Introduction The Expressive Therapies Continuum (ETC) is a developmental model used by art therapists. It provides a framework that is used to evaluate expressive elements of a client's artwork. These elements are divided into levels on a continuum. There are three levels, each one is a spectrum, beginning with kinesthetic and going to sensory, perceptual to affective, and cognitive to symbolic. An additional element on the top of the continuum is creative expression which can occur at any of the levels or exist as integrated functioning of all levels, but it is a temporary state. Art therapists use client's artwork to gauge on which level or level(s) of the continuum the client's work falls. Based on the client's location on the continuum, …show more content…
treatment goals and art therapy interventions are created.
The therapist is able to manipulate the client's creative expression through process and media to assist the brain in processing visual information (Lusebrink, 2015). Each type of media falls on a spectrum called the Media Dimensions Variable (MDV) which classifies art media and directives based on their inherent qualities. The MDV divides media onto a tri-level spectrum which begins with fluid media, such as watercolor, to resistive media, such as pencil. Next, the creative process can range from simple, such as pencil on paper, to complex such as printmaking. The third spectrum on the MDV is the level of direction given which ranges from unstructured to structured. The first part of this paper describes an intake session with Rachel, a seventeen year old girl who was assessed using the ETC. Post-assessment, the paper explores the course of therapy that was designed with the goal of reaching other levels of the ETC. The MDV was used to relate the media and the directives to Rachel's functioning level. The goal of our treatment was to help her process previous abuse and to …show more content…
inspire self discovery. The Independence Center is an open studio environment with individual rooms for private sessions. It was created to address the needs of females in the age range of early teenage years to geriatrics. Clients have often suffered trauma, abuse, addiction, and mental health issues. The population served is low income and the Center receives funding through a combination of grants and billable private sessions through Medicare and Medicaid. As the only art therapist on staff at the Independence Center, I recently met with a new client, Rachel.
She is a seventeen year old caucasian girl who arrived complaining of anxiety and depression from which she had been struggling since she was sexually abused by her mother's boyfriend at the age of seven. Upon discovering the abuse, Rachel's mother set up an appointment with a male cognitive behavioral therapist. She participated in an intake session with the therapist at the age of fourteen but did not feel safe or ready to talk about her experiences, so she did not return for additional sessions. Rachel stated that she felt apprehensive about beginning art therapy and was not sure if she could be helped. She rationalized that because she was unskilled at creating art, art therapy would not work for her. Throughout the conversation, she appeared anxious and
withdrawn. Rachel was asked to do a free drawing for fifteen minutes. I provided several options of media ranging from resistive to fluid including pencil, pen, marker, acrylic paint, and watercolor. She chose the closest, simplest, and most resistive media available: a number two pencil. I noted her discomfort as she began to look around the room avoiding the paper for the first five minutes of the task. After sighing several times, Rachel began by writing the words “Ugly, Fault, Guilt” repeatedly. She drew a two inch image of a face that looked like her own, floating in between the text, paying great attention to small details such as eyelashes, freckles, and pimples. The pencil strokes she used were light and without tonal range which made the image seem very flat. Each time she added a new detail she pointed it out to me. Her facial expression remained unchanged throughout the process. I gave her a two minute warning and she immediately stopped drawing, stared at her work, titled it Self Portrait and said, without affect, “I'll always be this way.” There were several aspects of Rachel's behavior that seemed to fit the cognitive level of the Expressive Therapies Continuum (ETC). This was evident by her actions when working, her choice of media, and the mood of her work. “Individuals who rely predominately on rationalization and intellectualization as coping devices and defenses may start expressing themselves in a cognitive level in the therapeutic setting” (Lusebrink, 2015 p.106). By saying that she was not skilled at art making and therefore would not be helped by art therapy, I realized Rachel was likely to rationalize. “The cognitive component of this level deals with logical, analytical thought and problem solving...” (Lusebrink, 2015 p. 95). As she spoke about each step, she provided me insight into her mental process. When referring to the cognitive component of the cognitive/symbolic level of the ETC, Lusebrink (2015, p. 95) stated, “Naming the product, verbalization of the procedure, and internalization of verbal commands constitute part of the