Artful Therapy / Edition 1

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This resourceful guide presents proven techniques of art therapy to mental health professionals and allied workers with little or no background in art. The author, an art therapist with over 40 years of experience in teaching and working with clients, cleverly describes how art and visual imagery can enhance the therapeutic experience of clients of varying ages and abilities and clearly explains how to incorporate art into the therapy process as another tool in the therapist's kit. As an added bonus, Artful Therapy contains a DVD of actual art therapy sessions led by well-known experts that provides visual expression to the concepts described in the book.

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Product Details

  • ISBN-13: 9780471677949
  • Publisher: Wiley
  • Publication date: 3/25/2005
  • Edition description: New Edition
  • Edition number: 1
  • Pages: 336
  • Product dimensions: 5.90 (w) x 9.20 (h) x 0.90 (d)

Meet the Author

Judith Aron Rubin, PhD, ATR-BC, is a licensed psychologist and faculty member of the University of Pittsburgh and the Pittsburgh Psychoanalytic Society and Institute. She is a former president of the American Art Therapy Association, the author of five books, and the creator of five teaching films. She consults, lectures, and gives workshops across the country as well as abroad, and is preparing a series of art therapy teaching tapes for students and professionals.

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Read an Excerpt

Artful Therapy

By Judith Aron Rubin

John Wiley & Sons

ISBN: 0-471-67794-9

Chapter One



A Psychiatric Hospital

In 1963 I became the first art therapist at the Western Psychiatric Institute and Clinic, working individually with youngsters who had been diagnosed with childhood schizophrenia. Although the label today might be different (e.g., autism, pervasive developmental disorder, or Asperger's disorder), there was no question that they were severely disturbed children.

Before I started seeing them, there had been some anxiety on the part of the staff about whether the children would be able to use art materials appropriately, rather than eating or throwing them. Happily, each child was able to find a way to use the art sessions productively, given a choice of media and surfaces. The many different ways in which they responded to the opportunity were impressive, ranging from performing calming repetitive movements with body and brush, to graphically organizing their perceptions, to expressing previously unknown feelings and fantasies.

It was soon apparent that some of those whose language was hard to understand were able to communicate remarkably clearly through art. This was dramatically true for Dorothy, a 10-year-old whose speech was frantic, garbled, and virtually incomprehensible (DVD 1.1). She began by drawing very competent pictures of birds (1.1A), then painting them (1.1B). But until she drew and painted first a monster(1.1C), then a bird devouring a human being (1.1D), the treatment team had been unable to decipher the fantasies behind her bizarre behavior of flapping her arms and making squawking sounds. In fact, it was only after her bird and then her cat fantasies (1.1E) were expressed and explored in visual form that Dorothy began to draw human beings: the other children on her unit (1.1F).

Despite her social isolation, it was evident that she had been observing these youngsters, who were instantly recognizable to everyone who knew them (1.1G). Although her group portraits were rather stiff at first, they soon included a good deal of action and a clearly defined environment (1.1H). It was during this period that Dorothy began, for the first time, to relate to the other children, and we can only speculate that making the drawings was a rehearsal for live social interaction.

Even the few children on the unit with normal speech began, in their art, to express feelings and fantasies that helped the staff to understand their often puzzling symptoms. This was true for Randy, a 12-year-old who suffered from Encopresis (DVD 1.2).

He was a sweet and affectionate child, whose aggression-which he denied but which was manifest in his explosive symptom-first came out symbolically. After drawing a picture of Mars (1.2A) with constellations named "The King" and "The Queen," Randy embarked on a book, "Our Trip through Outer Space," (1.2B) in which a Martian and I traveled together from one planet to another.

This was followed by some realistic paintings, including one of his "School on Fire" (1.2C), one of the "School Burning Up" (1.2D), and one of a "Dinosaur and Volcano" (1.2E). After expressing some of his pent-up rage, Randy turned to an elaborate oedipal fantasy in which he and I went on a trip, this time on Earth, and as clearly romantic companions.

In the course of this second journey, the Randy character became less Martian and more human, appearing at one point to have won me, who I believe represented his mother in the transference. This was evident in a picture of Randy as a Scotsman holding me on what looks like a leash (1.2F), presumably to keep me from falling while dancing. The eventual resolution, however, was a healthier one. In the final picture/story (1.2G), the woman rejects a sailor, "because she already had a boyfriend," the boy accepting the reality that mother belongs to father. What was interesting was that during his work on the picture series, Randy's symptom gradually went away.

Because his psychiatrist was also seeing him for both individual and family therapy, we cannot be sure what role, if any, the art had in his recovery. Both his doctor and I felt, however, that art therapy had had a positive impact on Randy and on his progress in treatment. Since Dorothy's severe language problems had prevented her from communicating effectively with her psychiatrist, the role of the art in her case was clearly vital. When Professor Erik Erikson was presented with her history and that of her treatment at a grand rounds 4 months after art therapy had begun, he felt that it had been critical to her increasing relatedness, and urged that it be continued.

