The American Art Therapy Association defines art therapy as:

    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.

    Art therapy is a mental health profession that uses the creative process of art making to improve and enhance the physical, mental and emotional well-being of individuals of all ages. It is based on the belief that the creative process involved in artistic self-expression helps people to resolve conflicts and problems, develop interpersonal skills, manage behavior, reduce stress, increase self-esteem and self-awareness, and achieve insight. Art therapy integrates the fields of human development, visual art (drawing, painting, sculpture, and other art forms), and the creative process with models of counseling and psychotherapy.

 

 According to internet source Art Therapy Blog http://www.arttherapyblog.com/art-therapy-benefits/#.VLhtfnucrBM

"While therapy and psychotherapy in general have many benefits, the concept of art therapy has proven to be successful in various ways that differ from traditional therapy practice. There are various uses for art therapy with regards to healing, but the benefits may surprise you if you’ve never heard of art as a form of therapy.

Who Benefits from Art Therapy?

Art therapy sets itself apart as a means of therapy by utilizing the creative process of art and having a low barrier to entry (anyone can be creative in some form or another). Art therapy can be especially beneficial to children as younger people are usually less capable and less comfortable expressing themselves via words.

While art therapy can benefit children greatly, it can also be very helpful to adults. Really, anyone can benefit from art therapy. Even if you’re using creative arts as a means of expression without the aid of an art therapist, there are still many benefits to be had. Read about some of these art therapy ideas and activities if you need some help getting started.

Art Therapy Benefits For The Average Person

By expressing yourself through art, an art therapist can help you see things about yourself that you otherwise may not have comprehended. Art therapists can help you process emotions and feelings that you are struggling with, so you can begin healing. Since art therapists are trained in the arts and, obviously, in therapy, they are capable of guiding you through the process of creative expression. They are also quite capable of providing insight into your creations and helping you understand certain aspects of yourself that maybe you didn’t know existed, whether good or bad.

It is this idea of self-exploration that can often lead a person to some insightful conclusions about themselves. Don’t be surprised if the effects of art therapy lead to a general sense of relief and overall better mental health. Again, it’s therapy, but with a completely different ingredient than most people are used to, art.

It’s important to note that you don’t need an art therapist to reap the benefits of art therapy. If you go into art as therapy and learn about the basic concepts and ideas that it represents, then you can learn a lot about yourself through your own isolated creative expression. It’s something you can do on your own to just relieve stress, discover yourself in new ways, etc. It’s also something you can do with other people. It’s truly a beautiful thing when you’re sharing art in an open, friendly, loving environment with other people that are on the same wave.

Art Therapy Benefits For People With More Serious Disorders

Without going into the details of all the possibilities, let’s just say that art therapy can benefit a wide-spectrum of disorders, diseases, and disabilities.

Art therapy can help improve various mental and pysical symptoms including, but not limited to, reducing pain, anxiety, and tension. It can be beneficial to those who have mental disorders, severe or light emotional abuse, cancer, post traumatic stress disorders (PTSD), people who are bipolar, and a variety of other serious ailments.

Benefits Of Art Therapy – In Conclusion

Art therapy can also help people with their social skills. The benefits of art therapy in these types of situations can help with people that are withdrawn or shy, or who, for some reason or another, have a difficult time functioning within social situations.

Basically, the benefits of art therapy can be quite broad. It can improve lives by helping people improve their mental, emotional, and even physical states. It can raise the quality of life for many people, and it’s worth considering if it can aid you in some way or another.

Again, maybe it’s just the act of executing creative expression on your own or with others, or maybe it’s seeking professional help with a certified art therapist. Either way, the benefits of art therapy make it worth exploring as a catalyst for healing."

 

 

 

 

 

Art therapy

 

From Wikipedia, the free encyclopedia

 

According to Wikipeia internet website http://en.wikipedia.org/wiki/Art_therapy#Definitions

 

An art therapist watches over a mental health patient during an art therapy workshop in Senegal.

