Children in Foster Care: The Benefits of Positive Art Therapy

Children in Foster Care: The Benefits of Positive Art Therapy

By Taisha Teal Wayrynen, B.A. Simon Fraser University

D.V.A.T.I. Vancouver Art Therapy Institute May 2020

All rights reserved. ©Taisha Teal Wayrynen. This work may not be reproduced in whole or in part without permission of the author.

Dedication & Acknowledgments

I would like to acknowledge my VATI sisters and teachers for their constant support. Thank you to my supervisors, Tatjana Jansen, Laura Worral and Kali Dukowski for guiding me through this art therapy journey. I would also like to thank my family and friends for their continuous encouragement and support!

With much love and gratitude, I would like to dedicate this paper to Allexanne, my sister, cousin, and best friend, who passed away during this program but has given me the strength to complete my studies and to live my best life. You will be deeply missed.

“It is only in being creative that the individual discovers the self” - D.W. Winnicott

Abstract

The aim of this paper is to discuss the importance of children and their primary caregivers, and how art therapy can increase emotional and physical self-expression. This paper reviews extensive literature highlighting the history of art therapy, the attachment theory and foster care. It also includes two case examples from my experience as an art therapy student.

Key Words: art therapy, children in care, attachment, foster care, secure attachment, insecure attachment.

Chapter 1

Introduction

Children in foster care are faced with many ups and downs throughout childhood. This paper will focus on the attachment theory and how art therapy can be beneficial for children in voluntary care. It will look at previous research analyzing art therapy, foster children, and how art therapy can help develop positive growth. It will also include two case studies from practicum work at elementary schools.

Background of the Study

Working as an Art Therapy student in an elementary school has its highs and lows; everyday is a learning experience with unpredictable situations arising. It can be difficult to hear stories from children about their family life, which bring the concepts of attachment theory and parent-child relationship issues to the forefront. As I am learning with this experience, I have found that every action and decision a parent makes can impact a child’s thoughts and behaviours. Therefore, it is important for a parent to set boundaries while at the same time providing room for the child to grow with love, support, and affection. Attachment theory explains how a strong emotional and physical connection with at least one primary caregiver is essential to healthy personal development throughout a person’s life.

While working with these elementary school children, I became curious as to how they will develop as they grow. Below are some of the questions that I have focused on in order to improve my understanding of art therapy, children in care, and attachment theory, and upon which I hope to shed light on in this paper. The research questions I have chosen to explore is as follows: How do children grow and learn without a primary caregiver? What are the physical and emotional needs that must be addressed? What do children experience while in care?

Historically, how has art therapy been employed with children who are in care? How can art therapy be helpful for someone struggling to express themselves? These questions will be the focus of the paper.

Significance of the Study

Children requiring voluntary care is a worldwide issue and it is important to know how art therapy can help children cope with their challenges. In my practicum work, some of the children are in care and I have noticed that art therapy is a helpful tool when parents are not fully present. There are many reasons why a child can be put into care and it can be a difficult time for both parents and children. Not many individuals have heard of art therapy before I worked with them and it would be valuable for children to have as another form of therapy as they are such a vulnerable population. Throughout the difficult process of therapy, the therapist must support the child fully to uphold their self-esteem and increase their happiness. The purpose of this paper is to discover the needs of children in care and to help them manage themselves when they do not have the support of their primary caregiver.

Chapter 2 – Literature Review

Introduction

This literature review will investigate the history of art therapy, the history of foster care, and attachment theory. I review the findings of influential leaders such as, Margaret Naumburg, Mary Ainsworth, John Bowlby, Adrian Hill and Edith Kramer, and a few others. It will also give an overview of definitions, positive psychology, and experiences from children in care, and how art therapy has been used in care.

History of Art Therapy

Even though art therapy is a relatively new field of practice, art has been used as a form of expression since the beginning of human history (The History of Art Therapy). Art is a natural way to communicate, a non-verbal language (Rubin, 2005). The oldest cave painting, which was found in the El Castillo cave in Spain, dates back 40,000 years (The History of Art Therapy). Before there were alphabets, humans were communicating through pictures, pictograms and hieroglyphics (Rubin, 2005). These forms of expression are part of our biological heritage, as were making the sounds that eventually became language (Rubin, 2005).

During the 1940s, Adrian Hill became the first to describe the therapeutic application of image-making as “art therapy” in the UK (Edwards, 2004). Hill discovered the benefits of drawing and painting while he was ill, learning the value of art therapy and releasing the creative energy of patients who normally do not self-express (Edwards, 2004). Around the same time, psychologist Margaret Naumburg was one of the first pioneers in the United States to describe her work as art therapy (Cane et al., 1983; Edwards, 2004). Naumburg’s model of art therapy suggests that an individual can “release the unconscious by means of spontaneous art expression”, (Edwards, 2004, p. 1) with the inclusion of free association. The treatment depends on the transference relationship along with a continuous effort by the patient to interpret the symbolic designs they have created, thereby facilitating a form of communication between patient and therapist which then forms symbolic speech (Cane et al., 1983; Edwards, 2004). Naumburg “suggested that the process of art therapy was based on the belief that an individual's most essential thoughts and feelings were derived from the unconscious and that unconscious content achieved its more complete expression in images rather than words” (Lusebrink, Martinsone & Dzilna-Silova, 2013, p. 78).

While Hill and Naumburg both used art in their practices, their approaches were different, with Naumburg describing art in therapy and Hill advocating for art as therapy (Cane et al., 1983; Edwards, 2004). Art therapy has developed two very similar, but also very distinct, “parallel strands: art as therapy and art psychotherapy” (Edwards, 2004, p.1). Art as therapy highlights the healing potential of art, and the other emphasizes the importance of the therapeutic relationship established between the art therapist, client, and their artwork (Edwards, 2004). Some individuals may question where the therapeutic change happens in art therapy: whether it is due solely to the creative process, or the nature of the relationship, or both (Edwards,
2004). Another artist and art educator was Edith Kramer, and she also used art as therapy, by highlighting the importance of sublimation and creativity (Lusebrink et al., 2013). Kramer believed there were many ways the art media could impact a person by the use of form to contain an emotion and the use of symbols, which can have multiple meanings and can be studied with or without words (Lusebrink et al., 2013).

Another art therapy pioneer was the artist Florence Cane, whose approach “was based on the belief that humans perceive the world and process information from it through three main functions.” (Lusebrink et al., 2013, p. 78). Cane believed that the main goal in life is to become whole and balanced by integrating all the main functions, which are movement, emotion, and thought. (Lusebrink et al., 2013). Elinor Ulman was similar to Kramer in that they both believed that the creative factor and sublimation were of highest importance. Ulman also suggested that the key to art therapy was not translating “symbolic expression into spoken words” (p.79), and that it was sublimation through creativity was most important (Lusebrink et al., 2013). As an artist, she also comprehended how powerful a creative experience could be when aiding an individual in understanding their own world and to “bring order out of chaos and to align one’s inner state and the outer representation to it” (Lusebrink et al., 2013, p. 79). This means helping the individual understand their emotions and feelings through creating visual representations such as art pieces, which in turn helps them become more aware of their concerns.

There are a few definitions of art therapy which follow from the perspective that it is “a form of therapy in which creating images and objects play a central role in the psychotherapeutic relationship established between art therapist and client” (Edwards, 2004, p. 2).
The definition of art therapy from the Canadian art Therapy Association’s (2017) website is as follows:

Art therapy combines the creative process and psychotherapy, facilitating self- exploration and understanding. Using imagery, colour and shape as part of this creative therapeutic process, thoughts and feelings can be expressed that would otherwise be difficult to articulate. (para. 1)

The American Art Therapy Association (2017) has a similar definition of art therapy:
Art Therapy is an integrative mental health and human services profession that enriches the lives of individuals, families, and communities through active art-making, creative process, applied psychological theory, and human experience within a psychotherapeutic relationship (para. 1)
It is important to note that art therapy does not involve other art forms such as dance, music or drama; it specifically focuses on visual arts that include painting, drawing, and sculpting (Edwards, 2004).

The focus of art therapy in the context of the Expressive Therapies Continuum (ETC) is to highlight and improve the patient’s strengths on multiple levels, while also attending to problems, which are shown through different visual expressions which could be associated to their struggles in psychological functioning or issues in other areas of life (Lusebrink et al., 2013). The ETC consists of three levels; kinaesthetic/sensory, perceptual/affective, and cognitive/symbolic, which are all interconnected by the creative level, and which all reflect different areas of the brain in processing visual information (Lusebrink et al., 2013). The concept of ETC was coined by art therapists Sandra Kagin and Vija Lusebrink based on the visual elements of expression (Lusebrink et al., 2013). The ETC “provides an opportunity to approach artistic expression on a systematic basis and it incorporates psychological and neuroscience approaches to imagery and visual information processing” (Lusebrink et al., 2013, p. 76). Understanding the artwork can be improved by highlighting the patient’s awareness and inner experience through ideas, observations, feelings, and impulses (Lusebrink et al., 2013).