cognitive level”. According to Lusebrink (1990, p.243), “Resistive and structured media, such as pencils or construction paper, enhance operations on the cognitive level.” Rachel's choice of a number two pencil demonstrated that she wanted to work with a media that offered an opportunity for control. Additionally, I noticed that Rachel's work contained a good deal of reflective distance due to her choice of media, which provided space between Rachel and the work she was creating. Lusebrink suggests that a therapist working with a client who is functioning on the cognitive level should slowly acquaint the client with other levels of the ETC (1990). From my initial impressions it seemed that Rachel was not ready to acknowledge her emotions, so I hoped to help her reach the affective level through a long course of therapy. A change from cognitive to affective would be difficult and emotionally taxing for Rachel. To keep her from experiencing a flood of emotions, I chose a gentle, slow-moving approach to maintain cognitive level through disconnection from the ETC for several sessions before facilitating a move through other areas of the continuum. Rather than asking “why” she worked in a certain way, I asked about the way the work made her feel in order to direct her toward the affective level (Lusebrink, 1990). I decided to encourage her, over the course of our time together, to make media choices that were less resistive, moving from pencil to cray pas, acrylic paint, and all the way to watercolor to facilitate an emotional release. “Fluid media are also hypothesized to access unconscious processes, mediated on a preverbal level by the right hemisphere of the brain and thus aid in the integration of long term memory (Morley & Duncan, 2007 as cited in Hinz 2015, p. 136) and trauma recovery” (Gant and Tinnin, 2009 as cited in Hinz, 2015, p. 136). By changing the media, I hoped to create changes in how Rachel processed her trauma. To help decrease the reflective distance between Rachel and her work, I decided to offer short brushes and eventually suggest she paint with her hands (Lusebrink, 1990). Realizing that Rachel needed to control some aspects of the transition, I encouraged her to choose her own subject matter through the use of minimally directed art tasks. I hoped this would inspire some creative expression to occur during our sessions. At the end of each session, I worked with Rachel on coming back to a safe place and acknowledged the difficulty of the work she just completed. At the affective level I chose to push Rachel toward addressing the trauma and using and expressing her emotions. I wanted to focus on the use of art making to aid in the mental processing of information (Lusebrink, 2010). “A fPet study on women with post traumatic stress disorder (PTSD) showed that emotional memories of sexual abuse in childhood activated the orbitofrontal cortex and anterior temporal lobes” (Carlson, 2001 as cited in Lusebrink, 2004 p.130). This suggests that these memories are emotionally charged (Lusebrink, 2004). Our goal was to gently explore these emotional memories and to help her process emotions within the amygdala (Christian 2008, as cited in Lusebrink 2010). Building on our previous work at the affective level, I chose to encourage movement through the ETC to the symbolic level to address the meaning of her own imagery. “The symbolic (Sy) component of this level emphasizes global processing by involving input from sensory and affective sources, processing of autobiographic material, and symbolic expressions” (Lusebrink, 2015, p. 59). A directed art task for Rachel asked her to depict her personal symbols using color and fluid media. According to Lusebrink, “The symbol formation per se may lead to the sublimation of more basic drives into culturally acceptable expression, thus leading to the next or creative level” (2015, p. 95). By identifying Rachel's mental and intuitive images I lead her through processing and resolving the meaning of her symbolism while using her own terms. The goal of this process was to inspire self discovery. “Through the art expression the individual makes sense of his/her experience. The process of sublimation uses analogy to establish a symbolic linkage between a primitive need and more complex ideas” (Kramer, 1979 as cited in Lusebrink, 1990 p. 23). Through the formation of intuitive concepts Rachel would have the opportunity to evaluate the changes in her reality. Conclusion Through the use of the ETC to create an incremented therapeutic intervention, I was able to help Rachel to experience instances of creativity which allowed her to move around the continuum. During a slow progressing course of therapy, she began at the cognitive level with a great deal of reflective distance and made her way to the affective level where she was able to address emotions she had been holding onto. I intended to work with her slowly to keep the intensity of our work at a level she was able to handle, always making sure to create a safe space for Rachel. The objective was to help her reconcile her previous trauma and to create new neural pathways through art-making. Afterward, my focus was on helping Rachel gain a greater sense of insight into the person she was and hoped to become through the exploration of her personal symbolism at the symbolic level.
