Art As A Therapeutic Tool (revised)


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  • I am also a therapeutic artist based in Bolton, England, and I work with vulnerable people form domestic violence, and other abusive relationships, it is awesome to finally finf other people who also practice the same as me....
    Tracy Fenton
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  • About Me: I’m an art therapist and licensed professional counselor. I split my time between my private practice downtown Denver, Denver Art Therapy Counseling Co., where I work with children and their families specializing in the areas of divorce and separation. and my job as Family Preservation Supervisor at the Griffith Centers for Children, Inc. I also serve on the board of the Art Therapy Association of Colorado as Public Relations Co- Chair.
  • Next we have Art Therapy - For this presentation I will be using definitions of Art Therapy from both the Art Therapy Credentials Board (ATCB) and the American Art Therapy Association (AATA). There are other organizations both nationally and internationally that also utilize art therapy, but in this country the since ATCB oversees the credentialing process of Art Therapists, and AATA serves as the primary professional and advocacy organization of ART Therapists we will stick with their definitions for the sake of simplicity. AATA and the ATCB’s both have educational and professional standards of conduct which protects the public from persons who falsely claim to be art therapists. Art Therapist Registered (ATR) is a protected titled, much like LCSW or LPC and the Credentials Board has leverage to restrict its use if needed.
  • However, Art Therapy as a discipline overlaps with many other creative and psychological disciplines, including the concept of “art” itself. Part of the potency of art lies in the fact that our notions of “what is art” have historically been in flux. Noted British philosopher of aesthetics Richard Wollhiem describes art as “one of the most elusive definitions in all of human culture”. Art Therapists recognize that they do not own “art” nor the healing that comes from its use. Likewise Art Therapists recognize to share knowledge is to be compassionate
  • And if we really wanted to make ourselves crazy we could examine several other disciplines and processes that overlap these fields as well …. Luckily we only have 45 minutes together, so I don’t have to go there. So, the purpose of this presentation is to educate clinicians on how art therapy differentiates from other mental health disciplines as well as to provide guidelines for the ethical use of art making within those other disciplines.
  • Art therapy is a non verbal expressive therapy that bypasses verbal defenses. For young children who have experienced trauma at the hands of a parent or caregiver, verbalizing their experiences may feel like a betrayal to the parent or even unsafe. Research demonstrates that traumatic memories are stored in the right hemisphere of the brain make verbal recall of these memories more difficult. This is especially true for young children. Even developmentally appropriate children lack the verbal capacity of adults by which to relay their experiences. Then as adults, we become very adept at “talking around” our feelings. And these are just a few of the many benefits of art therapy.
  • Artistic - in that the art therapist has proficiency in a wide range of art media and processes as well as the knowledge of the various client responses said media may elicit in therapyClinical – with regard to being trained and skilled in psychotherapeutic principals and methodsThe third area, which tends to be less well understood can be used to clarify and differentiate what art therapists have to offer – which is expertise in art therapy theory and methods. Malchiodi and Riley describe this combined skill set as a “ ‘aesthetic-pragmatic’ approach to therapy in that the therapeutic encounter contains the creative elements of artist and imaginative solutions to difficulties while simultaneously attending to the practical solutions that give support and comfort to the client”.
  • Much of these guidelines are drawn from the Colorado Department of Regulartory Affairs as well as the Art Therapy Credentials Board .
  • ATCB Codes of Professional Practice 2.1.2 outlines the recommended environment for which art therapists to practice. It is recommended Non Art Therapists adhere to these guidelines as well when using art in order to ensure the health and safety of their clients.
  • One of the best ways to gain knowledge of the various art media is to experiment with it yourself.
  • Often times clinicians are guilty of projecting their own assumptions onto the clients artwork. It is important to understand that there are no normed graphic indicators in art and imagery tends to be highly idiosyncratic. Although formula art therapy assessments exist, like the DDS or the PPAT, with normed graphic indicators they are not Secret Decoder Rings. One of the most popular Art Therapy Assements is the Diagnostic Drawing Series
  • All artwork is confidential.