Art therapy involves both the process and products of image-making, whether it be scribbling or more sophisticated forms of symbolic expression, as well as the establishment of a therapeutic relationship (Byng-Hall, 1995; Edwards, 2004). When the therapist creates a supportive environment through the therapist-client relationship, there arises a possibility for individuals to create images with a clear intent of exploring and sharing the meaning these may have for them (Byng-Hall, 1995; Edwards, 2004). Through these means, the client may understand why they are distressed or thinking certain thoughts. This can then lead to a positive change in the client’s sense of self, current relationships, and overall quality of life (Byng-Hall, 1995; Edwards, 2004). Creativity can aid in “finding symbolic solutions for the internal tensions and dissociations that all humans suffer from in a varying degree” (Edwards, 2004, p. 4). The aims of art therapy will vary according to the particular needs of the individual who is in therapy, and these needs can change as the therapeutic relationship develops (Edwards, 2004).

Even though art therapy has grown from its informal beginnings into a valued practice, there is still a misunderstanding concerning its aims and methods, such as it being viewed as a skill or technique rather than a distinct therapeutic modality (Edwards, 2004). This notion can be from professionals who have used art or image making in hospitals or therapeutic settings (Edwards, 2004).

Humans can communicate in many ways, but in modern societies, words are the dominant form of communication (Edwards, 2004). When we exchange information, words are the main medium that individuals have for expressing themselves and giving meaning to life’s experiences (Edwards, 2004). It is hard for human experience to be expressed only with words, anxiety, depression, love, hate or trauma may be beyond the ability of words to express (Edwards, 2004). This can be relevant where difficulties begin in infancy, when we experience the world without any capacity to explain it in words (Edwards, 2004). This is when art therapy comes in: to help overcome the “frustration, terror and isolation such experiences may stimulate, by providing an alternative medium for expression and communication where feelings may be conveyed and understood” (Edwards, 2004, p. 8). When much of our thinking is visual, a picture is worth a thousand words; like a chart or graph, it may help us to see trends and connections more clearly than words alone (Rubin, 2005). There are many things people can say in art that they are unable to put into words, such as images from dreams, thoughts, and feelings (Rubin, 2005). Sometimes when things get too overwhelming, it can feel safer to draw or paint and then reflect by looking at the art piece (Rubin, 2005). The artistic process can bring up material we were not aware of, such as preverbal memories, which are “events that occurred before the patient had language, and that are encoded in the body as well as in images” (Rubin, 2005, p. 23). If there is pre-existing trauma or forbidden memories, Linda Gantt (as cited in Rubin, 2005) suggested to “just let your hand remember” (p. 25), which means to let your hand paint or draw freely. The art therapist hopes that individuals can feel safe to express themselves through art, even their dark sides, as art provides an aesthetic and psychic distance through symbols which allow people “to say things long before they are ready to own them” (Rubin, 2005, p. 25). Art therapy can be helpful under many circumstances and for a wide range of needs (Edwards, 2004). When thinking and feeling through images, this involves the imaginable realm and potential risk taking on the part of the clients if it occurs in the context of a strong working alliance, art therapy can positively further a person’s self-esteem, emotional growth, psychological and social integration (Edwards, 2004).

Making art can also relieve tension; even touching the art medium or just doodling itself can be therapeutic and relaxing (Rubin, 2005). Ernest Kris (as cited in Rubin, 2005) explains “the ideas hidden in doodles are often ideas of which the ego wants to liberate itself” (p.22). Playing with plasticine can help reduce tension and anxiety in a patient of any age (Rubin, 2005). The more comfortable the person is, the more freely they will express themselves, so for patients who are usually shy, it is easier to communicate in words while creating art (Rubin, 2005). Creations made while playing with various art materials, such as markers or clay, with no pressure of what the final product will look like, can often reveal ideas and feelings of which the person may be unaware (Rubin, 2005). Visual thinking makes up a substantial part of our mental life (Rubin, 2005). Creating art can offer clients a means of externalizing ideas and thoughts so that they can then be viewed, potentially stimulating new thoughts and feelings (Rubin, 2005). Pat Allen suggests that “the act of making a work of art is another kind of thinking, so the act of looking at the product is another way of knowing” (Rubin, 2005, p. 23) meaning that creating the piece of art is another way to view what is happening within oneself. Knowing what our beliefs are requires confronting our fears and our resistance to change. However, sometimes we allow fear to stop the imagination before it really begins to work (Allen, 1995). Knowing the imagination is vital because the relationship with our imagination is a relationship with our deeper selves and it is the deepest voice of the soul (Allen, 1995). Art values freedom, no matter how dark the representations and symbols, and the freedom to have control of one’s own creativity to express what one feels (Rubin, 2005).

Positive Psychology

In the article Positive Psychology: Linking Positive Psychology to Art Therapy Theory, Practice and Research, (2013), authors Wilkinson and Chilton discuss the “relationship of positive psychology to art therapy and its capacity to mobilize client strengths, to induce experiences of flow and positive emotions, and to express life purpose and meaning as well as positive emotions'' (p. 4). Historically, positive psychology comes from many sources, such as religion and philosophy, but it is most related to humanistic psychology, which holds the belief that all humans are born to do good and driven to reach their full potential (Wilkinson & Chilton, 2013). Positive psychology is the “study of positive emotions, positive character, and the positive institutions and communities that promote their development” (Wilkinson & Chilton, 2013, p. 4). In another article, The Art of Positive Emotions: Expressing positive emotions within the intersubjective art making process (2015), authors Chilton, Gerber, Bechtel, Council, Creyer, and Yingling, explain that individuals expressing their emotions while creating art is the key concept to art therapy, but that this very understudied. Positive emotions are described as desirable adaptive experiences that “promote the discovery of novel and creative actions, ideas and social bonds, which in turn build that individual’s personal resources; ranging from physical and intellectual resources, to social and psychological resources” (Chilton et al., 2015, p. 13).

Research has shown that positive emotions can help individuals see complicated systems more clearly since they improve psychological and social wellbeing as well as building resiliency (Chilton et al., 2015). Since happiness is hard to measure, researchers have investigated human flourishing and well-being, which can be described as a mental “state where individuals function with high levels of psychological, emotional and social well-being” (Wilkinson & Chilton, 2013, p. 5). Well-being is connected to a person’s purpose in life, and finding that purpose is a human need that also creates stability and consistency (Wilkinson & Chilton, 2013). To find that purpose or meaning in life, individuals must make connections from life’s events and by being deeply involved in activities and by feeling the belongingness that springs from their serving something larger than themselves (Wilkinson & Chilton, 2013). Positive psychologists (and other researchers) have suggested that when art is created with a positive intention, there are “beneficial impacts on mood and repair of the after-effects of negative emotions (Wilkinson & Chilton, 2013, p. 7).

Attachment Theory

Attachment theory is a psychological and evolutionary theory that provides an expressive and descriptive framework for understanding interpersonal relationships between human beings (Bowlby, 1988; Byng-Hall, 1995; Synder, Shapiro & Treleaven, 2012). Attachment is defined as the relationship one has with a primary caregiver and, depending on the quality of the relationship, this template can affect future relationships (Ranson & Urichuk, 2008). The quality of parent-child attachments affects the child in many different ways and across many different domains (Byng-Hall, 1995; Snyder, et al., 2012; Szewczyk-Sokolowski, et al., 2005). Adolescents who are able to develop a secure attachment will have more positive outcomes involving social-emotional competence, cognitive functioning, and mental and physical health (Byng-Hall, 1995; Snyder, et al., 2012; Szewczyk-Sokolowski, et al., 2005). However, those who are not able to develop secure attachments will, unfortunately, have fewer desirable outcomes (Byng-Hall, 1995; Snyder, et al., 2012; Szewczyk-Sokolowski, et al., 2005).

There have been some researchers and academics that have challenged Attachment Theory - specifically, regarding the belief that our early experiences with caretakers have a major impact on adult functioning. In the article The Verdict is in (2011) by Sroufe and Siegel, the authors discuss some of the ideas that go against attachment theory. In 1968, some psychologists, such as Walter Mischel, argued that instead of having a core personality that coordinates our behaviour, a better predictor of what we think and do may be situational factors (Sroufe & Siegel, 2011). Another psychologist named Judith Rich challenged the concept by arguing that the only thing passed down to children from their parents are their genes, not their care (Sroufe & Siegel, 2011). Lastly, Jerome Kagan highlighted that inborn temperament shapes the human experience more than the effects of early attachment experience (Sroufe & Siegel, 2011).

