Art Psychotherapist Research Articles

In search of a family: The contribution of art psychotherapy to a collaborative approach with a man residing in a forensic learning disability setting

Accessible Summary Some clients in learning disability services have problems in their relationships with people. Some clients with learning disability have broken the law and live in hospital. For clients in hospital, treatment can be learning about managing behaviour, feelings and relationships. This treatment is given by different professionals. This treatment is important to help stop these clients getting into trouble with the police again. An important part of treatment is to help clients understand their experiences in relationships. This case study is about Oliver, and how psychologists and an art therapist worked together to help him.​ AbstractBackgroundClients with attachment issues are over‐represented in learning disability services. Forensic inpatient services are no exception. Treatment pathways comprise multidisciplinary interventions, and skills‐based treatments are considered vital to recovery and maintenance of prosocial and adaptive behaviour and reduction in risk. An important aspect of treatment is the psychological intervention to enable clients to understand their early experiences and the way this may have impacted on later relationships and behaviour. Without exploring the difficult early lives that many clients in forensic inpatient services have experienced, skills‐based treatments and attempts to facilitate discharge may not be effective.Materials and methodsThis case study presents the theoretical background of attachment, autism, learning disability and sexual offending that informed the collaborative multidisciplinary psychological treatment offered to one man with learning disabilities and autism in a secure forensic setting.ResultsThe introduction of Art Psychotherapy enabled the client to explore his history and the potential internal barriers to his therapeutic progress. Issues of safety and belonging, previously unexplored with this man, were uncovered and these themes were incorporated into his risk formulation and treatment plan.ConclusionsThe paper reflects on the specific contribution of Art Psychotherapy in specialist services, and the importance of the collaborative relationship between the Art Psychotherapist and the ward Multi‐Disciplinary Team.

Evaluation and review of art psychotherapy in private practice

ABSTRACTThis article considers the ways in which gathering evaluative evidence may be inhibited when working beyond the supportive frameworks provided by an employing organisation. While recognising these difficulties, the article then focuses on the differences in the practice setting and the ways in which visual arts-based methodologies are evolving. Two arts-based evaluation methods are described – the ‘retrospective review’ and the ‘reflect interview and audio-image recording’. This article also considers how art psychotherapists in private practice might adapt these methodologies in order to gather arts-based evaluative evidence within a collaborative client/therapist paradigm.

Exploring the benefits of intersectional feminist social justice approaches in art psychotherapy

This paper charts a research and knowledge exchange project between a university and group of art psychotherapists who came together in a project aimed at better understanding the benefits of critical feminist social justice approaches to art psychotherapy. It outlines the impact of the partnership for art psychotherapy practice, practitioners’ continued professional development and patients’/service users’ benefit. Drawing on knowledges of critical feminisms held within the university and art psychotherapy expertise from local health services, the project evaluated the benefit of a practice enhancement activity and resource hub as consciousness raising training in intersectional feminism for developing critical feminist social justice approaches to art psychotherapy practice. The project was designed as a qualitative participatory study. The four main salient themes emerging from the data were that the enhancement activity and resource hub provided; patient/service user benefits, improved practitioner reflexive critical thinking; recognition from practitioners of the importance of being attentive to patient’s/service users’ situatedness; and acknowledgement by practitioners of the helpfulness of likeminded collectives for sustaining critical feminist social justice praxis. Project findings suggest that critical feminist social justice approaches are beneficial to art psychotherapy praxis and that continued engagement with current and re-emerging feminisms could continue to progressively reimagine and reshape that praxis.

The role of art materials in the transferential relationship: Art psychotherapists’ perspective

According to psychoanalytic thinking, artistic expression provides access to unconscious materials. This study extends the literature by examining the role of art materials, art making, and the resulting artistic product in the transferential relationship. Ten senior art psychotherapists took part in semi-structured interviewers that were analyzed according to Grounded Theory principles. Two major themes emerged from the data. The first theme suggests that during the art making process, transference emerges in the way clients handle the art materials provided by the psychotherapist, and in the corresponding client-psychotherapist interaction. The second theme suggests that the resulting artistic product not only serves as a visual expression of inner-world representations but also as a container of transferential content. These findings reflect the unique therapeutic space created by the presence of art materials, which encourage intra- and interpersonal transferential relationships. Within this creative space, the art psychotherapist can participate actively in the reconstruction of the client’s early object relations, or may covertly function as a background witness who facilitates the client’s own self-exploration.