 

Definitions of art therapy vary due in two fields: art and psychotherapy. It can focus on the art-making process as therapeutic in and of itself ("art as therapy") or it can be “art in therapy” (art psychotherapy). The psychoanalytic approach was one of the earliest forms of art psychotherapy. This approach employs the transference process between the therapist and the client who makes art. The therapist interprets the client's symbolic self-expression as communicated in the art and elicits interpretations from the client.[1] Analysis of transference is no longer always a component. Current art therapy includes a vast number of other approaches such as: Person-Centered, Cognitive, Behavior, Gestalt, Narrative, Adlerian, Family (Systems) and more. The tenets of art therapy involve humanism, creativity, reconciling emotional conflicts, fostering self-awareness, and personal growth.[2]

 

Contents

• 1 Definitions
• 2 History
• 3 Art therapy and outsider art
• 4 Applications
  • 4.1 Pediatric trauma patients
• 5 Improvement of depression and locus of control in prison inmates
• 6 Purpose
• 7 A typical session
• 8 Art-based assessments
  • 8.1 The Diagnostic Drawing Series (DDS)
  • 8.2 The Mandala Assessment Research Instrument (MARI)
  • 8.3 House–Tree–Person (HTP)
  • 8.4 Road drawing
• 9 Professional practice
  • 9.1 Certification, registration, and licensure
  • 9.2 Post-master's
  • 9.3 General ethical principles
  • 9.4 Eligibility for credentials
  • 9.5 Standards of conduct
  • 9.6 Disciplinary procedures
• 10 Uses
  • 10.1 General illness
  • 10.2 Cancer diagnosis
  • 10.3 Disaster relief
  • 10.4 Bereaved children
  • 10.5 Incarceration
  • 10.6 Distraction
  • 10.7 As an approach to problem solving
  • 10.8 Dyslexia and art therapy
• 11 See also
• 12 References
• 13 External links

 

"Definitions

 

Various definitions of the term "art therapy" exist,[3] each reflecting the historical narrative or theoretical underpinnings of its proponents.

 

The British Association of Art Therapists defines art therapy as:

 

...a form of psychotherapy that uses art media as its primary mode of communication. It is practised by qualified, registered Art Therapists who work with children, young people, adults and the elderly.[4] Clients who can use art therapy may have a wide range of difficulties, disabilities or diagnoses. These include, for example, emotional, behavioral or mental health problems, learning or physical disabilities, life-limiting conditions, brain-injury or neurological conditions and physical illness. Art therapy may be provided for groups, or for individuals, depending on clients’ needs. It is not a recreational activity or an art lesson, although the sessions can be enjoyable. Clients do not need to have any previous experience or expertise in art.

 

The American Art Therapy Association defines art therapy as:

 

...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.[5]

 

Art therapy is a mental health profession that uses the creative process of art making to improve and enhance the physical, mental and emotional well-being of individuals of all ages. It is based on the belief that the creative process involved in artistic self-expression helps people to resolve conflicts and problems, develop interpersonal skills, manage behaviour, reduce stress, increase self-esteem and self-awareness, and achieve insight. Art therapy integrates the fields of human development, visual art (drawing, painting, sculpture, and other art forms), and the creative process with models of counseling and psychotherapy.[5]

 

History

 

Although art therapy is a relatively young therapeutic discipline, its roots lie in the use of the arts in the 'moral treatment' of psychiatric patients in the late 18th century[6] and in a re-evaluation of the art of non-western art and of the art of untrained artists and of the insane[clarification needed].[7]

 

Art therapy as a profession began in the mid-20th century, arising independently in English-speaking and European countries. The early art therapists who published accounts of their work acknowledged the influence of aesthetics, psychiatry, psychoanalysis, rehabilitation, early childhood education, and art education, to varying degrees, on their practices.

 

The British artist Adrian Hill coined the term art therapy in 1942.[8] Hill, recovering from tuberculosis in a sanatorium, discovered the therapeutic benefits of drawing and painting while convalescing. He wrote that the value of art therapy lay in "completely engrossing the mind (as well as the fingers)…releasing the creative energy of the frequently inhibited patient", which enabled the patient to "build up a strong defence against his misfortunes". He suggested artistic work to his fellow patients. That began his art therapy work, which was documented in 1945 in his book, Art Versus Illness.[9]

 

Edward Adamson, “the father of art therapy in Britain”.[10]

 

The artist Edward Adamson, demobilised after WW2, joined Adrian Hill to extend Hill’s work to the British long stay mental hospitals. Other early proponents of art therapy in Britain include E. M. Lyddiatt, Michael Edwards, and Rita Simon. The British Association of Art Therapists was founded in 1964.[11]

