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Art therapy, sometimes called creative arts therapy or expressive arts therapy, encourages people to express and understand emotions through artistic expression and through the creative process.
Art therapy provides the client-artist with critical insight into emotions, thoughts, and feelings. Key benefits of the art therapy process include:
- Self-discovery. At its most successful, art therapy triggers an emotional catharsis.
- Personal fulfillment. The creation of a tangible reward can build confidence and nurture feelings of self-worth. Personal fulfillment comes from both the creative and the analytical components of the artistic process.
- Empowerment. Art therapy can help people visually express emotions and fears that they cannot express through conventional means, and can give them some sense of control over these feelings.
- Relaxation and stress relief. Chronic stress can be harmful to both mind and body. Stress can weaken and damage the immune system, can cause insomnia and depression, and can trigger circulatory problems (like high blood pressure and irregular heartbeats). When used alone or in combination with other relaxation techniques such as guided imagery, art therapy can effectively relieve stress.
- Symptom relief and physical rehabilitation. Art therapy can also help patients cope with pain. This therapy can promote physiological healing when patients identify and work through anger, resentment, and other emotional stressors. It is often prescribed to accompany pain control therapy for chronically and terminally ill patients.
Humans have expressed themselves with symbols throughout history. Masks, ritual pottery, costumes, other objects used in rituals, cave drawings, Egyptian hieroglyphics, and Celtic art and symbols are all visual records of self-expression and communication through art. Art has also been associated spiritual power, and artistic forms such as the Hindu and Buddhist mandala and Native American sand painting are considered powerful healing tools.
In the late nineteenth century, French psychiatrists Ambrose Tardieu and Paul-Max Simon both published studies on the similar characteristics of and symbolism in the artwork of the mentally ill. Tardieu and Simon viewed art therapy as an effective diagnostic tool to identify specific types of mental illness or traumatic events. Later, psychologists would use this diagnostic aspect to develop psychological drawing tests (the Draw-A-Man test, the Draw-A-Person Questionnaire [DAP.Q]) and projective personality tests involving visual symbol recognition (e.g., the Rorschach Inkblot Test, the Thematic Apperception Test [TAT], and the Holtzman Inkblot Test [HIT]).
The growing popularity of milieu therapies at psychiatric institutions in the twentieth century was an important factor in the development of art therapy in the United States. Milieu therapies (or environmental therapy) focus on putting the patient in a controlled therapeutic social setting that provides the patient with opportunities to gain self-confidence and interact with peers in a positive way. Activities that encourage self-discovery and empowerment such as art, music, dance, and writing are important components of this approach.
Educator and therapist Margaret Naumburg was a follower of both Freud and Jung, and incorporated art into psychotherapy as a means for her patients to visualize and recognize the unconscious. She founded the Walden School in 1915, where she used students' artworks in psychological counseling. She published extensively on the subject and taught seminars on the technique at New York University in the 1950s. Today, she is considered the founder of art therapy in the United States.
In the 1930s, Karl, William, and Charles Menninger introduced an art therapy program at their Kansas-based psychiatric hospital, the Menninger Clinic. The Menninger Clinic employed a number of artists in residence in the following years, and the facility was also considered a leader in the art therapy movement through the 1950s and 60s. Other noted art therapy pioneers who emerged in the 50s and 60s include Edith Kramer, Hanna Yaxa Kwiatkowska (National Institute of Mental Health), and Janie Rhyne.
Art therapy, sometimes called expressive art or art psychology, encourages self-discovery and emotional growth. It is a two part process, involving both the creation of art and the discovery of its meaning. Rooted in Freud and Jung's theories of the subconscious and unconscious, art therapy is based on the assumption that visual symbols and images are the most accessible and natural form of communication to the human experience. Patients are encouraged to visualize, and then create, the thoughts and emotions that they cannot talk about. The resulting artwork is then reviewed and its meaning interpreted by the patient.
