Art therapy - WikiHQ

thumb|Art therapy workshop in [[Senegal]]

Art therapy is a distinct discipline that incorporates creative methods of expression through visual art media. Art therapy, as a creative arts therapy profession, originated in the fields of art and psychotherapy and may vary in definition. Art therapy encourages creative expression through painting, drawing, or modeling. It may work by providing persons with a safe space to express their feelings and allow them to feel more in control over their lives.

There are three main ways that art therapy is employed. The first one is called analytic art therapy. Analytic art therapy is based on the theories that come from analytical psychology, and in more cases, psychoanalysis. Analytic art therapy focuses on the client, the therapist, and the ideas that are transferred between both of them through art. It may also aide in resolving conflicts and reduce distress.

The tenets of art therapy involve humanism, creativity, reconciling emotional conflicts, fostering self-awareness, and personal growth.

Art therapy improves positive psychology by helping people find well-being through different unique pathways that add meaning to one's life to help improve positivity.

In November 2023, the National Council of the National Order of Nurses in France concluded that the approximately forty existing meta-analyses, encompassing more than 2,500 studies conducted on art therapy, found no evidence regarding its actual effectiveness on patients' health.

The Drawing Diagnostic Series (DDS) is a standardized tool used in clinical assessment to observe psychological patterns.

History

In the history of mental health treatment, art therapy (combining studies of psychology and art) is still a relatively new field. This type of unconventional therapy is used to cultivate self-esteem and awareness, improve cognitive and motor abilities, resolve conflicts or stress, and inspire resilience in patients.

Art therapy as a profession began in the mid-20th century, arising independently in English-speaking and European countries. Art had been used at the time for various reasons: communication, inducing creativity in children, and in religious contexts.

British artist Adrian Hill coined the term "art therapy" in 1942. Hill, recovering from tuberculosis in a sanatorium, discovered the therapeutic benefits of drawing and painting while convalescing. He wrote that the value of art therapy lay in "completely engrossing the mind (as well as the fingers)…releasing the creative energy of the frequently inhibited patient", which enabled the patient to "build up a strong defense against his misfortunes". He suggested artistic work to his fellow patients. That began his art therapy work, which was documented in 1945 in his book, Art Versus Illness.

thumb|right|[[Edward Adamson, "the father of art therapy in Britain"]]

Artist Edward Adamson, demobilized after World War II, joined Adrian Hill to extend Hill's work to the British long-stay mental hospitals. Adamson studied connections between one's artistic expression and one's release of emotions. One way in which Adamson practiced art therapy was through the depiction of patients' emotions in the art they created. To gain a deeper understanding of how the mind is affected by mental illness, Adamson's collection started as a way to create an environment where patients felt comfortable expressing themselves through art. Mental health professionals would then analyze the art. Other early proponents of art therapy in Britain include E. M. Lyddiatt, Michael Edwards, Diana Raphael-Halliday and Rita Simons. The British Association of Art Therapists was founded in 1964.

U.S. art therapy pioneers Margaret Naumburg and Edith Kramer began practicing at around the same time as Hill. Naumburg, an educator, asserted, "art therapy is psychoanalytically oriented" and that free art expression "becomes a form of symbolic speech which ... leads to an increase in verbalization in the course of therapy." Edith Kramer, an artist, pointed out the importance of the creative process, psychological defenses, and artistic quality, writing that "sublimation is attained when forms are created that successfully contain ... anger, anxiety, or pain." Other early proponents of art therapy in the United States include Elinor Ulman, Robert "Bob" Ault, and Judith Rubin. The American Art Therapy Association was founded in 1969.

Starting in 1974, Paolo Knill, Shaun McNiff, and Norma Canner developed "Expressive Arts Therapy" at Lesley University in Cambridge, USA, by establishing a master's program in "Creative Arts Therapy." This approach is an intermodal and intermedial form of artistic therapy, encompassing multiple art forms.

National professional associations of art therapy exist in many countries, including Brazil, Canada, Finland, Lebanon, Israel, Japan, the Netherlands, Romania, South Korea, Sweden, and Egypt. International networking contributes to the establishment of standards for education and practice.

Diverse perspectives exist on history of art therapy, which complement those that focus on the institutionalization of art therapy as a profession in Britain and the United States.

Definitions

Various definitions exist for the term "art therapy".

The British Association of Art Therapists defines art therapy as: "a form of psychotherapy that uses art media as its primary mode of expression and communication." They also add that "clients who are referred to an art therapist need not have previous experience in art, the art therapist is not primarily concerned with making an aesthetic or diagnostic assessment of the client's image."

The American Art Therapy Association defines art therapy as: "an integrative mental health and human services profession that enriches the lives of individuals, families, and communities through active art-making, creative process, applied psychological theory, and human experience within a psychotherapeutic relationship."

