Scientific/Pseudoscientific Critique

When
working with children and adolescents in a counseling setting it is often
difficult to maintain their attention while also creating a safe environment
where they feel comfortable enough to open up about their daily struggles,
traumas and crisis. This becomes even more difficult when working with children
who struggle with Attention Deficit Hyperactivity Disorder (ADHD), Oppositional
Defiant Disorder (ODD), and even Autism. So, the questions then become what can
we do as counselors to help these children? One realm that has started to show
effectiveness is bringing Art Therapy into work with children and adolescents
who struggle with these disorders and many more.

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Art Therapy

Art
therapy, is a nonverbal form of creative expression, that has been used to help
individuals from many age groups heal and find relief from mental health
problems, while also gaining insight, achieving personal growth, resolving
issues, and increasing their sense of well-being (Durrani, 2014). Art therapy
in and of itself is a relatively young modality, which was born in the second
half of the 20th century and developed by individuals, who were mostly artist
themselves with the belief that there was healing through art making (Durrani,
2014). From a theoretical standpoint “Art therapy approaches stem from
personality theories of Freud, Jung and techniques of psychoanalysis”
(Heckwolf, Bergland, & Mouratidis, 2014). Art therapy can help facilitate
communicative drives within children through providing a fun and leisure
activity while also developing and achieving goals.  When using an art
therapy perspective, the therapist’s priority is to establish a safe, trusting
environment in order to facilitate the client’s experience of healing and
growth. This perspective is based on the idea that the individual clients have
a natural, innate striving toward growth and self-direction (Perryman, Moss,
& Cochran, 2015).

As a
modality, art therapy uses a wide range of artistic materials to engage the
senses of sight, hearing, touch, and smell. Mediums used can vary on a wide
variety of spectrums through colors and textures such as clay, paint, sand,
play dough, pencils, crayons, glue, feathers, music and more all adding to the
incorporation of every human sense. Due to the wide variety of materials and
techniques used in art therapy it allows the counselor to adapt and tailor to
the needs of the hypo or hypersensitive children (Durrani, 2014). Art therapy
in and of itself can and is incorporated into an array of theoretical
frameworks such as Dialectical Behavioral Therapy (DBT), Gestalt Therapy, and
Cognitive Behavioral Therapy (CBT) when working with clients. It gives room to
offer patients more than what any one treatment may offer alone. Art therapy
and Dialectical Behavior Therapy (DBT) specifically are proven to be effective
treatments for a wide range of clinical disorders (Heckwolf, Bergland, &
Mouratidis, 2014).

Literature Review 

Upon looking into literature
there were found to be a growing body of empirically based outcome studies
demonstrating art therapy’s effectiveness within specific client populations. As
stated earlier art therapy is rarely if ever used solely on its own, but
instead in conjunction with other treatment modalities. In one case study
involving an early twenties university student seeking treatment for depression
and anxiety, the client sought out another option after months of outpatient
sessions with no improvement. That option was a longer term residential
treatment program involving the use of art therapy and DBT. Art therapy gave Anna
a safe place to work through the anger and intense destructive thoughts toward
her father and herself while building distress tolerance and coping skills
(Heckwolf, Bergland, & Mouratidis, 2014). Studies have shown that
adolescent’s often have difficulty expressing themselves verbally when
discussing personal issues and an expressive arts group and activities tend to
help these young adolescents communicate their difficult thoughts and feelings
through various artistic modes.

