Applications and areas of work of Art-Therapy

 

Art Therapy in Prisons

In Art Therapy, it is not so important to get a final aesthetic product as it is to help the inmate reflect on his or herself. This process takes place to help the artistic creation; this also acts as an intermediary facilitator of communication and exploration of feelings. In the last instance the objective in Art Therapy is to learn to use one´s own artistic creativity to resolve conflicts that are in a dimension other than the purely aesthetic. Prison is a paradoxical place, oppressed and denied feelings that wake them up and exacerbate with a lot of force; rage starts quickly like a bonfire, while in the very heart of the fire, hidden, often hides the most heartwarming tenderness. The work of the Art Therapist is to help the inmate to reconcile these two forces.

There are many psychological factors that the inmate has to face. The first one is obviously the lack of freedom, but it is also found in a hostile and threatening atmosphere, trapped in an alley in which the need to defend themselves and the threat of punishment coexist at the same time. The inmate lives far from their relative to see, if one sees them around the clock, in any case each visit represents a new farewell.
The manner in which the inmate lives his/her own crime is also a fact that has to be dealt with and whose resolution largely determines whether the crime will be repeated. A network of contradictory feelings lives inside the prisoner that is much more effective than the walls of the prison. So that the inmate may reach rehabilitation before leaving with the victim-executioner blame-punishment spiral in which one is trapped, only if he or she manages to achieve this goal of being able to confront what he or she lacks, being aware of the pain of others and taking responsibility for their own actions.

The Art Therapist accompanies the inmate in the difficult task of putting his or her life in order. Thus, artistic objects that occur in the Art Therapy session, whether individually or in a group, come as a vital importance to the personal development of the inmate and each image represents a step on the road to discover oneself. A value, but superior, in any other case than the one that is given to the work exhibited in an art gallery.

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Author:
Carles Ramos i Portas
Director of Art Therapy, Metàfora
carles.ramos@metafora.org

Art Therapy in Special Education

School occupies a primary part in the healthy emotional development of a child and adolescent, as well as his or her integration in society. Art Therapy in the school context provides an intermediate space where emotional and psychological aspects of the student which influences both their learning process as well as their behavior and self-development. Art Therapy is particularly suitable in the therapeutic work with children by using a form of communication that is more familiar or accessible than spoken language. Art materials offer children a more tangible expression and spontaneous medium to explore your needs, emotions, fantasies, desires, conflicts, and difficulties. In children and adolescents enrolled in special education, this alternative form of expression can be particularly valuable, since they often exist in these verbal communication difficulties.
To enrich one´s world with other channels of communication can help one to not speak through disruptive or aggressive behavior, or because they experience withdrawal and isolation. Artistic activity allows bridges to form between the behavior and the symbolic language. Art Therapy also offers a space to these children and adolescents where one can fully experiment with his or her own resources and abilities to solve problems, stimulating spontaneity, authenticity, and imagination. This helps them gain more self-confidence in themselves and self-esteem, a particularly important achievement for children who may feel vulnerable or who feel that they do not control important aspects of their lives. Also the development of creativity strengthens cognitive development, as creative and intellectual abilities are interrelated.
In Art Therapy this stimulation is conducted in a fun and non-directed way, favoring the autonomy of the child in his or her own learning process. Material handling or the creation of a symbolic work in Art Therapy facilitates the expression of disturbing emotions that are difficult to communicate directly. In disabled children this difficulty can be exacerbated by their dependency status. The creative act channels tensions and feelings of frustration, while the object itself created contains and can reveal these difficult emotions in a non-threatening way. The Art Therapist helps to support them, give them meaning, and transform them. The exploration of the emotions within the therapy then affects the life of the child or adolescent in the way of relating to others and to him or herself. Creative work within a safe therapeutic context also allows one to experiment and set limits. The experience of limits and containment helps the child or adolescent to safely explore overflowing emotions or feelings. In the work or the creative process these emotions, or other images or fuzzy thoughts, take shape and become controllable for him or her. This whole process inherent to the creative work impacts the development of their identity. In children and adolescents with autism or psychosis, a direct approach with the therapist can be distressing.
Art Therapy, intermediated by object and art materials, helps one relate in a less threatening way. Also the exploration and manipulation of different materials stimulates the child to form a more integrated boy concept and create a world of broader meanings. For children or adolescents with a diagnosis of a psychosis it also helps to differentiate between reality and fantasy. In conclusion, Art Therapy allows children and adolescents with disabilities the opportunity to feel joy and pleasure in the act of creating, feelings that they are usually denied. it also gives them the ability to feel independent, make decisions and feel they have control over their creative process, giving them the opportunity to be active agents of their own development.

