Psychology
Introduction
Art therapy is a well-known mental health profession that primarily uses creativity process of art making in order to enhance physical, emotional well-being, as well as and mental health of people. Art therapy is mainly based on belief that creative process of art-making helps people to resolve problems and conflicts, to develop interpersonal skills, to reduce stress, to manage behavior, and to increase self-esteem.
In general, art therapy incorporates the fields of visual arts, human growth, and the creative process with models of psychotherapy and counseling. The introduction of art therapy influenced significant changes on how people think, believe and behave in the community. The behavior therapy is a procedure intended to treat unwanted behavior that is directly observed. Art therapy is suitable because it has been developed as a different form of psychotherapy in the 18th century.
Roots and Theoretical Background For Art Therapy: Behavioral Approach
All types of art therapy are believed to be traditionally based on psychodynamic or psychoanalytic principles. The traditions mainly involve humanistic, behavioral, analytic, and integrative strategies. Based on traditional evidence, the art therapy involves the process of expressing creativity in movement, drama, art-making, and help clients to develop a much more integrated sense of self. It helps people to think correctly and enhance their behavior.
Art therapy offers a unique chance for the use of non-verbal communication that allows clients to express what they feel especially when they are stressed. This kind of therapy helps people to improve their health because it assists people to live through their problems and carry on with their lives. In every session of art, it is clear that the idea of art therapy helps individuals to have confidence in whatever they are doing (Rubin, 220.)
The roots of behavioral therapy were observed over the past 40 years or so by Pavlov, a Russian physiologist. Pavlov investigated the principle of classical conditioning by using dogs in order see their reaction. He realized then that every time he gave the dog some food, it responded to the stimuli. Later he resolved to use a metronome whenever he wanted to feed the dog. After a short period, the dog salivated every time a metronome produced a sound. This is an indication that the dog was responding to stimuli that were conditioned. Soon after this foundings, people discovered more kinds of conditioning techniques that affected people's behavior.
The behavioral approach of art therapy involves the application of behavioral modification techniques which involve modeling procedures and operant conditioning. The method of therapy requires therapists to be present in order to guide patients on how to practice art therapy. During the performance of art therapy, silence is required in order for healing to unfold (Rubin, 234.)
Approaching art therapy from the behavioral model is not one of the standard practices. However, it has been carried out, and it has proved to be effective. Most people have discovered that behavioral techniques are important especially when one is dealing with emotional distress, mentally retarded children, and domestic violence. However, people that face issues like this have believed that behavioral techniques can help them to recover. Behavioral techniques are significant because they help people to think straight and believe in themselves. Based on various researches, the art therapy approach applied for sensitively or emotionally disturbed or mentally retarded children is known as reality shaping. It mainly combines traditional art therapy techniques with behavior modification principles. In addition, it involves education, especially during the process of therapy. Reality shaping starts by identifying concepts that are poorly conveyed in children during the art sessions (Safran 223.)
According to Rubin, the behavioral approach to treatment starts by identifying a particular target behavior that needs modification. As a result, the story is elaborated to learn the causes and effects of behavioral issues. Rubin states that the therapist has the ability to state treatment goals. However, therapists spend much time evaluating the effectiveness of treatment.
Clearly, the behavioral approach to art therapy involves the application of behavior modification techniques to the practice of art therapy. The behavior modification techniques include operant conditioning and modeling procedures. The idea of behavioral approach to art therapy might appear opposing. However, art therapy has traditionally approached treatment from a psychodynamic viewpoint. In that case, behavior therapy and behavior modification techniques are not concerned with the unconscious as described through fantasies, dreams, or pictorial representation. According to Robin, it is clear that behavior approaches reject ambiguous intrapsychic conflicts (Rubin, 213.)
According to Rubin, the psychodynamic oriented art therapists use behavioral techniques in different ways. For instance, art therapist who encourages a blocked patient makes them draw in order to involve the patient with media and the praised the person for participating. It is clear that art therapists share a common ground, for instance, psycho-dynamically oriented art therapy and behavior therapy. Approaching the art therapy from behavioral model is not a common practice, but it has been described as effective. According to Rubin, it is clear that behavioral techniques are significant in improving the health of retarded children through art therapy. It is evident, that behavioral techniques are also helpful in improving adaptive behavior. According to Rubin, the behavioral techniques in art therapy address emotional needs of retarded children. Larry is one of the World’s famous therapists who used reality shaping.
According to Rubin, behavioral techniques to art therapy are demonstrated to be effective in different areas. For instance, reality shaping is a behavioral approach of special use for emotionally disturbed mentally disturbed children. It combines traditional art therapy techniques with behavioral modification principles. According to Rubin, reality shaping involves education during the process of therapy. This approach starts by identifying a notion that is poorly conveyed in the child’s productions during art therapy sessions. The notion is then developed into representational form through construction through a systematic manner (Safran, 23.)
