The making of mess in art therapy: Attachment,trauma and the brain

This article explores the hypothesis that artwork created during art therapy may activate neurological structures of the brain enabling non-verbal early experience to become known. Art making is a right brain activity and early experience is processed in the right brain. Art therapy can attempt to access early emotional trauma which has caused damage to the right hemisphere of the brain.

Mess is often present when working with children who have had early experience of abuse or neglect. The article investigates the meaning of this through a review of research on attachment, trauma and the brain, and linking it with case material. Early relational trauma is suggested as a possible explanation. Mess may be a consequence of damaged neural pathways resulting from early relational abuse with dissociation used to repress the memory of abuse or neglect and to stop thinking taking place.

Brain development in infants and young children is briefly explained, including how interpersonal relationships with carers and others are essential for this. Visual processes, the importance of the gaze between infant and career to establish a feeling of wholeness, and good attachment are discussed, emphasising the importance of regulation of affect by parents and others, which leads to healthy development of the mind.     

The art-gallery as a resource for recovery for people who have experienced psychosis

Dominant personal and community narratives of psychosis can often be experienced as oppressive and stigmatising. An important aspect of recovery may be overcoming this internalised, self-depreciating story. This intervention sought to understand whether an art gallery-based group facilitated modification of the dominant narrative of psychosis in the participants’ personal narratives, promoted recovery, wellbeing, and a subjective sense of social inclusion. The narratives of mental health and gallery staff were included to investigate the modification of the dominant narrative in their personal narratives. People with an experience of psychosis participated in a gallery-based group where they reflected on paintings related to their life experiences. Participant interviews at the conclusion of the group were subjected to literary and social context narrative analysis. The findings suggested that some individuals used art-related concepts to modify the dominant narrative within their personal narrative. A community narrative regarding a different staff–client relationship, characterised by validation, commonality, friendship and genuineness, emerged within the group. The intervention was depicted as promoting recovery and wellbeing, mainly through achievement, and described as more successfully addressing bonding social capital than bridging social capital. Art gallery-based interventions show some promise to provide a safe haven where people with a psychosis can engage in a recovery-oriented approach to mental health care, where a different staff–client relationship could occur, away from the demands and possible stigma of mental health services.     

Does prior psychotherapy experience affect the course of cognitive-behavioural group therapy for social anxiety disorder?

Objective: To examine whether and how different patterns of psychotherapy history (no prior therapy, successful therapy experience, and unsuccessful therapy experience) affect the outcome of future treatment among patients undergoing cognitive-behavioural group therapy for social anxiety disorder. Method: Fifty-seven patients with varying histories of psychotherapy participating in cognitive-behavioural group treatment for social anxiety disorder were included in the study. Symptom severity (including anxiety, depression, self-efficacy, and global symptom severity) was assessed at pre- and posttreatment. A therapist-rated measure of patient therapy engagement was included as a process variable. Results: First-time therapy patients showed more favourable pretreatment variables and achieved greater benefit from group therapy. Among patients with unsuccessful therapy experience, substantial gains were attained by those who were able to actively engage in the therapy process. Patients rating previous therapies as successful could benefit the least and tended to stagnate. Possible explanations for group differences and clinical implications are discussed. Conclusions: Prior psychotherapy experience affects the course of cognitive-behavioural group therapy in patients with social phobias. While patients with negative therapy experience may need extensive support in being and remaining actively engaged, those rating previous therapies as successful should be assessed very carefully and may benefit from a major focus on relational aspects.     

Music therapy: A community approach to social justice

This theoretical paper demonstrates how music therapy—and more specifically, community music therapy (CoMT)—can contribute to social justice. CoMT is a creative approach that the liberates expression, potentially empowering people of all ages, races, and statuses to build a better society. It also reveals how the leadership literature presents the concept of service in addressing social justice and how the fields of psychology and sociology of music shed some light on the use of music for social justice. Finally, future implications for training music therapists for social justice are explored.     

