Art Therapy rehabilitation psychiatric Therapist

Art Therapy - Potential for Creativity in Adults

by Lola Rosita Badman D.N.Z.C.R.S. Art Therapist

The author sees drawing as an attainable, enjoyable activity for people with all forms of personal disablement.
She hopes that art will become an integral part of the rehabilitation process in New Zealand. She writes as a practising artist and art educator.

Through teaching painting and drawing to adults and children over a fifteen year period, I became interested in the potential of this art form as a therapeutic aid in the rehabilitation of disabled persons, especially for those in psychiatric care. I chose art therapy as one of my practical options when studying for the Diploma of the New Zealand Council for Recreation and Sport, and commenced this work at the Psychiatric Unit, Waikato Hospital, in 1981. Art was incorporated into the occupational therapy programme for one period a week, with fullward involvement. Patients are short-stay 'acute' patients and the length of time spent in hospital is three to four weeks. Duration of each session is one hour, though patients may stay longer if they wish. A typical art therapy group consists of one occupational therapist, three or four psychiatric nurses; myself and up to eighteen patients, though the average number of patients is about twelve. Their ages range from sixteen to eighty years of age and the majority have not had any formal art training.

These include one long extension table seating up to thirty persons; large sketch blocks and rolls of newsprint; water-based paint (black, white, blue, red, yellow, green, brown, orange), crayons, pencils, and charcoal sticks, brushes of various sizes, magazines and materials for collage, glue, plastic palettes, screen printing frames. Facilities such as store cupboards, tables, a sink and wall space on which to display paintings, are essential. Often the character and atmosphere of the surroundings, rather than adequacy of space and materials is the important factor in creative endeavour. Warmth, informality and quietness are also important considerations. Sometimes, a patient may prefer to work on the floor. For psychiatric patients, theme choice, methods of application, and presentation by the therapist are the most important aspects. All depend on the level of group functioning.

My programme is strongly orientated towards education. An adult's expectation in an art situation, is to be able to produce a painting or drawing in which the subject matter is recognisable. A feeling of achievement and fulfillment, which can continue after hospitalisation is experienced by a person who has learned basic art skills. Still-life objects, which have bizarre and interesting shapes, offer a variety of interpretation, design possibilities and experiments with colour and texture. I have found that patients produce competent and pleasing works after one hour's tuition. They have a natural aptitude for aspects of rhythm; relating one object to another, understanding positive and negative space, intricacies of design, problems of scale and textural qualities. Male patients often possess an inclination towards graphic design and prefer a concrete exercise, using reference objects. Colour does not seem to play an important part for these patients, who are more concerned with tonal gradations, detail and scale. Their choice of subject is often architectural in theme or design.

In projective exercises, I use reference objects and word cues. Growth forms such as tree and plant roots, or a bony carcass from the local butcher's shop, lend themselves to a great variety of interpretation and visualisation. From a list of word cues, a patient can build up a picture, which may begin as a skills exercise, but which gives opportunities for organisational abilities and personal interpretation. Free expression and experiments with colour have cathartic value, especially where one large work is completed by a group of four or more people. All work together on a common theme, and the size, shape and design of the finished piece is dictated by table-size and the number and preferences of each group. Wet-in-wet techniques are relaxing and enjoyable and when dry may offer more scope for development. Other relaxing exercises emphasise a nonfigurative approach, such as printmaking, collage, rubbings from paper or cardboard templates, doodles and painting to music. I include aspects of art history in my programme, relating to the practical work patients are involved in. There are many large and colourful art books, which can be obtained from most Public Libraries in New Zealand. For the topic 'Dreams', I chose the work of Marc Chagall to illustrate elements of fantasy and originality, with his combination of people, birds, animals and landscape. Word cues, suggested by patients for this topic included - tunnels, redness, blackness, religious symbols, people, monsters, desert islands or lonely trees.

These are: to improve motor skills and co-ordination; to develop and enhance an awareness of everyday objects, people and the environment; to encourage alternative ways of Visualising and interpreting everyday events; to encourage self-expression in an indirect, objective and safe way; to keep patients conversant with the outside world by using topical events in art practice or discussion; to promote art through books, posters, prints, films and practice; to encourage patients to see the 'total' picture in art practice; and to ensure that aspects of art therapy can be applicable to other life situations.

An art therapy group is bonded by it's initial anxiety before a session, it's working relationship during a session, and in the sharing of results after a session. Painting and drawing place maximum demands on concentration and can be a guage to measure a patient's length of attention-span and level of concentration. In learning art skills, emphasis is placed on cognitive functioning. It also has value as a concrete exercise; one must use logic, analytical thinking, conscious thought processes and a disciplined approach to a set problem. A finished work can give a good indication of the aptitudes and capabilities of a person, which may not otherwise be discovered. The success of an art therapy session depends on patients' motivation and willingness to participate. This, in turn, depends on the therapist's presentation of the programme and the belief by all concerned that painting and drawing is a universal, permissible activity, and is not regarded as infantile or for the gifted only. Patients enjoy a simple introduction to art in the form of measured, precise demonstrations, as the amount of information the group can absorb is limited. The practice of art should compliment other therapies in a psychiatric institution. My aim is to suggest a theme which is easily visualised and which is suitable for all age groups. As the programme depends primarily on the functioning of the group as a whole, suggestions from the occupational therapist assisting are valuable.

As beginners in an art situation and as disabled people, I find that patients show extraordinary abilities in concentration and perception. They are receptive, open to suggestion and in many ways are more adventurous than an art student in an ordinary educational class. Participation is expected of all members, the nursing staff, the occupational therapist and I are active participants during a session. I have found that patients in psychiatric care are of an intuitive, vulnerable and sensitive disposition, which may be important factors in producing satisfying art. My assumption is that, contrary to popular opinion, depression can lead to creative thinking. It can be a time for introspection, quietitude and a time for reflection. Diagnostic interpretations of paintings are controversial and highly subjective. As a practicing artist and lay-person my interest in art as therapy is as a cathartic exercise, a form of recreation in a skills and educational context, and as an important aspect for self-development.

When painting and drawing become part of a therapeutic programme, a new enhanced concept of visualising ordinary, everyday objects, people and events is included, a person becomes more aware of his or her environment. For a person in psychiatric care especially, an increased sensitivity to the natural environment must be conducive to a speedier recovery.

In art practice, the artist seeks to find the fundamental aspects and the essence of the subject matter which is to be painted. Harmony is created in the natural environment in terms of unity, colour, rhythm, beauty of form and relatedness of one aspect to another. These values can be transferred to all aspects of daily life in a positive way, giving patients in psychiatric care a firm and secure basis upon which to fashion their behaviour and lifestyle.

Published in the Journal of the New Zealand Association of Occupational Therapists Inc, Volume 34 Number 2 Summer 1983-84, pages 27 and 28.