One of the lesser known approaches to addiction recovery is art therapy. The field of study on art therapy has only been extensively researched in the past 50 years, and its place in addiction recovery is even more infantile. However, researchers and therapists have linked art therapy with successful adherence to 12 step programs and more positive self-reported outcomes for women and adolescents in recovery.
Art therapy is the therapeutic application of art making between a professional clinician and client to help that client work through trauma, overcome an addiction, or personally develop. By combining psychotherapeutic models and techniques with the framework of the creative process, Art Therapy allows the patient to increase self-awareness, increasing coping skills, reduce anxiety, and express difficult emotions or thoughts.
Art therapy for the treatment of substance use disorders can be traced back to the 1950’s. Some of the methods used in art therapy include incident drawing, drawing or painting emotions, stress painting, creating an art journal, and creating sculptures.
Art therapists are professionally trained and accredited clinicians with a broad range of subject knowledge in the fields of psychotherapy and art. This includes education on brain development, psychology, symbolism, spirituality, multicultural artistic traditions, and therapy. Art therapists can work as individual therapists or group counselors within the realms of mental health, drug and alcohol rehab, medical hospitals, and community outreach centers. To become an art therapist requires education and certification, as well as a designated number of hours and portfolio work.
To legally be considered a professional art therapist as determined by the American Art Therapy Association, you must complete a graduate level master’s degree in art therapy or get a master’s degree in a counseling related field with an emphasis on art therapy.
Art therapy promotes some of the ideal characteristics of motivational therapy, including flexibility, toleration of uncertainty and ambiguity, and comfort with a silence that can generate anxiety free thoughtfulness. By emphasizing creativity, contemplation, and inner reflection, art therapy allows patients the chance to express themselves in a manner that might not be feasible in words, opening up new understandings of their affliction for their therapist.
Types of Art Therapy
Any creative expression can be used in art therapy. The primary qualities of art therapy involve creativity, imagination, and expression. The goal of art therapy is to help expand the patient’s forms of communication in order to convey experiences better. The types of art therapy include:
In addition to the different creative methods available, there are also different approaches that fall under the art therapy umbrella. These different approaches provide some flexibility for different patients and allow therapists to evaluate the problem from different angles. Here are some of the methods that art therapy commonly consists of:
The Gestalt method helps the patient work out their thoughts and feelings in a creative manner. The patient is asked to convey their attitude or opinions on a subject and to describe afterward why they chose specific colors, symbols, art styles, and depictions. This method allows the patient to delve deeper into their feelings without having to put them in words explicitly.
Active Imagination Method
In this method, the artwork is intended to be a starting point for the patient to allow their mind to wander. With an active imagination, there is no guidance from the therapist and the patient free associates what they are feeling in an expressive manner of their choice.
In this method, the therapist acts as an assistant to help the patient create the art. This could mean that the patient describes while the therapist paints/draws or the therapist discusses the development of the creation as the patient creates it, using the distraction of the artwork as a bridge to the patient’s inner psyche.
With the incident drawing, the patient recreates a traumatic event or recurring nightmare/dream/experience in their life. The patient is allowed to experience this experience while retaining control over the outcome.
Research Into Art Therapy
Many authors have written on the benefits offered by art therapy in treating substance abuse disorders, which includes bypassing defenses, promoting emotional expression, encouraging a spiritual recovery, and fostering creativity. Research into art therapy for the treatment of SUDs has suggested that art therapy can help decrease denial, reduce opposition to alcohol treatment, provide an outlet for communication, and motivate change. Art therapy provides an active means of experimentation with imagery to communicate symbolic meaning, clarify feelings, reduce distorted thinking, and foster increased insight for both the patient and therapist.
Most research into the subject can be divided among American and British authors. American literature on the subject has linked most outcome studies to the approaches effects on patient adherence to the 12 Step program. As the 12 Steps are an American creation, this is not so surprising. American authors have traditionally focused on art therapy’s connection to the 1st step in 12 Steps, which is overcoming denial and admitting powerless over addiction. Art therapy can help foster this acceptance because it breaks down resistance through active engagement. “Incident drawing” is a common method that has the patient recreate their feelings and the circumstances surrounding substance abuse. Other variants of incident drawing include having patients close their eyes to draw the artwork, or only use one hand, to emphasize the lack of control and sub-conscious aspects of addiction. This approach serves to break down resistance, foster powerlessness, and encourage the creation of distinctly positive images of recovery.
Alternately, British researchers have focused on art therapy’s relation to creating better patient-therapy psychodynamic understanding, better coping mechanisms for addiction recovery, promoting inner strength, and supporting realistic outlooks on recovery. These British authors examined art therapy models in 16 different rehab centers. The results showed that art therapy could positively impact client imagination and foster self-esteem. Art therapy, no matter the medium, was associated with activating the cognitive processes of decision making and valuation as well as engendering self-control and positive self-perception.
