Origin of art therapy

Art therapy is a non-verbal form of assessment and intervention that engages with individuals who are unable to verbally communicate their problems. It has been used to provide individuals with an outlet unique from traditional forms of psychotherapy. It is effective at treating patients of multiple ages who have a variety of abnormal behaviours as well as helping people to cope with daily life struggles. Art therapy has evolved recently as more psychologists and therapists integrate art into their practices. A limitation of using art therapy is its inability to supply researchers with valid and reliable standardized procedures, methods and results that can be generalized to multiple populations. Researchers are more likely to use art therapy on vulnerable populations such as traumatized children and people suffering from brain disorders. Incorporating art therapy practices into the education system has proven to be beneficial for students, enhancing academic skills and quality behaviour. Art therapy has improved many individual’s lives and with more research, it would be an effective way of assessing, treating, and preventing psychological disorders.

Researchers using art therapy have an ethical responsibility to their clients. Research that deals with human subjects for medical or behavioural purposes undergo ethical complications. Principles are manifested into every study in order to maintain an ethically safe procedure for participants. Respect for persons, beneficence and justice are essential principles in ethical research practices as they ensure a participant remains autonomous and safe throughout the entire study. Through informed consent, participants understand the research purposes as well as their ability to withdraw from the study at any point in time. Deaver (2011) related the ethical principles required for every research study to art therapy practices (Deaver, 2011, p. 175). The

initial impression of art therapy practices may appear simple as they do not cause participants any obtrusive or physical harm. However, the underlying purpose of art therapy is to engage with vulnerable populations and focus on their most traumatic experiences. In order to conduct research on human beings using art, the institutional review board must approve the study as being ethically sound by assessing the risk and benefit ratio and informed consent. As art therapy deals with particularly vulnerable individuals, the research presents more than minimal risk. Although participants may agree to take part in the study, they may not fully understand the extent to which the therapy operates. Misunderstanding the entire context of the therapy indicates that the research does not function under ethical principles. Art therapy requires that researchers are aware of the ethical principles when designing studies to ensure the safety and well-being of their participants (Deaver, 2011, p. 175).

Art therapists can work with a variety of patients dealing with the complex emotions experienced from daily life. Lister, Pushkar and Connolly (2008) review how art therapists work with bereaved patients. Bereavement refers to feelings of grief that an individual experiences at the death of a loved one. Bereavement theories have previously introduced stages or cycles that bereaving individuals face throughout a grieving process. Recent studies indicate that bereavement is specific to a person and is based on many factors such as personal experiences with loss and the relationship to the deceased individual. Art therapists are able to take a new approach to bereavement and apply it in their practice by focusing on the individual. They should be careful not to force a patient into an expected stage of grieving or to assume a patient is experiencing an unusual mourning process. Art therapy is useful for bereavement specifically because it can be used to reduce overwhelming grief at expected trigger situations. For example,

an anniversary shared between the patient and the deceased may trigger negative emotions. The art therapist can prepare for this by working with the patient to make a memorial piece that will can be reminiscent of happier experiences. Creative art can be a way for an individual to cope with spontaneous moments of grief because it can function as an outlet for complex and hard to cope with emotions (Lister et al., 2008, 249). Bereavement is an emotion that most individuals will experience in their lifetime. Art can be used to address complex emotions and reduce the burdens on a individual, improve coping strategies and increase the understanding of a traumatic event.

Art therapy has also been used to reduce the traumatic effects natural disasters have on individuals. Orr (2007) conducted a content analysis of the use of art therapy with children after a disaster. Most of the research Orr conducted focused on children who had experienced disaster and required emergency therapy to deal with the traumatic events. Artistic expression allowed children a way of understanding the event and processing it adequately by exploring the situation and coming to conclusions. They were able to make goals for themselves and identify their own coping mechanisms (Orr, 2007, p. 356). Creating a space where children could interact with other children and art materials allowed them to feel comfortable in a safe environment. Doing so prevented the children from harvesting negative feelings about the disaster that had occurred. Orr concluded that in the case of a disaster, art therapy was an effective way of providing emergency interventions.

Flaws in Orr’s research limit the reliability of using art therapy on victims of natural disaster. Orr used a content analysis in the place of a meta-analysis because the research on the subject was descriptive opposed to research oriented. Although Orr described effective results in the use of art therapy practices in children, it is important to address the complications in the presented research. The majority of the journal articles analyzed were descriptive accounts from the therapist’s experiences. Although the articles were informative, they did not add any empirical evidence to art therapy practices. Case studies were the most described method of intervention among art therapists. Therapists described the effects of the therapy on the client. In many situations, an exact procedure or design was not outlined. The results obtained could not be established as formal research as it was found under unpredictable circumstances. In order for research to be applicable to a field of study, it must have construct validity, internal validity, external validity and reliability. Art therapy procedures were practical in assisting children who had experienced disaster but the results were unreliable as they lacked any standardized method that could be retested.

It is natural for people to experience moments of psychological dysfunction when dealing with common life stressors such as the death of a loved one or a natural disaster. It is also common for individuals to seek psychological help in order to learn to adapt to these stressors. Regardless of the lack of empirical evidence to support art therapy, therapists use art as a way of developing stronger coping mechanisms and enhancing adaptability.