While some psychologists had alternative views on attachment, there have been many studies in the last 50 years supporting the idea that the most important influence on human development is the emotional quality of our earliest attachment experiences (Sroufe & Siegel, 2011). John Bowlby, who was a British Psychiatrist and Psychoanalyst, challenged the Freudian view of development, which focused on the inner world of the child without analyzing the relationship environment and how it forms the early phases of human consciousness (Sroufe & Siegel, 2011). Bowlby studied how animals rear their young, and his observations show that when young primates such as chimpanzees and gorillas are frightened, they run to a protective adult who carries them to safety (Sroufe & Siegel, 2011). From this survival pattern, he focused on its developmental significance and concluded that humans are connected to their primate relatives in that they form attachments, because otherwise, they wouldn't survive on their own

(Sroufe & Siegel, 2011). Bowlby made another essential distinction by explaining that infants are not attached to their caregivers because they feed them, it is because caregivers spark the infant's innate temperament in wanting to be close to a protective other (Sroufe & Siegel, 2011; Snyder et al., 2012). Bowlby’s theory had two main points; the quality of the interactions between infants and their caretaker infants and whether or not the attachment becomes secure. These attachment relationships become the basis for future personality growth (Sroufe & Siegel, 2011). Since secure attachments are not an innate trait but a quality of the relationship, this can be difficult to measure (Sroufe & Siegel, 2011).

Mary Ainsworth, who was a colleague of Bowlby’s, was another developmental psychologist who developed the laboratory procedure called the Strange Situation, in which this attachment relationship could be measured (Sroufe & Siegel, 2011). The Strange Situation is an assessment of the child-parent relationship based on the child’s response after a baby’s response to the reunion after a brief separation (Sroufe & Siegel, 2011). In this procedure, the quality of the mother-child relationship is assessed by simple observation. The Strange Situation triggers separation anxiety in the child, which is thought to activate the innate attachment system (Sroufe & Siegel, 2011). In conclusion, the clinical relevance of attachment theory is important because when “parents are sensitive to a child - when they pay attention to and tune in to the signals sent by the child, they make sense of these signals and get a glimpse of the child's inner experience, and then respond in a timely and effective manner - children are likelier to thrive” (Sroufe & Siegel, 2011, p. 9).

Parent-Child Attachments

Attachment theory explains how a strong emotional and physical connection with at least one primary caregiver is essential to healthy personal development throughout a person’s life (Ainsworth, 1979). Establishing and maintaining healthy peer relationships is also a very important element of psychological adjustment (Byng-Hall, 1995; Szewczyk-Sokolowski, et al., 2005). There are four main types of attachment styles: secure, insecure, anxious/ambivalent, and disorganized (Snyder, Shapiro & Trevleaven, 2012). As secure children are more socially competent among their peers, they have more pro-social groups and larger social networks (Snyder, et al., 2012; Szewczyk-Sokolowski, et al., 2005). However, caregivers who fail to maintain positive peer relationships can cause a child to develop delinquent tendencies, which can give rise to an increased social anxiety, which often leads to diminished performance in school (Snyder, et al., 2012; Szewczyk-Sokolowski, et al., 2005). This can have severe implications, as the relationship is a template to the child’s social life and provides the child with a guide as to what to expect and how to behave (Snyder, et al., 2012; Szewczyk-Sokolowski, et el., 2005). Insecure attachments are fostered when a child’s basic needs are not met, and they can be connected to a lack of expressed love and affection along with other negative influences (Ainsworth 1979, Snyder, et al., 2012). Not having an attachment, or having a negative one, can result in unhappy relationships or not having the ability to create relationships, which in turn may lead to isolation, negative behaviour and/or self-harm (Ainsworth 1979; Byng-Hall 1995).

Personal development can also be affected by parenting styles, determining the parent- child relationship (Ainsworth 1979; Byng-Hall 1995). Mother-child relationships are seen as the root of both intrapersonal and interpersonal functions in later childhood and adulthood (Ainsworth 1979). Having a secure attachment with a primary caregiver can result in positive life experiences, with relationships, skills, self-worth, self-love, and overall mental and physical health (Ainsworth 1979; Byng-Hall 1995).

History of Foster Care

Foster care is a system in which a child has been placed in a group home, foster family, family, or becomes a ward of the state, usually upon the recommendation of a social service agency. In the article Center on the Developing Child (2013), the authors suggest that positive early health experiences can create a strong foundation for brain structure, the ability to develop many skills, and learning aptitudes. There are three foundations for healthy development, which include, stable and responsive relationships, safe and supportive environments, and appropriate nutrition (Center on the Developing Child, 2013). These foundations spark either physiological adaptations or disruptions, which will then impact lifelong outcomes in health and behaviour (Center on the Developing Child, 2013). Studies show that children can be put into foster care for many reasons, such as being in a “crisis situation, endangered children, families unable to carry out parental responsibilities due to substance dependency, poverty, death or abandonment” (McDavid 2015, p. 1329). However, being separated from family members/caregivers and being put into the system can traumatize the child and have a negative effect on mental and physical health. (McDavid 2015; Lee & Morgan 2017). When a child enters the foster care system, it is important that the health care they are eligible to receive happen at one facility, as the facility itself may be the only constant in a child’s life (McDavid 2015). Most children enter the foster care system in the first year of life, which is the crucial time, that children bond and form attachments to their caregivers (McDavid 2015). Children in foster care have more mental health issues compared to children in the general population, especially as regards attachment disorders, because many children have more than one foster placement (McDavid 2015; Lee & Morgan,

2017). Unfortunately, many foster children experience “adverse events that increase risk for problematic emancipation, including neglect, abuse, trauma, disrupted attachments, unstable housing, multiple placements, fragmented schooling, disrupted social networks, poverty, and gestational exposures” (Lee & Morgan, 2017, p. 284). Research has shown that even if you remove a child from a negative setting and place them into a more nurturing setting, it will not ensure a healthy outcome, as some psychological burdens carry past childhood and into adulthood (McDavid, 2015; Lee & Morgan, 2017). These negative events “increase the risk that foster care alumni will experience negative functional outcomes, including lower educational attainment, unemployment, poverty, homelessness, food insecurity, mental health issues, substance abuse challenges, health problems, early pregnancy and parenthood, and involvement with the justice system” (Lee & Morgan, 2017, p. 284).

Foster care – Distress & Resilience

Children who are in care have many physical and emotional needs that need to be met during childhood. The authors Sherr, Roberts and Croome from the article Emotional Distress, Resilience and Adaptability (2017) help to explain how abandonment at birth affects children. Children who were brought up without primary caregivers present can suffer many detrimental internal and external after-effects in adulthood (Lee & Morgan, 2017; McDavid, 2015; Sherr et al., 2017). Interpersonal issues involving relationships and handling emotions are negatively affected once a child is abandoned (Sherr et al., 2017). There is a lack of motivation to seek out and sustain friendships, difficulties in opening up with trust and a fear of forming relationships (Sherr et al., 2017).

The majority of participants in this study verbalized long-term extensive internal grief and also expressed a need for reassurance, acceptance, and nonthreatening relationships (Sherr et al., 2017). Negative reactions such as anger and resentment were directed at the mother figure, the public care system, and sometimes at themselves (Sherr et al., 2017). Adjustments such as acceptance of their abandonment were very difficult for them to comprehend (Sherr et al., 2017). Some individuals would try to find their mother, and even if the search was futile, it occasionally afforded some sense of closure (Sherr et al., 2017). A mixture of coping strategies was expressed in forms of self-support and self-expression (Sherr et al., 2017). Denying and forgetting were some ways of adjusting to the truth (Sherr et al., 2017). One participant’s reaction was articulated as follows: “abandonment is like bereavement: you get through it, but you don’t get over it. It is like a dull ache for which there are no treatments” (Sherr et al., 2017, p. 204). This helps to explain the feeling of loss that you cannot ever come to terms with. The sense of identity was very confusing to most individuals since they did not know where they had come from, nor did they have an awareness of any medical illnesses in their family history, or any sort of identity from their parents (Sherr et al., 2017). Medical encounters and meetings with formal authorities that needed documentation were challenging because records expire after seven years, so often, there was no access to information (Sherr et al., 2017).

The concepts of shame, guilt and secrecy were very obvious, as individuals did not feel a sense of self-worth, nor did they want to tell others of their abandonment (Sherr et al., 2017). Mental health experiences frequently presented as ongoing depression, stress, and self-harm attempts for which formal help from doctors and psychiatrists were sought. This quote helps to explain overall life adjustment: “I think abandonment is rather like an illness. It’s rather like an ache but you can’t take a pill for it” (Sherr et al., 2017, p. 198) and its difficulties include feelings of helplessness as one faces life’s ongoing struggles. Those who were adopted were able to develop some sort of resilience, but there was always a struggle with interpersonal issues.