The website Psychology.org defines art therapy as: "a tool therapists use to help patients interpret, express, and resolve their emotions and thoughts. Patients work with an art therapist to explore their emotions, understand conflicts or feelings that are causing them distress, and use art to help them find resolutions to those issues."

Uses

thumb|Art media commonly used in art therapy

As a regulated mental health profession, art therapy is employed in many clinical and other settings with diverse populations. It is increasingly recognized as a valid form of therapy. Art therapy can also be found in nonclinical settings, as well, such as in art studios and creativity development workshops. Licensing for art therapists can vary from state to state, with some recognizing art therapy as a separate license and some licensing under a related field such a professional counseling or mental health counseling. Some of the states that are licensed are Connecticut, Delaware, Kentucky, Maryland, Mississippi, New Jersey, New Mexico, New York, Oregon, Ohio, Tennessee, Virginia, Texas, Pennsylvania, Wisconsin, and Utah, and the District of Columbia. Art therapists must have a master's degree that includes training in the creative process, psychological development, and group therapy, and must complete a clinical internship. Depending on the state, province, or country, the term "art therapist" may be reserved for those who are professionals trained in both art and therapy and hold a master's or doctoral degree in art therapy or certification in art therapy obtained after a graduate degree in a related field. Other professionals, such as clinical mental health counseling, social workers, psychologists, and play therapists, optionally combine art making with basic psychotherapeutic modalities in their treatment. Therapists may better understand a client's absorption of information after assessing elements of their artwork.

An article published by the American Art Therapy Association says that there is a 'small' (or limited) body of evidence—essentially two quantitative studies—that could support the idea of an efficacy of art therapy.

Acute illness

A review of the literature has shown the influence of art therapy on patient care and found that participants in art therapy programs have less difficulty sleeping, among other benefits. Additionally, clinical studies have uncovered that patients in units with art therapy exhibited better vital signs, reduced stress-related cortisol levels, and required less medication to induce sleep. Other studies have found that merely observing a landscape photograph in a hospital room had reduced need for narcotic pain relievers and less time in recovery at the hospital.

In a study involving women facing cancer-related difficulties such as fear, pain, and altered social relationships found: Another study showed those who participated in these types of activities were discharged earlier than those who did not participate.

Additionally, recent research has shown that creative expression during hospital stays can lower anxiety and pain perception and enhance physiological stability. In one clinical study, art therapy led to a statistically significant reduction in cancer-related symptoms, such as fatigue and emotional distress.

Dementia

Art therapy has been observed to have positive effects on patients with dementia, with tentative evidence supports benefits with respect to quality of life. Although art therapy helps with behavioral issues, it does not appear to reverse degenerating mental faculties. The art tools must be easy to use and relatively simple to understand. Art therapy had no clear results on affecting memory or emotional well-being scales. However, Alzheimer's Association states that art and music can enrich people's lives and allow for self-expression. D.W. Zaidel, a researcher and therapist at VAGA, claims that engagement with art can stimulate specific areas of the brain involved in language processing and visuospatial perception, two cognitive functions that decline significantly in dementia patients. Art therapy allows those experiencing memory loss to stay connected with other people and the world around them, by bringing them the opportunity to bond with those who matter to their lives. People with dementia can become very isolated, as many of their abilities, including the ability to understand abstract thinking and verbalize and communicate, disappear. Creating art in a group setting gives people with dementia a chance to interact with those around them, while reducing the pressure that many social gatherings can normally bring to those facing this condition. The creative activities involved in art therapy, such as painting or drawing, can affect certain skills, such as social interaction skills, which can be beneficial for those with autism. It is also thought to promote emotional and mental growth by allowing self-expression, visual communication, and creativity. Most importantly, studies have found that painting, drawing, or music therapies may allow people with autism to communicate in a manner more comfortable for them than speech. In Egypt, the Egyptian Autism Society implemented art therapy as a way to grow self-esteem and quality of life in children. They incorporated basketweaving, a common cultural art activity, in art therapy programs. These activities were part of studies that focused on self-esteem and proved that art therapy significantly, "...increased inner strength and daily living skills and reduced symptoms of emotional disorders...". In India, a study was done to show the effectiveness of art therapy by using both a controlled and experimental group on nine individuals with autism. One of the researchers, Koo, stated, "The positive changes were notable in the participants' cognitive, social, and motor skills". Group art therapy has been shown to improve some symptoms of schizophrenia. While studies concluded that art therapy did not improve clinical global impression or global assessment of functioning, they showed that the use of haptic art materials to express one's emotions, cognitions, and perceptions in a group setting lowered depressing themes and may improve self-esteem, enforce creativity, and facilitate the integrative therapeutic process for people with schizophrenia. Overall, some tests on the effectiveness of art therapy on patients with schizophrenia show effective results. From a pilot study done by Crawford, professionals worked through art-therapy inventions to assist the patient's process and understanding of the image when creating art, and these patients showed a decline in negative manifestations of schizophrenia, compared to patients who received the typical care for schizophrenia. Art therapy resulted in an increased emotional awareness for these patients, as by the end of the treatment, the treated group had very few positive manifestations of schizophrenia compared to the control group.