Psychologists also emphasize the effectiveness of art therapy when working with patients from vulnerable populations. Vulnerable populations are those who are at a greater risk of developing or who have already developed a psychological dysfunction or disorder. Many researchers address how art therapy has been used to help individuals who have experienced a serious form of trauma. Talwar (2007) looks at how art making interacts with brain functions and how traumatic memories can be accessed more readily using specific techniques. Traumatic memory can be accessed using non-verbal methods of communication. Art therapy is beneficial when verbal psychotherapy is not an effective form of treatment for a patient. Trauma can effect the body and the mind on many harmful levels when not dealt with properly. Trauma can remain implanted in an individuals memory, causing simple stimuli to arouse the negative emotions repeatedly over a person’s lifetime (Talwar, 2007, 23). Art therapy is a better method for dealing with specific traumatic situations based on how creativity is registered in the brain in comparison to verbal communication. Talwar (2007) found that there is little research to support hemispheric differences in the brain, indicating that creativity is a function that exists on both sides of the brain. Brain damage can severely impact language ability as well as memory, but artistic ability can remain active. Specific damage to the brain can result in diminished ability, but artistic strategies remain a consistent ability among patients who have experienced severe brain damage, dementia or memory loss due to accidents (Talwar, 2007, p. 26). Talwar (2007) also explains the process of art making as a way of communicating silent terrors that cannot be formed using words. Trauma is embedded in the somatic memory. Art making can access this by activating the amygdala, which is responsible for emotional responses, and putting it into words using the prefrontal cortex, which is responsible for activating and planning emotional processes. Art therapy is an effective way of dealing with emotional and physical side effects caused by traumatic situations.

Mills and Kellington, (2012) addressed how group art therapy can be used to address the shame and silencing surrounding children’s experiences with domestic violence. A child who has experienced trauma must be able to safely revisit the situation so as they can understand, tolerate and learn to adapt to the feelings that the trauma evokes. When a child can derive pleasure from the materials they are using, they are more capable of engaging with the therapeutic process. This is a result of calmly assessing the traumatic experience that is embedded in an individual’s amygdala. Art therapy can bring procedural memory into the hypothalamus where it can be processed and dealt with effectively (Mills and Kellington, 2012, p. 3). The reason that art is an appropriate method for coping is because it can release complicated emotions that children may not be able to fully understand. Children who are confused by their emotions and unable to process traumatic events benefit from using art. Both making and looking at images allows them to engage with the trauma and create a safe environment where they can learn how to accept traumatic situations and come to terms with their own emotions. Art therapy is an effective method of allowing children to discover the truth in their experiences and learn from it in order to develop a greater sense of self-worth (Mills and Kellington, 2012, p. 10).

Art therapy appeared to be an effective method of dealing with traumatized children. Mills and Kellington assumed that a child’s progress was directly related to the art therapy being conducted. However, in order to have statistical evidence that the results obtained were related to art therapy, they would need to remove all other factors from influencing the results. A number of factors could have confounded with a child’s success rate. Working in a group, being removed from the initial trauma setting and using art could have all been potential factors associated to a child’s improvement. Art therapy currently functions as an observational experimental method, making it difficult to determine causation between its practice and patient’s psychological improvement.

Eaton, Doherty, and Widrick (2007) also investigated how art therapy is an effective treatment for children who have experienced trauma. Therapists strive to formulate an intervention plan that is specific to the client’s direct needs using creative arts as a way to express themselves and engage with a healing process. Creating art, coupled with storytelling, allows children to build a better relationship with a therapist that assists them in learning how to cope with trauma and the accompanying emotions (Eaton et al., 2007, p. 256). Even though the results of art therapy are inherently beneficial to a client, there is not enough research to rely on the results. Eaton et al. (2007) conducted a review on art therapy practices and addressed it’s efficacy. They concluded that there was not enough information about the methods of art therapy that were chosen or the length of the process. Results were very difficult to quantify and find statistical evidence to support them. Research relied on small sample sizes or case studies, subjecting the results to power and type errors. Most of the research also lacked a control group, making it impossible to determine whether the effects were a result of the manipulations put in place by the art therapists or by other factors. Art therapy used to treat patients who have experienced trauma appears to be effective. However, more empirical information on art therapy is essential to further the understanding of its overall effects on vulnerable individuals.

The research presented has dealt with how art therapy can be an effective tool in relieving trauma in daily challenges and vulnerable patients. Art therapy has also been administered in school settings as a way of dealing with the social, emotional and academic adjustments required for students. Freilich and Shechtman (2010) focused their research on how art therapy could be used as an intervention that would assist children with learning disabilities in their academic and socio-emotional functioning. A learning disability refers to a child’s cognitive dysfunction such as comprehension, reading and writing. A child may also suffer from social difficulties as they may experience loneliness and social rejection. Freilich and Shechtman theorized that art therapy would be an effective way to assist students with learning disabilities as it provides an accessible outlet for children to explore their emotions and reflect on their feelings (Freilich and Shechtman, 2010, p. 98). Art therapy was compared to humanistic treatments that focused on emotional understanding to improve a child’s functioning. Children can connect more with art than with verbal communication, especially if language functions as a barrier preventing them from learning. Children can comprehend difficult emotions by exploring the meaning of the emotions using images that they create. Freilich and Shechtman found that children who received art therapy as well as academic help improved more in their functioning than did the children who only received academic assistance. Art therapy is an effective way of improving children with learning disabilities socio-emotional and academic functioning.