Flow in Art Therapy
According to Csikszentmihalyi, the flow is timeless state of deep engagement in the activity characterized by the loss of self-consciousness and also by absorption with the action performed (as cited in Wilkinson & Chilton, 2013.) Art therapy is one of the numerous ways to experience flow through identifying and emphasizing the client’s strengths and talents, through releasing creativity, spirituality, and compassion.
Many contemporary researches addressing the biological and psycho-neurological aspects of the state of flow prove that art therapy can unleash the state of flow in the process of art making and induce positive experiences and positive emotions.
Application and Efficacy of Art Therapy
According to Spafford (2014), art-therapy can be beneficial for various categories of people with various issues: mental illness, autism, Alzheimer’s disease, post-traumatic stress disorder, anxiety, trauma, chronic pain, and recovery from stroke or cancer.
Moreover, art therapy not only helps to deal with negative side of life experiences; it provides wide opportunities to boost positive emotions and explore the life meaning through the mediation of colors, shapes, symbols, metaphors in the process of creating drawing, sculpting, dancing, story-telling etc.
Art therapists have made real wonders in the society. They have come up with different strategies that have assisted people to recover through art-making such as painting, drawing, dancing, poetry, sculpting. According to art therapists, it is clear that the brain of a human being needs easing in order for people to think straight. Apparently, with all the stress people can face a number of multiple challenges that they cannot solve if behavioral techniques are not applied (Safran 123.)
Art Therapy In Children
According to Rubin, children that experience mental issues can use the process of psychological therapy in order to solve the condition. Art therapists believe that the best way to make children to express their feelings and to release internal blockages is art-making through drawing and painting. This process draws the child away from emotions or mental disability to a better quality of living. This process can take a short or a long time before the child’s health returns to normal or better state. For instance, a therapist can give a child a picture to draw and educate a child how to name the body parts.
Therefore, drawing and painting help in the growth and development of the brain. This is a clear indication that the use of behavioral modification techniques new practice and develop ideas primarily not fully understood by children. Today, professional share the view of dynamic psychotherapy that emphasizes the role of interior procedures and behavior therapy that focuses on the functional adaption of behavior (Rubin, 223.)
According to Rubin, it is clear that young children develop their minds through reality shaping. During development, children are given the opportunity to draw pictures. In the initial stages, the drawings that children make are not visible or apparent. Therefore, behavioral approaches can be important and effective because they have the cognitive effect on children.
There’re a lot of studies evidencing the positive effects of art therapy in children. For example, study conducted by Smitheman-Brown and colleagues in 1996, has shown that the mandala exercise has a positive influence on attention and decreased impulsive behaviors, also facilitating decision making, task completion in children with diagnosed attention deficit disorder.
Art Therapy In Elderly People
Art therapy is being successfully applied in elderly populations, in home, hospital and hospice care. In spite of therapeutic benefits (promoting relaxation, reducing stress, easing pain, fear and depression), there are sufficient psychological benefits, being achieved by the therapist via application of psychoanalytic and psychodynamic approaches to each specific patient (Stevenson & Orr, 2013.)
Whether the art-therapist uses directive or non-directive (with materials provided but without clear instructions), art therapy helps to focus on non-verbal communication and helps to explore creativity, to communicate difficult or problematic issues , to express and explore positive or negative (such as anxiety, grief, loss, depression) feelings and emotions, to recall the important experiences of the past, to facilitate socializing.
Art Therapy against Professional Burnout and Distress
Art therapy can effectively deal with the signs of professional burnout and exhaustion in various categories of professions. The study conducted by Potash and colleagues on a group of end-of-life care professionals (2014) proved that supervised art therapy comprising guided visualization, art making, reflective writing, group discussions helps to reduce an exhaustion, strengthening emotional awareness, ease communication of sensitive issues.
Results of the mentioned and other researches (such as Bakker et.al, 2005, Brooks et al., 2010, etc.) can be applied practically in working with people of various occupations exposed to the high risk of professional burnout (healthcare, social workers, disaster response services, etc.). Managers can consider providing opportunities for the art-therapeutic sessions as a part of holistic professional development program (Potash et.al, 2014.)
Post-Traumatic Stress Disorder and Depression
Numerous researches (Chapman et al, 2001; Howard, 1990, etc.) evidenced the efficacy of art therapy in clients with post-traumatic stress disorder: the studies outcomes demonstrated reduction of acute stress, increased self-awareness.
