Art Therapy: the Inpatient Service - Essay Example

Placement Essay Currently I'm doing my placement in a day hospital service within the Mental health unit for adults. The Day hospital designated for adults between 18 - 65 year old with severe or enduring mental health illnesses. The service is based on a holistic and multi-disciplinary team approach. The day hospital team is made up of nurses, doctors, psychologists, social workers, occupational therapists and patient organizations. The day hospital provides occupational therapy and art therapy which functions under occupational therapy, physical, social activities are also provided by the service. The referrals can be made through GPs, primary care providers and self-referrals also take place. The other area I had the opportunity to work in was in one of the inpatient wards for older people. The inpatient service is provided for older people who are diagnosed as suffering from functional and organic illnesses that require specialist care. I observed that multi disciplinary approach is also adopted here. In this section of the mental health unit the multi disciplinary team is made up of nursing staff, medical staff, occupational therapists, psychologists, dieticians, chiropodist, speech therapist, music and art therapy. In this inpatient ward my supervisor led a closed art therapy group, which he set up some time ago. I participated in these sessions for three months by shadowing my supervisor and helping him time to time in running the sessions. My supervisor is the only art therapist in a huge department. He works in 8 working areas within the mental health unit, which includes the day hospital for adults, the acute unit for adults and inpatient unit for older people. Hospital provides both art therapy in group and individual setting. Group art therapy has the same advantages as other types of group activity. It provides possibilities for the feeling of community to appear, it allows the patients see and recognize similarities and distinctions, it also positively influence communication skills and exchanging experience. It is much spoken about the importance of art therapy in mental health. "For example, individuals suffering with depression, facing loss, coping with trauma, dealing with addiction, recovering from sexual abuse, or seeking means to overcome anxiety have often found relief, courage, and strengthening insight through art therapy. Creativity can provide a means of expression for that which has no words, or is not yet fully understood. Using the client's art as an interpretive reference point, the art therapist helps the client further explore their feelings, experiences, and perceptions and claim renewed clarity and meaning in their life". (Raymer et al, p.38) Art therapy is considered to be a type of psychotherapy, where art (or creative self-expression) is implemented to reveal safe emotional expression. It encourages the patient to express his emotions and feelings freely with the help of art, making a link between subconscious and a piece of art produced. Art therapy provides for various possibilities, one of them is to examine the conflicts of the personality that cannot reveal in some other way, they help the specialists make better diagnosis and find appropriate treatment. In addition, art therapy positively influenced personal growth, it helps the person better understand himself. "Some of the potential uses of art therapy to be researched include reducing anxiety levels, improving recovery times, decreasing hospital stays, improving communication and social function, and pain control." (Case et al, p.67) Art therapy has always been used in hospitals as the way of engaging the patients' self-expression. This is always the toll that health the patients with mental illnesses reflect their emotions or ideas that are hard to be described verbally. Potential of the art therapy became evident after the world war the second, when the patients in rehabilitation centers and military hospitals used art therapy to overcome the results of their traumas. As it is defined by the scholars, "Art Therapy is a non-verbal way of revealing deeper emotions that may not otherwise be clearly expressed." (Raymer et al, p.39) As far as distinctions between group art therapy and other kinds of group therapy are concerned, the major difference is that the result of activity in group art therapy is making a piece of art work. The therapist in these groups performs the role of a leader in the process of creation; he provides counseling and support and prepares a ground for patients' self-expression, which, in turn, serves for the benefit of the whole group. The process of creation may be either nonverbal or verbal. Individual art therapy settings are based upon individual approach, accounting individual needs and demands. Images or other works of art that are made by individuals involved in art therapy can then become a starting point for further discussions, that often involve the issue that wouldn't appear otherwise. (Irwin, 1991; Simon, 1985). As soon as visual images may serve for multiple purposes, revealing contradictory ideas of the personality, feelings and emotional background, art therapy provides the patients with comfort and help in their lives. Art helps people examine their own thoughts and feelings from new angles of vision, and this could be impossible without art therapy. "Art provides a balance for feelings, thoughts, and experiences. It is this balance which provides hope and nurturing" (Raymer & McIntyre, 1987, p. 15) Art therapy was first begun in hospitals with psychiatric patients. As it is defined by the scholars, "Art therapy is the therapeutic use of art making, within a professional relationship, by people who experience illness, trauma, or challenges in living, and by people who seek personal development. Through creating art and reflecting on the art products and processes, people can increase