In clinical practice, formal elements of art products are regularly used in art therapy observation to obtain insight into clients’ mental health and provide directions for further treatment. Due to the diversity of formal elements used in existing studies and the inconsistency in the interpretation, it is unclear which formal elements contribute to insight into clients’ mental health. In this qualitative study using Constructivist Grounded Theory, eight art therapists were interviewed in-depth to identify which formal elements they observe, how they describe mental health and how they associate formal elements with mental health. Findings of this study show that art therapists in this study observe the combination of movement, dynamic, contour and repetition (i.e., primary formal elements) with mixture of color, figuration and color saturation (i.e., secondary formal elements). Primary and secondary elements interacting together construct the structure and variation of the art product. Art therapists rarely interpret these formal elements in terms of symptoms or diagnosis. Instead, they use concepts such as balance and adaptability (i.e., self-management, openness, flexibility, and creativity). They associate balance, specifically being out of balance, with the severity of the clients’ problem and adaptability with clients’ strengths and resources. In the conclusion of the article we discuss the findings’ implications for practice and further research.
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Imagery Rehearsal Therapy (IRT) is effective for trauma-related nightmares and is also a challenge to patients in finding access to their traumatic memories, because these are saved in non-verbal, visual, or audiovisual language. Art therapy (AT) is an experiential treatment that addresses images rather than words. This study investigates the possibility of an IRT-AT combination. Systematic literature review and field research was conducted, and the integration of theoretical and practice-based knowledge resulted in a framework for Imagery Rehearsal-based Art Therapy (IR-AT). The added value of AT in IRT appears to be more readily gaining access to traumatic experiences, living through feelings, and breaking through avoidance. Exposure and re-scripting take place more indirectly, experientially and sometimes in a playlike manner using art assignments and materials. In the artwork, imagination, play and fantasy offer creative space to stop the vicious circle of nightmares by changing theme, story line, ending, or any part of the dream into a more positive and acceptable one. IR-AT emerges as a promising method for treatment, and could be especially useful for patients who benefit least from verbal exposure techniques. This description of IR-AT offers a base for further research.
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Background: Art therapy (AT) is frequently offered to children and adolescents with psychosocial problems. AT is an experiential form of treatment in which the use of art materials, the process of creation in the presence and guidance of an art therapist, and the resulting artwork are assumed to contribute to the reduction of psychosocial problems. Although previous research reports positive effects, there is a lack of knowledge on which (combination of) art therapeutic components contribute to the reduction of psychosocial problems in children and adolescents. Method: A systematic narrative review was conducted to give an overview of AT interventions for children and adolescents with psychosocial problems. Fourteen databases and four electronic journals up to January 2020 were systematically searched. The applied means and forms of expression, therapist behavior, supposed mechanisms of change, and effects were extracted and coded. Results: Thirty-seven studies out of 1,299 studies met the inclusion criteria. This concerned 16 randomized controlled trials, eight controlled trials, and 13 single-group pre–post design studies. AT interventions for children and adolescents are characterized by a variety of materials/techniques, forms of structure such as giving topics or assignments, and the use of language. Three forms of therapist behavior were seen: non-directive, directive, and eclectic. All three forms of therapist behavior, in combination with a variety of means and forms of expression, showed significant effects on psychosocial problems. Conclusions: The results showed that the use of means and forms of expression and therapist behavior is applied flexibly. This suggests the responsiveness of AT, in which means and forms of expression and therapist behavior are applied to respond to the client's needs and circumstances, thereby giving positive results for psychosocial outcomes. For future studies, presenting detailed information on the potential beneficial effects of used therapeutic perspectives, means, art techniques, and therapist behavior is recommended to get a better insight into (un)successful art therapeutic elements.
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Presentatie gegeven over de review in Brussel Objectives: In the past decades many psychosocial interventions for elderly people with dementia have been developed and implemented. Relatively little research has been done on the extent to which these interventions were implemented in the daily care. The aim of this study was to obtain insight into strategies for successful implementation of psychosocial interventions in the daily residential dementia care. Using a modified RE-AIM framework, the indicators that are considered important for effective and sustainable implementation were defined.
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Abstract: This study sought to provide insight into how art activities influence the well-being of long-term care residents, and how artists and caregivers collaborate in offering these activities. In two long-term care facilities for people with dementia and one for older people with chronic psychiatric disorders, an uncontrolled pre- and post-test study was conducted using a mixed-method design. Forty-six residents participated in the study. Three art activities—(a) dance, (b) music and movement, and (c) visual arts—were studied and co-created with the residents and executed by artists and caregivers together in eight to ten weeks. The Face expression scale (FACE) was used to examine the extent to which participating in the art activity influenced resident mood. Qualitative data were collected via group discussions with artists, caregivers, residents, and an informal caregiver. The results indicated that participating in an art activity positively influenced resident mood (p < 0.000). p-values for the three art activities were: p < 0.000 for dance, p = 0.048 for music and movement, and p = 0.023 for visual arts. The qualitative data revealed that joining an art activity provided a positive effect, increased social relationships, and improved self-esteem for residents. The collaboration between artists and caregivers stimulated creativity, beauty, and learning from each other, as well as evoking emotions.
