize art therapy. In this way, the art therapist uses art as a window
into the subconscious of the patient, and from there can attempt to figure
out the underlying problems that the patient may be suffering from. It
can be risky to look into art too closely, but in the case of children,
who may not have the words to express how they are feeling, it is very
beneficial to use art as a mode of expression.
Assessment often comes at the beginning of art therapy, and usually happens
during the first session that the therapist has with the client. Assessment
is used by the therapist to find out what the client is going through,
and to gain any other information that he or she may wish to find out
about the client. It is important to be very up-front at this time with
the client, being very clear that the session is not treatment oriented,
but is for assessment purposes. Assessment at the beginning of therapy
is an important first step because it is at this point that the therapist
will decide if art therapy is a good option for the client or if it would
be a waste of time.
#2 Treatment in the Beginning
The very first thing that needs to happen during the first session of
treatment is for the therapist to establish a good rapport with the client.
This rapport between the client and therapist is an important one because
it allows for the development of trust in the relationship.
It is also essential in this first session for the art therapist to better
grasp the framework from which the client is operating. This is also done
in the assessment stage of the sessions.
After establishing a rapport with the client and getting a grasp on the
client's vantage point, the art therapist can introduce art therapy to
the client. This is done by giving back-round information about art therapy,
and answering any questions that the client may have. At this point, the
therapist may suggest doing some artwork.
This first piece of art that the client creates is a very important one
because it sets the tone for the rest of the session. Because many people
have art anxiety in these beginning sessions, it is important that the
therapist makes the client feel as comfortable as possible. This could
be done by saying to the client that they should not worry about artistic
accomplishment, but rather self-expression. Another important aspect of
this first artistic work is the reaction of the therapist to it.
After this first session, it is important for the art therapist to begin
developing treatment goals, as well as to reflect on what initial reactions
the therapist may have after the first meeting.
#3 Midphase of treatment
It is fairly hard to know when the treatment has moved from the beginning
portion to the midphase, but there are a couple of key differences that
do mark the midphase. First, trust between the client and therapist has
been established, and the focuses of the sessions are more goal oriented.
For this reason the midphase part of treatment is often thought of as
the post honeymoon period. In the midphase of treatment the therapist
establishes direction and boundaries, both personal and professional.
Lastly, the midphase portion of treatment is generally believed to be
when the major issues are treated.
There are many different techniques that are used in art therapy and
knowing which one to use at what time is one of the art therapist's toughest
jobs. Because each case is unique and each client is different, the art
therapist must custom fit the art therapy for each individual client.
The following are some techniques that art therapists use and a brief
description of what they are and what they are used for.
Techniques for Group and Individual
An exploration task can be quite liberating. The goal is to encourage
the patient/client to let go of conscious thoughts and controls, and to
have them express themselves as freely and spontaneously as possible.
In this way, exploration tasks are very much akin to verbal free associations.
Exploration tasks are generally used in the beginning sessions of art
Some examples of exploration tasks are :
- Automatic drawing (also known as the Scribble Technique) -In automatic
drawing, the patient/client is asked to relax and begin to make draw
free lines or scribbles on paper. In some cases the patient/client will
be instructed not to remove his or her pen from the paper until the
exercise is over. Automatic drawing provides an excellent way for the
patient/client to let down their guards and thus is a good starting
point for therapy.
- Free Drawing - In free drawing all the choices are up to the patient/client.
All that the are patient/client is told is to express him or herself
freely, and not to worry about planning the picture. This technique
is useful because the images that the patient/client create are often
mirrors into the person's present problems, strengths and weaknesses.
Often at the end of free drawing, the patient/client is asked to share
and explain what they drew about.
- Drawing Completion - In the drawing completion technique, a patient/client
is given one or more pieces of paper that already have a few lines or
simple shapes on them. These shapes or lines act as a starting point
for the art therapy artist, and they are to be incorporated into a larger
picture. Because of the wide individual responses to the same stimuli,
this is an excellent technique for a group discussion topic. Kinget
developed this approach for therapeutic purposes.
Rapport-building exercises are used in both individual and group art therapy
settings. The basic idea behind rapport-building exercises is to reduce
the amount of isolation that the patients/clients may feel while they
are creating their art. This includes isolation from the other patients/clients
in the group, and the distance they feel between themselves and the therapist.
Some examples of Rapport-Building are:
- Conversational drawing - In conversational drawing, the group is broken
up into pairs. The two people who are assigned to work together are
seated across from one another. The only way of communication is with
shapes, colours and lines. In this way, the pair is not only communicating,
but sharing at the same time. This is a good way from patients to get
to know one another a little better.
- Painting Completion by the Group - In painting completion by the group,
each member of the group is asked to name one thing, an object, feeling
or event, and then depict it. From here, one or more of the group members
begin adding to the collage, trying to improve upon what is already
there. This technique better enables people to become aware of how it
feels when they make something and have someone else "put upon you anything
they want to." The patients/clients are encouraged to share what they
are feeling about someone else adding to their work.
- Painting with an Observer - In painting with an observer, one member
of a pair tells the other one whatever comes to into his or her minds
as he or she watches the other one paint. The painter can respond to
what the other one is saying as he or she sees fit during their painting.
This exercise promotes discussion of feelings of dependency and autonomy,
as well as acceptance issues.
