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Tuesday, November 23, 2010

Treatment Tuesday - Art Therapy

I recently fielded a question from an email loop about art therapy, and it made me wonder if perhaps some of you out there also had the same type questions.

For the record, I'm not an art therapist. I do therapy utilizing art. There IS a difference, and that's important to note if any of your characters ever see this type of therapist.

Art therapists can be licensed mental health practitioners (like LMFTs, LPCs, LCSWs) but they also hold registration or board certification as an art therapist. Depending on the state the person is practicing in, the practitioner may have had to get a masters degree in art therapy or marriage and family therapy with an emphasis in art, etc.

This is not to say that someone like myself, licensed, but with no particular schooling in "art therapy" can't use crayons and paper and glue and scissors in session with a child or adult. I have and I do. The difference is that I don't label myself, advertise, or practice under the notion that I'm an art therapist. This is a HUGE distinction, and the difference between possibly getting sued for malpractice or practicing beyond the scope of your ability.

So what is art therapy all about? Art therapists believe that it is inherently a healing process to be creative. The broken things on the inside are healed through the act of making art as they express themselves authentically and realistically. This is typically thought of as art therapy. There is also the belief that art is a form of symbolism, a way of communicating emotions and working through trauma and conflict. This latter belief is probably the more stereotyped version of art therapy, and is called art psychotherapy.

In reality, if the above words in bold formed a continuum, real art therapy (in the general sense) is somewhere between these two. Art therapy isn't like an art class. There are no grades and no pressure. The images and ideas come from inside the person, and then the therapist can help guide them into understanding those images, finding a meaning for them or a story. I like to use art therapy techniques along with other eclectic techniques in my treatment of clients. I consider art just another avenue for healing, just as I would any technique from various theories. (But that's just me.)

Anyway, just food for thought. In California, saying you're doing art therapy when you're not a registered or certified art therapist is a big deal. When doing my treatment plans, I usually include "arts and crafts" or "art therapy techniques" as interventions, never "art therapy."

Hope this helps when you come to that crucial point in every writer's manuscript when you wonder, "Is this art therapy or therapy utilizing art?" :)

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16 comments:

Tessa Emily Hall said...

Thanks for sharing this! I'm currently writing a story about a girl who has come from a rough past, but loves to express herself through her art, so this really helps. =)

God bless,

Tessa

Kenda Turner said...

Thanks for the insight--I have a niece studying to be an art therapist, and this helps me understand what she hopes to do :-)

Cathy Malchiodi said...

Nice article! I don't think art therapy is regulated in California by law, although now those with certain coursework may sit for the professional counselor license. The issue that it really hard to tease out is this: Is any use of art considered therapy when performed by a therapist? Art therapists would say that art therapist = art therapy, but is that really true? It's an interesting question!

Marta said...

I really enjoyed your text. Sometimes it is difficult to explain people that to be an art-therapist you have to study a lot and have a complete degree. I am from Portugal, and here you have to be a psychologist or artist or something related and after you should study in a school for art therapists (2/3 years studing) or to be an art psychotherapist you should do 5 to 8 years of studing. It´s a big effort and it´s really sad when you understand that someone without trainning is trying to do art therapy!

Cori said...

For the record I am a Licensed Creative Arts Therapist in New York City. I thank you for highlighting the value of art therapy in general. I would like to ask for your clarification in providing more information in how you use “arts and crafts” and “art therapy techniques” during your sessions. What is the purpose of your art use during a given session? That would help me understand your perspective. As written above, my concern is that you are trying to justify your practice through semantics. In other words, I am concerned that you maybe violating the spirit and letter of regulation.

Jeannie Campbell, LMFT said...

Hi Cori - thanks for visiting and leaving a comment. I mainly use art and do crafts with children for different reasons: 1) it's a non-threatening, easy activity to ease them into therapy; 2) it frees their mind to talk about more serious things by occupying their hands (play-dough is my favorite for this....we'll just make little play-dough people or animals and be talking about heavy issues at home, for example); 3) their pictures help me see how they perceive themselves and their families. I like to have them draw a picture of their family at the beginning of therapy and toward the end, to see how dynamics might have changed.

So I'm actually not using art in and of itself as any kind of process technique, so therefore there is no violation of any regulation. It's just an activity I use in session to engage a child, like coloring with crayons. (I don't do this with adults, unless the adult is in the session with a child and I'm using a craft to engage the family in a positive bonding experience.)

Hope this clears up any concerns you have. Please feel free to email me with any additional questions.

Cori said...

Hi Jeannie, thank you for your clarification. I understand the use of art activities to ease the client,especially a child into therapy. However, as an art therapist, I would believe that the child is using the art material, while talking about heavy items, to help him/her to process the information (whether it is verbalized or not) which is part of the art therapy process. Also, you stated that you are using the completed artwork to assess the progress of the child are you assessing the artwork through your own evaluation or along with the child? My additional question is then, when does the activity cross the line into a more therapeutic process?

Theresaq said...