  • What should be included in a therapist’s informed consent when he/she is using creative interventions like art in his or her practice?Clients should be informed that …..
  • Here is my Voluntary Art Work release form. You will need to client’s or legal guardian’s permission before photographing, video taping or otherwise duplicating client art work whether for professional use or exhibition of client art work in a public setting. Once authorization has been granted, the therapist ensure that appropriate steps are taken to protect client identity.
  • The revived statutes of Colorado Mental Health Practice Act, Title12: Professions and Occupations, licenses social workers, counselors, psychologists, marriage and family therapists, and governs all who say they practice therapy.
  • Sue Sabini, an art therapist and LPC, has served both as President and Legislative Chair for of the Art Therapy Association offers a guideline of that if a clinician feels his/her client might be in need of the expertise an art therapist offers, they should refer that client to the art therapist for approximately 6 sessions, during which time the art therapist would consult with the primary therapist to share his/her observations. In this way the two clinicians can work together to make sure their client is getting the care he/she needs.
  • Other applications for clinicians who are using art as a therapeutic tool are Response Art and Self-Care. This piece I created after having a really difficult session with a minor client had a history of cutting and suicidal ideation. In our session the client expressed she had felt like cutting again recently due to chaos in her family life but had not yet acted upon that impulse. We ended up creating a safety plan and I had to break her confidentiality to share with her father my safety concerns. After the session, in addition to experiecincing vicarious trauma, I was also really worried about the client her and left with a sense that I had hurt our therapeutic relationship because I had to disclose her to her father. I was worried the client would not return to therapy – and for those of you in private practice, well we are much more aware of how our clients are directly connected to our income. Creating this image gave me a safe space to discharge all of those feelings – so I didn’t take them home with me, and gain some objectivity. Although I had created a safety plan and informed the parent I still felt very responsible and protective of the client, when the truth is after she left my office the situation was out of my hands. I’m the screaming one and I’m holding the client 
  • Here is another example of self care I call my “Right Brained Business Plan”. When I first started my private practice I felt unnerved by how immensely scattered I seemed to be. Later the image of a planting seeds came to me, and I wasn’t so much scattered as I was scattering seeds. Which is very logical b/c one is not quite sure which ones are going to take root. Further into the development of my practice
  • We are going to take the next ten minutes to make a drawing depicting a favorite summer memory.
  • Art As A Therapeutic Tool (revised)

    1. 1. Art as a Therapeutic Tool: Guidelines for Mental Health Clinicians<br />Erin Brumleve, MA, LPC, ATR <br />
    2. 2. Defining Concepts: <br />
    3. 3. A general term for a process of treating mental and emotional disorders by talking about one’s condition and related issues with a mental health provider with the goal of putting into practice the insights, knowledge, and healthy coping skills that are gained in the therapeutic process. <br />Psychotherapy: <br />(Mayo Clinic, 2008) <br />
    4. 4. Art Therapy: <br />American Art Therapy Association (AATA) defines art therapy as the “the therapeutic use of art-making, within a professional relationship by people who experience illness, trauma, or challenges in living, and by people who seek personal development. Through creating art and reflecting on the art products and processes, people can increase awareness of self and others, cope with symptoms, stress, and traumatic experiences, enhance cognitive abilities and enjoy the life-affirming pleasures of making art” (2009).<br />The Art Therapy Credentials Board (ATCB) regulates the educational, professional and ethical standards for the Art Therapist Registered (ATR) title . <br />
    5. 5. Is that Art? <br />….. “one of the most elusive definitions in all of human culture” – Richard Wollhiem<br />
    6. 6.