 

U.S. art therapy pioneers Margaret Naumburg and Edith Kramer began practicing at around the same time as Hill. Naumburg, an educator, asserted that "art therapy is psychoanalytically oriented" and that free art expression "becomes a form of symbolic speech which…leads to an increase in verbalization in the course of therapy."[12] Edith Kramer, an artist, pointed out the importance of the creative process, psychological defenses, and artistic quality, writing that "sublimation is attained when forms are created that successfully contain…anger, anxiety, or pain."[13] Other early proponents of art therapy in the United States include Elinor Ulman, Robert "Bob" Ault, and Judith Rubin. The American Art Therapy Association was founded in 1969.[14]

 

National professional associations of art therapy exist in many countries, including Brazil, Canada, Finland, Israel, Japan, the Netherlands, Romania, South Korea, and Sweden. International networking contributes to the establishment of standards for education and practice.[15]

 

Diverse perspectives exist on history of art therapy, which complement those that focus on the institutionalization of art therapy as a profession in Britain and the United States.[16][17][18]

 

Art therapy and outsider art

 

The relation between the fields of Art Therapy and Outsider Art has been widely debated. The term 'Art Brut' was first coined by French artist Jean Dubuffet to describe art created outside the boundaries of official culture. Dubuffet used the term 'Art brut' to focus on artistic practice by insane-asylum patients. The English translation Outsider Art was first used by art critic Roger Cardinal in 1972.[19][20]

 

Both terms have been criticized because of their social and personal impact on both patients and artists. Art therapy professionals have been accused of not putting enough emphasis on the artistic value and meaning of the artist's works, considering them only from a medical perspective. This led to the misconception of the whole outsider art practice, while addressing therapeutical issues within the field of aesthetical discussion. Outsider Art, on the contrary, has been negatively judged because of the labeling of the artists' work, i.e. the equation artist = genius = insane. Moreover, the business-related issues on the term outsider art carry some misunderstandings.[21][22] While the Outsider Artist is part of a specific Art System, which can add a positive value to both the artist's work as well as his personal development, it can also imprison him within the boundaries of the system itself.[23][24]

 

Applications

 

Art therapy Intervention Two convict artists draw designs of carpets on graph paper at Industrial Workshops of Central Jail Faisalabad, Faisalabad, Pakistan, in 2010 MeSH D001155

 

As a mental health profession, art therapy is employed in many clinical and other settings with diverse populations. Art therapy can be found in non-clinical settings, as well as in art studios and in creativity development workshops. Closely related in practice to marriage and family therapists and mental health counselors, U.S. art therapists are licensed under various titles, depending upon their individual qualifications and the type of licenses available in a given state. Art therapists may hold licenses as art therapists, creative arts therapists, marriage and family therapists, counselors of various types, psychologists, nurse practitioners, social workers, occupational therapists, or rehabilitation therapists. Art therapists may have received advanced degrees in art therapy or in a related field such as psychology in which case they would have to obtain post-master's or post-doctorate certification as an art therapist. Art therapists work with populations of all ages and with a wide variety of disorders and diseases. Art therapists provide services to children, adolescents, and adults, whether as individuals, couples, families, or groups.

 

Using their evaluative and psychotherapy skills, art therapists choose materials and interventions appropriate to their clients’ needs and design sessions to achieve therapeutic goals and objectives. They use the creative process to help their clients increase insight, cope with stress, work through traumatic experiences, increase cognitive, memory and neurosensory abilities, improve interpersonal relationships and achieve greater self-fulfillment. Many art therapists draw upon images from resources such as ARAS (Archive for Research in Archetypal Symbolism) to incorporate historical art and symbols into their work with patients. Depending on the state, province, or country, the term "art therapist" may be reserved for those who are professionals trained in both art and therapy and hold a master or doctoral degree in art therapy or certification in art therapy, obtained after a graduate degree in a related field. Other professionals, such as mental health counselors, social workers, psychologists, and play therapists combine art therapy methods with basic psychotherapeutic modalities in their treatment. Assessing elements in artwork can help therapists understand how well a client is in-taking information.[25]

 

Pediatric trauma patients

 