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Authors:
Gabriela Portas, Michéle Le Pape and Heleen Leper
MAs in Art Therapy UB, lics BBAA UB, lic Psychology

Art Therapy with the Disabled

An adequate understanding of the emotional world in the treatment of people with learning disabilities optimizes which other kinds of actions to achieve their objectives more easily. Behavior modification programs or activities aimed at the acquisition of motoric, cognitive, or social skills may be a greater or lesser benefit if at the same time the emotional needs of the patient are not properly addressed.
Art Therapy provides a suitable psycho-pedagogical team to approach the problems of the user when the language restrictions preclude access to their emotional world. Art Therapy differs from a plastic workshop that is not an occupational or educational activity. In Art Therapy the production of more or less decorative objects is not as important as the process of artistic creation itself. This process does not depend on their disability and their cognitive and motoric abilities, but encourages other potential capacities of the individual. Recognizing these skills and helping empower them helps to improve the quality of life for the Art Therapy user.

The non-threatening nature of the artistic activity allows users to approach the therapist without entering intolerable levels of anxiety. The non-directive activity that differentiates this form of treatment allows such patients to participate in activities in which they would not normally be capable of participating.

The Art Therapy user doesn´t have to possess artistic abilities of any kind, not even the most basic. Drawing a line of the paper or printing on a piece of clay with a finger is enough to begin to establish a work process where, at the pace that suits the individual, the patient will have enough space necessary to safely express his or her emotions and conflicts. The capacity contained from images made in the presence of an Art Therapy professional allows the emergence of unbearable, dangerous or forbidden feelings…feelings that if they do not find an exit would be locked inside the person and quite possibly would find other less desirable ways of expression than scribbles on paper or traces of a finger over the clay unconsciously.

The psychotherapist for art has been educated to understand the complexities of the non-verbal languages, especially the ability to decode the visual expression can be useful to the psycho-pedagogical team to help better understand the inner reality of the user and consequently optimizing it for the benefit of therapeutic and educational resources of the center.

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Author:
Carles Ramos i Portas
Director of Art Therapy, Metàfora
carles.ramos@metafora.org

Art Therapy with Children and Adolescents

The work of a therapist in Art Therapy is similar to the one of a mother with her baby: attend to the physical and emotional needs of the child, understand and respond appropriately to nonverbal messages, and finally, facilitate the learning of new forms of communication that are more elaborate. Psychotherapy for art is especially suitable for children because it uses a form of communication that is familiar and much more within reach than the spoken language. In the process of creation and manipulation of an image or art object, children express in both symbolic and literal form their fears and hopes, tell us about what is important, what worries them and excites them.

Art Therapy is used in the treatment of children and adolescents in group sessions, individual or jointly with family members. Outside Spain Art Therapy is practiced in a variety of institutions: schools, primary, secondary and special education, hospitals and clinics for children, rehabilitation centers of children, psychiatric centers, etc.

Art Therapy groups are particularly suitable for helping children to interact better with their peers (solitary, timid, overly aggressive children). Through artistic play the Art Therapist helps balance the forces that exist in the group, gives a voice to those who have lost it, contains excess activity, helps transform the acting out in other more safe and effective forms of expression, and helps children to share rather than compete.
Art Therapy family sessions are advisable when problems that affect the child are caused by family dysfunction. In these cases it would not be possible to only help the child individually, since the problem includes the other family members as well.

Individual sessions are appropriate for children who require special attention; children with psychotic disorders, children who suffer from some sort of mental deficiency, or simply children that have lived or are living a traumatic period in their life (illness or death of a family member, conjugal violence, abuse of some sort, divorce, birth of a sibling etc. ). Individual sessions are also suitable when it comes to characteristics that are likely to cause embarrassment or shame for the child such as: bed wetting, eating disorders, excessive parental dependency, inappropriate sexual conduct, etc.

