‘Who is in the castle?’ One man’s use of the Frankenstein story in art therapy

This article stems from my art therapy research MA and focuses on the themes of Frankenstein, the therapeutic use of story, the usefulness of story making and collaboration within one man’s art therapy treatment. It explores the story of Frankenstein and the themes embedded in the story investigating how they might help someone trying to make sense of their own experiences of a frightening if familiar world. The themes include issues of life, death and relationships for someone with a learning disability and links to art psychotherapeutic work are indicated. The pseudonym ‘Ben’ is used to protect the client’s identity.     

Processes of change in school-based art therapy with children: A systematic qualitative study

Although theoretical processes of art therapy with children have been suggested, they have lacked a systematic research basis. This systematic qualitative study explored children’s school-based one-to-one art therapy in order to create a theory of change. Across two primary schools, 14 children were interviewed individually, as were their parents, teachers and art therapists (total N?=?40). All children had received art therapy within the previous 12 months. Children completed an art activity to aid the interview process. Interview data were analysed using grounded theory methodology. The analysis generated a preliminary model with three components. ‘Component 1—school context’ highlights the systemic nature of art therapy as well as its mystique to those not directly involved. ‘Component 2—core model’ describes art therapy as individualised and child-centred. Art-doing and making were considered central to children’s expression and developing understandings. ‘Component 3—change and no change’ describes the connection between identifying therapy aims and perceiving change. Recommendations are that art therapy be considered for children struggling to verbalise their difficulties; that therapists focus on therapeutic experiences being fun and enjoyable for the child, as well as embedded within the child’s system; and lastly that clear target problems are identified at the start of therapy.     

Silence during art therapy: The art therapist’s perspective

ABSTRACT

This study examines the perceptions and experiences of Israeli art therapists regarding the use of silence during art therapy, and its effects on the art therapist, the client and the therapeutic relationship. The researchers interviewed 15 art therapists using the Consensual Qualitative Research (CQR) analysis method (Hill, C. E. [2012]. Consensual qualitative research: A practical resource for investigating social science phenomena. Washington, DC: American Psychological Association). The interview covered five primary domains: (1) silence as an art therapy tool—the art therapist’s depiction of a therapist who uses silence in therapy; (2) reasons for using silence in art therapy—the rationale for using silence as an intervention tool and the therapist’s perceptions regarding the client’s use of silence; (3) the art therapist’s perceptions of the effects of silence on the client, the therapeutic relationship and the therapeutic dialogue; (4) the role of the art therapist during moments of silence in the therapy room; and (5) the art therapist’s perception of the uniqueness of the art medium during moments of silence in therapy. These findings can lead to a greater understanding of the importance and contribution of silence in art therapy.     

Feedback feeds self-identity: using art therapy to empower self-identity in adults living with a learning disability

ABSTRACT

Although there has been little systematic research on the subject of feedback, this article attempts to explore the concept, use and function within art therapy and its potential in the learning disability population to create and reawaken self-identity. The author uses case material to illustrate how self-identity may be enhanced through amplification of the image, use of ‘third hand’ approaches and therapist engagement and feedback. The article is written in the form of a road map to identify key areas of research. Reflections on art therapy, resilience and implications for practice are discussed at the end. Pseudonyms, with consent, have been agreed for all client names except one person who wanted to use his first name. In an unorthodox manner, the author starts this article by exploring his own experiences of feedback and his knowledge of the learning disability setting to make up for a lack of research on this topic.     

Art therapists with experience of mental distress: Implications for art therapy training and practice

ABSTRACT

As part of its ongoing work to support and value the contributions to art therapy from service users, the British Association of Art Therapists (BAAT) conducted a survey of art therapists with dual experience as professionals and mental health service users. The survey aimed to establish if art therapists disclosed their experiences as service users when applying to train, during their art therapy training and/or when qualified. Participants (N?=?20) were also surveyed on their motivation for disclosure or non-disclosure, their experiences of the process and the quality of responses they met. They were additionally asked whether their experiences of mental health services had impacted on the quality of their art therapy practice and if so, how. The findings from this small sample suggest that disclosure was not easy. Reported responses to participants’ disclosures were mixed, with many experiencing both helpful and unhelpful responses. Emotional support appeared to be important for helping people both to normalise and to contain current distress. Another finding concerns self-reported increased empathy for service users. Awareness and management of one’s own limitations was another reported gain, since reflecting on oneself and one’s life was usually enforced through the ‘breakdown’, hospitalisation or disruption of career path.     

