لحظات تغییر در روند هنر درمانی

“How does art therapy work? What factors are responsible for the effectiveness of art therapy?” (AATA, 1999). These fundamental questions about the art therapy process were recently raised by the Art Therapy Research Initiative. Surprisingly, there is still a lack of systematic observations that would allow us to understand better how clients change and learn in the process of art therapy. There is a need to develop a deeper understanding of the therapeutic action of art therapy based on the study of art therapy in action. Therefore, I decided to study the art therapy process by observing an art therapist in her sessions with several emotionally disturbed children. This research gave me the opportunity to experience the art therapy process from an unfamiliar perspective, as an observer, and to document and analyze in great detail what happened in sessions. I interviewed the art therapist to learn how she understood the unfolding therapeutic process. One of her remarks about a profound experience in working with a 6-year-old girl caught my attention and eventually focused my inquiry: We are in a high swing right now. I see progress. Sheila is more organized and focused on the art process. And she expresses herself symbolically through the art and play. I see her smile a lot really getting satisfaction from the artmaking. Both of us get more out of the sessions. Oh yes, I feel a change, but I don’t know why.

This research contributes to the understanding of the therapeutic action of art therapy by documenting and analyzing the interaction in the triangle between art therapist, client, and artmaking from a new perspective. An observer in art therapy sessions has the unique opportunity to notice the exchanges between art therapist and client and their responsiveness to each other and the art. From this perspective the researcher can unravel some of the processes that lead to change and that remain unnoticed or mysterious to the participants. The findings of this study reflect the participants’ and the researcher’s perspectives and their efforts to describe what changes in the art therapy process, and how these changes occurred. The systematic analysis of interactions between art therapist, child and art revealed significant changes in the child’s processing of traumatic experiences within a period of 6 months. There was an increase in the child’s ability to symbolize her experience in words and images, to regulate her emotions and impulses, and to observe herself. The child experienced change as she worked together with the art therapist, and learned how to master the “ups and downs” in the art process and in her life. The art therapist experienced change as she could finally reach and nurture the child, and be “more motherly”. This case showed that the mystery of change centered mainly around the emotional aspect of the therapeutic experience and the mutual influence of therapist and client. Empathic processes could be discerned in the art therapist’s and the client’s interactions, particularly in the development of rhythm, resonance, and dissonance, and in the emergence of images from their exchanges. Theories of the therapeutic action of art therapy need to integrate the understanding of the healing potential of the creative process with a deeper understanding of the exchanges between art therapist, client and art process. Furthermore, focusing the analysis on moments of change provides insights in the immediate outcome of interventions in art therapy sessions and connects process and outcome research. Lack of documentation of the actual therapy process has been cited as a problem that confounds the validity and usefulness of outcome studies (Reynolds, Nabors, & Quinlan, 2001). Detailed documentation of sessions and the development of systematic analytic procedures can address this gap in art therapy research. Further research is needed to develop specific instruments that may allow us to measure change processes. We may eventually be able to identify markers of change, and to relate process variables to outcome measures. The findings of this study also indicate that research on the effectiveness of art therapy interventions needs to embrace the subjective experience of the participants. We need to observe the daily practice of art therapy and listen to clients and therapists in order to understand better how they perceive the art therapy process, what works and what is important to them.