The "analysis" of the artwork produced in art therapy typically allows patients to gain some level of insight into their feelings and lets them to work through these issues in a constructive manner. Art therapy is typically practiced with individual, group, or family psychotherapy (talk therapy). While a therapist may provide critical guidance for these activities, a key feature of effective art therapy is that the patient/artist, not the therapist, directs the interpretation of the artwork.
Art therapy can be a particularly useful treatment tool for children, who frequently have limited language skills. By drawing or using other visual means to express troublesome feelings, younger patients can begin to address these issues, even if they cannot identify or label these emotions with words. Art therapy is also valuable for adolescents and adults who are unable or unwilling to talk about thoughts and feelings.
Beyond its use in mental health treatment, art therapy is also used with traditional medicine to treat organic diseases and conditions. The connection between mental and physical health is well documented, and art therapy can promote healing by relieving stress and allowing the patient to develop coping skills.
Catharsis — Therapeutic discharge of emotional tension by recalling past events.
Mandala — A design, usually circular, that appears in religion and art. In Buddhism and Hinduism, the mandala has religious ritual purposes and serves as a yantra (a geometric emblem or instrument of contemplation).
Organic illness — A physically, biologically based illness.
Art therapy has traditionally centered on visual mediums, like paintings, sculptures, and drawings. Some mental healthcare providers have now broadened the definition to include music, film, dance, writing, and other types of artistic expression.
Art therapy is often one part of a psychiatric inpatient or outpatient treatment program, and can take place in individual or group therapy sessions. Group art therapy sessions often take place in hospital, clinic, shelter, and community program settings. These group therapy sessions can have the added benefits of positive social interaction, empathy, and support from peers. The client-artist can learn that others have similar concerns and issues.
Before starting art therapy, the therapist may have an introductory session with the client-artist to discuss art therapy techniques and give the client the opportunity to ask questions about the process. The client-artist's comfort with the artistic process is critical to successful art therapy.
The therapist ensures that appropriate materials and space are available for the client-artist, as well as an adequate amount of time for the session. If the individual artist is exploring art as therapy without the guidance of a trained therapist, adequate materials, space, and time are still important factors in a successful creative experience.
The supplies used in art therapy are limited only by the artist's (and/or therapist's) imagination. Some of the materials often used include paper, canvas, poster board, assorted paints, inks, markers, pencils, charcoals, chalks, fabrics, string, adhesives, clay, wood, glazes, wire, bendable metals, and natural items (like shells, leaves, etc.). Providing artists with a variety of materials in assorted colors and textures can enhance their interest in the process and may result in a richer, more diverse exploration of their emotions in the resulting artwork. Appropriate tools such as scissors, brushes, erasers, easels, supply trays, glue guns, smocks or aprons, and cleaning materials are also essential.
An appropriate workspace should be available for the creation of art. Ideally, this should be a bright, quiet, comfortable place, with large tables, counters, or other suitable surfaces. The space can be as simple as a kitchen or office table, or as fancy as a specialized artist's studio.
The artist should have adequate time to become comfortable with and explore the creative process. This is especially true for people who do not consider themselves "artists" and may be uncomfortable with the concept. If performed in a therapy group or one-on-one session, the art therapist should be available to answer general questions about materials and/or the creative process. However, the therapist should be careful not to influence the creation or interpretation of the work.
Art materials and techniques should match the age and ability of the client. People with impairments, such as traumatic brain injury or an organic neurological condition, may have difficulties with the self-discovery portion of the art therapy process depending on their level of functioning. However, they may still benefit from art therapy through the sensory stimulation it provides and the pleasure they get from artistic creation.
While art is accessible to all (with or without a therapist to guide the process), it may be difficult to tap the full potential of the interpretive part of art therapy without a therapist to guide the process. When art therapy is chosen as a therapeutic tool to cope with a physical condition, it should be treated as a supplemental therapy and not as a substitute for conventional medical treatments.
