Did you know?...Art Therapy and Substance Abuse Treatment Gioia Chilton, PhD, ATR-BC, LCPAT, CSAC
For the last two and a half years, I’ve been blessed to get to work with people needing substance abuse treatment. The bravery and compassion I’ve seen in the recovery community is inspirational—and can be heartbreaking. The losses in human potential from the opiate crisis and from alcohol abuse continue to mount, impacting families and neighborhoods locally and internationally. We now understand that addiction is not a moral failing but a brain disease which causes chronic relapsing. Yet, individuals can take significant responsibility for their own recovery by committing to long-term treatment. Art therapy can be a life-enhancing and enjoyable part of an often difficult and frustrating process of recovery from addiction.
A new book has been published, written by art therapist and substance abuse treatment expert Libby Schamke. Libby has been teaching art therapists about working with substance abuse populations for many years and serves on the faculty of Emporia State University. I have been to her master supervision group at American Art Therapy Conferences and have always learned a lot from her. I also appreciated her 2016 chapter in the new textbook, Wiley Handbook of Art Therapy. As this population has unique needs, culture and treatment approaches, art therapists should be well educated when specializing in this area. Art therapists working in addictions should have a solid understand of not just trauma and loss, but the disease model, Stages of Change, Motivational Interviewing, and 12-step terms and culture. Libby’s new book as a great place to start!
Libby begins the book with a story about a woman in substance abuse treatment who revealed though her art what she couldn’t say in words-that she had been raped, an untreated trauma that contributed to self-medicating with alcohol and other drugs. Libby discusses how many people with substance abuse problems also have traumatic histories. We are now beginning to understand that trauma and addiction create and compound underlying changes in the brain with devastating consequences. Art therapy is particularly useful for whole-brain healing as people can use artmaking with the safety of a therapeutic relationship to express unspoken feelings and learn to experience and regulate emotions without the use of substances. Obviously, much more research is needed to examine the exact mechanisms of change, but art therapy seems to impact the mind, body and spirit.
Libby’s book is filled with many more clinical case vignettes and suggestions for ways of using art therapy in working with those addicted, such as trigger mapping, working with shame and the inner critic, mountaintop self-portraits, even paper wall quilts. Chapters on working with groups and families, and on assessment and spirituality fill out this volume. I particularly appreciated the many citations and substantive literature review, as it is very useful to have what research that is available pulled together in one source. Libby’s book is a welcome contribution and should be required reading for anyone wishing to work with this population.
References: Schmanke, L. (2017). Art Therapy and Substance Abuse: Enabling Recovery from Alcohol and Other Drug Addiction. London, England: Jessica Kingsley Publishers.
Schamke, L. (2016). Art therapy and substance abuse. In D. Gussak and M. Rosal, (Eds.), Wiley Handbook of Art Therapy (pp. 361-386). West Sussex, UK: Wiley
Additional Reading: Brooke, S. L. (Ed.). (2009). The Use of The Creative Therapies with Chemical Dependency Issues. Springfield, IL: Charles C Thomas Publisher.
Horay, B. J. (2006). Moving towards gray: Art therapy and ambivalence in substance abuse treatment. Art Therapy, Journal of the American Art Therapy Association, 23(1), 14-22.
Wilson, M. (2003). Art therapy in addictions treatment: Creativity and shame reduction. In C. Malchiodi, (Ed.), Handbook of Art Therapy, pp. 281-293, New York, NY: Guilford Press.
Did you know?...Art Therapy and Cancer Treatment Gioia Chilton, PhD, ATR-BC, LCPAT
Art therapy involves the process of making artwork for the purpose of improved mental health and emotional well-being. Systematic reviews of research conclude that art therapy benefits cancer patients in various ways including improving their mental health (Geue et al., 2010; Wood, Molassiotis, & Payne, 2010). Monti, et. al., (2006) in a randomized, controlled trial of Mindfulness-Based Art Therapy (MBAT), demonstrated that cancer patients experienced not only significant decrease in symptoms of distress and but also significant improvements in health-related quality of life. Two randomized, controlled studies among women with breast cancer provide strong support for the use of art therapy to improve coping (Öster et al., 2006) and overall quality of life (Svensk et al., 2009). Cancer patients also found art therapy helpful in relieving overall distress and increasing positive emotions in a quasi-experimental study (Nainis et al., 2006). Spirituality was also found to be impacted in a more recent randomized, controlled study (Radl, 2015).
