Some practitioners have explored ways of understanding the process of expressive arts therapy within a single session or a series of sessions to help evaluate the individ-ual’s use of various art forms. Goren-Bar (1997) offers a “creative axis model,” an-other stage model that can be used a guide to expressive arts therapy treatment.
These stages can be summarized as follows:
1. Stage 1: Contact. This is the initial period in which a client makes contact with the art form (handling art materials, experimenting with musical instru-ments, etc.).
2. Stage 2: Organization. After choosing the art form, the client organizes the various elements (preparation of materials to create a drawing, playing notes or scales on a musical instrument, etc.).
3. Stage 3: Improvisation. A continuation of the organization stage, the client uses trial and error to explore materials and characteristics of the medium (such as exploring the relationship of lines on paper, or changing the range or chord of musical notes).
4. Stage 4: Central theme. This is the time during the session when a theme be-comes clear and the person invests more attention and effort in that particular aspect of the artwork (such as creating an image from lines in a drawing, or repeating a rhythm or melody).
5. Stage 5: Elaboration (Variation). This is the time following the formation of a central theme when the person is preoccupied with the modification, develop-ment, or improvement of the artwork.
6. Stage 6: Preservation. This is the ending of the experience, which may include distancing, preserving the work, putting it away, or presenting it (displaying or storing an art piece or performing a musical piece) (adapted from Goren-Bar, 1997, pp. 413–414).
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This sequence can be used to consider how a person progresses through the vari-ous stages, how the person transitions from one stage to another, or how an individ-ual struggles with particular stages or regresses to earlier stages. Goren-Bar hypothe-sizes that there are possible emotional reactions to each stage and that certain populations may experience difficulties at various stages in the sequence. For exam-ple, children and adults with learning difficulties may have difficulties at stages 1, 2, and 3, and prefer to go immediately to stage 4 (central theme). A child with a learn-ing disability might enter a session and, instead of experimentlearn-ing with materials, quickly execute repetitive drawings of an airplane. Individuals with behavioral diffi-culties or personality disorders may stay in stage 3, improvisation, because it is hard to move to and remain with a central theme. Although Goren-Bar’s hypotheses are the result of clinical observations and not systematic research, this model underscores the importance of noting points of reference during an expressive arts therapy session with regard to how a person engages in the creative process and how he or she uses an art form.
TREATMENT ISSUES
Expressive arts therapy is tailored to the individual. There is no set way to begin a session, although, depending on the practitioner, any art form could be used as a starting point for further art expression. For one person the art form may start from drawing, for another a piece of creative writing or poetry, and for others, improvised movements or dance. The following vignette provides an example of an expressive arts therapy session.
A expressive arts therapy group session in an inpatient unit of a psychiatric hospital begins with a warm-up activity and the therapist leads the participants in a brief series of movements and simple stretches from a seated position. After sev-eral minutes of movement the participants are then asked to make an oil pastel drawing using lines, shapes, and colors, showing a movement or stretch experi-enced in the warm-up (Figure 9.1). After completing these drawings, the therapist instructs the group members to select a musical instrument (drum, bells, maracas, keyboard) and make a sound to depict the rhythms of their drawings. From there the therapist may facilitate the group in working together with the musical instru-ments to create a group musical piece. At the close of the group, the participants return to their seats in the circle and discuss their experiences with movement, drawing, and music.
Spaniol et al. (1999) offer another example of a multimodal session:
A multimodal expressive arts therapy session might begin by having participants stand in a circle and take turns making a movement that expresses their immediate feelings. In the second phase of the session, they might use oil crayons, pastels, or a felt-tipped pen first to transfer that movement onto a large piece of drawing paper, then elaborate the graphic mark into a picture. . . . The therapists might suggest that the participants look at one
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other’s pictures and leave a written response on a nearby piece of paper. Each participant then uses the words and phrases to compose a poem that she or he recites to the group.
The sequential unfolding of expression, from physical gesture to recited poem, becomes the basis for a concluding discussion that might consider the interplay of emotion, bodily movement, and verbal expression or the insights gained through group interaction. (pp.
364–365)
A typical session with an individual might begin with a warm-up activity, such as spontaneous movement or drawing, similar to what was described in the vignette.
The therapist may also choose to engage the client in a modality that the person finds most comfortable and nonthreatening. In some situations, a person may naturally be attracted to one art form over another and begin to express through that modality without any suggestion from the therapist. As the level of comfort with a modality increases and expression becomes more spontaneous, the therapist may encourage
“transition” to another mode of expression (Knill, 1978). Children, in nondirective play, naturally move from one activity to another (e.g., finger painting to dramatic enactment to puppets); transition to another modality is a natural occurrence. Adults may also express themselves in several modes, but it is more likely that the therapist will need to direct and support movement from one form of expression to another.
The purpose of facilitating transition is to encourage spontaneous expression, stimu-late creativity, and enhance the experience feelings, allowing for deeper understand-ing. In the final part of the session, the individual may reflect on the images, words, sounds, or movements that were created and discuss the process of making them with the therapist.
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FIGURE 9.1.Drawing using lines, shapes, and colors to show body movement.
ART THERAPY AND MULTIMODAL TECHNIQUES
As mentioned, therapists using an expressive arts therapy or multimodal approach to art therapy may use other art forms along with visual expression to facilitate an indi-vidual’s or group’s self-expression. Because this chapter is part of a text on clinical art therapy theory and applications, some of the more common techniques in multimod-al work using art expression as centrmultimod-al to expressive arts therapy are briefly discussed in the following sections: creative writing and art expression, movement and art ex-pression, and an intermodal experiential starting with art and including a number of different art forms.