What is art therapy and how does it fit into the current interest in arts and health? Malcolm Learmonth and Karen Huckvale outline the work of the art therapist and address some common misapprehensions.
Working with the arts in the contexts of healthcare, social action, inclusion and creative empowerment is an idea with a long history. Art is valued as a means of making sense of life experiences; it encourages a sense of belonging and a sense of oneself as a creative being with choices. Art-making with others can be a powerfully inclusive and healing experience.
Behind all arts and health projects there is a shared assumption that the arts are in some way ?good for us?. Much of this benefit is psychological. Art therapy grew from the work of artists such as Edward Adamson, Adrian Hill and others, who from the 1940s on were establishing art studios (like early residencies) in healthcare settings, from mental hospitals to TB sanatoria. These artists and early art therapists sought better understandings of the way the personal relationship between the artist, the patient/painter and the artwork produced psychological change. They became fascinated by the living effects of creative engagement on the painters themselves. They developed approaches to art-making which considered and contained the intensity of emotions generated. Increasingly, art therapists began to focus on the importance of therapeutic relationships alongside therapeutic art-making. Psychotherapy thinking helped them to make these connections. It was a short step from this to the establishment of art therapy as a treatment in its own right.
Professional status
The British Association of Art Therapists (BAAT) was founded in 1964, and there followed training standards, recognised career structures, codes of practice and ultimately state registration (without which it is illegal to practice as an art therapist).These developments have been echoed in the fields of music and drama therapy, with dance/movement close behind. State registration is ultimately an exercise in public protection from amateur psychotherapy, and the professional development of art therapy has centred around gaining acceptance of therapeutic art-making as a ?treatment? requiring a trained practitioner. Art therapists operate across a broad spectrum, offering services ranging from art facilitation and enablement to intense psychotherapy. Nearly all art therapists have a first degree in art, and all a postgraduate qualification in art therapy. They are visual arts practitioners with specific expertise in the psychological and therapeutic aspects of art-making that underlie arts and health programmes and thinking.
There are over 1,500 state registered art therapists in the UK, working across health, educational and social fields in hospitals, prisons, schools, hospices, community settings and day centres. Much of their work is invisible. Art therapists are not at liberty to show much of the artwork produced. The psychological processes expressing, describing, understanding and changing a person?s emotional landscape through art are very powerful; they are also delicate and wither easily. Working sensitively and effectively with the painful stories which lie behind emotional and psychological problems means the artwork frequently has to stay out of the public domain. Art therapists do not therefore generally produce public murals or site-specific art, organise or take part in competitions, or offer many public ?drop-in? activity workshops.
Health benefits
Art-making combined with psychological understanding naturally contributes to emotional intelligence and creative problem-solving. These are key health benefits in the broadest sense, and are a powerful rationale for considering art therapy as a resource in a wider social context.
The first task for an art therapist is to create situations in which people, often estranged from their creative potentials since childhood, can begin art-making. This involves forming trusting relationships, safe environments, enablement and understanding. It can lead people to an authentic and vivid experience of expression, choices, feeling, insight, communication and understanding. Three users of an art therapy unit said the following in recent research (in a currently unpublished MSc by Sarah Bennet, Psychology Department, University of Exeter): ?It?s had a profound impact. I consider this the most successful thing that has happened in my mental health history. I?ve taken away what I did here, and use it?, ?I don?t feel like a prisoner of my depression any more. This has given me a new way of being, a different way of coping with being me?, and ?If only people were given the opportunity to go down the creative route. I?m just so sad more people can?t do this. I?ve seen what those drugs can do, and I?ve tried talking too. This was my light.?
Some misapprehensions
Just as we expect arts practitioners to have a developed visual literacy, the effectiveness of participatory arts/health projects will benefit from the emotional and psychological literacy that art therapy represents. Some misapprehensions can, however, cloud this:
? ?It?s nothing to do with art, it?s psychotherapy with felt-tip pens.? Our response is: art therapists are trained art practitioners themselves who work with a wide range of media. Jean DeBuffet also commented that ?Art is at its best when it forgets its own name.? The work of the therapy room often has a vigour and authenticity missing from formal art-making and teaching.
? ?It reduces art to complexes, pathologies, deficits, diseases and interpretations.? A basic premise of art therapy is that creativity is part of psychological and emotional self-regulation. Creativity is an instinctive human adaptive resource. It is an aspect of health, not an aspect of sickness. Respect and value of the person, regardless of label, is central to the art therapy approach. The meaning of an artwork is arrived at through conversation with the maker, not interpretation by the therapist.
Important contribution
The arts have a vital public health role to play and too often in art therapy they are working with reparation and damage limitation. As the agenda for emotional literacy and social inclusion expands, the pool of expertise and experience built up in art therapy has a great contribution to make to the re-engagement of art-making with the social, emotional and creative needs of the whole population.
Malcolm Learmonth is Senior Art Therapist at the Creative Therapies Service, Devon Partnership NHS Trust, Course Leader for the Foundation in Art Therapy at the University of Exeter, and Regional Co-ordinator for the British Association of Art Therapists. t: 01392 221241; e: malcolm@shangri-88.freeserve.co.uk; w:http://www.baat.org
Karen Huckvale is Senior Art Therapist at the Avon and Wiltshire NHS Trust. e: karen@shangri-88.freeserve.co.uk