Liminality,art therapy and childhood sexual abuse

Abstract

This article discusses the relevance of liminality for art therapy and childhood sexual abuse. ‘Liminality’ comes from the Latin word limen and refers to our encounters with, and experiences of, thresholds. Social anthropologists have studied liminality in the context of rite-of-passage rituals that commonly mark social and personal transitions, for example at puberty, marriage and death. I make two claims for the relevance of liminality in thinking about childhood sexual abuse. The first is that abused children become liminal personae (threshold-people) through their premature sexual knowledge and experiences. As we will see, in the anthropological literature liminal personae are considered to be anxiety-provoking. I believe that anthropological ideas can help us to make sense of public, media and government responses to the anxiety provoked by childhood sexual abuse. My second claim makes a link between liminality and trauma and brings together ideas about the breaching of thresholds, annihilation anxiety and experiences of the sublime. We will see that liminality is intimately linked with trauma and is therefore relevant for many art therapy clients. Images allow unspeakable traumatic experiences to be acknowledged and explored, which makes art therapy a particularly effective intervention for children traumatised by sexual abuse.     

Development of an art-therapy intervention for patients with personality disorders: an intervention mapping study

Art therapy for people diagnosed with personality disorders (PD) cluster B/C seems valuable to explore dysfunctional patterns in managing emotions. Current art therapy interventions are based on practical beliefs or commonsense approaches, without a sound basis in research results. To increase the effectiveness of art therapy for this target group, a planned, systematic and theory-based approach is needed. The principles of Intervention Mapping were applied to guide the development, implementation, and planned evaluation of the art therapy intervention. Empirical findings, theoretical models, and clinical practice experience were combined to construct a programme tailored to the needs of the target group. A structured 10-session art therapy intervention programme for patients was developed, aimed at: experiencing a (more) stable and positive sense of self, being able to express and regulate emotions, understanding emotions, thoughts and behaviours, using improved social and problem solving skills. Implementation took place and evaluation of the intervention is being carried out. The systematically developed art therapy intervention seems to be promising for PD patients in learning to deal with their problems. The results of the evaluation study may contribute to the knowledge about the use of art therapy for PD problems.     

Childhood trauma and dissociation in first-episode psychosis,chronic schizophrenia and community controls

Increasing evidence supports the role of childhood trauma in the etiology of psychosis but underlying mechanisms are poorly understood. Early maltreatment has been linked to dissociative symptoms in psychosis patients. We explored associations between childhood trauma (Childhood Trauma Questionnaire) and dissociation (Dissociative Experiences Scale) in first-episode psychotic patients (n=62), chronic psychotic patients (n=43), and non-psychotic community controls (n=66). Multivariate analyses of covariance were used to test associations between childhood trauma and dissociation by group while controlling for sex. Chronic patients reported the highest level of dissociation. More severe childhood trauma was associated with greater dissociative symptoms in all groups although most strongly in chronic patients. Emotional abuse showed the strongest associations with dissociation, with these being strongest for chronic patients, followed by first-episode patients — and least for controls. Men showed a stronger association between physical neglect and dissociation than women, irrespective of group. There were no significant group by sex interactions. Our findings replicate the strong association between childhood trauma and dissociative symptoms in chronic and first-episode psychotic patients relative to non-psychotic control subjects. We also demonstrate the salience of emotional abuse in explaining variance in dissociation, especially in chronic patients.     

The effect of integrating rational emotive behavior therapy and art therapy on self-esteem and resilience

This research explored the effect of combined rational emotive behavior therapy (REBT) and the art therapy (engraving method) on improving self-esteem and resilience. The research method was quasi experimental. The study used the Coopersmith Self-esteem Inventory (SEI) and the Connor–Davidson Resilience Scale as pre- and post-test assessments to assess the effects on a sample of Iranian students. A sample of 24 Iranian university students were randomly placed in two groups, including one experimental group and one control group. This was followed by REBT and art therapy while students in the experimental group were taught for 10 sessions over a 10 weeks period there was no treatment for the control group over this time. The participants in both groups were evaluated before and after 10 sessions. The gathered data were analysed using the t-test method through the SPSS package. The results showed that the integration of REBT and art therapy for increase the self-esteem and resilience of students. Further, implications of the study and suggestions for future use are discussed.     