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The goal of this study was (1) to determine whether and how nursing home residents with dementia respond to the interactive art installation in general and (2) to identify whether responses change when the content type and, therefore, the nature of the interaction with the artwork changes. The interactive art installation ‘VENSTER’ evokes responses in nursing home residents with dementia, illustrating the potential of interactive artworks in the nursing home environment. Frequently observed responses were naming, recognizing or asking questions about depicted content and how the installation worked, physically gesturing towards or tapping on the screen and tapping or singing along to the music. It seemed content matters a lot. When VENSTER is to be used in routine care, the choice of a type of content is critical to the intended experience/usage in practice. In this study, recognition seemed to trigger memory and (in most cases) a verbal reaction, while indistinctness led to asking for more information. When (initially) coached by a care provider, residents actively engaged physically with the screen. Responses differed between content types, which makes it important to further explore different types of content and content as an interface to provide meaningful experiences for nursing home residents. •Implications for rehabilitation •VENSTER can facilitate different types of responses ranging from verbal reactions to active physical engagement. The choice of a type of content is critical to the intended experience/usage in practice. •Activating content seems suitable for use as a meaningful experience during the spare time in between existing activities or therapy. •Sessions with interactive content are short (avg. 30 mins) and intense and can therefore potentially be used as an activating therapy, activity or exercise. •In order to actively engage residents with dementia, the role of the care provider seems very important.
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Art therapy is widely used and effective in the treatment of patients diagnosed with Personality Disorders (PDs). Current psychotherapeutic approaches may benefit from this additional therapy to improve their efficacy. But what is the patient perspective upon this therapy? This study explored perceived benefits of art therapy for patients with PDs to let the valuable perspective of patients be taken into account. Using a quantitative survey study over 3 months (N = 528), GLM repeated measures and overall hierarchical regression analyses showed that the majority of the patients reported quite a lot of benefit from art therapy (mean 3.70 on a 5-point Likert scale), primarily in emotional and social functioning. The improvements are concentrated in specific target goals of which the five highest scoring goals affected were: expression of emotions, improved (more stable/positive) self-image, making own choices/autonomy, recognition of, insight in, and changing of personal patterns of feelings, behaviors and thoughts and dealing with own limitations and/or vulnerability. Patients made it clear that they perceived these target areas as having been affected by art therapy and said so at both moments in time, with a higher score after 3 months. The extent of the perceived benefits is highly dependent for patients on factors such as a non-judgmental attitude on the part of the therapist, feeling that they are taken seriously, being given sufficient freedom of expression but at the same time being offered sufficient structure and an adequate basis. Age, gender, and diagnosis cluster did not predict the magnitude of perceived benefits. Art therapy provides equal advantages to a broad target group, and so this form of therapy can be broadly indicated. The experienced benefits and the increase over time was primarily associated with the degree to which patients perceive that they can give meaningful expression to feelings in their artwork. This provides an indication for the extent of the benefits a person can experience and can also serve as a clear guiding principle for interventions by the art therapist.
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Formal elements are often used in art therapy assessment. The assumption is that formal elements are observable aspects of the art product that allow reliable and valid assessment of clients’ mental health. Most of the existing art therapy assessment instruments are based on clinical expertise. Therefore, it is not clear to what degree these instruments are restricted to formal elements. Other aspects might also be included, such as clinical expertise of the therapist. This raises the question of whether and how formal elements as observable aspects of the art product are related to clients’ mental health. To answer this question, four studies are presented that look at: (1) a meta-theoretical description of formal elements; (2) operationalization of these formal elements so they can be analyzed reliably in clients’ art products; (3) establishment of reliable and clinically relevant formal elements; (4) the relationship between formal elements and adult clients’ mental health. Results show that the combination of the formal elements “movement,” “dynamic,” and “contour” are significantly interrelated and related to clients’ mental health, i.e., psychopathology, psychological flexibility, experiential avoidance, and adaptability. These findings give insight in the diagnostic value of art products and how they may add to clients’ verbal expression and indicate their potential to benefit from therapy.
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Many affective experiences and learning processes including attachment patterns from early developmental phases manifest during psychotherapy. The first 15 min in art therapy can potentially reveal clients’ preferred ways of processing information or Expressive Therapies Continuum components, attachment patterns in the material handling process, and emotion regulation strategies during art making. This article discusses how, through clients’ choice of materials and manner of interaction with those materials, information about attachment patterns and preferred emotion regulation is available in art therapy. Paying close attention to the first image and material interaction provides crucial information that will guide the goals and course of art therapy. Two case vignettes demonstrate that within the first 15 min of art therapy information is readily gathered about attachment styles, Expressive Therapies Continuum components, emotion regulation, and the course of art therapy.
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This paper reports the responses of nursing home residents who live in a psychogeriatric ward to the abstract interactive art installation ‘Morgendauw’, which was specifically designed for this study. All stakeholders were involved in designing and implementing Morgendauw. The artwork seems able to evoke responses in both the residents and their caregivers, but the amount and duration of the responses observed during the study were limited. 15 interactions over the course of 14 h were noted and almost all of them were initiated by the nursing home staff, physiotherapy students or visitors (n = 12). Interactions lasted for about 3 min on average. Although the nursing home residents initially did not seem to notice the artwork, the threshold of acknowledging and approaching the artwork was quickly overcome when staff nudged or directed the residents’ attention towards the artwork. Beyond this point, nursing home residents generally needed little explanation of the interface to interact with the artwork. The location in which Morgendauw was placed during the study or the characteristics of the installation seemed to create a threshold. Further research should focus on the importance and the effects of context when designing and implementing an interactive art installation in a nursing home environment.
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