In another study, involving at
risk students in a public school who had been referred to the school counselor
for disciplinary school office referrals and or difficult home situations
participated in an expressive arts group. This study used a
phenomenological approach in which they used a grounded theory that was
implemented to convey the experiences of the adolescent girls participating in
an expressive art play therapy group. The purpose of a phenomenological
qualitative research inquiry approach is to understand the meaning of the
participants lived experiences, or life instances specific to each individual’s
perception (Perryman, Moss, & Cochran, 2015).  The goals for the group
were that participants would develop appropriate social skills, gain an
awareness of behaviors causing interpersonal problems with one another and
family members, as well as gain healthy coping skills and methods for dealing
with feelings. The results showed that increased self-awareness was one of the
major themes throughout and personal growth was another characteristic of
expressive therapies, which was observed in the increased expression of
feelings and the sense of accomplishment and pride that the girls expressed
throughout the study (Perryman, Moss, & Cochran, 2015). To ensure
trustworthiness, honesty and comprehensions multiple forms of data were collected for
triangulation to occur and the transcriptions from each of the five sessions,
along with the participants’
journals and facilitators’ notes were used in the coding process. The coding
process consisted of two researchers coding the data separately in
which open, active, and selective codes were used to organize
each of the group sessions. The researchers then met and synthesized the data
together (Perryman, Moss, & Cochran, 2015).

One of the benefits to expressive
arts therapy is that the art process provides alternative channels for
communication that might have otherwise remained unknown. This is done as the
art gives away to allow for unconscious feelings or unknown stories to surface
and be processed at the client’s pace. Studies have shown that when clients,
specifically children and adolescent clients are given control to take things
at their own pace and have some control over what they can do in session leads
to the willingness of the client to work on the “hard things”. Each client a
counselor comes in contact with will and do hold different issues and
willingness levels to which art therapy is proven to be a useful tool when
working with different clients across the board.

A qualitative study done by Durrani
2014, followed a child by the name of Tom through a yearlong process of art
therapy sessions held once a week starting at thirty minutes then building up
to one hour. Due to the lack of involvement from the parents there was a lack
of background and developmental information on the given client. Throughout the
process the only results recorded were those observed by the therapist
providing the sessions. The results found that Tom’s self-stimulatory behavior
reduced significantly during the sessions as well as his head banging incidents
which started to become rare occurrences. This study showed that through art
therapy the client and therapist were able to bridge the gap built by the
clients struggle with language while creating a safe and welcoming environment
for the client to explore his self-worth and expression.

  Conclusions and Implications

When looking at the studies
explored earlier it can be shown that the use of expressive art therapy when
working with children and adolescents is and can be beneficial in many areas.  The
advantages when using expressive arts activities are shown to be especially
important when working with adolescents as they begin the process of self-exploration,
sometimes seen through experimenting with hair color, style of clothes, and
language as a way to express themselves. This period of time is often trying
for the adults in the individuals lives, thus leaving adolescents feeling
misunderstood and disconnected (Perryman, Moss, & Cochran, 2015). Art
therapy allows these individuals a place to express themselves freely while
also feeling understood and connected. From a logical standpoint, the
hypothesis that integrating art therapy into the work done with children and
adolescents will help foster self-worth, growth and awareness can be seen as
valid as research has shown that when using art therapy in conjunction with
other modalities such as DBT and CBT clients report an improvement in
self-worth, self-awareness and decrease in symptoms such as anxiety and
depression. In regard to the replicability and sufficiency of art therapy as an
evidenced based practice it was found that through research there have been
many observational and evidenced based studies done all show positive outcomes
for the participants and clients involved.

With
that being said there are some implications to the research done on the
effectiveness when using art therapy. Art therapy as seen through literature
and research is mostly used in conjunction with another modality thus raising
the question of if it can stand on its own from and evidenced based standpoint.
As Durrani, stated in his article Attachment in Children with Autism Through
Art Therapy: A Case Study, “the lack of evidenced-based practice in the field
of art therapy is a disserves to a therapeutic modality that has huge
implications for individuals, specifically those with Autism” (2014). Quantitative
studies using potential measures for obtaining more empirical data do exist and
need to be looked into and researched further. There is also literature that
talks about how the underlining neurological processes during the art making
process is a growing topic of art therapy. “The process of art making is
associated with the right brain’s areas of functioning, the hemisphere in which
a wide range of emotions are expressed and mostly processed” (Heckwolf,
Bergland, & Mouratidis, 2014). More research on the process of art therapy
from neurological 

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