Multiple Opportunities for Creating Sanctuary

This article describes the experience of five change agents from a diverse group of settings: two residential treatment programs for children and adolescents, a group home for disturbed adolescents, a residential substance abuse program for urban women, and an acute care psychiatric inpatient unit. What all of these innovators share is a willingness to engage in the challenging and complex process of changing their systems to better address the needs of the traumatized children, adolescents, and adults who populate their various programs. Using the Sanctuary Model as originally applied to a specialty inpatient psychiatric program for adult survivors of childhood abuse as their guide, the leaders of each of these organizations discuss the process of change that they are directing.     

A Korean art therapist’s autoethnography concerning re-acculturation to the motherland following training in the UK

In this study, the acculturation process experienced by a Korean art therapist who re-acculturated to her own culture after being trained in the UK was investigated as the art therapist built her career. Through this investigation, the study aims to share the significance behind the experience with the academic community and the educational institution in the UK that provided the art therapy training. In order to achieve this, the author chose the autoethnographic approach, which reflects the researcher’s own experience in an absolute sense and, thus, can show a minority experience through recollection and insight. Additionally, the researcher conducted early coding and in-depth coding and derived themes based on the data in accordance with the open coding method to consider a subjective experience in social and cultural contexts. As a result, four main themes were derived: ‘Acculturation in the UK: acceptance of a different culture and growth’, ‘Re-entry culture shock in Korea: resistance and anger’, ‘Re-acculturation in Korea: relearning and understanding’, and ‘Establishing a multicultural identity as an art therapist: integration’. Discussion of the results is presented.     

Art-thérapie et addictions, l’exemple des troubles du comportement alimentaire

The Centre d’Étude de l’Expression at the Sainte-Anne Mental Health Hospital is a particular unit of the hospital in the university clinic. This centre is specialized in psychotherapy through art, and there are 30 workshops of art therapy per week. The techniques used are painting, modeling, music, dance, theatre and creative writing. Each workshop is conducted by a professional specialized in art therapy and has much experience in this field. The way of being admitted into the workshops of art therapy is systematic. It is the same for all the workshops. Patients with nutritional problems are often capable of verbally expressing themselves at a good level. However, for them, the use of speech is not a way of communicating, neither with themselves nor with others. No verbal and artistic psychotherapies are then very useful and specific.     

Journey women: Art therapy in a decolonizing framework of practice

This paper presents the integration of art therapy in a decolonizing framework of practice used in a project called “Journey Women”. This framework of practice seeks to recognize and deconstruct the impacts of colonization and discrimination of First Nations, Inuit, and Métis peoples and to empower and inform people in their healing journey. “Journey Women” was an art exhibit of large-scale “body-map” images depicting the healing experiences of eight Aboriginal women, created in a three-day arts-based workshop. The collaborative research project between Minwaashin Lodge and Concordia University aimed to gain an understanding of the conditions that contribute or challenge Aboriginal women in their process of healing from violence and the impacts of violence. This paper describes the process of creating body-maps that integrated an art therapy framework with traditional Aboriginal ceremonies of prayer, smudging, drumming, and singing as well as movement and grounding activities, poetry, and art creation. In this article, we discuss how a public exhibit of body-maps acted as a powerful medium of empowerment, a forum for women to be witnessed by the community, and a means for Aboriginal women to act as their own agents of social change and social justice.     

Kids Together: A Group Play Therapy Model for Children with ADHD Symptomalogy

This article will present a group play therapy model designed for youth that present with Attention Deficit Disorder/Attention-Deficit/Hyperactivity Disorder (ADD/ADHD) symptomalogy. These symptoms include, but are not limited to impulsivity, disruptive behaviors, social skill deficits as well as ineffective communication skills. This model, unlike current deficit, psychoeducational models, is based in a play therapy, process-oriented framework. The model utilizes concepts from attribution theory as well as social learning theory to assist in skill enhancement and practical social experience. The research on this program will demonstrate a positive impact showing a significant increase in self-esteem, which ultimately allows for a heightened level of functioning and overall increased ability to engage in socially acceptable behavior.     