While more research is needed, the evidence for utilizing art therapy in cancer treatment is beginning to blossom!
References
Geue, K., Goetze, H., Buttstaedt, M., Kleinert, E., Richter, D., & Singer, S. (2010). An overview of art therapy interventions for cancer patients and the results of research. Complementary Therapies in Medicine, 18(3-4), 160-170.
Monti, D., Peterson, C., Kunkel, E., Hauck, W., Pequignot, E., Rhodes, L., & Brainard, G. (2006). A randomized, controlled trial of mindfulness based art therapy (MBAT) for women with cancer. Psycho Oncology, 15(5), 363-373.
Nainis, N., Paice, J., Ratner, J., Wirth, J., Lai, J., & Shott, S. (2006). Relieving symptoms in cancer: innovative use of art therapy. Journal of pain and symptom management, 31(2), 162-169.
Öster, I., Svensk, A., Magnusson, E., Thyme, K. E., Sjodin, M., Åstrom, S., & Lindh, J. (2006). Art therapy improves coping resources: a randomized, controlled study among women with breast cancer. Palliative and Supportive Care, 4(01), 57-64.
Radl, D. M. (2015). The Effects of Self-Book (c) Art Therapy on Emotional Distress in Female Cancer Patients: A Randomized Controlled Trial. Doctoral Dissertation, Drexel University, Philadelphia, PA.
Svensk, A., Öster, I., Thyme, K., Magnusson, E., Sjödin, M., Eisemann, M., . . . Lindh, J. (2009). Art therapy improves experienced quality of life among women undergoing treatment for breast cancer: a randomized controlled study. European Journal of Cancer Care, 18(1), 69-77.
Wood, M. J., Molassiotis, A., & Payne, S. (2010). What research evidence is there for the use of art therapy in the management of symptoms in adults with cancer? A systematic review. Psycho-Oncology, 135-145. doi: 10.1002/pon.1722
PATA Community-based Participatory Research Project
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Would you like to expand our art therapy knowledge base but doing research sounds hard/boring/no fun/impossible/like drudgery? It's not!
Come learn about participatory action research and make some art using
arts-based research techniques to explore if we could come together as a
community to research a cool art therapy topic (like, combating burnout
through art making, say, or discovering positive emotions through art,
or--you fill in the blank!) Visit our events calendar soon for details on the next research project workshop. We invite members of the DC art therapy community to collaborate with us on this Community-based Participatory Research Project, the exact form of which is yet to be determined.
Please visit our Facebook page to view video footage from our most recent research workshop led by Gioia Chilton, PhD, ATR-BC.
Background:
In the fall of 2014, the Potomac Art Therapy Association held an informational meeting and art-making session for those interested in participating in a Community-based Participatory Research Project in Washington, DC. A diverse group of twelve members of the art therapy community attended, including art therapists, art therapy graduate students, educators, parents, and a high school student. There, we learned about Participatory Action Research and Arts-based research and why those methods of research may appeal to us with art therapist and arts-based researcher, Gioia Chilton, PhD, ATR-BC. Then, we made art to generate research topic ideas.
Themes that came up during the discussion of our artwork…
Art as avenue for freedom to do/feel/be…
Barriers to… receiving care/art therapy/power
Connection/Communication (through art)
Love/Care/ Comfort/“Home”/Healing (in art therapy) and related Emotional/Spiritual connection (through art)
Universality of art to communicate--Global Mission/Movement (art therapy for all)
What is the impact of the art studio environment (including its natural light)?