A Child Study Center

At the same time that I was seeing the schizophrenic children, I was working with after-school groups at a child study center run by the Department of Child Development. There, we found that some children who were very shy were able to whisper in paint what they could not say in words. Youngsters who were impulsive were often able to settle down and focus, and some of the boys and girls whose self-esteem was low, blossomed artistically in this nonjudgmental atmosphere where, unlike in art class at school, there were neither assignments nor grades.

My colleagues-at both the hospital and the child study center-soon began asking for help in using art themselves. They wanted to know what materials to buy, as well as how to get the children to use them. It wasn't long before I also found myself, in addition to working with the youngsters, training other staff members. Some requested individual consultation, while others wanted to meet as a group and to work with materials. My first adult students in 1963, therefore, were teachers, child care workers, occupational therapists, social workers, psychiatrists, and psychologists.

An Institution for Disabled Children

In 1967 I started an art program at a residential treatment center for orthopedically disabled youngsters (DVD 1.3). The staff members, like those in the hospital, had been extremely pessimistic about the capacity of these severely impaired children to use art materials with any degree of success. We were pleased to discover how very many of them were able to be creative through adaptive modifications of tools, media, and work surfaces (1.3A). It was soon evident that art provided these youngsters with a pleasurable outlet, as well as a place to learn new skills, to develop their potential, and to enhance their fragile self-esteem.

Although the staff had feared that art would discourage them because of their poor fine-motor control, the children's excitement about the art sessions was evident from the first (1.3B). In fact, because it was so popular, an extra period in the art room became one of the most frequently chosen rewards in a newly instituted behavior modification system, even though it cost the most tokens.

Art was also a place where both conflicts and capacities were revealed-as with the deaf-mute girl (DVD 1.4), thought to be profoundly retarded, who first demonstrated (1.4A) her normal intelligence in pictures (1.4B). As a result, she was able to return to the classroom and to speech therapy, using a "talking book" of drawings to communicate with others (1.4C), long before she was able to master sign language (1.4D).

On the basis of her success, the psychology and speech therapy departments both requested in-service training so that they, too, could use art with the children they were treating. Soon, sessions on art activities were requested by the child care workers, the occupational therapists, and the nurses, all of whom found that it helped them to better achieve their goals.

A Child Guidance Center

When I became the first art therapist at the Pittsburgh Child Guidance Center in 1969, the psychiatrists, psychologists, and social workers on the staff were naturally curious about this new clinical modality. I invited them to watch the art sessions through the one-way observation windows used for trainees. I also let it be known that I was interested in our working together, and eventually did so with some of them as co-therapists with families or groups (cf. Chapter 14, pp. 230-233; Rubin, 1981b).

After several months of a part-time pilot program, there was steadily growing interest in referring patients for assessment and treatment. In addition, however, some clinicians were eager to learn how to incorporate more art into their own work. I therefore ended up consulting with many of my colleagues, to enhance their comfort in using art with the children and parents they saw.

In 1970, a psychologist and I designed a family art evaluation and presented it at a general staff meeting (Rubin & Magnussen, 1974). The interest was so keen that we soon formed a family art study group in which we trained other clinicians to conduct the evaluation, reviewing their videotaped sessions at our 2-hour weekly meetings. Observing their ability to use what they learned, and to modify the procedures to fit their needs, was an important learning experience for me (cf. Chapter 10, p. 152).

Pretty soon, the social workers requested a course in using art materials with the activity groups they were leading. There was also a series of meetings with the psychologists on the use of projective drawings in assessment. The psychiatric consultant to the clinic's therapeutic preschool requested an art therapy group for the mothers (DVD 1.5), to which the latter (1.5A) responded more positively (1.5B) than they had to a purely verbal group (1.5C). The teachers of these severely disorganized students wanted consultation in helping the children, whose controls were weak, to use art materials constructively.

Responding to requests from people working with troubled adolescents in the community, a psychologist suggested that we design a course in art for self-awareness (DVD 1.6). We did so, training workers from many different fields to use art activities with groups of teenagers-first experiencing the exercises (1.6A), then trying them out with teens, then returning for group supervision on their work (1.6B).

The director of research invited me to work with his department on what became a series of studies of children's drawings related to diagnostic issues (cf. Chapter 14, pp. 233-234). These were all two-way situations, in which I learned at least as much as they did.

Consultation to Other Institutions

My job at the Pittsburgh Child Guidance Center was half-time in Direct Service and half-time in Community Service, otherwise known as Consultation and Education. That meant that I could consult to other institutions in the community, which greatly expanded the clinic's ability to reach parents and children in the wider geographic area.

In the hospital across the street, which, like the center, was run by the Department of Psychiatry, the occupational therapists soon requested a series of classes. They wanted to deepen their use of art media, which at that time were central in their work. Because they had excellent art and craft supplies and equipment, and were seeing most of the patients in the hospital, helping them to be more creative and reflective in their approach to art activities had an impact on the majority of those being treated on the inpatient units.