Nissimov-Nahum (2008) also addressed the use of art therapy in the education system and focused on students with aggressive behaviour. The study focused on three main principles. First was to respond well to aggressive and unpredictable behaviour, second was to encourage free creative expression and third was to process the symbolic representation of the artwork. The purpose of art therapy when used to treat aggressive behaviour is to help children learn how to control their emotions. By expressing their aggressiveness in an artistic manner, children were able to understand the causes that triggered certain feelings and control their anger by directing it into their artwork (Nissimov-Nahum, 2008, p. 342). Many of the students involved in the study were able to control their emotions by the end of a few sessions. However, it was also common for individuals to act out when asked specific instructions. The signs of aggressive behaviours made the study complicated as some of the therapists were unable to deal with the aggressive behaviours, resulting in feelings of anger, fear and frustration. In order for art therapy to be an effective intervention for aggressive children, qualified individuals who are familiar with the behaviours and who have the patience and acceptance of these behaviours will have to implement the practice. By incorporating art therapy into the education system, children integrate therapeutic practices with their current studies and gain better understanding of their own feelings. Children learn to control emotions and improve academic abilities.

Art therapy’s success in the education system is reflected in basic therapy sessions when working with children. Children with issues ranging from mild to severe have shown greater improvement using art therapy than adults because they can engage with the materials, build a stronger relationship with the therapist and come to conclusions on their own (Waller, 2006, p. 272). Children who use inner feelings to create art are directing their most complex emotions into it, expressing themselves in a private way. Positive change begins to take place when the child feels comfortable enough to share their work with the therapist. Progress is determined by how well the child can understand their own work and share it with the therapist, resulting in behaviour changes and a deeper understanding of themselves. Some behaviours may be very strong within children and devotion to the child and patience may be the best way to see progress using art therapy. In time, the child may begin to feel more confident.

The increase in theorized success in case studies and problem populations using art therapy has encouraged many therapists to start using experimental procedures when working with clients. A review of the empirical evidence available for the field has concluded that art therapy, when conducted having no control group, having a controlled group and having a randomized control group, is just as significantly effective as other forms of psychotherapy when targeted at a specific population (Reynolds, Nabors, Quinlan, 2011, p. 212). Experimental research on art therapy should target specific populations such as children with learning disabilities, children with aggressive behaviour, or women survivors of sexual abuse. Researchers should attempt to use larger sample sizes in the studies in order to receive more significant results. When conducting the study, the procedure used, the methods followed and the subsequent outcomes should be recorded in detail to ensure the study can be replicated. By appropriating standard procedures of psychotherapy practices onto art therapy practices, the field may gain more significant research and stronger empirical evidence.

Art therapy has proven to be an effective method of psychotherapy under certain circumstances. The field has the opportunity to expand in order to assist many individuals who prefer to use non-verbal methods of communication when dealing with psychological dysfunctions. Art therapy has been used to address problems in everyday life, traumatic experiences and to improve developmental functioning using the education system. In order to gain more reliability as a therapeutic option for problem populations, the field requires more empirical research that will help it to apply to more than just theory based practices. Art therapy was most suitable for working with children as they could connect with the material and the therapist and subsequently showed greater success. Further research into the field of art therapy would give it the potential to adequately prevent, assess and treat psychological dysfunction in vulnerable populations.

Peer Feedback- Key Changes

The peer review initially comments on how the majority of the sources used in the paper reflect on art therapy and the impact it has on children. Children were a main focus in many of the sources but as the peer review suggested, it is essential to include multiple populations when looking into the effectiveness of any psychotherapy. I researched a couple of different sources that included a broader range of populations. I integrated sources that also focused on victims of abuse, depression, and anxiety.

Although the peer review describes the draft as being organized and clear, the fact that each paragraph had its own topic and source made it difficult to relate each paragraph to the next one. The paper was reorganized in a way that made each paragraph specific to a point highlighted in the introduction. The essay now follows a structure that outlines how art therapy is used on daily life struggles, trauma induced patients, the education system and in therapy sessions working with children. The topics of each sections are defined more accurately and easy to associate back to the thesis. This has also enabled concepts such as bereavement and trauma to be more clearly defined.

One of the major flaws that the peer review addressed in the draft was the lack of sources that indicated how the field of art therapy could progress. The initial draft only stated that more research was required. To fix this problem, a source was added that explained how the field can develop, focusing on ways to improve the procedures, methods and measures when conducting experimental studies on the effectiveness of art therapy. The paper now covers when art therapy has proven to be effective, the major limitations of the field, and how it can progress in the future.