Building resilience: a pilot study of an art therapy and mindfulness group in a community learning disability team

This article describes findings from a pilot study for a new art therapy intervention designed for clients attending an Adult Learning Disability Service. The intervention consisted of an art therapy and mindfulness group for clients, for 90?min per week over an initial 6–8 week period, with the aim of improving group members’ resilience and ability to cope with difficult life experiences. Clients completed questionnaires about their experience of the group sessions and a thematic analysis was conducted to identify three main themes. The results suggest that the clients who received this intervention experienced improvements in their clinical presentation as well as in their quality of life, an increase in joy and positive wellbeing, and a decrease in low mood and social anxiety.

Plain-language summary

This paper describes an art therapy group run for adults who have learning disabilities. In the group people used mindfulness practices as well as art making and discussion. This helped people to notice and share their thoughts and feelings. The paper shows the results of a questionnaire completed by the group members. It shares group members’ comments about how they found the group and how the group helped them.     

Group therapy for boys who have experienced sexual abuse: Is it the treatment of choice?

Although a growing body of evidence suggests that sexual abuse of boys is a serious and prevalent problem and that abuse may have a range of negative mental health effects, very little attention has been focused on the treatment of victimized males. The present study was designed to assess, through the use of behavioral measures, the utility of a group therapy program for boys who have experienced sexual abuse. Twelve boys, aged 7 to 10, participated in the study. Six of the boys were involved in a 12-week group treatment program at the University of Manitoba, while the remaining six children were assigned to a wait-list comparison group. Measures of various behavioral problems, including sexualized behavior, were completed by children's caregivers during pre- and post-treatment assessments. It was hypothesized that boys receiving group therapy would experience improvements in measured behavior over the course of the group intervention, and that improvements would be greater than those of boys in the wait-list comparison group. Analyses indicated that children in the treatment condition did experience improvements over the course of the intervention, although the effects of the treatment program varied considerably from child to child. Implications of the findings are discussed and suggestions are offered regarding future work with boys who have experienced sexual abuse.     

Consultation and group process with indigenous neighborhood workers

This paper describes a group experience with neighborhood workers in a black, ghetto community action program, with a white psychiatrist as group leader. It focuses on the definition of the task of consultation, derivation of mutually agreed upon goals, evolution of the group, and issues dealt with during the experience. Excerpts are presented to illustrate what the neighborhood workers themselves found relevant from the sessions. Finally, the meetings are discussed from the point of view of white professional consultation to a black community agency, and aspects of group dynamics are considered.     

Art therapy for people diagnosed with schizophrenia: Therapists’ views about what changes,how and for whom

Abstract

National guidance recommends that clinicians consider the offer of arts therapies including art therapy to people diagnosed with schizophrenia. However, because schizophrenia is a heterogeneous condition and this recommendation is based on population-level evidence, it may be difficult to meaningfully apply locally. Whilst art therapy is inextricably linked with ‘psychosis’ and receives clinical support, those charged with implementing guidance, developing and delivering services need to know more about art therapy, specifically what changes, how and for whom. We used grounded theory methods to address these questions from the perspective of art therapists. The data demonstrate richness and diversity in practice and therapists’ abiding belief in its inherent value; art therapy is ‘good’ for those who engage. We present therapists’ understandings of schizophrenia, conceptualise therapy as occurring in the complex interaction of use of art materials, space, therapist and participant and propose mechanisms of action, understood as both unique and universal and potential ‘outcomes’. Whilst therapists’ dedication to their practice is apparent and the potential benefits of its non-medical system status cannot be ignored it seems that integration of art therapy within the spectrum of care necessary to effectively support people diagnosed with schizophrenia will require clear articulation of theory and practice.