This approach she felt was prominent during the art making portion of the session. Besides from the art portion of a session, Riley believed the verbal component of art therapy was important. Riley explored the stigma surrounding art therapy and the client's verbal expressions. From the book, Integrative Approaches to Family Art Therapy (Riley & Malchiodi, 1994), Riley states: “Hearing client’s language does not negate the process of looking at the art product. It is a synthesis of two creative means of communication.” Joining these two stories was key in Riley’s
In 1982, the Diagnostic Drawing Series (DDS) was introduced by Barry Cohen as an assessment which focuses on form in client drawings, rather than content, to gain insight about a client in a way that allows for greater objectivity. The DDS is supported by extensive research, has reports of high reliability and validity, and is the only art therapy assessment tool that can be linked to the DSM-5 standards (Cohen, 2013).
The client stated that she came to therapy because she has been feeling really lonely and feeling as though that she is not enough since the death of her father. After the death of her father, her mother did not pay her any attention; she understood that her mother was grieving, especially when her grandfather passed a year later. I stated that the frequent death that surrounded her mother, seem to have caused her mother to distance herself from her. She responded “yes, and it even gotten worse when my mom started to date and eventually marry my stepfather”. She mentioned that once her little sister was born, she became jealous and envious. I emphasized with her by stating that she must have felt as though her little sister was going to take the attention that she sought from her mother. After confirming that her mother paid more attention to her sister and stepfather, she mentioned that during this time she began to cut herself in places that no one would notice. The pain did not take the feeling away, but she wanted to know that if she could still feel pain after the thought of losing everything. However, the only person who paid her any attention during this time, was her grandmother. Her grandmother showed her the love that her mother nor “father figure” never showed her. I stated, “the love that your grandmother showed was not the love you were
According to Sladyk (2008), interventions following the Psychodynamic Frame of Reference often lead clients to gain awareness of themselves and release what is inside of them (p. 2). This being said, art would be appropriate for Maggie to participate in. Art would allow her to release her emotions, and learn more about herself. Having an intervention of art for therapy would not only relate to the Psychodynamic Frame of Reference, but it would also relate to CMOP-E. Art relates to this model because Maggie would be engaging in a client-centered activity, leading her to learn more about herself, which she would then realize what she enjoys and finds
He/she can cut and tear papers of their choice. Also, they can glue and create their piece of art without adult’s interference or directions. Dr. Laurel demonstrated the pros of the Process Art Experience as it supports many aspects of children’s development. For example, physical, language, and literacy, and social/emotional development. Those linked to each other as it will be presented through the child’s own work. In contrast, the child in the Product Art Experience will be restricted to follow adult’s instructions or directions to make a product that was determined previously. The Product Art Experience limits or restricts children’s imagination and creativity. The child will not have the opportunity to choose the material. He/ she should follow the educator’s steps to make any pre-determined product. The Art versus Craft example, which displayed by Professor Walton, was reliably linked to the aforementioned experiences. She promoted the significance of creative thinking by showing high regards toward children’s individual abilities in techniques and skill levels. I learned from the Walton’s perspective that in order to stimulate children’s creativity, we should focus on children’s works, skills, and
The clients will be asked as a group to recall any other times they have had these feelings, with the therapist validating and normalizing clients’ feelings, explaining interactions between childhood trauma and self-image, expectations of others (including difficulty trusting), and any feelings related to power (Slotoroff, 1994). The therapist will ensure that a thorough follow-up of intense emotional provocations is provided for each client for the rest of the sessions. A recorded musical listening exercise while painting or drawing will close this session, taking pieces that evolve from this potentially angry emotional place to a more contemplative, and then a more joyous
People from all around the world suffer from many different anxieties and troubles. They turn to things they enjoy so that they can forget reality and be somewhat happy or simply to communicate with one another. Most of the enjoyment is temporary and not sufficient, that is why they continue doing what they do. Creative Arts Therapy, also known as Expressive Arts Therapy, helps those who find themselves completely lost and have nowhere to go or anyone to go to. They can express themselves however they please. In order to better understand arts therapy one must have a knowledge of creativity, emotions and, of course, people.