Art Therapy and Children in Care

In a three-year study focusing on primary school-based children, 45 children between the ages of 4 and 11 participated in art therapy sessions for data collection (McDonald, Holttum, & Drey, 2019). This research study was targeted at teachers and children to see if they had any changes in social, emotional, and mental health (McDonald et al., 2019). The teachers’ primary reasons for referring children for therapy were disruptive behaviour, witnessing domestic violence or murder, unhappiness, low self-esteem, suicidal thoughts, anxiety, and having family members with life-threatening illness (McDonald et al., 2019).

Evidence showed that failure to address or prevent mental health issues had negative effects on an individual's wellbeing, and also negatively impacted their role in society (Lee & Morgan, 2017; McDavid, 2015; McDonald, et al., 2019). For the child to feel safe, supported, and motivated, the art therapists ensured that the environment was nonthreatening and the quality of the art materials were soothing and nurturing (McDonald et al., 2019). The physical activity of creating art can help children process emotional and sensory data that would otherwise be difficult for them to understand (McDonald et al., 2019). Inviting self-reflection using art is a nonthreatening way to maintain engagement in exploring emotions. The art therapists asked the teachers of the students to do a questionnaire on the students’ strengths and difficulties both before and after the art therapy session, as well as to attend a focus group to learn about their observations of the children (McDonald et al., 2019). The art therapists also interviewed the children to see what changes they experienced by coming to art therapy (McDonald et al., 2019). The results of this study showed positive changes in children’s overall stress, conduct, hyperactivity, and prosocial behaviour (McDonald et al., 2019). The areas that the children found particularly helpful were making and thinking about art, expressing their thoughts and feelings through art, and sessions being fun (McDonald et al., 2019).

Chapter 3

Methodology & Ethical Considerations Methodological Approach

Data collection was based on methods gleaned from an extensive literature review, in addition to personal experiences from my practicum as a student art therapist. Together, these helped me develop a basis of knowledge for the topic. However, as I did not have access to a large sample of children in care, I utilized a great deal of material from published articles, reports, interviews, and journals to inform my work. I also researched other agencies that work with children in care. In addition, I reviewed data pertaining to the effectiveness of art therapy in helping children manage difficult emotions associated with being in care.

Ethical Considerations

Ethical considerations of paramount importance in providing care, and so many things must be taken into consideration. Some ethical considerations from working in a school or hospital setting are as follows: an adequate therapeutic space with running water, knowledge of toxicity of art materials, clients privacy, and confidentiality of the artwork (Green, 2012). It is important for art therapists to be open about potential ethical dilemmas, such as discussing the rights of the artwork, potential exhibition of artwork, and how it will be visually recorded (Green, 2012). Additional considerations, which may arise, can be discussed with the client during the initial sessions.

Chapter 4

Case Studies

From the analyses of the practicums I did as a part of my studies at The Vancouver Art Therapy Institute, I have developed two case studies for consideration of my findings.

Case Study #1

Type of Case: 8-year-old female child Client’s Name: Annabelle (pseudonym)
Clinical Placement Location: Elementary School

History and Reasons for referral: This student physically assaulted the principal and has had multiple outbursts in school, which usually involved swearing at her teachers. She was transferred to another school in the morning for behaviour correction and came back to regular classes in the afternoon. Parents were in the middle of a divorce. The student had attendance issues, and when in school, she had a hard time focusing in class.

Treatment Goals: To provide one-on-one attention and support while working on coping skills and managing outbursts of anger.

Summary:

As an Art Therapy student, I have worked one-on-one with eight children between grades three and seven. I have found that supervising this cohort requires a great deal of energy. It is apparent that some of my clients did not get the attention they wanted or needed at home as was evidenced by their constantly seeking confirmation that I was watching them.

Insecure attachments can be created due to a lack of love and affection along with other negative influences. One of the children I worked with showed signs of an insecure attachment. Annabelle – a pseudonym – was in third grade, and her parents were in the middle of a divorce, during which she often observed them fighting. She expressed anger towards authoritative figures, and was recently diagnosed with Oppositional Defiant Disorder (ODD). I believe her personality falls under Type C – insecure ambivalent/resistant. From what she told me, her father seems to have an authoritarian parenting style - very strict with rules and lacking in affection. Her mother is the opposite, showing a permissive parenting pattern, allowing Annabelle to have free range. Her mother’s parenting style caused issues at school, potentially because of the lack of discipline. Her parents’ behaviour towards each other also had a negative impact on her development. She has used swear words and physical abuse, and in the past she hit the principal. The lack of stability seems to have taken a toll.

Before my first session with Annabelle, I had been warned about her ODD and difficult behaviour. To my surprise, our first session was wonderful. She was engaging and laughed with me, and she painted a rainbow. Our second session was more challenging. Annabelle appeared agitated; She was withdrawn and unwilling to participate in any activity. When I met her before our session, she spotted her male counsellor (who may be a trigger for her) in the distance, and said: “I’m not coming; I don’t want to go and I’m staying here.” I spoke with her quietly outside, and asked if she enjoyed our last session. She confirmed she did, but that she did not feel like it on that day. I said that it was okay to miss the session and that I would see her in the next week. I was mindful that we were in the beginning stage of building a therapeutic rapport and wanted to create a safe space.

Our third session could be described as hectic. She would only participate if she could bring a friend. She brought another client of mine for whom I already had consent to work with, so I allowed it. Both students have ODD and the other child has ADHD, so it was difficult to stick with one project during the whole session. In observing the way Annabelle spoke to her friend, I was able to discern more signs of an insecure attachment. She wanted complete control by demanding that we do things her way. When her friend didn’t comply, she was mad and threatened to leave the room. When he apologized, she was resistant and stubborn. I realized that she needed one-on-one attention, and that having a friend in the room did not benefit her. I therefore ensured that future sessions would remain one-on-one.

Subject to a tremendous amount of emotional pain but without the words to express how she feels, Annabelle often has outbursts of anger. However, the therapeutic process with art can break the cycle of violence and aggression. It can strengthen a sense of self, provide a path to express negative emotions, tap into empathic responses and create new meanings (Gussak, 2016). It will be important for Annabelle to learn to let go of her anger, which is likely a result of her parents who have not met their child’s needs with regards to love and affection (Gussak, 2016).

Annabelle was in love with slime, which we played with frequently. I believe the hand movements she made with slime helped her to express and release her anger. Creating art has several roles in the development of the emerging ego of the child. It activates different pathways in the brain, allowing a child to experience the neurological benefits of processing life and events in multiple ways, thereby helping them to produce core social and emotional skills. This is also fundamental to the ego and self-esteem of the child (Essame, 2010). If I were able to work with her again, and when she opens up more, I would like to guide Annabelle through techniques for coping and/or meditation. I want to help her notice her anger before an explosion.

Enhanced Case Study #2: Foster Care

Type of Case: 10 year old female child

Client’s Name: Madison (pseudonym)

Clinical Placement Location: Elementary School

History and reasons for referral: Madison, a child who is in foster care and needs one-on-one attention and support, is bullied at school. She lives in a foster care home with a family that includes 5 siblings. She has never met her father, and her mother had her at 18 years old and put Madison up for adoption at age 3. While she is bullied at school, she also has many friends. Her favorite subject in school is art class and participation in other classes is minimal depending on her mood.

Treatment Goals: Creating a therapeutic alliance to allow Madison to express the challenges she faces being without biological parents. Providing support, one-on-one attention, and stress- free time during school.

Use of Art Therapy: Since we have started Art Therapy together, Madison has asked me personal questions to get to know whom I am. As she is in foster care, she has many social workers and is comfortable being with adults. Art Therapy has been really beneficial for Madison, as she doesn’t get much attention at home. She enjoys all kinds of art and exploration as well as the special attention given. She is able to express herself through her art and understand the emotions that arise. She is able to confide in me and share her true feelings.

Themes & Core Issues in the Art: Most images are of her in painted self-portraits or clay self- portraits. She talks a lot about being in foster care, wanting to be adopted, and being angry with her mother. Other images are of trees and nature. From the themes seen in her art and what she has expressed during our sessions, there are issues of abandonment, self-doubt, rejection, neglect, and anxiety about not being good enough. Based on her behavioural reactions when I come to get her from class, she has an insecure/ambivalent attachment. She showed signs of anger and resistance when I did not take her out of class at the time she wanted and got envious when she saw me walking in the halls with other students.