awareness of self and others, cope with symptoms, stress, and traumatic experiences; enhance cognitive abilities; and enjoy the life-affirming pleasures of making art." (Codispoti et al.) Since the early days of the profession the practice of art therapy and approach to art therapy in mental health has evolved. The desire of the patients to express their selves via forms of art has been investigated by many scholars (Peckman, 1965; Hatcher, 1985; Dissanayake, 1988). Hatcher (1985) speaks about this phenomenon from a viewpoint of anthropology: "Whatever the theoretical explanation, it is clear that art somehow helps human beings cope with the trauma of death. Beauty and art forms have been part of funeral ceremonies since Neanderthal times. This universal human problem is met everywhere with symbolic solutions to satisfy the mind and esthetic solutions to release the emotions (pp.106-107)." Process of art making within the context of a psychotherapeutic relationship can facilitate a positive change within the individual, it can facilitate development of communication skills, and it can help the individual to develop a positive self-image. Art therapy can provide a social interactive experience where the patient can learn to use their potential to express and explore feelings. Art therapy can provide the patient the safe environment where creativity can take place, where patients can lower some of their rigid defences raised against any type of communication. Tyler explains that, "Pictures are gentle and universal, they precede language" (1998, p. 125). Additionally, art provides a means for the patient to express feelings when verbal skills are unavailable due to the patient's physical or emotional impairment. Increasing manual strength and dexterity, as well as enhancing functional range of motion, are two benefits of creating an art object (Bruck, 1996). Moulding clay, cutting with scissors, using glue, controlling a pen or manipulating a paintbrush all reinforce the hand-eye-brain connection (Fox, 2003). Williams and Kramer (1997) maintain that the physical experience of creating art produces a flow between body and mind and also that "[i]mage-making involves all aspects of the brain, from the most primitive to the most developed." There are various potentially positive results that may appear after the use of various types of art therapy. The most significant benefits are as follows: Art therapy is not based upon verbal communication or language. It often provides modality for the patients with various disabilities Access to experiences is carried out under control of a specialist Art therapy makes the patient focus on one special kind of activity, forcing out all other thoughts that may disturb the process Art therapy develops creative thinking Art therapy proves the idea that creative process is therapeutic in its essence Art therapy may lead to safe emotional release The process of creating a work of art may be fun In art therapy especially when starting a group at first it can be an overwhelming experience being around other patients. There are various approaches to meet the needs and demands of the patients. A multidisciplinary team approach is one of these approaches, providing the possibility to care the patients better, compared to care provided by physicians to individual patients. In case this approach is implemented carefully, it has significant outcomes. As it is described by the specialists, "with a diverse group of healthcare professionals, such as physicians, nurses, pharmacists, dieticians, and health educators with the patient at the center of the team, the team can ensure treatment goals are maintained for chronic diseases". (The Care Programme Approach) A multidisciplinary approach includes satisfaction and self-control of the patient, working out and advancing community support, mutual understanding, cooperation, use of various tools and technical mechanisms, use of computer system and, which is of a great importance, evaluating the results. There are two various approaches towards art therapy used in daily hospitals for the adults with mental illnesses. One of these approaches is based on the idea that the process of creating a product of art is therapeutic in itself, helping the patient clearly see his inner conflicts and emotions without of any interpretations made by the therapist. Another approach accepts the idea that the act of creation is an alternative to verbal method of communication, allowing the specialist to see and define the needs of the client with the help of interpretation. There are group and individual art therapy sessions. The first consultation is designed to define a general condition of the health, details of lifestyle and necessary medical treatment before the sessions start. It is not necessary that the patient has a special experience in artwork, because the purpose of the therapy is to provide communication with inner feelings and emotions for further patient's interpretation According to the results of art therapy practice, it produces desirable effect on the patients. As the specialists say, "it helps people express hidden emotions, reduces stress, fear and anxiety, and provides a sense of freedom". (Schaverien, 1999, p. 132) It is also believed that creative process influences the brain cells and makes necessary chemicals release by the cells of the brain. Before the session starts a patient is given special tools for producing an artwork - drawing, painting, sculpture or something other. The art therapist helps the patients in expressing themselves and discusses feeling and concerns of the patients in relations to their artwork. There is another kind of art therapy, when the patient looks at the artworks, for instance, pictures and then described the specialist what he sees. A member of the patient's family may collect various pieces of art, for instance, photographs o Some of the potential uses of art therapy to be