What is Art Therapy?

By: Audrey Di Maria

The goals of art therapy are formulated in accordance with each client's diagnosis, needs, interests, and capabilities, and may include strengthening ego functions, increasing communication, providing opportunities for sublimation, and promoting insight. In art therapy, emphasis is placed upon the creative process, rather than upon the finished project. Trained and skilled in art therapy techniques and intervention, the art therapist, who may serve as primary or adjunctive therapist, encourages clients to express personal concerns through the creation of art. The work produced can be viewed as a tangible record of progress made toward meeting treatment goals, as well as an indication of where further therapeutic interventions should take place. The art work may serve as a springboard for increased verbal communication and may also be a source of pride for the client who made it. (From the Guidelines for Assignment of Clinical Privileges for Art Therapists, DC Department of Mental Health)

What training must art therapists have?

The American Art Therapy Association (AATA) regards the Master's degree as entry level to the profession. It sets standards for the training of art therapists that include the completion of 45 credit hours of course work and 700 hours of supervised practicum work. Many programs require more. At the George Washington University Art Therapy Program, where I teach "The Principles and Practice of Art Therapy With Children", students must have a minimum of 1,100 hours of clinical work: one year with children and one year with adults.) Settings range from psychiatric wards to hospices, prisons, shelters, nursing homes, hospital waiting rooms, and even corporate board rooms!

Graduates of AATA-approved programs (of the 40 training programs nationwide, 28 have been AATA-approved) must accrue 1,000 hours of direct client contact before applying for registration with the Art Therapy Credentials Board; graduates of non-approved programs must accrue 2,000 hours. At least half of the 100 hours of supervision required must have been provided by a registered art therapist (an ATR). At present, 2,200 art therapists are registered with the Art Therapy Credentials Board, and, thus, are eligible to sit for the national certification examination. Individuals who pass the exam are entitled to add "-BC" after the "ATR", becoming Art Therapist, Registered, Board-Certified. Currently, 1,200 art therapists have been certified by the ATCB, which also has a recertification program.

Do art therapists work in schools?

They do; in fact, art therapy can help meet a wide variety of goals listed on the Individualized Education Program. Interested readers might want to contact the American Art Therapy Association for a copy of the brochure entitled "Art Therapy in the Schools", as well as to refer to an article I wrote on "Art and the IEP". (The latter can be found in Anderson, F. (1992). Art for all the children (2nd edition). Springfield, IL: Charles C. Thomas, pp. 213-218.) For the past 30 years, individual art therapy has been a primary treatment modality where I work, the Paul Robeson School for Growth and Development in Washington, DC. Directed by Harriet D. Crawley, LICSW, the school is a psychoeducational facility operated by the DC Department of Mental Health, Community Services. With a commitment to, and an emphasis upon, early intervention and intensive treatment for learning disabled and/or emotionally disturbed children, it is the mission of the school to provide each child with the support needed to enable him or her to return to his neighborhood school within two years.

How does art therapy help children who are learning disabled and/or emotionally disturbed?

One of the 5 year olds with whom I used to work always called Art Therapy "Art Thirsty" - and, indeed, the children who have bounded, trudged, raced, stomped, or eased their way into my office every school day for nearly 25 years have been thirsty, thirsty for opportunities to express themselves. Art therapy has offered the creative and amazingly resilient 6- to 12-year olds who attend Paul Robeson School a chance to communicate their worries, their questions, and their hopes in symbolic form and, in the process, to gain a sense of accomplishment and confidence. The array of art work that they have produced provides a durable record of challenges faced, problems solved, and goals met. Creating it - and working to understand what it may be able to teach them about themselves - has helped the children to feel more competent - not only in their art-making, but in other areas of their lives.

Children often come to their first art therapy session expecting to fail. They are afraid that they are going to "mess up" or that their art work is going to be compared unfavorably with that of other children. One of my primary jobs, as art therapist, is to help them to see how special their own ideas are and, as they give form to those ideas, how extraordinary they are. The goal is not to produce uniform work, but to celebrate the diversity of each child's unique creation. This can help to raise the child's sense of self-esteem, fostering the development of a more positive self concept.