Presentation of the Art:

Figure 1:”Rainbow girl” 8 by 11 inch paper, Tempera paint

Session 1: The above painting was from our first session. When Madison first sat down, she said: “If we’re going to do this, I’m going need to ask you a few questions first.” I said that that was okay, and her first question was “what is your favourite color?” I answered, and she then explained that she was in foster care and had a lot of social workers and people that ask her questions. If she was going to start working with me then she needed to know more about me. I answered most questions, as they were pretty simple. She then began to talk a little more about being in foster care, and explained that she was with a family that had five siblings. In the future she wanted to be a performer, either in singing or dancing. She seemed very mature for her age. When I asked if she would like to do art, she said that she loved all kinds of art and she wanted to paint today. She painted a “rainbow girl,” which was an image of her and what she wore that day. She used tempura paint and enjoyed mixing all the colors. We talked a lot, and as we got close to ending the session and I mentioned we had ten minutes left, she looked at me with a confused expression and did not want to leave. She asked if she could stay longer. I explained that she had recess next and I had to start cleaning up, which led her to asking me which other students I was going to see next. I then explained that everything we do and talk about is confidential, so I could not share my clients’ information and that I never shared any of her personal information with my other clients.

Figure 2:”Self-portrait” two, 8 by 11 inch paper taped together, Tempera paint

Session 2: Madison appeared to be in a good mood and maintained eye contact with me. She wanted to paint a self-portrait with what she was wearing that day. She was very focused on capturing the exact shade of pink that her shirt was. It took her twenty minutes of blending colours to achieve the perfect shade of pink. She taped two pieces of paper together because she wanted to create a life-size image. Madison opened up about her siblings, mostly to do with one sister specifically, who is apparently “pretty-looking” but does not talk with her much. When I asked if they hung out, she said, “I would never ask her to hang out.” It seemed as though they did not have much of a relationship, although there is a large age gap, which could explain the reason her older sister did not want to hang out with her.

Figure 3: Continued “Self-portrait”, two 8 by 11 inch white papers taped together, Tempera paint

Session 3: Madison did not seem interested in participating in this session. She did not make much eye contact and shrugged her shoulders as she walked through the hallway. She continued her painting from the week before, painted her face and added the cats that were on her shirt. While painting, she opened up about being bullied at school by a boy because he knew that she went to art therapy. Another child had told me that this boy had bullied him as well. She said he called her “stupid” for going to art therapy. We agreed to talk to her teacher regarding this issue - specifically, to ask the teacher to be mindful of sharing information regarding the art therapy sessions to the class. Madison and I also discussed how she could express herself to the boy. She did not really care that other kids in her class knew she went to art therapy. She did not think it was something to be embarrassed about because she enjoys doing art.

Figure 4:”two sisters” Made out of Slime Figure 5: “Pac-lady” Made out of Slime

Session 4: When I came to take her out of class, she was resistant and said she would only come if she could bring her it. I allowed her to bring it, but during the session she did not open her sketchbook. She spoke a lot about becoming an actress. This session was in December, near Christmas break. She spoke about the Christmas concert and how she was in the choir but did not have a solo part. She played with the Slime that was in the counsellor’s office and made something for herself and for the sister that she lived with. Madison also created a “Pac-lady.” She said that Santa was not real because he never brought her anything she asked for. She seemed frustrated that she did not get what she wanted, but also mature about the situation, as though she were proud that she was old enough to know Santa was not real.

Figure 6 (left): “The heart of the painting” cut out heart, Tempera paint, 3 pieces of white paper Figure 7 (right): “Love” outline of heart, Tempera paint

Session 7: When I took her out of class, she was wearing large pink glasses as a disguise “for fun.” When she sat down, she knew exactly what she wanted to do that day. She asked for scissors and paper, then proceeded to cut out a heart, put it on different paper, and then painted splats of colour around it. She then took the heart from the white paper and placed it on top of black paper so that she could see it better. The outline of the heart was on the white piece of paper and she really liked it, so she then used a sponge to apply colours around the heart. During the process, we talked about her winter break and how she missed school because she missed her friends. She also asked if her “real” (biological) mother knew about her participation in art therapy. I said, “I think your foster mother signed the consent form, to which she responded very negatively, replying, “That’s because my real mom doesn’t know anything about me.” I asked if she saw her real mom over the break and she replied with “No, I don’t like her anymore.” Madison did not say anything else and continued to sponge paint the page. Near the end of the

session, she told me she got ice skates for Christmas and went skating, which was very exciting for her.

Figure 8:”Aurelia Borealis” 8 by 11 inch white paper, Watercolour painting

Session 9: When I came to get Madison in the morning, she did not seem very happy. She walked with a hunched back through the hallway, making minimal eye contact. This was the first day I had watercolours, so I asked Madison if she wanted to try the medium, and she did. She explained that she wasn’t having a good day and just wished she could paint every day. Some days, she did not want to participate in anything at school, so she enjoyed mixing the watercolours and watching them move on the paper. There was minimal talking; this session mainly focused on experimenting with the paint.

Figure 9: “Sunset”, 8 by 11 inch white paper, Tempera paint

Session 10: When I got her from class for our tenth session, she appeared distressed. When I asked how she was doing, she talked about how relieved she was that she had art therapy that day because school was really stressful, and art therapy gave her time to calm down. She started playing with the slime and created a figure called the “alien monkey.” Before I could take a photo, she mushed it up back to nothing. She then asked to paint something soothing, so I got the colours that she wanted and she painted a sunset on top of the ocean, with a silhouette of a palm tree on an island. While it was drying, she talked about how proud she was of her painting and said that she wanted to sign it. She started to practice her signature in handwriting. I cut out the bottom of the painting with her initials for the purpose of confidentiality.

Figure 10: “Tree roots”, 8 by 11 inch paper, Watercolor

Session 11: As Madison walked with me in the hallway; I could tell she was happy. She made plenty of eye contact and danced while walking. She was in a very talkative mood and wanted to paint with watercolours. She talked about making her summer plans and going to an art camp, which she was very excited about because she had made several friends last year and was excited to see them again. She explained that she is in a better mood when the weather is warmer, especially when it is sunny outside. She will also be visiting her Grandma in the United States with her social worker. She had a lot to look forward to for the summer, and she was excited about the new things that were going to be in her life.

Figure 11: “Self-portrait”, Plasticine figure

Session 12: Madison walked through the halls reasonably happily, skipping along the way. This time, she wanted to model herself out of plasticine and also create her outfit. She talked about her summer plans and how she would be flying to San Diego with her social worker and going to the San Diego Zoo with her Grandma. She asked about what kind of art I created in my own spare time, and I said I had many different styles. While she was creating her figure, she talked about her body image with regards to being skinny and tall with black hair. She seemed confident and accepting of her own image. There were no signs of body distortion. She was just very happy to be tall and in good shape.

Figure 12(left):”Self Portrait” plasticine Figure 13(right): “Dress” plasticine

Session 13: Madison was in a contented mood, maintaining regular eye contact but without the dancing in the halls. She wanted to continue working on her plasticine figure and finished her face. During this process, she talked about being taken away from her biological mother when she was three years old, due to her mother’s being pregnant at 18 and too young to take care of her. She explained she was in foster care until her mother wanted her back – but that she did not even want to go back with her even if she asked. She said that her mother had another child and gave it up as well, and that she was mad at her mom because she did not give her any attention. She said it actually made her sad when she watched movies where someone had a younger child. She did not like her younger sister because she thought she got more attention. Madison continued to work on finishing her plasticine face, and then began mixing the colours to create the dress that she was wearing that day. She wanted to create another version of herself with her outfit that day. She then mentioned that she did not think she would be successful in life for the reason that she did not like school projects. I reassured her that she would not be getting school projects for the rest of her life.

Figure 14: “Herself” in tie-dye dress, Plasticine

Session 14: Madison was in a positive mood and played with the rice bowl first. She said she had a good weekend and celebrated Ramadan. She had fasted for a few days and, for school, her foster mom gave her a snack. I let her know that we only had a few more sessions together. She asked if I could come back next year, and I said I would talk to the principal but that there were no promises. She continued to make her plasticine figure with a dress, body, and detailed wavy hair. During the making of the hair, she mentioned that she had Skyped her little sister’s dad on the weekend, and that she was hoping to see her sister again. Madison spoke again about how her mom never told her that she had had another baby. It was frustrating for her that the social worker had been the one to tell her that she had a sister. I asked when the last time she spoke to or saw her mom was. She replied that she did not speak to her and would sometimes write letters, but that she did not like writing so it hardly ever happened. She enjoyed creating the figure above and put a lot of detail into it.