...t's problems. Instead, it should permit the client to feel that she has support to dive into emotions she might have been afraid to do so before entering client centered therapy.
“Art therapy is a form of therapy in making of visual images (paintings, drawings, models etc.) in the presences of a qualified art therapist contributes towards externalization of thoughts and feelings which may otherwise remain unexpressed”(Walter & Gilory, 1992).
For example, adolescents are often forced into therapy by their parents or school as a result of an inability to cope with stress in a socially acceptable way. Patients at this stage are too old to engage in play therapy, where therapists analyze a child’s behavior during play and when presented with toys. Also, patients acting out during adolescence are often too young to obtain the maturity to verbalize their emotions in a socially acceptable form. Art therapy is useful at this stage of development because similar impulses expressed in play therapy are expressed through drawings, meanwhile not requiring verbal communication. Art therapy introduces the mature defense mechanism of sublimation to the patient, guiding them to achieve better self control as they learn to communicate their impulses through art and talking about their art. A particular form of therapy is managed in groups, and adolescents are encouraged to engage in conversation about their drawings while they are creating them. This creates an environment of low anxiety, allowing patients communicate internal conflict and disregard their normal defense mechanisms that are used to conceal these emotions. The defense mechanism of sublimation is apparent in this process, as the use of color, composition, space and shapes to provide an
Trauma, as defined by the American Psychological Association, is an emotional response to a terrible event like an accident, rape or natural disaster. In order to process and overcome a traumatic experience, most seek a therapist. This is especially true for individuals who have dealt with childhood sexual abuse. There are different types of therapy and therapists that exist that individuals go to. Art therapy is a kind of psychotherapy that uses art as it’s main technique of communications in order to improve the emotional and mental well being of the patients. It combines the areas of human development, visual art such as drawing, sculpture, painting and other kinds of art and the artistic process with counseling and psychotherapy.
Expressive arts therapy is the use of art modalities, creative process, and aesthetic experience in a therapeutic context. It is a therapy of the imagination (McNiff, 1992). Effective communication is an essential element in therapeutic relationships and, although verbal language is the most conventional means of conveying information, other forms can convey just as much as words. The arts are an alternative form of communication that has recently received recognition for their value in therapeutic settings. There is a long well-established connection between the arts and psychology. Expressive arts therapy builds on a natural, complimentary relationship between the two disciplines. As a formal therapy, this form is relatively new with its own influences, history, processes, techniques, and considerations.
As we observe developmental progress, we see that structural growth in terms of representing and differentiating experience is a gradual process that can be partially attained. To foster differentiation and integration, use of therapeutic relationship and transference relationship is effective. In a developmentally based therapy, the therapist lets the patient do the construction of his own bridges. The therapist looks for those areas where the patient avoids making connections and lets the patient do the work so that he/she constructs his own emotional self.
The mind creates the emotions and ideals responsible for art. The brain is capable of imagining glorious things, and art is the physical manifestation of these ideals. These ideals are usually intense emotions with aesthetic power (Wilson, 220). Art organizes these emotions in a matter that can easily express the ideals to...