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.     

Taking the pulse of american art therapy a report on the 27th annual conference of the american art therapy association,november 13th 17th, 1996, philadelphia

Abstract

Last year we attended the 27th Annual Conference of the American Art Therapy Association, following in the footsteps of Joan Woddis and Peter Byrne who attended the 16th and 17th Annual Conferences of AATA. In this paper we describe our experiences at the 1996 Conference and reflect on what we learnt there about art therapy in the differing cultural contexts of Britain and the United States of America. We set our thoughts in the developing debate about Anglo-American approaches to art therapy, aware that our impressions are based on a limited experience, not necessarily reflective of American art therapy as a whole     

Veterans’ perspectives on the acceptability of art therapy: a mixed-methods study

Art therapy has been suggested to support veterans who may not benefit from verbal therapeutic approaches. Little is known about the perspectives of UK veterans with mental health difficulties on engaging in art therapy. This study aimed to explore the acceptability of art therapy for this group, employing a mixed-methods design. The sample was drawn from clients of treatment programmes provided by a national veteran mental health charity. It comprised 547 veterans with a range of mental health difficulties who had attended an art therapy group session. The veterans in the sample rated the usefulness of art therapy positively, with a mean score of 4.43 using a Likert scale where the maximum score was five. Veterans positively endorsed the likelihood they would apply the knowledge gained, with a mean score of 4.15 using the same scale. Content analysis was used to explore text comments. The themes were: experience of sharing with others, exploring difficult feelings and environmental aspects. In conclusion, this study provides an initial indication that art therapy may be an acceptable treatment approach for UK veterans with mental health difficulties. Further research should explore its impact on veterans' mental health.     

Art therapy,arts-based research and transitional stories of domestic violence and abuse

Visual imagery within qualitative research is an established method of gathering data that has parallels to the way in which images are used within art therapy. This article explores how visual imagery was used to investigate women’s responses to domestic violence and abuse and examines how art therapy principles shaped the development and conducting of that research. Through the use of collage, participants created visual representations of their responses to experiences of domestic violence and abuse. The visual representations, when combined with spoken words, created stories that reference the past, present and future. The stories created have been termed transitional stories of domestic violence. These stories show that the home has special significance for women as they transition away from domestic violence and plan for their future. The home becomes both a metaphorical and physical manifestation and container of hopes for a harmonious future that often incorporates the desire for the return to the idea of a complete family. This article will present the findings of the arts-based research conducted, and consider the implications upon art therapy practice of those findings.     

Coordinating principles of art therapy and DBT

Coordinating treatment modalities may offer patients more than what any one treatment may offer alone. Art therapy and Dialectical Behavior Therapy (DBT) are effective treatments for a wide range of clinical disorders and are often applied in conjunction with other forms of therapy. Common clinical symptoms, such as emotional dysregulation, may be particularly amenable to a combined art therapy and DBT approach. Informed by the theoretical foundations of interdisciplinary care including both art therapy and DBT, this paper offers an approach and examples of strategic use of art therapy and DBT together as part of an interdisciplinary treatment plan. Advantages of using treatments simultaneously may include reinforcement of learning skills, contribution to interdisciplinary team synergy, and enactment of bilateral integration. A common factor approach is used to coordinate theoretical principles of art therapy and DBT and a case study illustrates coordination of the two therapeutic approaches. Implications for populations at varying levels of care are discussed.     

Developing in splendid isolation? a critical analysis of german art therapy approaches in key papers from 1990 to 1999

Abstract

Within Europe, there is a tapestry of diverse approaches to art therapy which, as Waller (1998) shows, are quite different from the British model. Germany, Austria and Switzerland constitute a lingual area of approximately 95 million people, big enough to sustain a system of training, practice and publishing that is largely unaware of the developments in Britain and the US, or in neighbouring countries such as France or the Netherlands. Researching the area often felt like mapping a minefield, as terminology was elusive, diverse and contradictory, and some comments between the lines hinted at the hostility, competition and confusion between some German art therapy factions. Even though different approaches could be identified, few have developed into distinct schools; they often overlap and refer to established theory and practice of great variety, and draw from such models as the educational, medical, psychological, psychoanalytic, psychiatric and artistic.

This article attempts to screen the large body of German art therapy literature. In the first part I look briefly at art therapy training and professional organisation and regulation in Germany. In the following section I describe and discuss the main approaches identified in the literature and limit my research to books published from 1990 to 1999.1 leave aside anthroposophical art therapy, an approach based on the philosophy and teaching of Rudolf Steiner. Even though this approach makes up a large portion of German art therapy, it constitutes a field in itself and requires an analysis of Steinerian philosophy Anthroposophy which cannot be done in the frame of this article. In addition, I look at the literature concerning professional issues.