Shortly after that, the staff of the then-new day hospital asked for consultation on the use of art in group therapy. We began by having the patients make collaborative murals, inspired by an early book on art therapy in a New York day hospital: Murals of the Mind (Harris & Joseph, 1973). I ended up both observing the social workers leading the groups, and working alongside them.

The work of an art therapy intern at the children's hospital next door to the center stimulated a long-term collaboration with the pediatricians on art activities for their waiting rooms, something we had already instituted at our clinic (see Figure 1.1). For a number of years, I met for a series of workshops with the graduate students in child development and child care who conducted evening play programs for the children in that hospital. Their interest was in making the recreational art activities as therapeutic as possible, especially for those youngsters who had long hospital stays. Later, when a Child Life Department was formed, I conducted regular training sessions on the use of art media for its staff members.

I eventually found myself giving talks and workshops, as well as teaching courses for those who worked in other mental health centers (see Figure 1.2). They were offered not only at the clinic, but also in the community, in a wide variety of settings, including universities. For those who attended, I created a mimeographed handout entitled "Some Ways to Use Art in Therapy," which listed basic art materials; how to offer them; how to decide what to do, depending on diagnostic and treatment goals; and how to look at the art work that was evoked. I had forgotten that handout, which I used with other clinicians for many years, until I started work on this book. Artful Therapy is clearly a logical extension of those early efforts to share the wealth (so to speak) with those in other fields who wished to add a creative dimension to their therapy.

Perhaps the most important thing I learned from these experiences was that if people are well trained and knowledgeable in their own disciplines, they are able to incorporate art activities in ways that are therapeutically relevant. And, as is true for art therapists as well, they inevitably do so in ways that fit their theoretical outlooks as well as their preferred styles of relating.

Where Can You Use Art?

The kind of basic materials recommended in this book, most of which are only minimally messy, can be used in almost any place where you might be helping someone. In addition to using them in an office, you can offer art to people of all ages not only in clinics and hospitals, but also in schools, shelters, prisons, and rehabilitation centers, even in their own homes (DVD 1.7).

Just as art is possible with people of all ages-as soon as a child can hold a marker and not put it immediately in the mouth-so it is possible to make it available in virtually all kinds of settings, including outdoors, as with the wall mural done by adolescent gang members in a project facilitated by their leader (a woman who had also been in a gang). The theme of the mural is their dreams for the future (DVD 1.8).

Naturally, as with any kind of psychotherapy, it is ideal to have a space that is private, protected, and quiet-and if there's a sink in the room or nearby, it helps to allay anxiety about getting dirty. Even when there is no private work space, however, and even if the table is mahogany and the floor is carpeted, you can easily protect both work and fallout surfaces with newspaper or plastic cloths.

Although some settings, like a shelter or a hospital ward, are unavoidably noisy, crowded, and full of interruptions, it is really amazing how people of all ages can concentrate on making a drawing or a collage when they are genuinely engaged in the process (see Figure 1.3). I once had a book called Art Is a Quiet Place, which is what often happens, even with otherwise disorganized individuals.

I once had the good fortune to accompany my colleague, art therapist David Henley, on a visit to a zoo where he had been going for weekly art sessions with the animals. While there, I had the pleasure of observing a gorilla named June create a crayon drawing, which I treasure as a memento of the visit (DVD 1.9). June's drawing itself was unremarkable, like any young child's scribble (1.9A). But watching her concentrate on the activity for a full five minutes in a large cage full of noisily playing apes was astonishing (1.9B). Although I have often seen human beings similarly absorbed in the act of drawing, I felt like I was witnessing firsthand the primal pleasure of a deep engagement in the creative process. This organization of the organism's faculties in such purposeful, focused activity is one of the broadly therapeutic aspects of art activities.

It is therefore not surprising that art has always provided a refuge (DVD 1.10), and that making even a simple drawing can be a way of escaping a painful situation (1.10A). The children in the Nazi concentration camp of Terezin were enabled to create by a teacher named Friedl Dicker (1.10B), whose art classes were an island of peace in a sea of despair (Jewish Museum of Prague, 1993; Makarova & Seidman-Miller, 1999; Volavkova, 1962; 1.10C).


Excerpted from Artful Therapy by Judith Aron Rubin Excerpted by permission.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

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Table of Contents


DVD Contents.



Chapter 1: Overview.

Chapter 2: Why Add Art?

Chapter 3: Inviting Art-Making.

Chapter 4: During the Process.

Chapter 5: After the Process.

Chapter 6: Using Art in Assessment.

Chapter 7: Art Therapy Assessments.

Chapter 8: Art in Adult Therapy.

Chapter 9: Art in Child Therapy.

Chapter 10: Art in Family and Group Therapy.

Chapter 11: Using Other Art Forms.

Chapter 12: Using Mental Imagery.

Chapter 13: Assigning the Arts.

Chapter 14: Using Art Therapists.


Appendix A. More about Art Materials.

Appendix B. More about Different Approaches.

Appendix C. More about Art Activities.



About the Author.

About the DVD-ROM.

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