Depression, which is the considerable problem for modern World (about 15-20% of adults express symptoms or signs of various stages of depression), can be addressed with a complex approach including creative therapy. For example, study of poetry therapy applied in clients with depression, conducted by Parsa & Harati in 2013, evidenced the sufficient positive outcomes of the art therapy. During the study, such positive results as increase in self-esteem, awareness and expression of emotion, improvements in self-exploration and self-declaration, have been reported (Parsa & Harati, 2013.)
Positive Psychology and Art Therapy
Positive psychology focusing on positive emotions, happiness, well-being and meaningfulness of life, has deep relations with art therapy. Positive art therapy helps people improve their well-being through “a variety of creative pathways that uniquely illuminate purpose and meaning and increase positive emotions and engagement” (Wilkinson & Chilton, 2013.)
In contrast with the common approach of picturing suffering and pain, positive art-therapy concentrates on post-traumatic meaning-searching process, shifting the cognitive and emotional processes towards maintaining sense of meaningfulness of life and positive attitudes. Numerous researches (for example, Collie, Bottorff, and Long, as cited in Wilkinson & Chilton, 2013) prove the efficiency of the positive art-therapy in different categories of patients (starting from patients with cancer to disaster survivors.)
The research by Curl comparing the effects of art making with a positive versus negative event focusing displayed a greater stress-reduction effect of an art-therapy focused on positive memories and experiences (Wilkinson & Chilton, 2013.)
Digital Art Therapy
In the modern World, people of younger generations are open to digital and mobile technologies facilitating processing information and communication. There’re a lot of high-tech applications contributing to performance of the healthcare system, including, for example, health information technologies used for self-monitoring, interaction with medical personnel and supporting treatment.
In art therapy, where the focus lies mostly in the “sensory nature of art materials and the artistic/creative process” (Hsin & Garner, 2013), technology use is controversial, as it makes impossible building relationship between a client and therapist and also rises lots of ethical, privacy and educational issues in art therapy professionals.
But in art works assessment procedures, digital images analysis have been applied successfully (the specific art therapy assessment software has been used for the first time by Garner and Hsin.) Digital Art Therapy Assessment (DATA) has a huge potential to increase penetration in schools, universities, research centers and healthcare institutions, as in provides many benefits: greater accessibility and storage, automated responses, reducing standard procedure time, etc.
The study of the art therapy clients’ preferences has shown that the younger people (aged 21-30) would prefer working with digital art therapy assessment tools due to time efficiency, fast response, interactivity, possibility of long-distance use (Hsin & Garner, 2013.)
These developments predict a greater interpenetration in the areas of art therapy and innovative digital technologies. There’s still a space for further researches and innovations.
The Role of Art Therapist
According to Health & Homeopathy (2012/2013), the art therapists should be trained in the psychology of symbolism, in non-verbal communication, psychotherapeutic understanding of human development, including family dynamics and children development. It’s not an easy and a very challenging work role requiring high level of professionalism along with sensitivity, attentiveness, creativity and responsibility.
The art therapist is not only an educated and qualified healthcare professional, but a person who’s relationship with a client (patient) should be based on the principles of openness, trust and mutual understanding. Whether the art therapy is conducted in individual or group session format, the art therapist should select the methods and instruments most appropriate for each case, to adapt the materials and approaches in order to meet the specific needs of an individual or the group and also to support their clients (Stevenson, Orr, 2013.)
When working with people, no matter which category of clients they represent – people in hospice or palliative care, elderly people, children, people with post-traumatic experiences or under distress, - the art-therapist should remember that the relationship built with a patient is as important as the art work produced (Buday, 2013.)
Art-therapist can work alone, but in most cases – as a part of multi-disciplinary team, so she or he creates “another layer of support for the mind, body, and spirit” (Buday, 2013) of the client or patient, contributing to their quality of life and overall well-being.
Another important aspect for each art therapist is releasing and supporting her or his own creativity. Without creating their own art, without involving in the practice of creativity and art-making, the art-therapists are exposed to a risk of “clinification’ (Allen, as cited in Iliya, 2014.) According to Iliya, the therapist should stay “connected to their art form in order to advance their personal and professional development;” without gaining a personal experience of expressing the emotions, growing, insight and enjoyment, the therapist cannot neither transfer this experience nor advance in their profession.
The personal creativity can be applied by an art therapist in a variety of forms. For example, Allen suggested an artist-in-residence model of entrenching the personal creativity in work: art therapist can have open studio hours for her or his clients while she or he is engaged on their own personal art-making (as cited in Iliya, 2014.) This model differs a lot from the more common directional art-therapy model, when the therapists not only provides the clients with the art materials, but also guides them through the process of art-making.
