Originally used in individual sessions, art therapy is taking a more active and integrated role in family therapy, crisis interventions such as violence in the home or alcoholism in the family, with mental health patients (e.g. schizophrenics), and children who are adopted or in foster homes. Families are a complex system comprised of subsytems, alliances, and triangles. In order to get a better understanding of familial patterns and how the family operates, art therapy “sessions with the entire family provides an unusual opportunity to observe how the family unit functions in a situation less formal and less subject to their established mechanisms of control than is the purely verbal pyschotherapeutic interview” (Kwiatkowska, p. 27).
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Art therapy is useful for “providing an individual the opportunity to step back and evaluate the meaning of his or her subjective art expressions. This promotes a person’s ability to symbolize, to think, and to think about thinking. Visual representation offers a means to express multiple layers of meaning in a condensed format. The graphic product is durable, allowing a client to review and respond to what has been expressed” (Linesch, p. 26). Individuals, family members and the therapist literally have a visual picture of how an individual views themselves, their role in the family, wishes they have for their family, or anything else they have kept to themselves.
Another effective use for art therapy is using metaphors to teach parents and children new roles and relationships, thus adding a new dimension to structural family therapy (Linesh, p. 51). For example, if a family is struggling with their adolescent child and the child draws his mother with a big mouth and says that mother is always yelling, mother realizes how she is affecting the family with her yelling. According to Kwiatkowska, the focus of therapy often switches because of the way different family members present their views of the problem. The initial reason for seeking treatment is overshadowed by a totally different aspect of the family disurbance brought to their awareness through their art productions (p.139).
Drawing pictures, painting, or working with clay may seem easy and fun to do but “this work demands a solid backgorund in family therapy and extensive psychoterapeutic experience in addition to art therapy training” (Kwiatkowska, p. 137). Case and Dalley agree that “the theory and practice of art therapy has evolved to require that the practioners of art therapy are highly trained and experienced people whose skills continue to develop after their initial training program” (p. 146). Like regular therapists, art therapists must create boundaries with their clients and their families. One must be firm with families who disrupt the session either with constant bickering or irrelevant flow of words. Eventually such maneuvers should be explored as one of the patterns of family behavior (Kwiatkowska, p. 31).
The basic role of the therapist is to create a non-threatening environment for the family as some members may feel anxious about working with art. It is the therapists duty to remind the family that “when doing evaluations, it is important to emphasize that they will not be graded or tested on their artistic skill but instead use the media as a way to communicate and self expression” (Kwiatkowska, p. 85). It is also important that the “room must feel safe enough to express ideas, feelings, thoughts. Having open access to materials can make avilable man posible avenues of expression” (Case and Dalley, p. 99). Case and Dalley believe “it is not the job of the therapist to encourage spilling out of emotions but in fact to help the client feel that her feelings, however difficult to express, will be contained, listened to and understood” (p. 102).
“The therapist’s role is to remain open to the imagery and all its potential meaning for the patient and containt the anxiety and feelings that are generated in attempting to understand it. It is possible a clear meaning will not emerge until weeks into therapy where connections can made and understanding takes place” (Case and Dalley, p. 65).
During assessments or therapy sessions the therapist will give the family some directives. For example, the therapist may request that the family draw “a free picture, a picture of your family, an abstract family portrait, a picture started with the help of a scribble, a joing family scribble, then another free picture” (Kwiatkowska, p. 86). The therapist should take notice of what materials each member uses and how they are explaining their picture. Proulx explains that
as the art therapist views the work, they keep in mind the interactions that occurred how the material was used to symbolically represent the relationship and the amount of personal space occupied by the child or parent. Intensity of media application, amount of energy portrayed: is it full of life, full of color? Also note in the portrait who is included, who is left out, and which part of the work becomes the parents possession or the child’s. Are there obvious projections ontothe child by the parent? Is there engagement, communication, emotional contact, enjoyment and loving? ( p. 72).
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Although some directives are given, the therapist should not offer help to the “children until the parents or siblings have responded (or not responded) to the child’s plea for help. Their behavior in this regard is an important source of information about how the parents have met their need of their adolescent or young adult offspring in their early childhood” (Kwiatkowska, p. 85).
In a regular session, the therapist can get more information from the family by asking them to “explore self-perceptions. To do this, therapist can ask family members to draw themselves as they feel inside and to draw themselves as they imagine they look to their family” (Linesch, p. 28). “To facilitate adaptive coping, therapist might ask family to choose pictures or draw images that describe possible solutions to the problem. Family members may also be asked to represent themselves and their families as they are now and as they would like to be in the future. This can bring to light individual needs and family problem-solving” (Linesch, p. 29).
One of the disadvantages of art therapy is that the therapist is more vulnerable to misinterpretation in terms of the objective understanding of content. Care must be taken not to make rapid interpretations which might prevent or even deny the client the satisfaction of discovering and finding out for herself (Case and Dalley, p. 65). Because art therapy involves a lot of interpreation, it is understandable that critiques about this technique are similar to that of psychotherapy. The individual’s images can come across as many things but only the individual himself can explain it. The therapist is urged not to point out obvious red signals, instead they should allow the client to come up with their own interpretations. Their own interpretations alone are something to make note of as it may shed some light on the client’s thought process.
Throughout many examples explored, art therapy was useful in helping family members listen to one another, rebalance hierarchies, and “provided a vehicle for the individuals to take advantage of increased self-expressive abilities and share their internal experiences as communication between family/system members (Linesch, p. 158).