P A R T I I
Clinical Approaches
chology. Thus, it is difficult to say which approaches are most used and under what circumstances.
From the available data and from reviewing the contemporary art therapy litera-ture, psychoanalytic and analytic theories (Chapter 4) still significantly influence the way that many art therapists practice and form the basis from which almost all art therapy approaches grew. When art therapy first appeared as form of psychotherapy in the mid-20th century, it was rooted in psychoanalysis, the dominant paradigm at the time. The idea of art expression as a reflection of the art maker’s unconscious was a natural fit with the central concepts of both psychoanalytic and Jungian analytic theory that stressed the importance of the individual’s internal world. Object rela-tions theory (also described in Chapter 4) evolved from psychoanalysis and also has been used as a framework for understanding the therapeutic value of art expression as a mirror of internal object relations.
Humanistic theories of psychotherapy (Chapter 5) emerged in reaction to many of the ideas proposed by psychoanalytic models, introducing concepts of self-actual-ization and personal potential. Ideas such as Maslow’s peak experience that encom-passed theories of creativity supported art therapy’s underlying principle that the cre-ative process of art making is life enhancing for all individuals (American Art Therapy Association, 1996). Person-centered, Gestalt, existential, and the more con-temporary outgrowth of transpersonal therapy all support a belief in the person’s cre-ative resources to achieve insight and wellness and have been synthesized within approaches to art therapy.
As psychotherapy began to explore the areas of information processing, cogni-tion, and human behavior, cognitive-behavioral models of treatment rapidly devel-oped. Cognitive-behavioral approaches of Albert Ellis, Aaron Beck, and, later, Don-ald Meichenbaum were adapted to art therapy (Chapter 6), reflecting the idea that making images of negative behavior or anxiety-producing thoughts could be helpful in inducing change. Images, according to this approach, are recognized as not only reflections of feelings but also cognitive representations that can be modified to help the person eliminate or reduce stress, fear, or other troublesome emotions.
This section also introduces examples of approaches that reflect art therapy’s in-tegration of newer psychotherapy theories. Solution-focused and narrative theories (Chapter 7) are representative of two contemporary approaches to psychotherapy that underscore the role of the individual in treatment as a collaborator with the therapist in creating solutions to presenting problems. Art expression is used within these models as a way to help clients make visible their world views and use creative expression to imagine positive changes to problem-laden stories. Whether or not these specific approaches will be embraced by increasing numbers of therapists and stand the test of time remains to be seen. However, they are approaches that reflect the current trends in brief therapy and the demands on all clinicians to accomplish treatment goals in a limited number of sessions.
The developmental approach to art therapy (Chapter 8) is somewhat related to cognitive-behavioral models because of its emphasis on understanding normal hu-man growth, cognition, and behavior throughout the life cycle. This approach’s foundations include the developmental aspects of normal artistic expression during childhood and the cognitive levels of development proposed by Piaget. Although 38 Clinical Approaches to Art Therapy
most often applied to work with children, the principles and overall approach are used by many practitioners in both therapy and assessment of individuals of all ages.
Finally, an expressive arts therapies (also referred to as multimodal) approach is described in Chapter 9, a model based on the concept of using all the various art forms—art, music, dance, drama, and creative writing—in therapy. While this con-temporary approach is gaining recognition in treatment, expressive arts therapy has been linked to the traditions and cultural precedents of world healing practices that include the application of all the arts (McNiff, 1981). This model offers unique op-portunities for self-exploration and emphasizes that all the arts can be used in an integrative way to enhance therapy.
Some art therapists believe that art therapy should have its own theory and be an approach, in and of itself, rather than relying on other frameworks of therapy. As we learn more about the “science” of art making and image formation (as discussed in Chapter 2), the connections between art and health, and changes in the brain as a re-sult of exposure to images and art expression, a free-standing theory of art therapy may very well emerge.
Many of the approaches in this section naturally employ concepts from several theories; for example, a transpersonal approach often uses humanistic, Jungian, and even mind–body principles in practice whereas a developmental approach might in-clude some cognitive-behavioral elements or the inclusion of other modalities such as music or movement. Most clinicians who use art therapy in their work believe that dimensions of the individual are overlooked if a therapist is restricted to a single the-ory or way of working. Although it is possible to use an eclectic approach to art ther-apy, it does not mean that simply choosing techniques from various frameworks leads to sound therapeutic treatment. In all circumstances, they must be used in re-sponse to the person’s needs and specific objectives for growth and change.
As we see in the pages that follow, all approaches to art therapy have a powerful capacity to tap elements of experiences, thoughts, and emotions that verbal therapy alone cannot. This ability to capture through visual image the internal world of feel-ing, sensations, perceptions, and cognitions makes art therapy, whether from a psy-choanalytic, humanistic, developmental, or other approach, a unique, creative, and effective way to work with clients of all ages.
REFERENCES
American Art Therapy Association. (1996). Mission statement. Mundelein, IL: Author.
Elkins, D. E., & Stovall, K. (2000). American Art Therapy Association, Inc.: 1998–1999 Member-ship survey report. Art Therapy: Journal of the American Art Therapy Association, 17, 41–46.
Freeman, J., Epston, D., & Combs, G. (1997). Playful approaches to serious problems. New York:
Norton.
Gladding, S. (1992). Counseling as an art: The creative arts in counseling. Alexandria, VA: Ameri-can Counseling Association.
McNiff, S. (1981). The arts in psychotherapy. Springfield, IL: Charles C Thomas.
Rubin, J. (2001). Approaches to art therapy. New York: Brunner-Routledge.
Selekman, M. D. (1997). Solution-focused therapy with children. New York: Guilford Press.
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