Conclusion
It is clear that art therapy encourages self-expression, emotional g5rowth, and self-discovery. In that case, it has been used in several kinds of treatment of mental for more than 10o years. People are encouraged by art therapists to visualize and create thoughts and emotions that cannot talk about.
Treating various pathology states using art gives the healthcare professionals a tremendous opportunity “for engaging brain networks that enhance the way the brain processes information, incorporates external and internal data, and develops new efficient brain connections” (Konopka, 2014.)
During the 20th century, art therapy was very popular as a form of milieu therapy, and it was important to influence on the development of art therapy in America. Milieu therapists mostly focused on putting patients in a therapeutic social environment that offered chances to develop self-confidence and relate with others in a positive way (Rosal 34.) Clearly, art therapists avoid the use of medical terminology and diagnostic labels with their clients. Today, art therapists use material qualities of art and media as one of its primary elements. These set of factors work through rehabilitation in order to help people solve their major problems.
However, it is evident that art therapy is at early stages of finding appropriate, suitable research strategies further to understand the qualities of its benefits and practice as well as appropriate ways to evaluate its practices. From exploration health careers; art therapy is an establishment of the mental profession that utilizes the creative process of art making in order to improve the physical, mental, and emotional well-being of people at all ages.
Art therapy has a huge potential for further penetration into research and treatment practices. In collaboration with other multi-disciplinary professionals, art-therapists can make their contribution to a holistic well-being, development and personal growth of their clients. The future directions of art-therapy development can be as follows: increasing use in psychological analysis and therapy of different categories of people; increasing variety of forms, methods and instruments; mutual intersection with other health care disciplines; penetration of innovative data analysis and digital technologies.
Works cited
Rosal, Marcia L. Approaches to Art Therapy with Children. Burlingame, CA: Abbeygate Press, 1996. Print.
Rubin, A., Judith. Approaches to Art Therapy. New York. 1992.
Safran, Diane S. Art Therapy and Ad/had: Diagnostic and Therapeutic Approaches. London: Jessica Kingsley, 2002. Internet resource.
Wilkinson, R.A. and Chilton, G. Positive Art Therapy: Linking Positive Psychology to Art Therapy Theory, Practice, and Research. Art Therapy: Journal of the American Art Therapy Association. 2013, Vol. 30 Issue 1, p4-11. 8p
Buday, K.M. Engage, empower, and enlighten: Art therapy and image making in hospice care. Progress in Palliative Care (PROG PALLIAT CARE), 2013 May; 21 (2): 83-8.
Stevenson, M., Orr, K. Art therapy: stimulating non-verbal communication. Nursing & Residential Care, June 1, 2013
Potash, J. S.; Y. Ho, A. H.; Chan, F.; Xiao Lu W.; Cheng, C. Can art therapy reduce death anxiety and burnout in end-of-life care workers? A quasi-experimental study. International Journal of Palliative Nursing (INT J PALLIAT NURS), 2014 May; 20 (5): 233-40
Spafford, Ch. Art THERAPY. Alive. Oct2014, Issue 384, p53-55.
Smitheman -Brown, V., & Church, R. P. Mandala drawing: Facilitating creative growth in children with ADD or ADHD. Art Therapy: Journal of the American Art Therapy Association, 13 (4), 252 -262.
Chapman, L. M., Morabito, D., Ladakakos, C., Schreier, H., & Knudson, M. M. (2001). The effectiveness of art therapy interventions in reducing Posttraumatic Stress Disorder (PTSD) symptoms in pediatric trauma patients. Art Therapy: Journal of the American Art Therapy Association, 18 (2), 100 -104.
Parsa, A.N., Harati, S. Art Therapy (Poetry Therapy) Can Reduce the Effects of Depression. International Journal of Academic Research. Jul2013, Vol. 5 Issue 4, p149-152.
Hsin, C.& Garner, R. Digital Art Therapy Assessment: Overcoming Cultural and Language Barriers Globally. International Journal of Technology, Knowledge & Society. 2013, Vol. 9 Issue 3, p35-47. 13p.
Iliya, Y. The purpose and importance of personal creativity for creative arts therapists: A brief literature review. Journal of Applied Arts & Health. 2014, Vol. 5 Issue 1, p109-115.
Konopka, L. Where art meets neuroscience: a new horizon of art therapy. Croatian Medical Journal [Croat Med J] 2014 Feb; Vol. 55 (1), pp. 73-4.
Slayton, S. Outcome Studies on the Efficacy of Art Therapy: A Review of Findings. Art Therapy: Journal of the American Art Therapy Association. 2010, Vol. 27 Issue 3, p108-118. 11p.