The efficiency of treatment interventions for post traumatic disorder in children have not been researched upon extensively. Linda Chapman and fellow psychologists have, however, researched the effectiveness of art therapy on pediatric trauma patients. Early in the research, analysis showed that there were no significant reductions in PTSD (post traumatic stress disorder) symptoms between the patients and the control group. However, acute stress disorder symptoms were reduced for the children who received the art therapy intervention.[26]

 

Another use that is becoming more prevalent is aiding in the recovery of eating disorders. There are a few reasons why this type of treatment is helpful when treating eating disorders. One reason is the ease of communicating deep issues non-verbally. In many cases people use food restriction as a way to gain control and divert attention from a much deeper problem in their lives. These deeper issues are in most cases so hard to deal with that the use of art, pictures, and movement can provide needed insight. The way this works is through the interpretation of the things that the patient has drawn. There are many things to look for when interpreting art work. Not only do you look at what is on the paper and the symbolism in that, attention also needs to be paid what is not there, the things that people omit from a work can be just as informative. The placement of each part of the art work will provide insight. Art therapy also allows the individual to play a vital role in recovery as well as track their progress. A third reason is that it helps to build a more aware and healthy relationship with the individual’s body. One major way art therapy helps with this is through a technique called Body image tracing. Body image tracing is where a patients compare the outline of how the perceive their body to a true out line of their body. Because of these reasons art therapy has been a useful and quite successful tool in many venues, including out and in-patient treatment facilities, hospitals, schools, and private practices.[27] [28]

 

Art therapy can be used to help at-risk children, which is stated in Stella A. Stephney's book titled, "Art Therapy With Students At Risk: Fostering Resilience and Growth through Self-Expression." This is a second edition and it includes information about adolescents and how art therapy can help them work through their issues in a different way than regular therapy. In an article written by Shirley Riley titled, "Art Therapy with Adolescents," she talks about the usefulness of art therapy and how doing art therapy over the more conventional talk therapy, can actually help adolescents trust their therapists more and be more open and expressive. The article also discusses how adolescents find it more comfortable to express themselves with pictures or drawings than to talk about their feelings. Some adolescents who are acting out might be battling depression and would rather hurt themselves and feel the physical pain than feel the internal pain. [29] [30]

 

Improvement of depression and locus of control in prison inmates

 

A 2009 study of prison inmates done by David Gussak discovered that art therapy aided in the improvement of mood within prison inmates. It is believed that prison inmates experience an external locus of control and as such feel they do not control their lives and subsequently experience a higher instance of depression and overall poor mood. Art therapy however was proven by David Gussak to assist inmates to shift their locus of control from an external to internal and thus allow inmates to feel they had some control over themselves. This feeling of control led to improvement of mood and the associated depression within the inmate population.

 

It should be noted that art therapy was found by Gussak to be more helpful in improving the mood of female inmates than male inmates, this however is not necessarily a completely conclusive result and requires further study.[31]

 

Purpose

 

Art media commonly used in art therapy

 

The purpose of art therapy is essentially one of healing. Art therapy can be successfully applied to clients with physical, mental or emotional problems, diseases and disorders. Any type of visual art and art medium can be employed within the therapeutic process, including painting, drawing, sculpting, photography, and digital art.[32] Art therapy stands in contrast with other kinds of creative or expressive arts therapies that use dance, music or drama. One of the major differences between art therapy and other forms of communication is that most other forms of communication elicit the use of words or language as a means of communication. Studies have demonstrated the efficacy of art therapy, as applied to clients with memory loss due to Alzheimer’s and other diseases; stroke residuals;[33] cognitive functioning;[34] traumatic brain injury; post-traumatic stress disorder (PTSD);[35] depression; dealing with chronic illness;[36][37][38][39] and aging.[40][41] However, the potential healing power of art therapy has not been thoroughly studied in certain patients, such as trauma victims with disorders such as PTSD. "....Art therapy is not being properly reviewed. Art therapists report remarkable results from work with combat veterans, traumatized victims, sexual abuse survivors and survivors of natural disasters... Published case stories and research projects also support the efficiency of the approach. Yet no major clinical studies have been launched to scientifically examine the outcomes of art therapy as treatment for PTSD."[42] Another purpose of art therapy is determining existing disorders. Trauma, depression, schizophrenia, and PTSD are just a few mental illnesses that can be detected through art therapy.[43] "Sixty-four renal transplant recipients, 6-21 yr of age, were evaluated using self-report measures (CDI and Davidson) and art-based assessments. Subject art was analyzed by art therapists using seven of the 14 elements of the (FEATS), to assess depression. Unlike CDI and Davidson self-report testing, all patients were able to complete the art-based directives. When self-report measures and art-based assessments were combined, 36% of the study population had testing results consistent with depression and/or post-traumatic stress. The FEATS assessments identified a subset of patients who were not identified using the self-report measures. There was a correlation between CDI and Davidson scores (p < 0.0001), Davidson scores correlated with hospital days (p = 0.05), and FEATS correlated with height Z score (p = 0.04) and donor type (p = 0.01). Patients who required psychological interventions including antidepressant therapy, psychological counseling and psychiatric hospitalization during the year after the study were identified as depressed."[44] As art therapy grows in popularity and gains recognition, the purpose will become more clear and branch out to different patients. The purpose of art therapy is to provide a new healing opportunity to those who will benefit most from alternative therapy methods.