Problems encountered in the art-making process often parallel problems encountered in life. Addressing them when they arise in the art and working them through within the context of the creative process can help the child learn that areas in need of change can be targeted, that "mistakes" can be salvaged, that resources can be identified, that problem-solving skills can be developed, that areas of strength can be distinguished from areas of weakness, and that feelings of pride can be derived from successfully meeting goals that one has set. This process can help the child to increase his ability to control his impulses, to increase the level of his frustration tolerance, and to delay gratification. It can also help him to perceive himself as a person who "can" rather than as someone who "cannot".

Art therapy can offer children a safe place in which feelings that might be considered too difficult to talk about can be given graphic form, rather than acted out. It can provide a vehicle for the expression of a wide range of emotions, including uncomfortable or disruptive ones, helping children to better understand those feelings as a result of their efforts to more appropriately focus, contain, modulate, or channel them. For example, one can splash feelings onto a sheet of paper without hurting anyone and without feeling guilty or fearful of retaliation. When the work containing those emotions is attached to the wall of the art therapy room for further comment by the child, he is able to view it with a greater sense of objectivity. Thus, the art can serve as a stimulus to increased verbalization, such as story-telling or discussion of a more direct nature. Then, there is the richness of the imagery itself!

What are some specific guidelines for those who work with children who have learning disabilities?

Art therapist Frances Anderson, Ed.D., ATR, offers the following "Adaptations and Suggestions for Teachers and Art Therapists who Work with Children with Learning Disabilities":

  • Apply self-instruction, self-monitoring and reciprocal teaching. (Self-instruction is modeled by an adult. First one talks out loud and the child repeats this same behavior. Next the child repeats, but whispers. Next he talks to himself. The child self-monitors to check if he is staying on task.)
  • Incorporate token economies.
  • Utilize direct instruction. (Focus on the material to be taught, not on the learning problem of the child.)
  • Incorporate microcomputers.
  • Use game strategies.
  • Use structured approaches for hyperactivity.
  • Incorporate movement in the art experience.
  • Reduce extraneous stimuli in the art room.
  • Match tasks to the learning level of the child.
  • Clearly state directions.
  • Check for understanding by having the child tell you in different words what he is supposed to do.
  • Put the easily distractible child in low stimulus areas.
  • Poor motor skills may require extra adult help.
  • Art helps with perceptual learning in providing practice seeing gestalts and part-whole relationships.
  • Art helps with visualization.
  • Art enables multisensory approaches.

(Anderson, F. (1994). Art-centered education and therapy for children with disabilities. Springfield, IL, p. 11; quoted with permission of the author)

I would refer readers, also, to the publications of art therapist Rawley Silver, Ed.D., ATR, particularly Developing Cognitive and Creative Skills Through Art. Published in 1978 by Ablin Press in New York, it is currently available as a back-in-print edition through Amazon.com and Barnes and Noble.com.

In my work, I have found that children who have learning disabilities often respond best to 3-dimensional materials that allow them to "construct" art in a very hands-on manner. So, in my art therapy room, I have a range of building materials such as large chunks of Styrofoam, wood, spools, cardboard tubes, mat board, sheets of foam core, and, of course, clay. In fact, a recent group art therapy project consisted of the creation of a diorama (to be exhibited in a public space) that depicts the Mall, from the Capitol to the Washington Monument, with the Air and Space Museum, the Hirshhorn Museum and Sculpture Garden, and the Smithsonian "Castle" in between. For the foreground (and with the assistance of GWU art therapy interns Berre Burch and Jenny Dipasupil) the children modeled 45 clay figures, jogging, jumping rope, playing soccer, roller-blading, reading, walking dogs, flying kites, planting flowers, and picnicking. The diorama, entitled, "Growing Up Healthy in the Nation's Capital" was unveiled last summer in the office of the Secretary of the U.S. Department of Health and Human Services, Tommy Thompson. The children's pride in their accomplishment was evident on their faces at a reception given for them by Secretary Thompson and Deputy Secretary Claude A. Allen. The exhibit includes a 5'' high likeness of Secretary Thompson, created by a 6 year old, shown riding his motorcycle to work in the HHS Building, right beside the Capitol (see Figure).

What are other sources of information about the field of art therapy?

Audrey Di Maria, MA, ATR-BC Art Therapist Paul Robeson School for Growth and Development DC Department of Mental Health, Community Services Adjunct Associate Professor The George Washington University Graduate Training Program in Art Therapy Secretary Art Therapy Credentials Board

Audrey Di Maria (2001)