Who is a person who would come to a community art studio? What are characteristics of this client?
We plan to have more meetings to see if we can collaboratively, in the spirit of PAR, continue to focus in on our collective interests through creative means. Our goal might be to find a topic broad enough to be interesting to all of us and specific enough to become a viable research question. In our next meeting(s), we hope to specify the research problem, which can be simply a lack of knowledge about some particular area of art therapy or a specific practical issue that needs study. The research ‘problem’ can also be thought of as the research opportunity, which will lead us to generating the major objective or intent to our project. We may want to use the ideas generated in the first meeting to direct us to this next step.
More information about PAR & ABR:
Community-based Participatory Research (CBPR) is sometimes called Participatory Action Research (PAR). Community-based research projects can empower individuals because knowledge generated by a community increases its ability to promote empowerment and change—leading to a society with increased justice, health and wellbeing.
CBPR/PAR –Whatever, but what is it?
An approach to organizing communities to address concerns
Participatory/ democratic /cooperative, engaging whole community in co-learning
Empowering communities’ capacity building—individuals and communities develop skills of inquiry
Change-oriented
Grew from social justice movements, used in adult education, sociology, community work, feminist studies, psychology, organizational development, to address health disparities, etc.
Different styles were developed in the 1970s by Paolo Freir (1970) and later Kurt Lewin (1997).
Decenters academic authority/loosens universities grip on knowledge creation
Process of inquiry is as important as specific outcomes
Action and research are in balance (doing it, and studying what is done)
Those coming from a Participatory Worldview believe:
Persons have a right to have a say in decisions that affect them and that claim to generate knowledge about them
Empowering people will forward social justice and help to address injustice in the form of classism, neocolonialism, poverty, sexism, racism, homophobia, ableness, mental health stigma, etc
There is a need to increase purpose and meaning, spirit and beauty to heal the world
Participatory Action Research(PAR)is relevant for mental health professionals because:
Creates practical knowledge that aids well-being
Focuses on building sustainable relationships in communities
Transformative, leads new abilities to create knowledge
Social justice focus
What is Arts-Based Research (ABR)?
The systematic use of a range of artistic practices for the purpose of contributing to a useful, transformative, and socially responsible body of knowledge (Finley, 2011; Kapitan, 2010, Leavy, 2009; McNiff, 1998). Can include use of kind of art form, including literature, drama, dance, music, & visual art, combinations as needed.
Could involve these methods:
- A/r/tography (art/ teaching/research) - Autoethnography- first person stories we write about being art therapists/art therapy clients/family members; “part auto or self and part ethno or culture” (Ellis, 2004, p. 31) - Dance as research - Ethnodrama - Fiction: Novels, Novellas, Short Stories - Film/Video Inquiry - Music as research - Performative Inquiry - Personal Narrative/ Autobiography - Photo Elicitation - Photovoice (Wang & Burris, 1997) - Poetic Inquiry - Visual art of all kinds
Those coming from an Art-based Worldview believe:
Artistic form aids understanding and examining truth, including the truths we don’t have words for
Art accesses our valuable inner life as well as our social and emotion life
Participatory art making can increase human capacity for empathy and positive transformation
Art-making provokes our old ideas, shifts our perspective, and generates new feelings and ideas via symbols/metaphors and is thus transformative
Arts-based Research (ABR) is relevant for art therapists because:
ABR is connected to core practices of art therapy and utilizes the strengths of art therapists (McNiff, 1997, Kapitan, 2010).
ABR is part of our heritage as creative art therapists, we have been exploring this method for some time and have skills and experience in using art as a tool for discovery-- It’s what we do! (Kossak, 2012).
This form of research is good for increasing “voice” of people who are not always heard; transformative and healing practice that is congruent with our values
While we can’t use ABR to “prove” the “efficacy” of art therapy with a certain population (and that will take decades) it’s good for interpersonal, social/emotional, relational, spiritual, artistic topics, promoting empathy and self-reflection, etc.