 

A typical session

 

A man draws in response to an art therapy directive

 

Malchiodi (2006)[citation needed] provides an example of what an art therapy session involves and how it is different from an art class. "In most art therapy sessions, the focus is on your inner experience—your feelings, perceptions, and imagination. While art therapy may involve learning skills or art techniques, the emphasis is generally first on developing and expressing images that come from inside the person, rather than those he or she sees in the outside world. And while some traditional art classes may ask you to paint or draw from your imagination, in art therapy, your inner world of images, feelings, thoughts, and ideas are always of primary importance to the experience.

 

The word "therapy" comes from the Greek therapeia, which means 'to be attentive to.' This meaning underscores the art therapy process in two ways. In most cases, a skilled professional attends to the individual who is making the art. This person’s guidance is key to the therapeutic process. This supportive relationship is necessary to guide the art-making experience and to help the individual find meaning through it along the way. It helps the individual trust themselves more.

 

The other important aspect is the attendance of the individual to his or her own personal process of making art and to giving the art product personal meaning—i.e., finding a story, description, or meaning for the art. Very few therapies depend as much on the active participation of the individual (p. 24)." In art therapy, the art therapist facilitates the person's exploration of both materials and narratives about art products created during a session.

 

Art therapy can take place in a variety of different settings. Art therapists may vary the goals of art therapy and the way they provide art therapy, depending upon the institution's or client’s needs. After an assessment of the client's strengths and needs, art therapy may be offered in either an individual or group format, according to which is better suited to the person. Art therapist Dr. Ellen G. Horovitz wrote, “My responsibilities vary from job to job. It is wholly different when one works as a consultant or in an agency as opposed to private practice. In private practice, it becomes more complex and far reaching. If you are the primary therapist then your responsibilities can swing from the spectrum of social work to the primary care of the patient. This includes dovetailing with physicians, judges, family members, and sometimes even community members that might be important in the caretaking of the individual.”[45] Like other psychotherapists in private practice, some art therapists find it important to ensure, for the therapeutic relationship, that the sessions occur each week in the same space and at the same time.[46]

 

Art therapy is often offered in schools as a form of therapy for children because of their creativity and interest in art as a means of expression. Art therapy can benefit children with a variety of issues, such as learning disabilities, speech and language disorders, behavioral disorders, and other emotional disturbances that might be hindering a child’s learning .[46] Similar to other psychologists that work in schools, art therapists should be able to diagnose the problems facing their student clients, and individualize treatment and interventions. Art therapists work closely with teachers and parents in order to implement their therapy strategies.[46]

 

Art-based assessments

 

Art therapists and other professionals use art-based assessments to evaluate emotional, cognitive, and developmental conditions. There are also many psychological assessments that utilize artmaking to analyze various types of mental functioning (Betts, 2005). Art therapists and other professionals are educated to administer and interpret these assessments, most of which rely on simple directives and a standardized array of art materials (Malchiodi 1998, 2003; Betts, 2005).[47] The first drawing assessment for psychological purposes was created in 1906 by German psychiatrist Fritz Mohr (Malchiodi 1998).[47] In 1926, researcher Florence Goodenough created a drawing test to measure the intelligence in children called the Draw–A–Man Test (Malchiodi 1998).[47] The key to interpreting the Draw-A-Man Test was that the more details a child incorporated into the drawing, the MORE intelligent they were (Malchiodi, 1998).[47] Goodenough and other researchers realized the test had just as much to do with personality as it did intelligence (Malchiodi, 1998).[47] Several other psychiatric art assessments were created in the 1940s, and have been used ever since (Malchiodi 1998).[47]

