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How Art Therapy Can Complement the Cognitive-Behavioural and Psychodynamic Approaches to Therapy

Naman Magan Bhatnagar

Blog Post 3

              This blog aims to substantiate how art therapy can complement trusted approaches to therapy – particularly the cognitive-behavioural approach and psychodynamic approach – to help better treat patients. This shall be done by (1) providing an expose into what art therapy is, (2) understanding the advantages art therapy brings, (3) assessing how it complements the 2 aforementioned approaches, and (4) finally considering its advantages in light of its shortcomings.
To provide a brief description of what art therapy is and what it entails: Art therapy is defined as “therapy based on engagement in artistic activities (such as painting or drawing) as a means of creative expression and symbolic communication” (Merriam Webster, 2019). According to Mayte Parada, “you do not have to be an artist to benefit from art therapy” (Parada, 2017) because art therapy doesn’t focus on art, but rather on the process of creating it. The aim is to help a patient’s self-exploration and self-understanding (Parada, 2017). Let’s explore how art therapy helps benefit its patients.
              Art therapy helps patients better express themselves. Laurie Wilson suggests when counsellors and patients face roadblocks communicating with each other verbally, “practice in symbolizing, by making visual images, can further development” (Wilson, 2016). It shifts the focus of therapy from using language as the means of expression to using symbols instead. This poses numerous advantages to both patients and counsellors. Counsellors could use the patient’s work to better assess the patient’s ailments and create an effective treatment plan accordingly. Similarly, “representing a conflict or feeling… allows clients literally to see their problems from all sides” (Malchiodi C. A., 2002). Patients could then externalise their problems and gradually “confront” (Wilson, 2016) their stressors and address them in treatment.
              Additionally, a lot of the principles of art therapy and the cognitive-behavioural (CBT) approach intersect. Aimee Rozum suggests both kinds of therapy deal with “logic and cognition and questions and answers” (Malchiodi C. A., 2002) wherein art therapy applies the principles of CBT to identify false/negative rules and assumptions. For example, Steele and Raider (2001) employed cognitive reframing in their art therapy to help children identify “faulty or maladaptive patterns of thinking” (Merriam Webster, 2019) and process grief during traumatic events. Art therapy helped these children depict their feelings and allowed counsellors to address their posttraumatic stress. Questions like “draw something that makes you happy”, were then used to and showed significant success “(n=44, p<0.01)” (Steele, 2001) in restoring positivity to the children and acted as a reinforcement to the therapy. Similarly, Camic (1999) used creative arts to distract his clients from their painusing these modalities as a reinforcement for pain reduction” (Malchiodi C. A., 2002) showing significant signs of improvement when CBT was employed in art therapy. This overlap between the two form of therapies shows how art therapy can enhance patient therapy in conjunction with CBT.
              Likewise, the psychodynamic approach shares many similarities with art therapy as well. According to Wilson, “We experience it [a dream] predominantly in visual images . . . Part of the difficulty of giving an account of dreams is due to our having to translate these images into words.” (Wilson, 2016). The idea of having patients draw dreams when they struggled to verbalise them served as an inspiration for the emergence of art therapy. Psychologists like Margaret Naumberg then adapted Freud’s and Jung’s theories and focused “not just on the art, but also on the therapeutic relationship with art” (Wilson, 2016) echoing theories on psychotherapy. Thus, psychotherapy became a predominant analytic tool in art therapy sourcing of “spontaneous expression as material from the unconscious” (Wilson, 2016). Although, seeing as to how beneficial and well-adapted art therapy is to both the psychodynamic approach and CBT, why isn’t more prevalent?  
              Though art therapy is so beneficial, its implementation comes with numerous drawbacks. For one, it takes far longer to depict one’s feelings than it does to verbalise them. Given the time-constraints of therapists and their sessions, art therapists would need to spend longer periods of time with their patients. Furthermore, a current diagnostic manual for art therapy has not been established due to the little research done to establish which symbols constitute what mental disorder. This adds on to the ethical debate of whether personalised artworks of patients should be shared across therapists (Wilson 2016). Moreover, it is still unclear whether art therapy works for a large body of patients and/or whether it is equally effective for those who don’t like art/ craft in general.
              In conclusion, though this form of therapy faces numerous implementational drawbacks, art therapy does complement approaches such as the CBT & psychodynamic approach. Adding it to the repertoire of modern-day therapists would certainly provide an additional tool to communicate with and benefit patients.

References

Boseley, S. (2014, May 26). Misjudged counselling and therapy can be harmful, study reveals. Retrieved from The Guardian: https://www.theguardian.com/society/2014/may/26/misjudged-counselling-psychological-therapy-harmful-study-reveals
Malchiodi, C. (2018, July 26). Art Therapy: It’s Not an Art Class. Retrieved from Psychology Today: https://www.psychologytoday.com/us/blog/arts-and-health/201807/art-therapy-it-s-not-art-class
Malchiodi, C. A. (2002). Handbook of Art Therapy. Guilford: The Guildford Press.
Merriam Webster. (2019, March 16). Art Therapy - Definition. Retrieved from Merriam Webster: https://www.merriam-webster.com/dictionary/art%20therapy
National Health Society UK. (2019, March 16). Entry requirements and training (art therapists/art psychotherapists). Retrieved from Health Careers: https://www.healthcareers.nhs.uk/explore-roles/allied-health-professionals/roles-allied-health-professions/art-therapistart-psychotherapist/entry-requirements-and-training-art
Parada, M. (2017, January 2). The Benefits of Art Therapy. Retrieved from Montreal Therapy: https://www.montrealtherapy.com/benefits-art-therapy/
Steele, M. C. (2001). Structured Sensory Therapy (SITCAP-ART) for Traumatized Adjudicated Adolescents in Residential Treatment. The Haworth Press, Vol. 25(2).
Wilson, L. (2016). Approaches to Art Therapy. New York: Routledge.


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