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Author:
Carles Ramos i Portas
Director of Art Therapy, Metàfora
carles.ramos@metafora.org

Art Therapy in Palliative Care

Art Therapy has shown to be very effective in the treatment of palliative care. In the United States and Great Britain it is used in hospitals for patients with cancer, AIDS, family care centers, hospices and rehabilitation centers. Often it is mistakenly believed that Art Therapy is a ‘constructive’ way of evading difficulties. The reality is quite different, using Art Therapy patients have the opportunity to communicate what concerns them without resorting to words. Artistic activity, understood as a means to facilitate the expression of emotional content, can help people address their problems more clearly.
Art Therapy in palliative care is offered to patients in different ways, both if they are in a bed in the hospital or at their house. Creative activity may consist of drawing, painting, collage, writing or reading poetry, etc. It is not necessary at all for people who access this service to have experience in the use of artistic materials. Instead, to discover a creative experience, is not only enjoyable but enlightening in many ways and especially in such difficult and painful circumstances that arise from an immediate palliative effect.

With the creative opportunity the patients find a way to express and reflect on the feelings experienced, when coming to terms with an irreversible illness. These feelings, already in themselves difficult to articulate in words, patients often hide from relatives and friends for fear of making them suffer. Hospitalization or medical treatments may stir up in the patient difficult feelings such as excessive dependency, powerlessness against disease, loneliness, rage, despair, etc. At the opposite extreme, when one I near, feelings like gratitude, tenderness or appreciation often appear, these feelings also being difficult to verbally articulate.
The Art Therapist in palliative work is a fair companion, someone who offers his or her knowledge and experience to give emotional support to patients at the time are certainly more critical of their life. Exploring our own latent creativity not only allows us to discover our inner strength, but it also enriches our lives with a new beginning in a time which the end occupies the most prominent place. Often psychotherapy by art in this field is not limited to working with the sick, in many centers and hospice clinic Art Therapists also work with the families of the sick. That can be done in various ways: working with the dying at the hospital or at home, with the most vulnerable members of the family during the illness and/or after the death accompanying the mourning process.

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Autor:
Carles Ramos i Portas,
Director de Arteterapia, Metàfora
carles.ramos@metafora.org

Art Therapy for Mental Health

At the beginning of the 20th century, arts focus their attention to the subjectivity of the artist, psychoanalysis and its idea of the unconscious emerges, the modern artists reflect on the images of the inner world and not only the appearance of the exterior. The value of expressionism for example, as current aesthetic self-expression and the inner world of the artist and the assessment of creativity that of the mentally ill is made in these modern aesthetic currents, closer to the world of psychiatry with art, marking a first reference for the development of the Art Therapy in the field of mental health.
On the other hand, after the Second World War, the various institutions and mental health professionals face the challenge of treating and rehabilitating large populations of people affected, damaged and traumatized by the effects of a devastating war. These events mark the start of the search for new therapeutic practices that allow the treatment and the rehabilitation of these people. New techniques and therapeutic methods emerge and develop, such as group therapy, occupational therapy and the therapy through art. Specifically the first experiences in mental health arose from the practices of teaching arts to the interior of the psychiatric hospitals.
Artists were inserted within hospitals and help diverse patients initially to occupy their free time in leisure activities group and focused instead on making art objects. However, progressively as different mental health sciences deepen their notions of psychotherapy and treatment, artists or art teachers are recognizing in artistic practice not only a means of recreation, but also a form of experience that allows one to deploy a set of affective, motivational and social functions in different patient groups. In this sense, the development of the Art Therapy in mental health moves between the first practices with patients to the present in which the various forms of Art Therapy include different psychotherapeutic strategies in individual and group-based art workshop. The areas that meet a greater diversity of practices in the field of mental health are without doubt, the area of treatment and rehabilitation of severe mental disorders. Wood, C. (1997) points out that the work of Art Therapy in the area of severe mental disorders has been present since the early days of the profession in the 1930’s to the 1950’s, in Great Britain; he explains how the pioneering artist Adrian Hill, works with this population in psychiatric hospitals, however, he points out that this Art Therapist did not work with psychotic people, although with some people with a history of psychosis.