    7. 7. A nonverbal expressive therapy that bypasses verbal defenses …<br /> (Klorer, 2005)<br />
    8. 8. The 3 Primary Skill sets of Art Therapists:<br />Artistic<br />Clinical <br />Therapeutic use of art<br /> “Aesthetic – Pragmatic”<br /> Approach<br />(Malchiodi & Riley, 1996; AATA, 2000) <br />
    9. 9. Recommendations for Non Art Therapists using Art <br /><ul><li>Environment
    10. 10. Knowledge of Materials
    11. 11. Clinical Records
    12. 12. Informed Consent
    13. 13. Scope of Practice
    14. 14. When to Consult with or Refer to an Art Therapist
    15. 15. Art Making as Self Care</li></li></ul><li>Environment<br />Safe and Functional<br />Including but not limited to:<br /><ul><li>Proper ventilation
    16. 16. Adequate lighting
    17. 17. Access to water supply
    18. 18. Knowledge of hazards or toxicity of art materials with regard to health of clients
    19. 19. Storage space for art projects
    20. 20. Secured areas for any hazardous materials
    21. 21. Monitored use of sharps ….
    22. 22. Lastly – work area that is available to get messy! Clients may feel intimidated if there is too much concern with keeping everything neat.</li></ul> (ATCB, 2005 ; AATA, 2000)<br />
    23. 23. Knowledge of Materials<br /><ul><li>Be familiar with the media and processes you are using*
    24. 24. Different Materials may produce different emotional responses
    25. 25. Intense Emotional Responses May be Triggered – Assess for Risk Factors and Be prepared</li></ul>(ATCB, 2005)<br />
    26. 26. * Art Imagery Does Not Come with a Secret Decoder Ring<br />Imagery tends to be idiosyncratic <br />Ask questions to create dialogue<br />Be aware of your own projections<br />Formal Art Therapy assessments with normed graphic indicators exist, but still Not a Secret Decoder Ring: <br /> Diagnostic Drawing Series (DDS) <br /> Person Picking an Apple from a Tree (PPAT) <br />(AATA, 2000)<br />
    27. 27. Confidential <br />Clinically significant art work = part of clinical record<br />Treat information in conformity with state regulation, and clinical practice<br />No less then seven years<br />Secure, locked storage<br />Art Work as Clinical Record<br />( AATA in Cuther, D. & Malchiodi, C., n.d)<br />
    28. 28. Informed Consent<br />Clients should be informed that:<br /><ul><li>Art making and creative self expression are useful in therapy, but</li></ul>clients must clearly be informed about their purpose in treatment.<br /><ul><li>While these interventions are widely used, there are pros and cons for their use.
    29. 29. Some methods have not been extensively researched.
    30. 30. Clients may sign an Voluntary Art Work Release Form for art work to be shared outside of the session, but should know that the therapist may document clinically significant art work as part of the clinical record.</li></ul>(Cuther, D. & Malchiodi, C., n.d)<br />
    31. 31. VOLUNTARY ART WORK RELEASE FORM<br /> <br />I, ______________________, agree to allow Erin Brumleve, MA, LPC, ATR.<br /> (Client Name) (Therapist Name)<br /> <br />To use and/or display, and/or photograph my artwork for the following purposes:<br />__ Exhibition<br />__ Publication in a professional journal<br />__ Presentation at professional conferences<br />__ Educational purposes<br />__ I do wish to remain anonymous<br />__ I do not wish to remain anonymous<br /> <br />I understand that there are times when my work with you, in art therapy, will be discussed with a clinical supervisor and/or in consultation with other mental health professionals. I understand that all efforts will be made to keep<br />my identity anonymous and confidential unless I specify otherwise.<br /> <br />Client Name __________________________<br />Client Signature__________________________Date_______________<br />Parent/Guardian Name_____________________<br />Parent/Guardian Signature__________________Date_______________<br /> <br />Therapist Responsibility: <br /> <br />I, Erin Brumleve MA, LPC, ATR , agree to the following: to safeguard your artwork to the best of my ability and to notify you immediately of any loss or damage while your artwork is in my possession, to provide an appropriate<br />format for presentation if I exhibit your artwork, to bear other costs related to exhibition, to return your artwork immediately if you decide to withdraw your consent, and to safeguard your confidentiality.<br /> <br />Therapist Signature_______________________ Date_______________<br />(Spaniol, 1996)<br />