Figure 15 (left): “Maniac” Plasticine
Figure 16 (right): “Skull and bones” 8 by 11 inch paper, Tempera paint

Session 15: Madison was in a good mood at the beginning. I let her know that we only have one more session left and she said that was okay. Madison informed me that she got a new family services counsellor and that she had been able to see her biological sister on the weekend. She finished the plasticine model of herself and worked on her face. She thought the eyes looked like those of a “maniac,” so she called her “Trixie,” thinking that she might play tricks on people. I asked to take a photo of the two completed figures and she placed them beside each other, calling the bigger one her “fat mom.” She then laughed while thinking about what might happen if her mom were ever to see it. The painting seen in Figure 16 was made with a drawing of a skull, then cut out and placed on another sheet of paper, and then sponge-painted it black, blue and purple. During the creation of this image, she talked about seeing her sister for the second time. Madison’s biological mother had another child who is now three years old, and she had only just found out about her sister this year. She was shocked when she learned that her mother gave up her sister also, however her sister was able to live with her father. Madison explained that she had never met her biological father because he had moved back to the Philippines before she was born. She got frustrated when talking about her biological mom because she could not understand why her mom would have another child and not take care of it, it, especially considering the fact that she had already had a child, Madison, and had to give her up because she was not able to care for her.

Figure 17: “Taisha” 11 by 18 inch paper, Tempera paint

Session 16: I came to get her and she did not want to come with me because I had arrived at a bad time (art class). I let her know that it was my last day that day and I had some of her past work that she could take home. She came with me to pick it all up, and once she got into the room, she decided to paint something. She asked for green, red and yellow, used a sponge and started a circular movement. She asked me to guess what it was, and since it was only a few sponge marks, I had suggested that she tell me. She said it started with the letter ‘H’ and to wait and see. It turned out to be a Christmas door ornament – holly. I explained that I am Jewish, so I did not know the name of the Christmas door ornament. She said “Well, my foster family is Hindu, so they don’t celebrate Christmas either – they just give me presents on Christmas.” She wrote my name in the middle and put hearts around the holly. She said she would put it on her wall so that she would always remember me. I asked how she is with goodbyes and she said that she is pretty good at them, but that she would miss me. We discussed the topic of boys. She said she did not have any crushes this year because she was still getting bullied for liking a boy last year. As we were talking about summer plans, she got excited about her art camp. She said that she would miss me but that she would be having so much fun this summer that she would probably forget about me. I told her that it was okay to forget me, and then we went through all her paintings from throughout the year. She decided she would sell them for millions, and as we were walking back to class, she asked her friend if she wanted to buy one. I said goodbye and thanked her for allowing me to work with her. She ran off trying to sell her paintings.

 Summary

Overall, art therapy was a greatly beneficial experience for Madison in multiple ways. She was able to express parts of herself that had been mostly hidden. She learned more about her emotions and how she expresses herself in times of anger, sadness and frustration. Being in foster care has limited her ability to confide in others, as she lacks consistent relationships and support. Therefore, I believe our 50-minute sessions once a week were helpful for her to be able to relieve some tension she had been dealing with at home and in school. She is a strong individual who is creative and talented, and I believe she will do well in the world if she has the right resources and support. I am still learning what questions to ask and being mindful of difficult topics for Madison. For example, some questions regarding her mother were emotionally challenging for her. However, it seemed that she wanted to let me know when she was upset with her mother and that it was okay to talk about it. Madison was usually the one who brought her mother up, and after she had talked about it, there seemed to be a sense of relief following the sharing of her feelings. During our final sessions, she let me know how helpful art therapy had been to her and how much she had enjoyed working with me; she wanted me to come back. Madison’s final image was my name surrounded by colourful hearts and Christmas joy. I hope she continues to create art, sing, dance, and perform to her best abilities.

Chapter 5 - Analysis and Findings

Findings from Case Studies

Case study 1 and 2 were diverse, challenging, and rewarding. Although each individual differed greatly, both Annabelle and Madison were able to work calmly and follow directions once they had the attention needed. I feel that I have learned much more about children and adolescents, particularly in how they socialize and interact with adults, especially new adults such as I was. Working with Annabelle was very informative in regards to understanding how an insecure attachment impacts development, thinking, and behaviour - and especially how needs are communicated.

Providing support and intervention to vulnerable children and youth early on in life is necessary for future success. Having the opportunity to assist in this healthy development is gratifying. Art therapists have the ability to help children learn productive coping mechanisms such as breathing techniques, meditation, and managing uneasy feelings through the means of art. In addition, art therapists can help support their client’s in developing a positive self-esteem. Providing individuals with these skills in turn helps them to deal with unpredictable feelings or situations and also increase their ability to develop secure attachments in the future.

When reviewing challenges and strengths, I believe I excel in finding creative ways to connect children, especially those deemed “difficult.” In order to manage the more difficult instances, I try to practice good self-care through mindfulness and meditation skills. In addition, I try to avoid internalizing difficult sessions (i.e., when a child yells and says they hate me). This is an ever-learning process. Finally, I also ensure to engage in daily reflections as these are helpful compartmentalizing clients’ difficult stories/trauma and thus, not feeling burnt out.

Art therapy provides a positive means of creating new and enriching interactions and the possibility of breaking negative patterns in a child’s sense of self-worth. It is important to teach coping skills because most of the children I see face some adversity. I think art is a great way for them to help release any anger or pain that they may be struggling with, helping them to move forward more positively in life. Knowing a child’s family background history is very important when trying to decipher why a child is acting a certain way. This can also be helpful when deciding what art materials to use as each medium can create a different feeling: solid mediums such as pencils and crayons lend a feeling of more control, compared to painting where there is less control.

Analysis from Literature Review

Definition of art therapy

There are many definitions of art therapy. The reading by Edwards, (2004), describes how “Art Therapy allows a client to express themselves through creative expression,” which I think is the clearest definition. An important thing to remember is the healing potential of art, particularly in the context of the therapeutic relationship between the therapist, client, and artwork. When there are no words, art therapy provides a unique space where the therapist and client can communicate through body language and artistic expressions. When someone is creating, there is an intense concentration that can become meditative. The difference between art therapy and art is that one must be present in the experience, rather than focused on the outcome or art product itself. While your hands are busy creating, your mind wanders, and so many thoughts and emotions can come to you. It becomes very important to not judge yourself, and to enjoy what you have created. As well, you can hate your emotions and release them into an art medium. All in all, I believe art therapy brings an alternative way to overcome some struggles or traumatic events, with the expression and communication through which emotions can be understood.

Outcomes of the Therapeutic Process

Healthy functioning is typically defined by a stable lifestyle including activity and proper nutrition, but it also involves the well-being of a person’s physical and mental state. Mental health is sometimes overlooked, so it is important to understand your own emotions and maintain the ability to take care of yourself on all fronts. I believe art therapy can help further a person’s emotional growth, self-esteem, and psychological and social integration.

How is healthy functioning evaluated? Art therapists are constantly assessing a client. If a therapist is conducting a group therapy session then it is important to interview the clients first to ensure the group’s cohesiveness. There should also be an overview of what will go on, what materials will be available and what procedure will be followed. In group art therapy, there needs to be a set of rules to go over, i.e. no swearing, and respect for the others by coming to session on time. Depending on the type of group, there needs to be similarities in age, culture, common issues, high risk or low risk, and disabilities that are visible or invisible, for the individuals to relate to one another. This helps to create a sense of connectedness. Usually the client will show the therapist in some way what is bothering them, what needs are not being met, and what goals they would like to achieve. As for assessment strategies, observation is key. I usually have a plan for the session but when we sit down, I always ask if they would like to use a specific material or create anything specific that day. Usually I have been given background information on my clients so I know what materials would be triggering. With clients for whom I do not have background information, I would observe their behaviour, body-posture, and facial expressions towards how they feel and would ask simple questions to make sure I do not trigger them in any way.

In either group or individual sessions, when the sessions are coming to an end, it is important to help the clients prepare for a sense of loss. What was their part in the group and what was my part as a therapist in the group? It is imperative to talk about the end of sessions well before, to help plan for what feelings or insecurities they may have. It is essential to know what resources are outside the school, agency, or area they live in for extra help when needed. In terms of art therapy outcomes, it is important to look at all the artwork produced, assess the changes, and discuss what was made and what they might have not been able to work on. 

Change Processes

The role of therapist and client in the art therapy process involves a mutual respect for one another in a non-judgmental and safe space. The therapist is mindfully present at all times, acknowledging what is happening in the client’s life, considering that the client is their own expertise. It is important for the client not to worry about the outcome of the art but rather to focus on the art therapy process itself. Talk therapy is not very helpful when the individual does not have the words to explain what happened. In order to create a therapeutic environment for individuals to feel comfortable to share their dialogue with me, I need to create a safe space for an individual to be vulnerable. It is underscored that clients understand that they are the focus, and that the therapy is about the person as a whole. Providing a warm and welcoming space is very important - this communicates to the client that the therapist is present.