 

Notwithstanding, many art therapists eschew diagnostic testing and indeed some writers (Hogan 1997) question the validity of therapists making interpretative assumptions. Below are some examples of art therapy assessments:

 

The Diagnostic Drawing Series (DDS)

 

The Diagnostic Drawing Series (DDS) is a three-picture art interview designed by Barry M. Cohen and Barbara Lesowitz in 1982. It is one of the most commonly taught art therapy assessments and, with more than 60 DDS studies to date, it is the most researched art therapy tool worldwide. Cohen and colleagues wrote the DDS Rating Guide that directs mental health professionals on how to score the DDS. The related research, based on the structure rather than the content of the drawings, offers a way for the art therapist to contribute to the diagnostic process.[48]

 

The Diagnostic Drawing Series is standardized and was designed to be compatible with empirical social science methodology. Administrators also pay attention to the behaviors and behavioral changes of the test-taker. The DDS is designed to be administered to people aged 13 and over, but there are versions that are geared toward the assessment of children.[49]

 

The assessment is administered at a table. The subject is given flat-sided chalk pastels and 18 X 24 inch white drawing paper.

 

Research on the DDS uses criteria that includes the following:[49]

 

• Color: number used
• Enclosure
• Line length
• Space usage
• Integration
• Movement
• Placement on the page

 

The DDS has a drawing archive for reference. Cohen provided a quantifiable assessment for art therapists to use around the world. The test protocol attempts to control for the influence of medications and pharmaceutical confounding factors. The DDS is considered to be a reliable and valid assessment tool, and evidence continues to accrue to support this.[50] In general, projective tests tend to be much more unreliable than objective tests.[51] Training in the Diagnostic Drawing Series increases administrators' ability to apply research findings to the appropriate assessment of the subject.[48]

 

The Mandala Assessment Research Instrument (MARI)

 

In this assessment, a person is asked to select a card from a deck with different mandalas (designs enclosed in a geometric shape) and then must choose a color from a set of colored cards. The person is then asked to draw the mandala from the card they choose with an oil pastel of the color of their choice. The artist is then asked to explain if there were any meanings, experiences, or related information related to the mandala they drew. This test is based on the beliefs of Joan Kellogg, who sees a recurring correlation between the images, pattern and shapes in the mandalas that people draw and the personalities of the artists. This test assesses and gives clues to a person's psychological progressions and their current psychological condition (Malchiodi 1998). The mandala originates in Buddhism; its connections with spirituality help us to see links with transpersonal art.

 

House–Tree–Person (HTP)

 

Main article: House-Tree-Person test

 

The House-Tree-Person test (HTP) is a projective test designed to measure aspects of a person’s personality. The test can also be used to assess brain damage and general mental functioning. By virtue of being a projective test, the results of the HTP are subjective and open to interpretation by the administrator of the exam.[52] HTP was designed by John Buck and was originally based on the Goodenough scale of intellectual functioning. Buck included both qualitative and quantitative measurements of intellectual ability in the HTP (V). A 350-page manual was written by Buck to instruct the test-giver on proper grading of the HTP, which is more subjective than quantitative.[52] In contrast with him, Zoltán Vass published a more sophisticated approach, based on system analysis (SSCA, Seven-Step Configuration Analysis).