It also highlights the impact of mental health policies and changes in psychiatric institutions as a challenge for the development of various forms of treatment for people with severe mental disorders. Some important changes relate to the closure of the old psychiatric asylums and the implementation of a set of instances of community care (day hospitals, therapeutic communities, day centers, acute units, etc.).

Wood, C. (1997) stresses that each of these contexts demands a kind of intervention in Art Therapy, differentiated. Art Therapy inserted within a set of psychosocial interventions in this type of treatment can contribute to the strengthening of various ego functions in various people, enhancing the sense of competence and self-esteem, is a space that allows containment of psychotic anxiety and is a vehicle for interpersonal relationship (Kings, 2003). Currently we find diverse practices of Art Therapy in the field of mental health, in recent literature found Art Therapy practices, long and short term formats with children, young people and adults with addictions inserted in therapeutic communities, in care of acute in format of open group workshop, with depressed people, eating disorders, and severe personality disorders, psychosis, among others. Art Therapy is an alternative especially recommended with those people struggling to verbalize experiences and symbolize his or her inner world.

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Author:
Pamela Reyes
Lic Psicologia
University of Santiago, Chile
MA Art Therapy UB.
artepamela@yahoo.com

Art Therapy and Mental Health (Adults)

Art Therapy is used in treatment and support to the diagnosis of mental disorders in the adult population. The spectrum of treatable psychopathology in Art Therapy is as broad as these, from psychoses to the psychoneuroses, personality disorders, drug addiction, depression, disorders, eating disorders, etc. Using images patients can distance themselves from their conflicts and as a mirror, reflected in a non-threatening way. The appropriateness of the use of Art Therapy as a therapeutic modality will depend not so much pathology as the specific circumstances of each patient, their level of disturbance, the potential for significant relationships, the ability to express and reflect on own emotions, and obviously the will of the patient to engage in a therapeutic process in which the creation of images is an important factor.

Psychotherapy for art or Art Therapy is practiced in individual sessions and in groups. Treatments can be short, medium, or long term depending on whether the work is of containment, focusing on the conflict, intrapsychic or interpersonal exploration.

The versatility of Art Therapy allows it to carry out important work in different health care environments. The acute psychiatric unit, can serve to counteract the adverse emotional effect involved in the patient in a hospital admission, as immediate effect decreases the level of anxiety while facilitating communication between patients and the staff of the clinical team.

Once out of the hospital, the possibilities of Art Therapy are multiplied. At the Day Hospital can help patient and medical teams to explore the causes that provoked the crisis and thus preventing crises by helping the patient to find alternative means to express their conflicts. At the Day Center, Art Therapy can be useful to patients as well as to think creatively on the staff of each situation individually.

In the treatment of less severe psychopathies, with patients who tend to distance themselves from their feelings, overly intellectualizing his or her conflicts, Art Therapy can help the patient to establish contact with his or her emotional world without compromising their defensive strategies.

Metaphorical images used in the spoken language are not permanent while visual images, even after they are made, maintain emotional and communicative power. This feature allows the Art Therapist to wait for the right time to review an image that refers to particular conflict, which is when the patient is prepared to deal with it and not before.

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Author:
Carles Ramos i Portas
Director of Art Therapy, Metàfora
carles.ramos@metafora.org

Art Therapy and Parkinson´s

Throughout life unforeseen difficulties arise to which we have to face and try to overcome them. Sometimes this difficulty is irreversible, as it may be in the case that we are diagnosed with a degenerative disease without a cure, like Parkinson´s. We cannot change the diagnosis but we can find resources that will allow us to coexist with it. Art Therapy is proving to be an adequate therapeutic intervention to face this disease.
Parkinson´s
Parkinson´s is a disease of the central nervous system, caused by a deficit of a neurotransmitter, dopamine, vital to coordinate movements and balance of the human body. This deficit prevents the fluid transmission of messages to the central nervous system. Some of the most common symptoms present in tremors, muscle rigidity, the slowing of movements (occurs in both automatic movements-swallowing, blinking, etc., as well as voluntary movements),postural abnormalities and difficulties walking. Someone affected by Parkinson´s can, for example, intend to move but his or her body does not respond. This is a huge frustration for the individual. Dementia is not a definitive sign of Parkinson´s although in the advanced stages it may be more prevalent. However from the onset of the disease there may be certain cognitive alterations (difficulties in organization, planning, slow thinking, concentration problems).