To set the scene and explain the wealth of literature and the diversity of German art therapy approaches, I look at the way art therapy is taught, organised and regulated in Germany and take a glance first at the terminology used.     

Acceptance in the Hearing Voices Movement: how might this be relevant for art therapy service-users?

ABSTRACT

This paper considers what is shared by voice-hearers in the Hearing Voices Movement (HVM) and by service-users in art therapy. Both highlight what they see as the value of acceptance, peer-support, and clear collaborative communication. The paper considers how research and literature informed by lived-experience in the HVM and, UK art therapy might strengthen practice.

Life-stories by voice-hearers, included in the HVM literature, explain what has helped them and what is meant by acceptance within the movement. For those voice-hearers with a psychosis-related diagnosis, joining HVM could mean they find hope, even though the diagnosis means that they may face deep prejudice and some of their unusual experiences are frightening.

The paper also looks at what art therapy clients voice as helpful: the support found in group work; art-making; and honest, collaborative styles of communication overlaps with much that is described and explored in the work of HVM.

Although much smaller in scope, feedback given by art therapists to a professional regional-group provides additional indications that the profession is responsive to service-user perspectives, collaborative work, and to HVM.

Plain-language summary

This paper considers the Hearing Voices Movement in relation to adult mental health. Often people who hear voices receive a psychiatric diagnosis for which the primary treatment is medication. These diagnoses are known as ‘psychosis-related’. In the psychiatric system, voice-hearers are not usually encouraged to speak about their unusual experiences. In the Hearing Voices Movement, those who hear voices are encouraged to speak about their voices and other unusual experiences and to find ways of coping with them.

This paper looks at the literature of the Hearing Voices Movement to explore what ‘accepting voices’ means and how this may be relevant for art therapy clients. People who hear voices, family members, friends, health professionals, and social workers make up the movement and, they are all asked to work alongside one another in the interests of authentic collaboration aimed at improving the lives of voice-hearers.

The paper also looks at what is said in life-stories by voice-hearers about the value of acceptance, peer-support, and clear collaborative communication. Even though some people with a psychosis-related diagnosis are afraid of their experiences and face damaging prejudice, joining the Hearing Voices Movement can mean they find hope. Also, the art-making, group work, and honest, collaborative styles of communication valued by art therapy clients overlaps with much of the work and research of the Hearing Voices Movement.

Being respectfully accepted as a voice-hearer seems to help people feel that they can work towards a sense of control, self-direction, and self-acceptance in their lives.

Feedback given by art therapists to a professional regional-group offers indications that the art therapy profession is responsive to service-user perspectives, collaborative work, and to the Hearing Voices Movement.     

A case example of art therapy in relation to Dialectical Behaviour Therapy

Abstract

Theoretical and practical aspects of Dialectical Behaviour Therapy (DBT) as developed by Marsha Linehan are related to the development of a pragmatic art therapy approach to working with severe distress and disturbance, including ‘borderline personality disorder’, through a case example. The dialectical approach of DBT to acceptance and change, emotional regulation and the development of ‘wise mind’ are found to resonate with art-making processes, both inside and outside the formal art therapeutic space, and the art therapist's interventions become central to a team approach. Innovative art therapy interventions (for example the structured use of ‘homework’) and theory (for example ‘the Learning Circle’) contribute to a therapeutic journey from dangerous and extreme patterns of self harm and in patient admissions to a stabilised and community-based level of support. The approach challenges the helpfulness of a formal psychodynamic psychotherapeutic model of art therapy in all circumstances. It opens up the possibilities of developing art therapy not only as an integrated aspect of a DBT-based approach, but also of developing art-making and therapeutic relationships in terms of a psychosocial education model. Psychotherapy understandings underpin, contain and amplify pragmatic, arts-based interventions which are shown to catalyse profound psychological change.     