 

Administering the Test: HTP is given to persons above the age of three and takes approximately 150 minutes to complete based on the person's level of mental functioning. During the first phase, the test-taker is asked to draw the house, tree, and person and the test-giver asks questions each picture. There are 60 questions originally designed by Buck but art therapists and trained test administrators can also design their own questions, or ask follow up questions. This phase is done with a crayon.[52] During the second phase of HTP, the test-taker draws the same pictures with a pencil or pen. Again the test-giver asks similar questions about the drawings. Note: some mental health professionals only administer phase one or two and may change the writing instrument as desired. Variations of the test may ask the person to draw one person of each sex, or put all drawings on the same page.[52]

 

Examples of follow up questions:

 

• After the House: Who lives here? Is the occupant happy? What goes on inside the house? What's it like at night? Do people visit the house? What else do the people in the house want to add to the drawing?[53]
• After the Tree: What kind of tree is this? How old is the tree? What season is it? Has anyone tried to cut it down? What else grows nearby? Who waters this tree? Trees need sunshine to live so does it get enough sunshine?[52]
• After the Person is drawn: who is the person? How old is the person? What do they like and dislike doing? Has anyone tried to hurt them? Who looks out for them?[52]

 

Interpretation of results:

 

The quantitative measure of intelligence for the House-tree-person has been shown to highly correlate with the WAIS and other well-established intelligence tests.[52]

 

The subjective analysis of the test takers responses and drawings aims to make inferences of personality traits and past experiences. The subjective nature of this aspect of the HTP, as with other qualitative tests, has little empirical evidence to support its reliability or validity. This test, however, is still considered an accurate measure of brain damage and used in the assessment of schizophrenic patients also suffering from brain damage.[52]

 

Road drawing

 

In this drawing assessment and therapeutic intervention, the patient is asked to draw a road. This is a projective assessment used to create a graphic representation of the person's "road of life." The road drawing has the potential to elicit spontaneous imagery that represents the client's origins, the history of his or her life process, experiences to date, and intent for the future - even from a single drawing (Hanes, 1995, 1997, 2008). The road's reparative features or its need for "periodic upgrade" can serve as a metaphor for the client's capacity for change and restoration (Hanes, 1995, 1997, 2008).

 

Professional practice

 

Certification, registration, and licensure

 

In countries other than the US, governmental or regulatory boards oversee the training and practice in mental health care. Because art therapy is still considered a developing field, most countries do not regulate its practice and application.

 

In the United States, art therapists may become Registered (ATR), Board Certified (ATR-BC), and, in some states, licensed as an art therapist, creative arts therapist (LCAT; NY State only), or professional or mental health counselor (many states). Becoming a registered ATR requires that one complete a graduate-level program in art therapy from an accredited university, as well as completion of practicum and an internship, and additional clinical experience post-graduation with supervision from a professional clinician.[54] U.S. art therapists who meet credentialing requirements may go on to earn the supervisory credential of Art Therapy Certified Supervisor.

 

For more information on how to become licensed, US art therapists should contact the state licensure board in the state in the US in which they wish to practice. Art therapy students who are preparing for practice in the field should consult with their academic advisers about what courses are necessary to meet board certification and/or licensure requirements. Licensure is generally needed to obtain reimbursement for services as an independent practitioner and in some states, is required by law in order to practice independently. To receive certification, a significant amount of coursework and clinical experience is required. Depending on where an art therapist practices geographically, certification is not always necessary in becoming a professional art therapist.[54] Typically, the minimum requirement is a master’s degree in art therapy, or a master’s degree in related counseling or psychology fields, with an art therapy focus.[54] According to the American Art Therapy Association, it is imperative that master’s program students must successfully take courses in a variety of studio art disciplines as a means of signifying artistic proficiency. Additionally, students are required to take at least 48 credit hours at the graduate level in particular psychology related topics, as well as successfully partaking in practica and internships.[54]

 

Post-master's

 

In the United States, the practice of art therapists is governed by the Art Therapy Credentials Board (ATCB). The ATCB Code of Professional Practice addresses General Ethical Principles, Eligibility for Credentials, Standards of Conduct, and Disciplinary Procedures.[55] In order to apply for an ATR or other registered art therapist certifications, students are required to complete 1,000 hours of direct client contact post-graduation from a master’s program. After obtaining an ATR, individuals have the opportunity to apply for Board Certification from the Art Therapy Credentials Board by passing an examination. Like many psychology-related licensing, art therapy licenses vary by state, and having a license does not necessarily mean a therapist is nationally certified.[54]

 

General ethical principles

 

One topic covered in this section describes the responsibility art therapist have to their patients (ATCB 2005). According to the ATCB, art therapists must strive to advance the wellness of their clients, respect the rights of the client, and make sure they are providing a useful service (2005). They cannot discriminate against patient whatsoever, and may never desert or neglect patients receiving therapy.[56] Art therapist must fully explain to their patients what their expectations of the patients will be at the outset of the professional relationship between the two. Art therapists should continue therapy with a patient only if the client is benefiting from the therapy. It's against the principles established by the ATCB for art therapist to have patients only for financial reasons.[56]