There are several groups of drugs useful in the treatment of Parkinson´s disease that allows us to control the main symptoms. Despite this, from the outside, Parkinson´s disease may seem capricious due to the variations in the effect of the medication throughout the day. This act causes its limitations to be more or less evident depending on the time. To preserve their autonomy, patients should perform all of the actions that they are able to by themselves.

The development of any activity may require more time than usual, but one should achieve an adaptation to their new rhythm, and attempt to ask and receive help always provided that it is necessary. Drugs alleviate the symptoms of the disease, which together with the acceptance and adaptation to the disease by the patient, usually means that the patient can lead a full life despite these limitations, Parkinson´s does not shorten life expectancy. To coexist with an optimal quality of life with the disease however it is advisable that the person follow a comprehensive treatment i.e. both pharmacological and non-pharmacological. There is a range of complementary and recommended therapies for these cases: physiotherapy, occupational therapy, hydrotherapy, speech therapy, music therapy, psychotherapy and Art Therapy. As a result, the person will keep an active and healthy life physically and emotionally.

Parkinson’s normally appears in people between 50 and 65 years of age; and indiscriminately affects both sexes. It cannot be considered only a disease, we must bear in mind that at this age the person undergoes other changes in his or her life, might have to be considered the end of their working life. This feeling of loss of skills to develop a job can mean a step that requires him to reorganize his life. Today’s post-modern society does not leave a space socially accepted for the elderly; a set of technological changes occurred in such a short period of time, have left him in a situation of inferiority and marginalization by their difficulty in joining the future world. From this lack of an accepted role may arise certain questions of difficult solution to which we cannot offer immediate responses, and that could be treated in a therapeutic environment.
Art Therapy – Methodology
Art Therapy is a kind of therapeutic intervention of psychodynamic orientation that is used as a method of expression of the artistic languages. The use of art in this context provides a way of non-verbal communication through which one have the possibility to express his or herself both consciously and unconsciously. In Art Therapy, the creative process and the resulting artistic object form a third very important element in the therapeutic relationship, which allows a person to express their emotions, feelings, and thoughts as a whole by means of comments made to the Art Therapist on the work or by the meaning of the work itself without words.

The method most commonly used is nondirective, so that the patients can express themselves freely and thus issues that they are working with are guided by the needs of each individual or group. Art Therapy provides people affected by Parkinson’s a tool to reduce anxiety towards the disease, and a way of adaptation to the changes involved in old age, with the aim that keep feeling full, autonomous and continue to live with the consciousness of his or her distressing situation accompanied by a greater serenity.
Objective of Art Therapy for People Affected by Parkinson’s:

-Develop creativity, spontaneity and the potential of each individual, with the goal of recovering the value of their individuality.

-Explore their capabilities in the creative process to promote good adaptation to the limitations of movement caused by the disease.

-Enhance fundamental cognitive functions such as: attention, memory, executive functions, and coordination, which are frequently affected by the disease.

-Provide a place to regain their freedom in decision-making, experiment and test ideas in the creative process, thus increasing one´s capacity for self-management.

-Encourage relaxation and search for harmony.

-Provide a safe and enjoyable space where one can express and share issues that tend to be difficult to articulate and confront (pain, loss, death, dependence) and promote the development and acceptance of this.

-Promote an improvement in the communication of the patient with his or herself, and with others, through the creative process, participation and involvement in the process therapeutic group or individual.
In summary, Art Therapy is a contribution to the improvement of health, directing the mind to different levels where the visual mode prevails on the logical, and connects to the person with their creativity, which is very important for someone who has to adapt to certain limitations and a new situation due to a disease like Parkinson’s.

The realization of this therapeutic process, can be a path to the expression and favorable exploration of feelings difficult to articulate that will allow one to continue on the road to emotional well-being.

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Author:
Sally Schofield
MA Art Therapy UB
President Association of Art Therapy, Ate

Published in Catparkinson,
Rev. Catalan Association for Parkinson’s, Jan.-March 2007, Nº3.