Definitions:
Art Therapy: The use of the creative process, particularly visual arts, by trained professionals for therapeutic purposes, to optimize health and respond to life’s challenges.
Artistic Inquiry: Informal use of artistic practice for learning, intentionally using artistic activities to integrate and generate ideas; "little r" research- experiential learning-by-doing.
Arts-Based Research (ABR): The systematic use of a range of artistic practices contributing to a useful, transformative, and socially responsible body of knowledge (Finley, 2011; Kapitan, 2010, Leavy, 2009; McNiff, 1998). Can include use of kind of art form, including literature, drama, dance, music, & visual art, combinations as needed.
Community: a group of individuals linked by common identity, interests, location, or background.
Participatory Action Research (PAR): Active and democratic research, which produces practical knowledge to empower, increase well-being and generate sustainable relationships within communities (Bradbury & Reason, 2008).
Research: Can be simply a creative act of searching for art therapy knowledge that matters (Kapitan, 2010). "Research is formalized curiosity. It is poking and prodding with a purpose." – (Hurston, 1942)
Bibliography
Allen, P. B. (2012). Art as enquiry: Towards a research method that holds soul truth. Journal of Applied Arts & Health, 3(1), 13-20. doi: 10.1386/jaah.3.1.13_1
Betts, D. J., & Laloge, L. (2000). Art therapists and research: A survey conducted by the Potomac Art Therapy Association. Art Therapy: Journal of the American Art Therapy Association, 17(4), 291-295.
Bradbury, H., & Reason, P. (2008). Issues and choice points for improving the quality of action research. In M. Minkler & N. Wallerstein (Eds.), Community-Based Participatory Research for Health (2nd ed., pp. 225-242). San Francisco: Jossey-Bass.
Chavez, V., Duran, B., Baker, Q., Avila, M., & Wallerstein, N. (2008). The dance of race and privilege in community-based participatory research. In M. Minkler & N. Wallerstein (Eds.), Community-Based Participatory Research for Health: From process to outcomes. San Francisco: Jossey-Bass.
Chilton, G. & Leavy, P. (2014). Arts-Based Research Practice: Merging Social Research and the Creative Arts. In P. Leavy (Ed.), Oxford Handbook of Qualitative Methods (pp. 403-422). New York, NY: Oxford University Press.
Chilton, G. (2013). Altered inquiry: Discovering arts-based research through an altered book. International Journal of Qualitative Methods, 12, 457-477. Available: http://ejournals.library.ualberta.ca/index.php/IJQM/article/view/17416/15713
Finley, S. (2008). Arts-based research. In J. G. Knowles & A. L. Cole (Eds.), Handbook of the arts in qualitative research: Perspectives, methodologies, examples, and issues (pp. 71-81). Thousand Oakes: Sage.
Finley, S. (2011). Critical arts-based inquiry. In N. K. Denzin & Y. S. Lincoln (Eds.), The SAGE Handbook of Qualitative Research (4 ed.). Los Angeles, CA: Sage Publications.
Finley, S. (2012). Ecoaesthetics: Critical Arts-Based Research and Environmental Advocacy. In N. K. Denzin & M. D. Giardina (Eds.), Qualitative Inquiry and the Politics of Advocacy. Walnut Creek, CA: Left Coast Press.
Fish, B. J. (2013). Painting research: Challenges and opportunities of intimacy and depth. [Article]. Journal of Applied Arts & Health, 4(1), 105-115. doi: 10.1386/jaah.4.1.105_1
Franklin, M. (2012). Know thyself: Awakening self-referential awareness through art-based research. Journal of Applied Arts & Health, 3(1), 87-96.
Gerber, N., Templeton, E., Chilton, G., Cohen Liebman, Manders E., & Shim, M. (2013). Art based research as a pedagogical approach studying intersubjectivity in the Creative Arts Therapies. In S. McNiff, (Ed.), Art as Research: Opportunities & Challenges (pp. 39-48). University of Chicago Press/Intellects Books. Originally published as a peer reviewed article in under the same title in Journal of Applied Arts and Health, 3(1) 39-48.
