Art therapy is the main representative of a broader, relatively new group of creative/expressive therapies, which also includes dance therapy, music therapy, poetry/bibliotherapy, (some include psychodrama and drama therapy). Art therapy is specifically focused on the visual arts (primarily painting, drawing and sculpting).
Art therapy developed and evolved throughout the 20th century alongside the development of psychiatry, psychotherapy and psychoanalysis and new art trends such as surrealism and expressionism. It gets its modern form in the 1940ies when it starts being officially called art therapy. In the UK, artist Adrian Hill is generally acknowledged to be the first person to use the term ‘art therapy’ to describe the therapeutic application of image making. For Hill, who had discovered the therapeutic benefits of drawing and painting while recovering from tuberculosis, the value of art therapy lay in ‘completely engrossing the mind (as well as the fingers)… and releasing the creative energy of the frequently inhibited patient’. This, Hill suggested, enabled the patient to ‘build up a strong defense against his misfortunes’. At around the same time psychologist Margaret Naumberg also began to use the term art therapy to describe her work in the USA. Naumberg’s model of art therapy based its methods on releasing the unconscious by means of spontaneous artistic expression; it has its roots in the transference relation between patient and therapist and in the encouragement of free association. It is closely allied to psychoanalytic theory. Treatment depends on the development of the transference relation and on a continuous effort to obtain the patient’s own interpretation of his symbolic designs. The images produced are a form of communication between patient and therapist; they constitute symbolic speech.
Art therapy today is based on a synthesis and subtle interactions between the creative process itself and the nature of the relationship established between the client and therapist. In art therapy this dynamic is often referred to as the triangular relationship. Within this triangular relationship greater or lesser emphasis may be placed on each axis (between, for example, the client and their artwork or between the client and the art therapist) during a single session or over time.
In practice, art therapy involves both the process and products of image making (from crude scribbling through to more sophisticated forms of symbolic expression) and the provision of a therapeutic relationship. It is within the supportive environment, fostered by the therapist–client relationship, that it becomes possible for individuals to create images and objects with the explicit aim of exploring and sharing the meaning these may have for them. It is by these means that the client may gain a better understanding of themselves and the nature of their difficulties or distress. This, in turn, may lead to positive and enduring change in the client’s sense of self, their current relationships and in the overall quality of their lives.
Art therapists are highly skilled professionals and require certain qualifications in artistic and therapeutic work. Art therapy has to be differentiated from occupational therapy and in their discussion of this issue, Atkinson and Wells identify four main areas of difference between art therapy and the use of art in occupational therapy. They distinguish these as: education and training, the use of a single art based medium, the importance attached to the artwork, and the level of direction evident within the therapeutic approach.
Clients who are referred to an art therapist do not need to have previous experience or skill in art, the art therapist is not primarily concerned with making an aesthetic or diagnostic assessment of the client’s image. The overall aim of its practitioners is to enable a client to effect change and growth on a personal level through the use of art materials in a safe and facilitating environment. A wide range of people may benefit from engaging in art therapy: people who experience illness, trauma, or challenges in living, and people who seek
personal development. All age groups are included. Recently, a growing body of evidence has confirmed this. Some of the disorders noted are schizophrenia, depression, dementia, PTSD, stress and trauma related disorders (in adults and children), eating disorders, borderline personality disorder, suicidal behavior, etc. as well as some somatic disorders where quality of life has been reduced, especially in the field of psycho-oncology.
“I became… a diligent and leisurely composer of precise pencil productions, each of which, in the terms of my restricted medium, sought to express my personal reactions to the unreality of my existence.” (Adrian Hill, 1945).
“To be happily occupied is at all times a gift from the gods, and in a period of long convalescence, it is a positive saving grace… The Art germ once it becomes firmly planted in the mind and the heart, is far more difficult to dislodge than another germ with which you are all more familiar. Indeed the former germ can help enormously in banishing the latter bug.” (Adrian Hill, 1945)
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The African Consortium of Art Therapy (ACAT)
Chapter written by Ana Papić and Nikola Žaja, psychiatry trainees from University Psychiatric Hospital Vrapče, Zagreb, Croatia