Jung, art and psychotherapy re-conceptualized by the symbol that joins us to the wildness of the universe

Despite the impact of the publication of Jung's own (literally) monumental work of rendering images in The Red Book (2009), the relation of art, artists, art psychotherapy and Jungian studies is puzzling and complex. As Tjeu van den Berk's excellent Jung on Art (2012) demonstrates, Jung by no means posited a comfortable continuum between his psychology and aesthetics. Even artists impressed by his notions of the inherently creative unconscious imagination do not share the priorities of Jungian-oriented art psychotherapists. In exploring this problem of Jungian psychology and the aesthetic domain, I take issue with some of van den Berk's conclusions, proposing instead that in his core concept of the ‘symbol’ Jung constructs a theory of the imagination that overcomes disciplinary, mythic and individual boundaries: rather, it is an idea of radical re-visioning of psyche as expressed in time and space. By dismantling the notion of psyche as bound to an individual person, I suggest the symbol transforms the dialogue of Jung, Jungians and art.

3 Man unlock: out of sight, out of mind Art psychotherapy with a woman with severe and dangerous personality disorder in prison

‘3 Man Unlock’ refers to the status of prisoners who are considered so volatile that they cannot be let out from behind their doors without three officers present at all times. This paper uses clinical material to illustrate the use of art psychotherapy to contain the trauma and violent acting out of a woman in a prison setting, whose status was frequently ‘3 Man Unlock’. The powerful projections from behind this locked door pervaded the landing, and it began to resemble the woman's mind: fragmented, split and paranoid. Through the development of a relationship with the art psychotherapist and the making of images, these toxic projections became part of a narrative that enabled the woman to express her feelings and see them contained, perhaps allaying the fear that her anxiety would overwhelm those around her and instigate a further lock-up. This woman's work illustrates the fear and dangerousness prisoners may feel themselves, and the cycles such punitive environments may re-enact.

Dyadic art psychotherapy: Key principles, practices and competences

A recent survey indicates that a dyadic parent–child approach to art psychotherapy is being used by 60% of British art psychotherapists working with children and young people with some degree of frequency (Taylor Buck, Dent-Brown, & Parry, 2012). However, currently there is insufficiently robust evidence to support the efficacy of this approach. Outcome-based studies are needed to demonstrate efficacy, and an important first step in designing such research is to establish an accepted definition of the process and practices of dyadic art psychotherapy. A two-round Delphi process was used to seek consensus on the core therapeutic principles, practices, and competences required for the delivery of dyadic art psychotherapy. Consensus was reached on ten principles, six practices and fifteen competences required for the delivery of art psychotherapy which could be used in practice, evaluation, and future outcome-based research.

Fight like a ferret: a novel approach of using art therapy to reduce anxiety in stroke patients undergoing hospital rehabilitation

RationaleThe holistic aspect of stroke rehabilitation to include psychological well-being is currently neglected, with more emphasis placed on physical recovery despite anxiety and depression being common poststroke. From the limited...

Overcoming Organisational Challenges Together: Art Psychotherapy within Central and North West London (CNWL) NHS Mental Health Services

As the largest community facing NHS organisation Central and North West London Foundation Trust (CNWL) is perhaps unique in its aspirations to place art psychotherapy as one of the core psychological therapies for patients diagnosed with severe mental health disorders. CNWL is the largest NHS employer of arts therapists and currently employs 43 arts therapists across the trust of which 25 are art psychotherapists. We work with some of the most transient and deprived populations within London. Of the 1.2 million members of the population that we serve, approximately 17% will have a severe mental health issue at some point in their life. There is high cultural diversity and mental health services are accessed by people of all cultural backgrounds. Our motto is ”˜Wellbeing for life’.

What is the theoretical ground on which art therapy stands

I am an Art Psychotherapist and a Jungian Psychoanalyst and, whilst my theoretical influences have developed from traditional Jungian views, his call to us to ”˜follow the image’ is still central in my thinking about art within analysis. I do not have time to discuss the details of this picture so I hope it will give you a feast for your eyes and for speculation (in every sense of the word) as I speak. (Speculate = conjecture Imagine]. This is what Jung did with alchemy; he speculated about these images, about their meaning and he imagined. He knew alchemy had been a physical art with spiritual resonance. The chemical reactions were thought to transform matter into gold - and Jung turned this into a metaphor for the analytic journey and for psychological transformation.

Conference Exhibition Catalogue

As part of this landmark conference an exhibition was installed in the heart of the space, positioning the imagination as central to the aims of this gathering. Bringing together artwork of art psychotherapists and the people they work with, including painting, drawing, photography, sculpture, installations and time-based, audio-visual works, enabled an aesthetic engagement with the conference theme. This catalogue provides insight into this exhibition and the diversity of ideas, forms and practices emerging from art psychotherapy in finding a voice and making your mark .