Jeannie, I appreciate you making the distinction between art therapist and therapist who uses art, but the difference between them isn't simply a matter of title, which is where the ethical considerations of being either actually come in to play. Perhaps that's why your blog here seems motivated by legal more so than ethical concerns. What really got my attention was your statement,"This latter belief is probably the more stereotyped version of art therapy, and is called art psychotherapy." I have no idea what you mean by that and I hope you will clarify.
Thanks, Theresa

Jeannie Campbell, LMFT said...

theresaq - thanks for participating in the discussion. i wrote that particular little blurb about art psychotherapy that caught your eye from something i read on wikipedia about art therapy. you can read that article here. personally, i've never much made the distinction the writer of that article did (in paragraphs 4 and 5) about art as therapy or art therapy. i feel that when people think of "art therapy" in general, the stereotype is a therapist working with them using painting and the like to work through some sort of abuse or past trauma. read the article and let me know what your thoughts are.

Jeannie Campbell, LMFT said...

cori - thanks for checking back for my response. i would agree with you that the child probably is using the art to work through things just as much as he or she would be utilizing the talk therapy or even just the safe environment my office provides. difference is, i'm not trained in that field....so i don't touch it. i don't write about it any notes or indicate on billing that i did art therapy. quite honestly, i think art therapy is another whole beast and this very discussion is evidence of why i wanted to bring this distinction (blurry though it may seem) to light for writers (as is the whole purpose of this blog).

when i stated that i use completed art work to assess where the child is....it's nothing formal. to me, if a child is no longer drawing guns and blood but starts drawing dogs and ice cream cones, to me, that would indicate some sort of progress in his healing. i would not, however, analyze how the dog was drawn, etc. don't art therapists do that type of in-depth analyzing? please respond....perhaps you might could shed some light on where you think the line is drawn.

terru said...

Hi Jeannie, thanks for thinking of me. I have the greatest respect for certified Art Therapist, and often thought about adding that to my skills, formally. However, as a therapist (LCSW) I have, and continue to use various forms of art, and craft to provide another opportunity to express emotions, thoughts, dreams, hopes, with children, teens and adults. I do not use the work as a basis for diagnosis, but, like your, can get some more information about what my client is experiencing at that time. I am always careful not to give the impression that I am an Art therapist. But, as I think about it, using art activities is much like using sand-tray, puppet play, and other non-verbal communication styles. thanks Terri

Cori said...

Hello Jeannie, I believe that ethical issues can arise when non-art therapists use art during therapeutic sessions. Part of any therapeutic process includes building trust and a relationship with your client. If you are introducing art making into a therapeutic session, shouldn’t the client have a trust that you are trained in art and in the therapeutic modality? You gave a perfect example above. If a child draws a gun during your non-art therapy session what do you do? Since you have stated you don’t touch the processing of the artwork with the client and you don’t write about it in your notes, would that piece of artwork not get acknowledged or discussed? An art therapist is trained not to assume the meaning behind what is drawn during a therapeutic session. So, then I have to ask, is it acceptable for a non-art therapist to be able to assume or ignore what was drawn, since the work during the session is not being called “art therapy” and no processing of artwork is taking place?

In response to your question, art therapists do an in-depth analysis of the client’s overall work during a session. The artwork is considered as a part of the overall work that took place during the session. So the overall session is therefore analyzed in a variety of ways. The artwork is looked at not just in how the piece was drawn or created but what was drawn or created, what was the clients verbal/non verbal response, what materials were used, how were they used, did the client have a choice of materials, what was talked about or not talked about while the art was being produced, what was the therapists response, after time was there a repetitive subject matter created, and much more.

Just because one doesn’t write about the artwork in his/her notes as being art therapy, include it in his/her billing as art therapy, or suggest he/she is an art therapist when they are not, doesn’t mean the work doesn’t cross an ethical line. I believe that art making during a therapeutic session should be left to trained art therapists. Art therapists should be valued for their experience and expertise in the therapeutic modality that they are trained.

Mehdi said...

Hi Jeannie

I enjoyed your conspicuous tongue-in-cheek approach to the definitions of art therapy as well as your subtle sarcasm (the 'big deal' comment). I have always observed with amazement how in USA it is OK for you to do anything as long as you don't get caught doing it. That's the American entrepreneurial spirit.

Jeannie Campbell, LMFT said...

thanks for stopping by mehdi. went to your site...great explanations of why art and play therapy are so needed.

Paul Lee said...

Hi Jeannie,

It is a great blog post here to give general public a general perspective here; and especially by a non art therapist. It is a question seems to me a big debate and point of difference between art used by art therapist and non art therapist. There is not only ethical issue to be considered, but many other issues to be addressed appropriately. Art is a common form of activity, learning, play and expression. It is part of the growing up for many children to do art and craft. It is also used by many counselors, social workers, psychologist, occupational therapist, etc. to use art as a means to get connected to their clients. But it should move on to their professional training and not to keep introducing art or attempt to process it or using art as their intervention. It is because processing art for or with clients by non art therapists can be a dangerous and potentially abusing the clients psychologically.

There is a key point that I disagree with you is that art therapy connects to the deep inner psychological space of an individual, it touches authentic and creative self of a human being and in many cases, there is no need of any verbal argument or finding a meaning...

Thanks for bringing this hot topic again.

Jeannie Campbell, LMFT said...

paul - thanks for jumping in! i agree with you...art doesn't need to be belabored in therapy by non-art therapists. what i have issues with is someone saying that counselors can't use ANY kind of art in sessions. just as you said, it can connect a client to the therapist and it's a common form of activity!

i'm happy to bow to your assessment of art therapy connecting to deep inner psychological spaces of an individual. i don't believe i wrote anything that would contradict that.

thanks for stopping by!

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Both comments and questions are welcome. I hope you enjoyed your time on the couch today.