researched include reducing anxiety levels, improving recovery times, decreasing hospital stays, improving communication and social function, and pain control, or pictures, providing the patient with the possibility to enjoy art. Art therapy gives access to nonverbal type of memory. The patient makes a graphic description of his problem in a manner that embraces the fragmented picture and results in closure of his experience. The process of drawing makes a fixed image broader, its highlights the moral background of the patient and the alterations that are caused by the disease. Drawing also fills the breaks in conscious memory of the patient. Drawing is often used in amnesia treatment, because "the graphic narrative is "out there," relatively detached from the artist, making it easier to manage emotional distance and hold an objective viewpoint". (Raymer, p.67) One of the results of this kind of art therapy is that the event, concerning the patient, becomes a part of his historical experience, rather than unfinished event. Art therapy has some fundamental positions. One of these positions is called Expression. In the foreground it is a creative process as such. Patients' ability of self-expression (for example in painting) is encouraged by art therapists. In psychoanalytical art therapy a process of Perception is on the first place. Perception and comprehension appears in many psychoanalytical studies. I would like to illustrate the process on the example of the picture. In this picture the painter is sitting leaning against the tree. A mother is standing on her knees with outstretched arms looking in another direction: 1. The I in a psychodynamics' context First of all it is necessary to search for the I in the place that the artist shows and says: " It is me." The position of the painter's I in this picture is regressive (looking to the left in the picture) and helpless (leaning / outstretched arms). 2. The mechanism of protection / Concentration The painter is concentrated on the mother. "My mother is kneeling in a cave, having bent forward, and asks for attention. If I will die, you will be guilty! At last she has committed suicide." Sitting at a root of a tree, as if pasted to it, the painter "looks at fault" left after mother's death. Observing complex of guilt and therefore destroying her spiritual energy, the painter opens the way to progress for herself. 3. Transfer/ Projection Each picture, drawn spontaneously, contains elements of relations. There is dynamics changes of relations not only between the people drawn in the picture, but also between automobiles, roads, rivers, animals, colours and subjects. Psychoanalytically oriented art therapists investigate this dynamics of relations either in the actual and projective meaning. 4. Mutual Transfer The therapists who went through approximately the same concerning their mothers, may be inclined to mixing their own negative feelings and feelings of the painter in order to estimate the mother's attitude as pressure and, hence, to complicate the patient's conflict with mother. 5. Resistance. The offer of the doctor to continue a picture on the sheet of a paper put on the right i.e. to represent a distance between the patient and her mother or a new situation of the relation, put the patient into indecision. Resistance is seriously perceived and processed by the art therapists. It means refusal of concentration on a complex of guilt, in this case, separation from mother. At last the painter managed to draw a road as continuation of a picture, which leads her, her brother and sister in the own life. The new context of this picture transforms old guilt into " a black callous " which nobody is concentrated on now. 6. Sources The tree and the sun above it now light up the road, which three brothers and sisters are walking on. A tree is a symbol of the mother. The sun symbolizes the father. The symbols represent a counterbalance to the lack of the real parents. As we could see, psychoanalytical art therapy demands both from the therapist and the patient the disclosing of all notional channels and channels of perception. Bodies, souls, language (of pictures), mind and spirit share the fruits of perception: the clearness and the truth. Works Cited Irwin, H.J. (1991). The depiction of loss: Use of clients drawings in bereavement counseling. Death Studies, 15, 481-497. Simon, R. (1981). Bereavement Art. American Journal of Art Therapy, 20, 135-143 Peckman, M (1965). Man's Rage for Chaos: Biology, Behavior and the Arts. Philadelphia, PA: Chilton. Hatcher, E. (1985). Art as Culture. Landham, MD: University Press of America. Dissanayake, E. (1988). What is art for Seattle, WA: University of Washington Press. Raymer, M. & McIntyre, B.B. (1987). An art support group for bereaved children and adolescents. Art Therapy, 4, 27-35. Codispoti C., Douglas M. R., McCallister T., Zuniga A. The use of a multidisciplinary team care approach to improve glycemic control and quality of life by the prevention of complications among diabetic patients. Available at http://www.ncbi.nlm.nih.gov/entrez/query.fcgicmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15212108 The Care Programme Approach. Available at http://www.markwalton.net/Userguidea/walkthru/cpa.asp Schaverien, L. & Cosgrove, M. (2000). A biological basis for generative learning in technology-and-science: Part II - Implications for technology-and-science education. International Journal of Science Education 22(1): 13-35. Schaverien, L. & Cosgrove, M. (1999). A biological basis for generative learning in technology-and-science: Part I - A theory of learning. International Journal of Science Education 21(12): 1223-1235. Case, C., Dalley, T. (Eds). (1990). Working with children in art therapy. London: Routledge Kramer TL, Daniels AS, Zieman GL, et al. (2000) Psychiatric practice variations in the diagnosis and treatment of major depression. Psychiatric Services 51:336-340. Read More