Exploring a dyadic approach to art psychotherapy with children and young people: A survey of British art psychotherapists

Dyadic art psychotherapy, which routinely involves parents and carers together with the child in sessions, appears to be an important emerging practice. We designed a non-standardised questionnaire to estimate how many art psychotherapists working with children and families adopt a dyadic parent–child approach and what influenced them to do so. Participants were asked about the frequency of involving parents and carers in assessment and therapy, their theoretical influences and their degree of familiarity with related interventions. The majority (60%) of the respondents reported involving parents and carers in art therapy sessions with some degree of frequency.

Connecting with the image: how art psychotherapy can help to re-establish a sense of epistemic trust.

The International Centre for Arts Psychotherapies Training (ICAPT) was established by CNWL NHS Foundation Trust in London in November 2011. The centre was set up to further research and advance clinical practice within NHS mental health settings. At the la unch of the research arm of ICAPT in July 2012, Professor Peter Fonagy spoke on the subject of the future of research in arts psychotherapies. This paper is a response to Professor Peter Fonagy’s presentation (The ICAPT 2012) on the potential arts psychoth erapies have to enhance the development of the therapeutic relationship. During the presentation Fonagy suggested to a group of arts psychotherapists that: ”˜the future of research is trying to understand what you guys do that actually helps re - establish in our patient a sense of epistemic trust, a sense that human knowledge and human communication, as communicated by fellow human beings can be trusted, can be relied on ... ’ A recording of this presentation is followed by a discussion section in which two art p sychotherapists explore and expand upon the ideas presented by Fonagy. They explore his question about what the processes of making and reflecting on images in a therapeutic context can add to the development of ”˜epistemic trust’ within the therapeutic rel ationship. It is suggested that creative arts have the potential to enhance the development of epistemic trust within the therapeutic relationship by offering opportunities for contingency and joint engagement. Individual, group and dyadic art psychotherap y allow for the creation of an external object which is congruent with the maker's internal world. The art making process and the art object itself can create an additional channel of communication which helps the art psychotherapist to understand the client’s inner world. This greater understanding can support the psychotherapist’s capacity to respond in an attuned way to the client. The authors explore the idea that joint engagement in art making can lead to opportunities for enhanced mentalizing and that with sufficient research and theoretical underpinning, this type of model could help to define clinical practice for arts psychotherapies in mental health. Key Words: Fonagy; mentalization; contingent communication; mechanisms of change; joint engagement.

Alchemy, sandtray and art psychotherapy: Sifting sands

To an art psychotherapist working with sandtray the material itself—the sand—may be central. Traditional sandtray largely sees the sand as a backdrop to the narratives created by the objects, as ‘ground’ rather than ‘figure’, the stage on which the action happens rather than the action itself. The paper starts from a specific ‘child-led’ innovative process of sieving sand and amplifies this with mythological and symbolic material to clarify how profound issues may unfold through attention to the drama: what is done, as well as the stories told about what is done. Sandtray is easily represented as though it is a ‘diagrammatic’ process. In this paper physicality, embodiment and enactment in relation to the material are re-emphasised, developing an art psychotherapy perspective on sand itself as an art material. The place of performance art as part of art therapy practice is briefly considered. Clinical vignettes are illuminated by parallels from Jungian psychotherapy and one of its central metaphors: alchemy. The ‘alchemical’ processes of dissolving, separating and purifying prime material—the sand—are explored as key psychotherapy processes. The accompanying images arose out of the therapist's reflective practice about the case.

Art psychotherapy, disability issues, mental health, trauma and resilience: ‘Things and people’

This paper addresses impairment, disability, trauma and art psychotherapy through a personal narrative written by the person having that experience (‘the service user’, Kathy Gibson), alongside a more contextual account by the art psychotherapist (Malcolm Learmonth). Through these accounts we attempt to identify the factors of resilience, creativity and healing at a personal level, but also to see these processes as taking place in a social, political, and historical context. We argue that intra-psychic models do not alone equip psychotherapists to work with these complex levels, and there is a need to learn from disability, public health, systemic, communicational and resilience models. This includes considering the social antecedents and consequences of traumatisation alongside its personal meaning. Bringing together accounts by both participants in a long-term therapy encounter is intended to contribute to a democratisation of the professional literature, in tune with the concept of ‘disabling’ as a social process, and challenging the comparative silencing of multiple voices in accounts of art psychotherapy. We also defend the necessity for long-term psychotherapy with these levels of complex issues.