Art therapy for patients diagnosed with personality disorders cluster B/C: A thematic analysis of emotion regulation from patient and art therapist perspectives

ABSTRACT

This study examined the explanation for the found causal relationship between art therapy and positive therapeutic effects, in a previously conducted randomised controlled trial (RCT) with personality disorders cluster B/C. In-depth interviews were used to collect the data, in order to examine the experience without preconceived notions or expectations. Thematic analysis was used to analyse the data to generate and interpret themes. Eight patients who participated in the RCT intervention were asked to evaluate their experiences with art media highlighting emotion regulation and Expressive Therapies Continuum (ETC) levels. Also three art therapists were asked to evaluate the artwork made by these participants. Thematic analysis resulted in five themes. These results suggested that through the targeted use of art assignments, material handling, and preferred approaches to art process and ETC levels, patients experienced, shaped and shared emotions not previously wilfully encountered. The therapeutic effects were explained by combined specific art therapy factors linked to the art media. These factors were reported by participants as evoking and helping them understand and regulate internal images and emotions. Results suggested that art therapy encourages a present-focused awareness and stimulates emotional processes evoked by material interaction.     

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.     

Art therapy with refugee children: a qualitative study explored through the lens of art therapists and their experiences

ABSTRACT

This article sets out to explore the use of art therapy with refugee children, from the perspective of art therapists and their experiences. Three semi-structured interviews were conducted to gain insights by capturing experiences and stories. Using thematic analysis, five themes were identified: (1) giving voice; (2) rebuilding trust, opening wounds; (3) sharing stories, healing pain; (4) exploring identity, discovering new-self; and (5) understanding art therapy. Upon reflection, two key aspects of art therapy were established, these were identified as: (1) providing refugee children with a safe space to heal and discover new-self, and (2) giving refugee children a voice to express and share stories. Despite the last of the five themes (understanding art therapy) being established as a factor that limits the use of art therapy, this has created an avenue for further research. From the findings, it was concluded that art therapy can be a useful form of psychotherapy for refugee children. Art therapy can provide these children with a safe space to heal, and give them a voice to be heard.

Plain-language summary

This research explores the use of art therapy with refugee children from the art therapist’s perspective. Three semi-structured interviews were carried out with art therapists who had experience of working with refugee children. Once interviews were collected, these were then analysed using a method of analysis which enables common themes to be found amongst the unique set of experiences and stories collected.

The analysis generated five themes, which were: (1) Giving Voice, (2) Rebuilding Trust, Opening Wounds, (3) Sharing Stories, Healing Pain, (4) Exploring Identity, Discovering New-self, and (5) Understanding Art Therapy. The first four themes suggested that art therapy is a useful form of therapy for refugee children. However, theme 5 (understanding art therapy) could be a limitation for art therapy with this client group, as art therapy is often unknown to them. Taking this research forward, it will be important to explore the use of art therapy with refugee children by carrying out further research with the children themselves.

In conclusion, art therapy can be a useful form of therapy for refugee children. Art therapy provides these children with a safe space to heal, and gives them a voice to be heard.     

Material interaction in art therapy assessment

Diverse approaches to art therapy assessment agree that art materials should play a central role. However, relatively little research is done on the role of different art materials. This article describes the results of a qualitative study on the use of art materials by art therapists in art therapy assessments of adults with mental health problems in The Netherlands.Nine qualitative in-depth interviews were analyzed using Grounded Theory, which produced a theoretical framework of the use of art materials in art therapy assessments. This study showed that the way in which a client interacts with specific properties of art materials (i.e., the material interaction) reflects aspects of the client's mental health. Methodical application of specific properties of art materials enables art therapists to observe the client's material interaction and gain insight into the client's mental health. This observation helps art therapists with decisions to offer further treatment, formulate treatment goals and choose appropriate art interventions. Material interaction links art material properties to art making, art product and mental health, and it may connect the diverse approaches to art therapy assessment.     

Off-shore: A deconstruction of David Maclagan's and David Mann's ‘Inscape’ papers

Abstract

This paper is a response to two recent papers in The International Journal of Art Therapy: Inscape that set out positions in relation to art therapy theory. David Maclagan (2005) argues for the importance of ‘imagination’ in art therapy, and David Mann (2006) responds by defending a Freudian view of art therapy which he feels Maclagan has unfairly attacked on the grounds of it suppressing imagination. The view of this paper is that the arguments in both papers perpetuate the split in art therapy between an emphasis either on the art in art therapy or the therapy in art therapy, and in both cases this is because the authors neglect the significance of embodiment. An acceptance of ourselves as physical beings brings with it an awareness of context and of gender and therefore of political relations. The two papers are deconstructed to reveal that the suppression of the perceptual results in a perpetuation of the crystallisation of imagination rather than the releasing of it, which the authors are intending. The feminist philosopher and psychoanalyst Luce Irigaray's writings are used to propose a new way in which we might think about the relationship between art and talk in art therapy.