 

Another topic of this section discusses the competency and integrity art therapists must possess (ATCB 2005). The ATCB states art therapists must be professionally proficient and must have integrity (2005). Art therapists must keep updated on new developments in art therapy. They are only supposed to treat cases in which they are qualified as established by their training, education, and experience (ATCB 2005). They are not allowed to treat patients currently seeing another therapist without the other therapist's permission (ATCB 2005). Art therapists must also observe patient confidentiality (ATCB 2005).

 

Other topics covered in this section further discuss responsibilities of art therapists. These responsibilities include, “responsibility to students and supervisees, responsibility to research participants, responsibility to the profession” (ATCB 2005). This section also establishes the rules by which art therapists must follow when making financial arrangements and when they choose to advertise their service (ATCB 2005).

 

Eligibility for credentials

 

This section of the ATCB Code of Professional Practice outlines the process by which art therapy students receive their credentials. It discusses the standards for eligibility and describes the application process. It also states that the ATCB certificates are the property of the ATCB and that any art therapist who loses their certificate and still claim to have ATCB credentials can be punished legally. It also discusses the procedure to follow when accused of wrongdoing related to art therapy. Lastly, it discusses the wrongdoings related to art therapy that therapists can be convicted for with a felony or another criminal conviction. These wrongdoings include rape, sexual abuse, assault, battery, prostitution, or the sale of controlled substances to patients.

 

Standards of conduct

 

This section of the ATCB Code of Professional Practice addresses in detail confidentiality, use of clients’ artwork, professional relationships, and grounds for discipline.[56]

 

Art therapists are not permitted to disclose information about the clients’ therapy sessions. This includes “all verbal and/or artistic expression occurring within a client-therapist relationship” (ATCB 2005). Art therapist are only allowed to release confidential information if they have explicit written consent by the patient or if the therapist has reason to believe the patient needs immediate help to address a severe danger to the patient's life.[56] Also, therapists are not allowed to publish or display any of the patient's work without the expressed written consent of the patient.[56]

 

The standards of a professional relationship between art therapists and clients are covered in this section. Within a professional relationship, art therapists are banned from engaging in exploitative relationships with current and former patients, students, interns, trainees, supervisors, or co-workers.[56] The ATCB defines an exploitative relationship as anything involving sexual intimacy, romance, or borrowing or loaning money.[56] Within professional relationships, therapists are to do what they feel is best in the client's interest, shall not advance a professional relationship for their own benefit, and shall not steer their patients in the wrong direction.[56]

 

The breaking of any of the standards established in this section is grounds for discipline.[56]

 

Disciplinary procedures

 

The content contained in this section of the ATCB Code of Professional Practice specifically discusses in legal and technical detail the entire disciplinary procedures for wrongdoings in art therapy (2005). Main topics covered in this section cover: "submission of allegations, procedures of the Disciplinary Hearing Committees, sanctions, release of information, waivers, reconsideration of eligibility and reinstatement of credentials, deadlines, bias, prejudice, and impartiality".[56]

 

While the ATCB oversees disciplinary procedures for art therapists, if an art therapist is licensed, the state board through which the art therapist is licensed carries out disciplinary action for violations or unethical practice.

 

Uses

 

General illness

 

People always search for some escape from illness and it has been found that art is one of the more common methods. Art and the creative process can aid many illnesses (cancer, heart disease, influenza, etc.). People can escape the emotional effects of illness through art making and many creative methods.[57]

 

Hospitals have started studying the influence of arts on patient care and found that participants in art programs have better vitals and less complications sleeping. Artistic influence doesn't need to be participation in a program, but studies have found that a landscape picture in a hospital room had reduced need for narcotic pain killers and less time in recovery at the hospital.[57]

 

Art therapy has been shown to help students ages 11 to 18 with autism spectrum disorder to increase their social skills. There was improvement in assertion scores, and hyperactivity scores and internalizing behavior (harming oneself) significantly decreased with art therapy sessions.[58]

Research has also indicated that art therapy can increase a child’s willingness to participate in therapy."