Lesson 5: How does Art Therapy Work in Practice?

How does Art Therapy Work: Considerations for the Physical Environment 

The following conditions are ideal for success:

  • Ample space to create
  • Adequate lighting
  • Clean up equipment
  • A room that resists or can accommodate stains
  • Storage of the art and materials
  • If group discussion consider whether works are displayed - such as hung up or held by the participants in the therapy session

How does Art Therapy Work: Session structure

The structure of each art therapy session is unique and determined by treatment goals. Goals should be set on the basis of the group or individual seeking help. For example, not every client will respond to an unstructured task but some will get the most out of being unconstrained; some may need more warm up time to feel confident whereas others are ready to jump right in; some may need to talk a lot about what they created whereas others may not be ready to talk yet.  Here are some of the variables to consider:

  • length of sessions
  • media used 
  • amount of time devoted to creating vs. discussing
  • whether or not creative activity is timed
  • length of warm up time
  • open task or structured task
  • whether or not socialization is permitted (if in a group)

Art media and processes - 

The media should be selected purposefully. Should one use clay or colored pencils or acrylics. Here are some questions to consider: 

  • Should the participant(s) choose materials themselves?
  • Is fast media needed? Like pens require no drying time whereas oils take a long time to dry 
  • Is there preparation required?
  • Is cleanup easy or difficult?
  • Do materials need to be easily manipulated (for example, children or differently-abled participants may need materials they can handle easily)
  • Should a variety of techniques and materials be provided? Variety is often a good choice but in some populations it can be overwhelming
  • Generally, avoid frustrating materials. Participants should not be focused on learning how to use the materials. A related idea is whether or not the materials are easy to control. For example, colored pencils or markers are easy to control whereas watercolors are not. 

How Does Art Therapy Work? Process and Product

  • The creative process (doing)

The therapist gives a structured or an unstructured directive to the client(s). Then, the therapist closely observes how the client approaches and executes the task in addition to reflecting on the final product. 

"A picture may be worth a thousand words, but to observe the making of a picture is worth ten thousand words" (Ault, 1983, cited in Rubin, 1998).       

General Process: 

  • Warm up exercises – scribbles, use of initials as a starting point
  • Structured directive:
    1. make a picture that shows why you think you are in therapy
    2. create a sculpture that shows something you feel strongly about
    3. make something that shows what you wish you could change
    4. make something the shows your thoughts and feelings about retirement
    5. make something that shows how you feel about your parents' divorce, etc…
  • Unstructured directive:
    1. draw something together
    2. make a free drawing about anything you want to express today

The therapist may pay close attention to how the client approaches the process; for example, did she start eagerly or reluctantly; did they all work together or separately; did they ask any questions and so on. 

The artistic product

The therapist examines a number of elements: placement, style, emotional tone, color choice, symbols, themes, patterns, etc…

  • Reflecting on the work: Sharing and discussing

Therapist and client discuss what the art work is 'saying' and what it means to the client.

  • Gaining insight: The therapist may highlight features or components of the work that the client was not previously aware of. These components are discussed within the context of the client's life
  • Over time, a number of pieces are made and the series can be used therapeutically
  • Recurrent feelings and ideas are highlighted and discussed.
  • Changes in content, emotional tone, expressive style are highlighted and discussed
  • A 'story' may emerge
  • These issues are not discussed abstractly – they are discussed within the context of the client's life

TEST YOUR KNOWLEDGE: Lesson5: Process or Product

 

How Art Therapy Works: Two main Approaches to Art Therapy

  • Psychodynamic - Includes psychoanalytic (Freudian), Jungian, and all other insight-oriented approaches. The focus is on self-expression, self-awareness and working through long-standing psychological conflicts and issues. Both the past and the present are addressed. Art therapy has its roots in the psychodynamic tradition.
  • Humanistic /Existential – The ideas behind these approaches originated in philosophy and became popular during the human potential movement of the 1960s. The focus is on the present rather than the past. These approaches emphasize choice, intentionality, finding meaning, as well as discovering and expressing one's unique identity.

Take a minute to take some notes: Compare the psychodynamic vs. the humanistic approaches to art therapy

 

 

 

Art Therapy Examples from Harriet Wadeson's book Links to an external site.

Example: Art Therapy with a Survivor of Rape

  • Jennifer, 26 yrs.
  • Well-dressed, cautious, unable to talk about the event, marked startle reflex
  • For weeks only painted soothing pictures calm her and to take her mind off of intrusive thoughts
  • This was created after weeks of therapy:

Jennifer Drawing 1

The prompt for this painting was to draw a picture of herself showing how she was feeling. She first drew the picture without the gash, then when asked “How does she look like you” she drew the gash saying, "she’s trying to keep it all inside her cracking her open shattering her calm appearance.”

Over the next few weeks, she began to process the event and her emotions about it. Below is one of her creations: 

Jennifer Drawing 2

Over the next weeks she made several pictures depicting fear, rage and depression. She had always been timid and art was her refuge. The pictures prompted her to talk about her feelings. At some point she said she “wanted a life,” and drew herself at work. 

She had always been a fearful person and the incident exacerbated those responses. Toward the end of her therapy, Jennifer stated, “Now I am a much more relaxed person.” When asked why she felt that way she said, “I think it was the way you let me go at my own pace. I never felt pushed. Getting out my own feelings in all those pictures was a totally new experience for me. I had no idea I had so much rage. I think it was eating me alive.”

Jennifer started dating a man named Tom. Here is a drawing of her folk dancing on a date with him: 

Jennifer Drawing 3

Jennifer and Tom married. In true survivor style she was able to "have a life."

 

Take a minute to take some notes: How do you think art helped Jennifer process her traumatic experience?

 

Example 2 from same book: Substance Abuse

Research Study on Art Evaluation of Alcoholic Families

Tipler Family

  • Mr. Tipler, 60, sober for 10 years in AA, for 10 years before his recovery was a severe drinker
  • Mrs. Tipler, 58, non-alcoholic
  • Paul, 32, history of alcohol abuse, not present at session, divorced, living on a boat
  • Jerry, 29, in business with his father
  • Annette, 27, married, alcoholic during college, counselor for recovering alcoholics

Instructions:

1. Please depict your family overall in a symbolic way. In other words, don’t draw people, draw images that represent your family. 

2. Please divide your paper in half and depict on one half you maternal grandparent’s family in a symbolic way and on the other side the paternal grandparent’s family in a symbolic way. < Then, after completion> Please mark with a check which of the 2 most closely resembles your first picture

3. Please depict the consumption of alcohol in your family as it has affected your lives

Here is Annette's Symbolic Portrait: 

SubstanceAbuseArtTherapy1.png

Prevalent in this picture is Paul represented by the boat on the upper left. Paul was described by other family members as antisocial. His depiction here is the darkest. Paul was the first family member that Annette drew.

 

The study included alcoholic fathers active in recovery. Interestingly, they drew pictures that were optimistic and positive. They felt that recovery brought them closer to the family. Often this was symbolized by sun shining through clouds. In contrast, their wives tended to remember the difficult times. Below is a picture created by a wife of an addict:

 

SubstanceAbuse2

  • The Flower on the right shows her husband sober: beautiful or handsome
  • The Flower on the left represents her husband wilted by alcohol

Take a minute to take some notes: How do you think art helped researchers and the therapist understand family dynamics involved in substance abuse?

There are many more examples in this wonderful, accessible book.