Post-traumatic stress disorder

Art therapy may alleviate trauma-induced emotions, such as shame and anger. It is also likely to increase trauma survivors' sense of empowerment and control by encouraging children to make choices in their artwork.

Art therapy may be an effective way to access and process traumatic memories that were encoded visually in clients. Through art therapy, individuals may be able to make more sense of their traumatic experiences and form accurate trauma narratives. Gradual exposure to these narratives may reduce trauma-induced symptoms, such as flashbacks and nightmares. This has been proven effective only in long-term art therapy interventions. As with other sources of trauma, combat veterans may benefit from art therapy to access memories and engage with treatment. A 2016 randomized control trial found that art therapy in conjunction with cognitive processing therapy (CPT) was more beneficial than CPT alone. Walter Reed Army Medical Center, the National Intrepid Center of Excellence and other Veteran Association institutions use art therapy to help veterans with PTSD.

Bereavement

According to the AATA, art therapy is "particularly effective during times of crisis, changes in circumstance, trauma, and grief." Bereavement is one challenging time where clients find verbalizing their feelings of loss and shock to be difficult, so may use creative means to express their feelings. For example, it has been used to enable children to express their feelings of loss where they may lack the maturity to verbalize their bereavement.

Eating disorders

Art therapy may help people with anorexia with associated depression and weight management. Traumatic or negative childhood experiences can result in unintentionally harmful coping mechanisms, such as eating disorders. Art therapy may provide an outlet for exploring these experiences and emotions.

Art therapy may be beneficial for clients with eating disorders because clients can create visual representations with art material of progress made, represent alterations to the body, and provide a nonthreatening method of acting out impulses.

Some types of art therapies include therapeutic photography, photo-art therapy, and video therapy. Therapeutic photography involves using photography for artistic statements with no real therapist involved. It is a type of self-directed art therapy that involves self-awareness, creative expression, and wellness. Photo-art therapy involves using photographss as the method of art. It involves art making during the therapy session, and can involve photographic techniques. Films can also be considered in this classification of art therapy. Finally, video therapy is an early term that is used to describe film in art therapy. Art therapists use videos to assist in treating clients, as patients watch certain videos known to have therapeutic results.

Art-based assessments

thumb|A [[coloring book page with a mandala motif]]

Art therapists and other professionals use art-based assessments to evaluate emotional, cognitive, and developmental conditions. The first drawing assessment for psychological purposes was created in 1906 by German psychiatrist Fritz Mohr. In 1926, researcher Florence Goodenough created a drawing test to measure the intelligence in children called the Draw-a-Man test, which posited the notion that a child who incorporated more detail into a drawing was more intelligent than one who did not.

Mandala drawing is one of the most diverse art therapy methods that can reach different groups of people to address a wide variety of needs. A mandala is a drawing that starts from an inner point and then expands outwards using circles. Mandalas have been used to identify psychological issues, reduce stress and anxiety, and improve one's self worth and well-being.

House–Tree–Person

Modeled after Goodenough's Draw-a-Man test, childhood psychologist John Buck created the house-tree-person test in 1946. In the assessment, the client is asked to create a drawing that includes a house, a tree, and a person, after which the therapist asks several questions about each. For example, with reference to the house, Buck wrote questions such as, "Is it a happy house?" and "What is the house made of?" Regarding the tree, questions include, "About how old is that tree?" and "Is the tree alive?" Concerning the person, questions include, "Is that person happy?" and "How does that person feel?"

The house–tree–person test is a projective personality test, a type of examination in which the test taker responds to or provides ambiguous, abstract, or unstructured stimuli (often in the form of pictures or drawings). It is designed to measure aspects of a person's personality through interpretation of drawings and responses to questions, self-perceptions, and attitudes.

Outsider art

The relationship between the fields of art therapy and outsider art has been widely debated. The term art brut was first coined by French artist Jean Dubuffet to describe "art created outside the boundaries of official culture". Dubuffet used the term art brut to focus on artistic practice by insane-asylum patients. The English translation "outsider art" was first used by art critic Roger Cardinal in 1972. Outsider art continues to be associated with mentally ill or developmentally disabled individuals.

Both terms have been criticized because of their social and personal impacts on both patients and artists. Art therapy professionals have been accused of not putting enough emphasis on the artistic value and meaning of the artist's works, considering them only from a medical perspective. However, critics of the outsider art movement suggest that crediting an artist's work to an impairment is reductive.

References

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