Hurston, Z. N. (1942/2010). Dust Tracks on a Road. NY, NY: Harper Perennial.
Kapitan, L. (2003). Re-enchanting art therapy: Transformational practices for restoring creative vitality. Springfield, IL: Charles C Thomas Pub Ltd.
Kapitan, L. (2010a). Art-Based Inquiry: An emerging paradigm in art therapy. Introduction to Art Therapy Research (pp. 161-182). New York: Routledge.
Kapitan, L. (2010b). Introduction to art therapy research. New York: Routledge/Taylor & Francis Group.
Kapitan, L., Litell, M., & Torres, A. (2011). Creative Art Therapy in a Community's Participatory Research and Social Transformation. Art Therapy: Journal of the American Art Therapy Association, 28(2), 64-73.
Knowles, J. G., & Cole, A. L. (2008). Handbook of the arts in qualitative research: Perspectives, methodologies, examples, and issues. Thousand Oaks, CA: Sage.
Kossak, M. (2012). Art-based enquiry: It is what we do! Journal of Applied Arts & Health, 3(1), 21-29. doi: 10.1386/jaah.3.1.21_1
Leavy, P. (2009). Method meets art: Arts-based research practice. New York: The Guilford Press.
Leavy, P. (2011). Essentials of Transdisciplinary Research: Using Problem-Centered Methodologies (Vol. 6). Walnut Creek, California: Left Coast Press.
Manders, E., & Chilton, G. (2013). Translating the essence of dance: Rendering meaning in artistic inquiry of the creative arts therapies. International Journal of Education & the Arts, 14(16). Available: http://www.ijea.org/v14n16/
McNiff, S. (1998). Art-based Research. London, England: Jessica Kingsley Publishers.
McNiff, S. (2008). Art-based research. In J. G. Knowles & A. L. Cole (Eds.), Handbook of the arts in qualitative research: Perspectives, methodologies, examples, and issues (pp. 29-40). Thousand Oaks, CA: Sage.
McNiff, S. (Ed.). (2013). Art as Research: Opportunities and Challenges. Bristol, UK: Intellect.
Minkler, M., & Wallerstein, N. (2008). Introduction to community-based participatory research: New issues and emphases. In M. Minkler & N. Wallerstein (Eds.), Community-based Participatory Research for health: From process to outcomes (pp. 5-46). San Francisco, CA: Jossey-Bass.
Moon, B. L. (1999). The tears make me paint: The role of responsive artmaking in adolescent art therapy. Art Therapy: Journal of the American Art Therapy Association, 16(2), 78-82. doi: 10.1080/07421656.1999.10129671
Norris, J. (2009). Playbuilding as qualitative research: A participatory arts-based approach. Walnut Creek, CA: Left Coast Press.
Poindexter, C. C. (2009). Research as poetry: A couple experiences HIV. In P. Leavy (Ed.), Method Meets Art: Arts-Based Research Practice New York: Guilford Press.
Reason, P. (2007). Education for ecology: Science, aesthetics, spirit and ceremony. Management Learning, 38(1), 27-44. doi: 10.1177/1350507607073021
Shelton, D. (2008). Establishing the public's trust through community-based participatory research: A case example to improve health care for a rural Hispanic community. Annual Review of Nursing Research, 26(1), 237-259.
Spaniol, S. (2005). "Learned Hopefulness": An arts-based approach to participatory action research. Art Therapy: Journal of the American Art Therapy Association, 22(2), 86-91. doi: 10.1080/07421656.2005.10129446
Wadeson, H. (2003). Making art for professional processing. Art Therapy: Journal of the American Art Therapy Association Association, 20(4), 11.
Wang, C. (1999). Photovoice: A participatory action research strategy applied to women's health. Journal of Women's Health, 8(2), 185-192.