In addition, the therapist must be genuine. It is an incredibly vulnerable experience having to pick up a paintbrush to share one’s thoughts and emotions. Therefore, having a therapist who is authentic and true to themselves makes for a more supportive experience.

Meditation music is something that helps clients keep focused during an activity. I might play a gentle melody in some sessions if need be. I also believe it is vital to encourage the client to speak without thinking – to have a raw dialogue, without judgment or second thought. However, clients are also encouraged to not use words during the sessions if they are not helpful. Instead, clients can simply express themselves through clay, painting, drawing or whichever medium they wish. During this process, I, the therapist, would be observing their behavior, actions, and facial expressions. Are they letting the emotion out? Are they becoming more angry, sad, or happy? After the individuals express themselves through creative expression, some feel a sense of relief by letting the emotion out into the art. After an art piece is done, I would usually talk about the artwork, what it is, what it means to them, why they chose the colours, and how it made them feel. Art therapy is still a relatively new profession to a lot of people across the world, and it will be interesting to see how these methods expand and further develop as it reaches more populations.

Necessary conditions for change

When I think about therapy and my personal experience with it, I have noticed that the clients who come to therapy with a motivation to change are those who will indeed make certain changes in their lives. There must be a want or a need to change, for developing an open mindset to learn ways of coping, or to learn certain skills that will help in times of distress. The necessary conditions for change can be in an Art Therapy space that is safe and with a nonjudgmental therapist. Creative expression can help so many people in several different ways – especially when talk therapy is not an option. Though healing can come by way of many modalities, I believe art therapy is the best way to express oneself, experience the potential pain and anger that may come with the process, and then grow from this and develop self-awareness. Art expresses outwardly not only what is felt inwardly but can also help build compassionate communities of people who better understand human connectedness (Levine, 2011). Art is a universal language and form of expression that everyone can understand and grow from.

Influencing client change

In order to produce or influence client change, the therapist and client must have a therapeutic alliance. I believe the person-centered approach, developed by Natalie Rogers, is very important in producing client change. The person-centered approach embraces the importance of self-direction, creativity, and building meaning in human interactions. The therapist must welcome the client into a safe place where raw emotions can truly be expressed. The client should have clear goals, such as changes they would like to make in their or behaviours or ways in which they would like to develop. In a group therapy session, the therapist needs to have key leadership qualities in order to promote change. I believe my strongest leadership qualities are open-mindedness, accountability, and trustworthiness. When someone is telling or showing their inner self, it is important to be open-minded and nonjudgmental.

It is also important not to decipher what the client is trying to say with their art piece. The client must explain the piece on their own. Ensuring that the client is accountable is essential, because, as a group leader, you must be the responsible figure who is able to intervene if there is an issue. Lastly, as a group leader, your clients need to trust you. Confidentiality is highly related to trustworthiness. Clients will feel uneasy if a connection cannot be created through trust. The client will not be comfortable being vulnerable without a sense of safety and trust with the therapist. With these elements, the client will be able to develop a healthy sense of self and positive coping skills. They will be open to growth if the opportunity arises and if there is a therapist to help lead them on the path they wish to be on.

There are some contextual factors that can impact the change process. This can include an individual’s physical environment, age, gender, values, sociocultural influences, and socioeconomic status. Every age group has a different way of releasing energy, and so it is important to always stay up to date with the new ways of self-expression. It’s also important to understand what age groups do well with what art directives. I use play therapy with one of my clients in an artistic way, i.e. having a color conversation or perhaps playing tag with them on a piece of paper. In a group art therapy session, factors such as culture, religion, and group cohesiveness can also have a big impact on change. Is everyone on the same page as regards working towards becoming a better person or changing a bad habit? The process can be disrupted or slowed should some member or members of the group not share these common goals. This takes us back to Attachment Theory: A child can have all of the advantages of a good socio-economic status, a good physical environment, and a good school, but still have their progress disrupted by insecure attachments.
Implications for Practice and Continued Professional Development

With limited experience, I have found that it is most impactful when clients are able to have individual, customized sessions. Everyone has a different story, and consequently there is not one approach that works for all. Every therapist needs to develop their approach based on the client’s needs. Therefore, most clients would benefit from my approach of an individualized program because I work with everyone based on their current needs. It is important to note, however, that my methods might not be appropriate for some individuals - particularly those who are not open to creating and expressing themselves.

Professional practice issues can arise from the general public’s lack of knowledge about Art Therapy and its benefits. As well, most community centers and agencies have a limited number of experts to offer to the public. Most mental health departments do not provide art therapy, and so there are limited job opportunities for art therapists. I have also noticed the lack of funds being provided for mental health. For example, it is cheaper for someone to see a psychiatrist who prescribes medication because it is part of their medical plan. It is more expensive for someone to work with an art therapist because they have to pay out of pocket. This creates a problem, as art therapists have limited areas to work, and opening their own practice is also extremely expensive.

Some strategies for continuing to work towards a coherent approach to professional practice would be to continue learning, to participate in workshops held by professionals, and to keep in contact with my current classmates. I think my approach will always be changing and developing. As the world and the field of art therapy continue to grow, so I must also grow. It is important to stay up to date with the latest information on expressive therapies and new approaches in psychology. In order to maintain and increase my knowledge, I must attend seminars regularly. Discussing issues with my supervisor and classmates also helps to learn what to do when difficult situations arise. Exchanging information with my classmates will help me learn both the benefits and the pitfalls of various practices and situations. Practice is also another way to develop my skills, and continuing to work with a diverse range of individuals will build my knowledge. The more individual and group therapy sessions I facilitate, the more experience and knowledge I will have to share with the public, thereby contributing to the greater good. Self-care and regulation are also important skills to keep up, as burnout can easily occur with large groups and too many back-to-back individual sessions.

Summary

The world is ever-changing, and, being a relatively new field, art therapy will continue to grow and change. I am positive that my theories and approaches will also continue to change, as I learn more and the practice expands and develops. Art is not just an activity but also a way of being, a way of expressing oneself without words. Art is a universal language, which everyone can experience, and everyone is an artist in their own way. There is no right or wrong when creating art, nor good or bad; it simply a form of expression. With the proper support systems in place, and compassion and empathy are employed, anything is possible in terms of how art therapy can help children at risk.

After I have completed all my schooling and practicums, I will have created a palette of knowledge based on the learning opportunities I have experienced throughout this program. There is not one right approach toward art therapy because each client is uniquely different and everyone deals with trauma in their own personal way. I think it is important to know about all the different approaches in order to tailor the therapy towards the individual. There are many benefits to art therapy that can help foster a healthy mindset and create a safe and trustable environment for clients to work through their issues. I hope that by teaching and promoting creative expression through therapy, I can contribute towards efforts to provide another method of coping and developing positive mental health.

Chapter 6 – Discussion & Conclusion

Discussion

After carefully examining all the literature in my review, my personal experiences and case studies, I can conclude that it is imperative for children in care to have supportive primary caregivers. Art therapy can be a tool for children to use in order to express themselves and overcome struggles early on in life.

Although I conducted a case study consisting of only two individuals (within a short period of time), I was able to use my findings and current literature to strongly infer that art therapy is a necessary program for healthy development. Each individual will experience a form of trauma and/or a difficult life event, and all can benefit from the experience of art therapy.

When reviewing the research questions, it is clear that if a child does not have a primary caregiver then they may have a more difficult time in developing appropriate coping skills and establishing healthy relationships. With the assistance of art therapy, however, individuals have the opportunity to improve their skill sets, as well as their overall sense of self and personal happiness.
Conclusion

Art therapy is a great method for creating new interactions and breaking negative patterns in a child’s sense of self. As adversity is inevitable, it is important that children are taught healthy coping skills early in life. I believe art is a special tool that children can utilize in order to express difficult emotions such as anger and sadness. A key element when working with children is having a comprehensive understanding of a child’s family history - this is underscored when analyzing an individual’s behavior and thoughts.

There are many benefits to art therapy: It can help foster a healthy mindset and create a safe and trustable environment for clients to work through personal issues. I hope that by teaching and promoting creative expression in therapy, I can contribute towards efforts to provide another method of coping and developing positive mental health.

References

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Allen, P.B. (1995). Art as a way of knowing – A guide to self-knowledge and spiritual fulfillment through creativity. CO: Shambhala

American Art Therapy Association. (2017). Retrieved March 18, 2020, From: https://arttherapy.org

Bowlby, J. (1969). Attachment and loss (Vol. 1). New York, NY: Basic Books. Bowlby, J. (1988). A secure base: Parent-childattachment and healthy human development. New York, NY: Basic
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Attachment Theory for Family Therapy. Family Process, 34(1), 45–58. DOI: 10.1111/j.1545-5300.1995.00045.x
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Cane Detre, K. , Frank, T., Refsnes Kniazzeh, C., Robinson, M. C., Rubin, J. A., and Ulman, E. (1983). Roots of art therapy: Margaret Naumburg (1890-1983) and Florence Cane (1882-1952) - A family portrait. American Journal of Art Therapy, 113- 116.