    32. 32. Scope of Practice<br />All helping professionals only practice within the scope of their education and training. <br />Section 12-43-202 of the Colorado Mental Health Practice Act (2008) regulates Scope of Practice and states:<br /> “Notwithstanding any other provision of this article, no licensee, registrant, certificate holder, or unlicensed psychotherapist is authorized to practice outside of or beyond his or her area of training, experience, or competence.” <br />Therefore counselors and other professionals who may not be formally credentialed in Art Therapy use only techniques and methods in which they have had training . <br />
    33. 33. When to consult with or Refer to an Art Therapist<br />The Client expresses himself more easily through visual images. <br />The client experiences intense affect during or after an art process. <br />The client has a preverbal trauma.<br />The client’s artwork is disturbing to the therapist or the therapist has questions about how to respond to it. <br />Further information about the therapeutic use of art is desired. <br />(AATA, 2000)<br />
    34. 34. Art Making as Self Care<br />Response Art <br /> The page is a safe place to hold strong counter transference feelings.<br />
    35. 35. <ul><li>Practice Thinking Visually – Right Brained Business Plan</li></li></ul><li> What is it like to create in the presence of a mental health clinician? Let’s find out!<br />Take the next 10 minutes to draw an image of a favorite summer memory.<br />
    36. 36. Art Therapy Resources Online: <br />AATA Approved Graduate Programs:<br /><br />Extensive Catalog of Art Therapy related Books for purchase: <br /> Jessica Kingsley Publishers -<br /> Stern’s Books -<br />Art Therapy Organizations: <br /> Art Therapy Association of Colorado -<br /> American Art Therapy Association -<br /> The Society for the Arts in HealthCare -<br /> International Art Therapy Organization -<br />Art Therapy and Social Networking Sites: <br /> Art Therapy Alliance: - Organization of Art Therapists on Linked In<br />Art Therapists who use Twitter: <br /> @arttherapynews, @erinbrumleve, @kellydarke, @PoppyATR, @verdissage, @turningturning, @LaniPuppetmaker, @gretchenmiller<br />  Go to to get a free account<br />IATO and Art Therapy Alliance both have Facebookpages<br />Art Therapy Credentials Board – Codes of Professional Practice<br /><br />
    37. 37. Resources<br />American Art Therapy Association. (2009). Retrieved July 14, 2009 from<br />American Art Therapy Association (2000) Ethical Considerations Regarding the Therapeutic Use of Art by Disciplines Outside the Field of Art Therapy. Mundelein, IL: American Art Therapy Association.<br />Art Therapy Credentials Board, Inc. (2005) Retrieved July 15, 2009 from<br />Colorado Mental Health Practice Act, 43 C.R.S. § 12-43-202(2008)<br />Cuther, D. & Malchiodi, C. (n.d) Creative Interventions and Counseling: Issues for Counselor Ethics [Power Point] Retrieved July 15, 2009 from<br />Klorer, P. (2005). Expressive Therapy with Severely Maltreated Children: Neuroscience Contributions. Art Therapy: Journal of the American Art Therapy Association, 22(4) 213-220.<br />Sabini, S. (2005) Protecting Our Profession with the Current Colorado Mental Health Statute. Unpublished document. <br />Spaniol, S. (1996) Confidentiality Reexamined. American Journal of Art Therapy, 32, 69-74.<br />Mayo Clinic. (2008) Retrieved August 10, 2009 from<br />
    38. 38.<br /><br /> Referrals Welcome  <br />Questions or Comments: <br />