Music therapy is a more recent development in the field of expressive and art therapy for SUD treatment. Much like art therapy, it is used to help patients tap into emotions and thoughts that are difficult to convey or painful to express in words. The American Music Therapy Association advocates musical therapy as a viable model of recovery regardless of the patient’s background in music training or understanding.
Common forms of music therapy are songwriting, musical games, lyric analysis, relaxation training, neurofeedback, and improvising music based on emotion. Research into the subject of music therapy has turned up some positive outcomes. For example, songwriting and lyric analysis are related to positive emotional changes in patients suffering from SUDs. Drumming is associated with increasing relaxation and reducing anxiety, while other music therapy activities, including listening to recovery songs, have been linked with decreasing anger and stress as well as increasing the willingness to participate in drug and alcohol rehab. While still a relatively young field of study, researchers are hopeful surrounding musical therapy’s potential for successfully treating drug and alcohol addiction.
Benefits for Women and Adolescents
Research into addiction recovery for men and women has suggested that each gender responds more positively to recovery models that are catered explicitly by gender. Women, in particular, may benefit from art therapy models. Treatment centers with a higher percentage of women are more likely to use art and music therapy and report more successful outcomes using these methods. Likewise, treatment centers catering to more adolescents deploy music therapy and report more positive results than centers that do not, suggesting a possible link between younger ages and success rates for musical treatment.
Benefits of Art Therapy
- Increase acceptance of addiction
- Reduce opposition to further treatment
- Improve patient/therapist relationships and understanding
- Provide an outlet for communication
- Reduce distorted thinking
- Encourage positive feelings towards therapy
- Reducing pain, anxiety, and tension
Traditional psychotherapy and therapy have their benefits, but art therapy can approach the problems of mental health, motivational therapy, and personal expression in ways that other methods cannot. There are various ways to perform art therapy with regards to treating substance use disorders, but each one carries unique benefits that separate it from traditional approaches.
Art therapy sets itself apart from the pack by utilizing the creative process of art, encouraging active participation, and having a low barrier to entry. In fact, art therapy is especially helpful for children, as younger people are generally more comfortable expressing themselves in ways other than words. Art therapy can also be a fun and rewarding experience. Anyone can benefit from art therapy and the creative arts without the aid of a trained therapist.
By expressing your feelings through art, clinical art therapists help patients to see things about themselves that may have been unconsciously holding back or were unaware of in the first place. These sessions can help patients process emotions to begin healing. Well-trained art therapists can even point out symbolism and art techniques you may be used to provide insight into your work. This self-exploration can help lead to a general sense of relief and overall improved mental health.
History of Art Therapy
Art therapy is a creation of the 20th century, but humankind has harnessed the therapeutic and positive benefits of art since prehistory. The oldest cave paintings in the world can be found in Castillo cave in Cantabria, Spain, Chauvet cave in southern France, and in Sulawesi, Indonesia. Depictions of animals grazing, running, or being chased by hunters are rife within old cave paintings, the oldest of which date back some 40,000 years. We can’t be sure of the exact purpose that these cave drawings served if any, but we can understand a little bit more about our innate predisposition to artwork and creation. It’s possible that these drawings were used as part of religious or hunting ceremonies. Either way, humanity has demonstrated a need or inclination to make art.
Throughout history, art has developed and been refined as an outlet for expression, a means for political aims, farce, relief, erotica, and more. It wasn't until the 1940’s however that art was integrated into a model of therapy similar to what we know today as art therapy. In Europe, the model for art therapy was created by Adrian Hill, an artist and psychiatric ward patient who advocated for art projects to help his fellow patients. In his book “Art vs. Illness,” Hill coined the first usage of the term “art therapy.” Art therapy began to be introduced in British hospitals for the mentally ill thanks to the efforts of Edward Adamson, a fellow British artist. Throughout his life, Adamson advocated for the expansion of art therapy into mental health treatment facilities. Along the way, he collected over 100,000 pieces of art made by patients and displayed them in facilities. Adamson saw that art could help people psychologically recover from many afflictions. He felt especially strongly that the patient’s work should in no way be influenced by the therapist, dismissing therapeutic interpretations as “projecting.”
In the United States, art therapy was pioneered by psychologists Margaret Naumburg and Edith Kramer. The American approach focused on using art as a means to free the unconscious through free association. The resulting artwork was open to interpretation by both the therapist and patient and was intended to be analyzed symbolically. The first official art therapy degree program was founded by artist and clinical psychologist Dr. Edith Kramer at New York University. Since the 1950’s art therapy has been studied concerning substance use disorders and been implemented in rehab and counseling programs. Today, research demonstrates that art therapy can provide beneficial outcomes for patients seeking treatment for substance abuse. Most art therapy programs are available in the following settings.
- Residential treatment facilities
- Private practice
- Medical and psychiatric hospitals and clinics
- Outpatient treatment facilities
- Nursing homes
- Schools including colleges and universities
- Halfway houses
- Correctional institutions
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