Expression of Inner Feelings
These techniques are designed to help the patient/client get in touch
with inner feelings, desires and fantasies and to make visual representations
of them. This is done in the hopes that the patient will become increasingly
aware of him or herself. The therapist will then attempt to help the patient/client
deal with these feelings, and move in a direction toward a solution.
An example of expression of inner feelings technique is called "three
- Three Wishes - In the three wishes technique, the patient or client
is asked to paint or portray three or more wishes. Responses tend to
be of desires for things, personal security and so on. Responses to
this exercise reflect maturity level, degree of egocentricity and so
on. Discussion that follows this exercise focuses on the strength of
the wish and whether or not these goals/wishes are attainable.
The self perception technique is aimed at moving a client toward a more
complete awareness of personal needs and body image.
Some examples of this technique are as follows:
- Immediate States -Here the patient/client selects one or more of statements
"I am", "I feel", "I have", or "I do" to paint about.
- Self-Portraits -Self-portraits can vary from being realistic, done
with or without a mirror to abstract. A variation of this technique
is to give a time limit to the painter, such as one minute. In this
way, the artist is forced to quickly decide what important feature about
themselves they wish to draw.
- Draw Yourself as an Animal - Here the patient/client is asked to draw
themselves as any kind of animal, or as the animal that they see themselves
as most similar to. This is a good group building technique because
the discussions are usually funny as well as revealing.
The interpersonal relations technique is designed to make the patient/client
more aware of others, and how others may perceive him or her.
Some examples of this technique are as follows:
- Portraits of Groups Members - Here group members are asked to depict
each other. This exercise helps groups members to more fully clarify
their feelings toward each other.
- Group Mural - Here the group works cooperatively on a large project.
The choice in subject matter and materials may be left up to the group
or predetermined by the therapist. This exercise promotes cooperation,
group unity, fitting in individually to a larger whole and self-expression
in a larger group setting.
The Individual's Place in the World
This technique is designed to help the patient/client to see where he
or she fits into the world, and hopefully accept and deal with this realization.
Some examples of this technique are as follows:
- House-Tree-Person Here the patient/client is asked to depict a house,
tree and a person in one picture. The patient/client is faced with the
task of how to relate the human figure to the other two common environmental
- Collage and Assemblage -Here the patient/client is allowed to create
a personal world out of any materials that he or she may desire. The
therapist may predetermine themes, or the patient/client may work until
themes begin to appear by themselves.
It is important to keep in mind that although there are many techniques
available to the art therapist and all of them are valid, no one technique
should dominate. This is because the techniques discussed here are only
loose guidelines that the art therapist should take into consideration.
More important than these guidelines are that the approaches that the
art therapist chooses to take are well designed and thought out to meet
the specific demands and needs of the individual or group.
The termination of art therapy is initiated abruptly and clearly. Either
the art therapist or the client can initiate the termination of the art
therapy. Termination is generally decided upon when the therapist or the
client realizes that the therapy is finite.
Termination is a very important part of the therapy process. The way
in which therapy is brought to a close is crucial to the outcome of the
treatment. If termination is handled incorrectly, the client or patient
may regress as the end of therapy approaches.
The therapist should prepare the patient well in advance. This can be
done by bringing up the issue of termination, focusing on its importance
and discussing and interpreting feelings and behaviors due to the pending
ending of the sessions. This is a difficult tightrope for the therapist
to walk because focusing on the end often brings to mind other separations
that client may have suffered.
When nearing the end of the therapy, the client and therapist should
begin re-looking at the art that the client has created throughout the
sessions and talking about the progress that the client has made. It is
also a good idea to use art in these last few sessions to help express
feeling about the termination of the therapy sessions. The therapist often
will join the client on these works of art.
The termination of the art therapy brings up a very practical question
as well, what should be done with the art that the client created during
the course of the sessions? This is a tricky question, but ultimately
it is one that should be answered by the client. They could keep the art
as a form of remembrance to the journey they went through, or give it
to the therapist to show the importance of the therapeutic bond that they
reached. These are of course not the only two options that the client
has, but two of the most common ones.
Some important things to remember
about art therapy
Art therapy is not just a stepping stone to a verbal exchange, and should
not be treated in this way. The art therapist should be very careful of
over or under reliance on the verbal amplifications of the art by the
client or patient.
There are some ways to get away from becoming too verbally oriented in
art therapy. One way involves a group therapy activity in which the members
of the group each create a piece of art, and then share it with the rest
of the group. However, rather than explain what it means to the rest of
the group when it is finished, they should focus on exploring and telling
about the part of the art that they find the most interesting or exciting
or puzzling. The other members of the group also talk about what the find
interesting in the piece. From here the client again creates a piece of
art, this time focusing on what they found interesting in their previous
work. The process is repeated until the client feels that they have a
finished piece of art that they are happy about. This process is a valuable
one because it allows the artist a departure from traditional, intellectual
expressiveness toward a more purely emotional response.
According to the American Art Therapy Association, Inc.'s professional
definition of Art Therapy, Art Therapy is a human service profession that
utilizes art media, images, the creative art process and patient/client
responses to the created products as reflections of an individual's development,
abilities, personality, interests, concerns and conflicts. I hope that
you see that defining art therapy is a daunting task because it is an
evolving science, and one which we just recently started using. Just because
it may be hard to come up with a definition that fully encompasses what
art therapy is doesn't mean that it is any less beneficial as a form of
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