Image: Reflections on the treatment of images and dreams in art psychotherapy groups

Social Dreaming sees dreams as differentiated particles of the undifferentiated unconscious, here understood as infinite and containers for unconscious wisdom. Through sharing dreams and their free associations in a particularly structured meeting called the Matrix, Social-Dreaming promotes access to unattended knowledge and transformation of thinking. Analytic Art-Psychotherapy groups promote therapeutic change through image making and interpersonal contacts. Neurological phenomena associated with both dreaming and creativity suggest that art and dreams can act as conduits to unattended knowledge, bridging conscious and unconscious thinking. The author suggests that in Art Psychotherapy this dimension could be enhanced by viewing image ownership as collective rather than individual and by routinely using free association in preference to more common, explanatory practices and describes some structural modifications to the context of Art Psychotherapy group work with clinical evidence. The conclusion is that creative thinking promotes homeostasis, a state of internal equilibrium, necessary to well being and a function of internal coherence. The ideas in this work derive from the author's personal experiences in Social-Dreaming and as an Art Psychotherapist. Relevant here are Gordon Lawrence's works on Social Dreaming; David Maclagan's on Imagination and Lois Oppenheim's on Neuro-psychoanalysis.

Supporting cancer patients and their carers: the contribution of art therapy and clinical psychology

The value of various types of psychosocial support for people with cancer is now becoming well established. Typically the term 'psychosocial' includes: counselling and psychotherapy, cognitive behaviour therapy, education and information, and social support. The research literature sometimes fails to clarify the exact nature of the different approaches and their relative efficacy. Inevitably, even within a specific type of therapeutic approach, there is variation owing to the professional background and skills of different practitioners. This article describes the relative contributions made by an art psychotherapist and a clinical psychologist working together in a cancer and palliative care service in Wales. The referrals come from the same sources and tend to be for similar types of problem. The assessment and formulation processes are also broadly similar. Interventions, however, are markedly different. These are described in some detail through case study examples.

Supporting cancer patients and their carers: the contribution of art therapy and clinical psychology

The value of various types of psychosocial support for people with cancer is now becoming well established. Typically the term 'psychosocial' includes: counselling and psychotherapy, cognitive behaviour therapy, education and information, and social support. The research literature sometimes fails to clarify the exact nature of the different approaches and their relative efficacy. Inevitably, even within a specific type of therapeutic approach, there is variation owing to the professional background and skills of different practitioners. This article describes the relative contributions made by an art psychotherapist and a clinical psychologist working together in a cancer and palliative care service in Wales. The referrals come from the same sources and tend to be for similar types of problem. The assessment and formulation processes are also broadly similar. Interventions, however, are markedly different. These are described in some detail through case study examples.

The art therapy large group as a teaching method for the institutional and political aspects of professional training

AbstractThis paper discusses a unique experiential teaching method in the context of training for art psychotherapists and raises issues relevant to teaching for all workers in health and social care. The art therapy large experiential group of all the students and all the staff (80+), which is held six times a year on the 2‐year full‐time/3‐year part‐time programme, is identified with three educational components: learning about art therapy processes, learning about the educational process of becoming a professional, and learning about institutional and political issues relevant for the work‐place. This educational method engages the unconscious dynamics of both students and staff and brings this together, through creative activity, with a critical engagement in social and political issues. The group has implications for all health workers in its attention to non‐verbal communication, activity as a means to learning and agency in institutional issues in the work‐place. The paper brings together a case example in which students were able to process the impact of a nationwide, union strike in the university, with relevant literature from large group theory, small art therapy group theory and performance art. Discussion is given to the process by which the art therapy large group meets its learning objectives.

The evolution of theory, the theory of evolution: Towards new rationales for art therapy

This paper is an attempt to locate art psychotherapy theory in the context of evolutionary psychology. Art psychotherapists have often touched upon an argument for art making, and healing through art making, as having deep roots in the human past, but have seldom expanded this into specific constructs relevant to everyday practice. Recent work in related fields such as archaeology, anthropology and evolutionary psychology is yielding specific formulations that enable this development. The paper looks both at earlier and current thinking about art making as an adaptive process, in both the evolutionary and personal senses. Drawing particularly on the work of Ellen Dissanayake and Steven Mithen, it relates their concepts of ‘making special’ and ‘cognitive fluidity’ to an endeavour to outline a rationale for art psychotherapy rooted in human ‘natural history’.