Research and general acceptance
A wide body of literature supports the use of art therapy in a mental health capacity. And as the mind-body connection between psychological well-being and physical health is further documented by studies in the field, art therapy gains greater acceptance by mainstream medicine as a therapeutic technique for organic illness.
Ganim, Barbara. Art and Healing: Using expressive art toheal your body, mind, and spirit. New York: Three Rivers Press, 1999.
American Art Therapy Association.1202 Allanson Rd., Mundelein, IL 60060-3808. 888-290-0878 or 847-949-6064. Fax: 847-566-4580. E-mail: email@example.com http://www.arttherapy.org.
activity therapy in the nursing interventions classification, a nursing intervention defined as the prescription of and assistance with specific physical, cognitive, social, and spiritual activities to increase the range, frequency, or duration of an individual's (or group's) activity.
aerosol therapy see aerosol therapy.
animal-assisted therapy in the nursing interventions classification, a nursing intervention defined as the purposeful use of animals to provide affection, attention, diversion, and relaxation.
anticoagulant therapy see anticoagulant therapy.
antineoplastic therapy see antineoplastic therapy.
antiplatelet therapy the use of platelet inhibitors such as aspirin, dipyridamole, or sulfinpyrazone, to inhibit platelet adhesion or aggregation and so prevent thrombosis, alter the course of atherosclerosis, or prolong vascular graft patency.
art therapy in the nursing interventions classification, a nursing intervention defined as facilitation of communication through drawings or other art forms.
aversion therapy (aversive therapy) a form of behavior therapy that uses aversive conditioning, pairing undesirable behavior or symptoms with unpleasant stimulation in order to reduce or eliminate the behavior of symptoms. The term is sometimes used synonymously with aversive conditioning.
behavior therapy see behavior therapy.
carbon dioxide–oxygen therapy see carbon dioxide–oxygen therapy.
chest physical therapy see under physical therapy.
client-centered therapy a form of psychotherapy in which the emphasis is on the patient's self-discovery, interpretation, conflict resolution, and reorganization of values and life approach, which are enabled by the warm, nondirective, unconditionally accepting support of the therapist, who reflects and clarifies the patient's discoveries.
cognitive therapy (cognitive-behavioral therapy) a directive form of psychotherapy based on the theory that emotional problems result from distorted attitudes and ways of thinking that can be corrected. Using techniques drawn in part from behavior therapy, the therapist actively seeks to guide the patient in altering or revising negative or erroneous perceptions and attitudes.
collapse therapy a formerly common treatment for pulmonary tuberculosis in which the diseased lung was collapsed in order to immobilize it and allow it to rest. pneumonolysis and thoracoplasty are methods still sometimes used to collapse a lung and allow access during thoracic surgery.
combined modality therapy treatment of cancer using two or more types of therapy, such as with chemoradiotherapy. Called also multimodality therapy.
compression therapy treatment of venous insufficiency, varicose veins, or venous ulceration of the lower limbs by having the patient wear compressing garments such as support hose.
continuous renal replacement therapy hemodialysis or hemofiltration done 24 hours a day for an extended period, usually in a critically ill patient.
convulsive therapy treatment of mental disorders, primarily depression, by induction of convulsions. The type almost universally used now is electroconvulsive therapy (ECT), in which the convulsions are induced by electric current. In the past, drugs were sometimes used.
couples therapy marital t.
diet therapy treatment of disease by regulation of the diet.
electroconvulsive therapy (ECT) (electroshock therapy) see electroconvulsive therapy.
endocrine therapy treatment of disease by means of hormones; called also hormonal or hormone therapy.
estrogen replacement therapy administration of an estrogen to treat estrogen deficiency, such as that occurring after menopause; there are a number of indications, including the prevention of postmenopausal osteoporosis and coronary artery disease, and the prevention and treatment of vasomotor symptoms such as hot flashes and of thinning of the skin and vaginal epithelium, atrophic vaginitis, and vulvar atrophy. In women with a uterus, a progestational agent is usually included to prevent endometrial hyperplasia. Called also hormone replacement therapy.