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Chilton G., Gerber N., Bechtel A., Councill T., Dreyer M., & Yingling E. (2015). The Art of Positive Emotions: Expressing positive emotions within the intersubjective art making process, Canadian Art Therapy Association Journal, 28:1-2, 12-25. DOI: 10.1080/08322473.2015.1100580

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Jansen, T. (2019). Lesson Two: American and Canadian pioneers of art therapy and its emergence internationally.

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to art therapy: Theory and technique (2nd ed.), (28-39). New York: Brunner-Routledge.

Lee, T., & Morgan, W. (2017). Transition to Adulthood from Foster Care. Child and Adolescent Psychiatric Clinics of North America, 26(2), 283–296. DOI: 10.1016/j.chc.2016.12.008

Levine, S.K. (2011). Art opens to the world: Expressive arts and social action. In E.G. Levine & S.K Levine (Eds.), Art in action: Expressive arts therapy and social change. London, UK: Jessica Kingsley Publishers. Lusebrink, VB., Mārtinsone, K., & Dzilna-Šilova, I. (2013). The expressive therapies continuum (ETC): Interdisciplinary bases of the ETC, International

Journal of Art Therapy, 18(2), 75-85. DOI: 10.1080/17454832.2012.713370 McDavid, L. M. (2015). Foster Care and Child Health. The Pediatric Clinics of North

America, 62(5), 1329–1348. DOI: 10.1016/j.pcl.2015.06.005 Naumburg, M. (1987). Dynamically oriented art therapy: Its principles and practice (2nd ed.). Chicago: Magnolia Street.
Ranson, K. E., & Urichuk, L. J. (2008). The effect of parent-child attachment relationships on child biopsychosocial outcomes: A review. Early Child Development And Care, 178(2), 129-152. doi:10.1080/03004430600685282 Rubin, J. (2005). Artful therapy. NJ: John Wiley and Sons.
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Sroufe, A., & Siegel, D. (2011). The Verdict is in: The case for attachment theory. Psychotherapy Networker. Retrieved from: https://www.drdansiegel.com/uploads/1271- the-verdict-is-in.pdf

ART ASIA 2018

Hello Art Lovers!

Art Asia was November 22nd-25th, 2018! It was a fabulous art fair and even though I didn’t sell my work, I made some AMAZING connections!

Such as getting picked up by “K Auction” which is an auction house is South Korea. They never accept anyone outside of Korea but they made an acception for my work!

Please take a look at the link below!

http://www.k-auction.com/KOnline/WorkList.aspx?page_no=5&auc_num=142&t_seq=&s_type=&s_str=&l_mode=I&of=lot_num&ot=a&n_mode=N

Art! Vancouver 2018

This year at Art! Vancouver I had the most positive response with my paintings. I am so happy with this years results! :) 

One comment I received was that one art collector would like to see all my styles, and since I like to only show one theme per year, I had a new idea. I decided to mix my themes over the past couple years and combine them, my spray painted hearts as one background, as well as spray painted drips for others. My crowns were to show that you can always wear your invisible crown. 

For my "15 minutes of fame" I spoke about my past with art and my future with art therapy. 

The Art Gallery in London wrote an article about Art! Vancouver's

Here is the article written by @theartgallery in London, I am on the front page!!! :)

http://theartgallery.co/2018/03/27/a-place-for-every-creative-soul-lisa-wolfin-art-vancouver/

Marilyn featured in Rental homes in Whistler!

So excited to have my work in 4 rental units in Whistler, Canada. Please contact for more info! 

The Populist

Here is an amazing article written by Amar Mirchandani that was posted on The Populist (online news article) 

Thank you so much for choosing me to write about!! :)

http://thisispopulist.com/artist-spotlight-6-things-about-artist-taisha-teal/

Art of Art: Westcoast Formal Charity event!

This is what I completed at the Art of Art Charity Event with the Youth unlimited. Very happy I was able to participate in this event as all proceeds went to the Youth who are at-risk in Vancouver. Thank you to everyone who came to support me! :)

The Art of Art event Nov. 18th, 2017

I will be participating in the Art of Art event for at-risk youth, by painting LIVE and auctioning off my painting at the end. The event will be held at the Pipe Shop in North Vancouver on November 18th, 2017. Get your tickets online at https://www.eventbrite.ca/e/the-art-of-art-a-westcoast-formal-tickets-37473847286

Check out my promo video! - https://www.youtube.com/watch?v=bbWQWFiMoW8&feature=youtu.be

Bar None Night Club

My first time having my paintings in a nightclub on Granville Street Downtown Vancouver! Very exciting to walk in and see my work on the walls! 

Marilyn

Bar None Night Club

Art! Vancouver 2017

This year I did a series of naked ladies. I wanted to create a reaction from the crowd. I usually use lots of color in my paintings but this year I decided to change it up and only use black and white. I also decided to use charcoal and used my finger to smudge to round the edges. 

This series more personal and it was a way for me to express my mental state of overcoming a personal trauma. I wanted to show some vulnerability by involving women's skin. Women are taken advantage of everyday and its hard for women to protect themself. Society judges women very harshly for their bodies, social media escpecially. Making women feel as though their bodies are not good enough and to try products that will make them "feel better about themselves". The women I chose were also very important people to me as they played a big part in the healing of my trauma. They helped me to understand confidence, happiness and self-worth. I took photos of my friends and myself to show that all bodies are beautiful, at whatever angle, it is okay to show some skin.  Women create and nurture babies, the body should be seen as a temple. Some people get offended by naked women, but they shouldnt be.Women make the earth go round, they give life! Yet, women are still being taken advantage of, put down and not given the credit they deserve. However, my pieces are not fully naked, and some pieces express the individual by showing yoga, meditation and peacefulness. I had a wonderful year at Art! Vancouver and ended it by selling the middle piece titled, "Empowered women empower women" to a wonderful lady!

Good Bags/Bad Bags

This piece was made for Canada's 150th Birthday this year. I incorporated my style of the bleeding hearts, which is done with spray paint. I then added a white Maple leaf on top, using my own technique and wiped out the thick line and showing the outline of the famous maple leaf. 

"The art project - Bad Bags/Good Bags“ by German artist Reinhard Wanzke is about travelling and connecting artists all around the world. Wanzke is carrying seven „Ferragamo“ handbags with him, which are central to the art project. Starting his tour in Frankfurt (Germany) he meanwhile visited Kampala (Uganda), Sydney (Australia), Kuching (Malaysia), Changzhou (China) and now Vancouver. His last but one stop will be New York before he returns end of June to Germany. There will be the final exhibition with then 49 artworks from all around his world trip and the seven bags empty. Why empty? 
The modus operandi always has been the same during his travel: he invites artists to contribute one work of art to one of the bags, and during the first, the local exhibition the art work will remain invisible to the audience. So e.g. the Vancouver art works will be on display for the first time at the New York exhibition and then in Kassel (Germany), when there is documenta14.

The collection now will be extended by art works from Vancouver based artists Taisha Teal, Skyla Wayrynen, Irene Hyojeong Hwang, Hank Bull among others."

Detailed informations you’ll find
Wordpress: http://wanzke.dasbyro.de/?p=70
facebook: https://web.facebook.com/groups/1688010458195657/
google sites: https://sites.google.com/view/budesheim/ausstellungen-2000/bad-bags-good-bags

BC Crafts Council Fair

I am lucky to be in another art fair with my mother and sister outside the Vancouver Convention Center!

RAW: Vancouver

I am excited to announce I am in another Show with many more amazing artists! 

Burts Bee's / Preservation Canada

Experience SHADES by Burt’s Bees Lipstick! 

I have had the privilege and honour to work with Burts Bee's these past few months to make them a custom painting using their new lipstick line. My artwork will be auctioned off with proceeds supporting Wildlife Preservation Canada

Please help support this cause by spreading word to those in Toronto, and if you are in the area, please visit the Arta Gallery in Toronto’s Distillery District between Feb 27 & Mar 11, 3 – 8pm. Enjoy a FREE Admission & FREE Gift daily!

Message me for more details as I would love to see you all there! :)

10 Artists. 14 Shades of Lipstick. Endless creativity. 

Art Vancouver

Extremely happy to announce my Marlyn Monroe painting was featured on Art! Vancouver's magazine and sold at Art fair last May 2015.