exercise therapy: ambulation in the nursing interventions classification, a nursing intervention defined as promotion of and assistance with walking to maintain or restore autonomic and voluntary body functions during treatment and recovery from illness or injury.
exercise therapy: balance in the nursing interventions classification, a nursing intervention defined as use of specific activities, postures, and movements to maintain, enhance, or restore balance.
exercise therapy: joint mobility in the nursing interventions classification, a nursing intervention defined as the use of active or passive body movement to maintain or restore joint flexibility.
exercise therapy: muscle control in the nursing interventions classification, a nursing intervention defined as the use of specific activity or exercise protocols to enhance or restore controlled body movement.
1. group therapy of the members of a family, exploring and improving family relationships and processes, understanding and modifying home influences that contribute to mental disorder in one or more family members, and improving communication and collective, constructive methods of problem-solving.
2. in the nursing interventions classification, a nursing intervention defined as assisting family members to move their family toward a more productive way of living.
gold therapy chrysotherapy.
group therapy see group therapy.
helium-oxygen therapy see helium-oxygen therapy.
hemodialysis therapy in the nursing interventions classification, a nursing intervention defined as management of extracorporeal passage of the patient's blood through a hemodialyzer. See also hemodialysis.
hemofiltration therapy in the nursing interventions classification, a nursing intervention defined as cleansing of acutely ill patient's blood via a hemofilter controlled by the patient's hydrostatic pressure. See also hemofiltration.
highly active antiretroviral therapy (HAART) the aggressive use of extremely potent antiretroviral agents in the treatment of human immunodeficiency virus infection.
hormonal therapy (hormone therapy) endocrine therapy.
hormone replacement therapy the administration of hormones to correct a deficiency; usually used to denote estrogen replacement therapy occurring after menopause.
host modulating therapy efforts to control periodontal disease by directly targeting the host response; an example is the use of drugs that do this, such as sub-antimicrobial doses of doxycycline, nonsteroidal antiinflammatory drugs, or bisphosphonates.
humidification therapy (humidity therapy) the therapeutic use of air supersaturated with water to prevent or correct a moisture deficit in the respiratory tract; see also humidity therapy.
immunosuppressive therapy therapeutic immunosuppression.
inhalation therapy the term formerly used for respiratory care (def. 3).
intravenous therapy (IV therapy) in the nursing interventions classification, a nursing intervention defined as administration and monitoring of intravenous infusions of fluids and medications.
leech therapy in the nursing interventions classification, a nursing intervention defined as the application of medicinal leeches to help drain replanted or transplanted tissue engorged with venous blood.
marital therapy a type of family therapy aimed at understanding and treating one or both members of a couple in the context of a distressed relationship, but not necessarily addressing the discordant relationship itself. In the past, the term has also been used in a narrower sense to mean what is defined as marriage therapy, but that is increasingly considered a subset of marital therapy. Called also couples therapy.
marriage therapy a subset of marital therapy that focuses specifically on the bond of marriage between two people, enhancing and preserving it.
1. treatment, usually in a psychiatric treatment center, that emphasizes the provision of an environment and activities appropriate to the patient's emotional and interpersonal needs.
2. in the nursing interventions classification, a nursing intervention defined as the use of people, resources, and events in the patient's immediate environment to promote optimal psychosocial functioning.
multimodality therapy combined modality therapy.
1. the use of music to effect positive changes in the psychological, physical, cognitive, or social functioning of individuals with health or educational problems. Music therapy is used for a wide variety of conditions, including mental disorders, developmental and learning disabilities, Alzheimer's disease and other conditions related to aging, brain injury, substance abuse, and physical disability. It is also used for the management of acute and chronic pain and for the reduction of stress.
2. in the nursing interventions classification, a nursing intervention defined as using music to help achieve a specific change in behavior or feeling.
neoadjuvant therapy in single-agent therapy or combined modality therapy for cancer, initial use of one modality, such as chemotherapy or radiotherapy, to decrease tumor burden prior to use of another modality, usually surgery.
nutrition therapy in the nursing interventions classification, a nursing intervention defined as administration of food and fluids to support metabolic processes of a patient who is malnourished or at high risk for becoming malnourished. See also nutrition.
occupational therapy see occupational therapy.
optometric vision therapy a treatment plan prescribed to correct or improve specific dysfunctions of the vision system; it includes, but is not limited to, the treatment of strabismus (turned eye), other dysfunctions of binocularity (eye teaming), amblyopia (lazy eye), accommodation (eye focusing), ocular motor function (general eye movement ability), and visual-motor and visual-perceptual abilities.
oral rehydration therapy (ORT) oral administration of a solution of electrolytes and carbohydrates in the treatment of dehydration.
oxygen therapy see oxygen therapy.
peritoneal dialysis therapy in the nursing interventions classification, a nursing intervention defined as administration and monitoring of dialysis solution into and out of the peritoneal cavity. See also peritoneal dialysis.
physical therapy see physical therapy.
play therapy see play therapy.
pulp canal therapy root canal therapy.
PUVA therapy [psoralen + ultraviolet A], a form of photochemotherapy for skin disorders such as psoriasis and vitiligo; oral psoralen administration is followed two hours later by exposure to ultraviolet a radiation.
radiation therapy see radiation therapy.
recreation therapy in the nursing interventions classification, a nursing intervention defined as the purposeful use of recreation to promote relaxation and enhancement of social skills.
reminiscence therapy in the nursing interventions classification, a nursing intervention defined as using the recall of past events, feelings, and thoughts to facilitate pleasure, quality of life, or adaptation to present circumstances.
renal replacement therapy therapy such as hemodialysis or transplantation that takes the place of nonfunctioning kidneys. See also continuous renal replacement therapy.
replacement therapy treatment to replace deficient formation or loss of body products by administration of the natural body products or synthetic substitutes. See also replacement. Called also substitution therapy.
respiratory therapy respiratory care.
root canal therapy that aspect of endodontics dealing with the treatment of diseases of the dental pulp, consisting of partial (pulpotomy) or complete (pulpectomy) extirpation of the diseased pulp, cleaning and sterilization of the empty root canal, enlarging and shaping the canal to receive sealing material, and obturation of the canal with a nonirritating hermetic sealing agent. Called also pulp canal therapy.
shock therapy obsolete term for convulsive therapy.
simple relaxation therapy in the nursing interventions classification, a nursing intervention defined as the use of techniques to encourage and elicit relaxation for the purpose of decreasing undesirable signs and symptoms such as pain, muscle tension, or anxiety.
speech therapy the use of special techniques for correction of speech disorders.
substitution therapy replacement therapy.
swallowing therapy in the nursing interventions classification, a nursing intervention defined as facilitating swallowing and preventing complications of impaired swallowing.
thrombolytic therapy the administration of drugs for thrombolysis (dissolution of a thrombus in an artery), to reduce the size of occlusion and thereby reduce damage to muscular tissue; the coronary artery is a commonly used site. Agents commonly used are streptokinase and tissue plasminogen activator (t-PA).
thyroid replacement therapy treatment of hypothyroidism by administration of thyroxine, usually in the form of levothyroxine sodium. Called also thyrotherapy.
ultraviolet therapy see ultraviolet therapy.
Psychotherapy that incorporates the production of visual art, such as painting or sculpture, in order to understand and express one's feelings.
the use of art media to reconcile emotional conflicts, foster self-awareness, and express unspoken and frequently unconscious concerns. Art therapy is often used when traditional forms of verbal psychotherapy have failed or been rejected by an individual and when individuals have difficulty expressing feelings or use verbalization as a defense mechanism.
a nursing intervention from the Nursing Interventions Classification (NIC) defined as facilitation of communication through drawings or other art forms. See also Nursing Interventions Classification.