Art Therapy and Autism
Definition of Art Therapy
Art therapy is a mental health profession in which clients, facilitated by the art therapist, use art media, the creative process, and the resulting artwork to explore their feelings, reconcile emotional conflicts, foster self-awareness, manage behavior and addictions, develop social skills, improve reality orientation, reduce anxiety, and increase self-esteem. A goal in art therapy is to improve or restore a client’s functioning and his or her sense of personal well-being. Art therapy practice requires knowledge of visual art (drawing, painting, sculpture, and other art forms) and the creative process, as well as of human development, psychological, and counseling theories and techniques.
Today, art therapy is widely practiced in a wide variety of settings including hospitals, psychiatric and rehabilitation facilities, wellness centers, forensic institutions, schools, crisis centers, senior communities, private practice, and other clinical and community settings. During individual and/or group sessions, art therapists elicit their clients’ inherent capacity for art making to enhance their physical, mental, and emotional well-being. Research supports the use of art therapy within a professional relationship for the therapeutic benefits gained through artistic self-expression and reflection for individuals who experience illness, trauma, and mental health problems and those seeking personal growth (American Art Therapy Association 2013).
Historical Background of Art Therapy
Throughout time humans have used symbols and images to express themselves. From Egyptian hieroglyphics to mask making to other objects used in rituals, art has been important in creating visual records of self-expression and communication. The development of art therapy has been a process which stems from previous interests in the observation of art and human behavior. In the late nineteenth century, French psychiatrists Tardieu and Simon published studies on the similar characteristics of and symbolism in the artwork of the mentally ill. Shortly after, Ernst Kris made connections to art and psychoanalysis believing in strong links between psyche, artistic works, and creative imagination. Like Freud, he believed that artists had an easier time accessing the “id” for material.
The field of art therapy really took form in the 1950s and 1960s. One of the modern pioneers of art therapy was Margaret Naumburg who was primarily an educator, second a psychotherapist, and third the first art therapist. She believed that art was a powerful vehicle in unlocking repressed material. Her perspective, often referred to as “art psychotherapy,” was based on the recognition that an individual’s most fundamental feelings and thoughts coming from the unconscious were expressed more powerfully through images rather than words. Her book, Dynamically Oriented Art Therapy was published in 1966 which still serves as an important text to students of the field.
Edith Kramer was another early contributor to the field. Kramer’s approach, “art as therapy,” was developed with her work with children and adolescents who were often unable to describe their feelings with words. Kramer believed that the process of making art allowed the children to access these feelings and identify them through the creative process. Her first book written in 1958, Art Therapy in a Children’s Community, described her initial experiences with her clients. After another 13 years of working in a hospital setting and psychiatric ward, she published Art as Therapy with Children in 1971. Edith Kramer along with Dr. Laurie Wilson founded the graduate program at New York University in 1976 which was one of the first successful programs and is still active today. It is important to note that Kramer believed that product was as important as process in art therapy. She felt that denying the client the gratification of the end art product was robbing them. Lastly, Kramer believed that the field of art therapy should be in the category of humanities rather than psychology.
Purpose and Underlying Theory
The intention of the art therapist is to offer and share the creative process with their clients in order for them to access their own inner healing. Art therapy in its totality can be adapted to various theoretical approaches which exist in today’s mental health field. As part of a comprehensive art therapy training, art therapists study psychoanalytic theories, Freudian, Jungian, and others. In addition, art therapy training includes historical and theoretical perspectives of other approaches, such as gestalt, object relations, humanistic, and family therapy.
Within the context of these theories, the art therapist integrates creative modalities and uses artistic media in the sessions with their clients. Sometimes the sessions may combine verbal or “talk” therapy; however, this is not necessary, and the act of art making can be as far as the client wants to go. In any case, while the creative process is taking place, all the art therapists are constantly assessing and tuning into their clients reactions to the materials, the direction that the art is going as well as subtleties in expression and body language.
Benefits of Art Therapy with Individuals with Autism
Autism is a pervasive developmental disorder in which social interactions are the main impairment along with delayed or impaired language development. Individuals with autism are deprived of the resources from which the mind organizes and develops (Emery 2004). Rigid thinking and inability to read other’s emotions tend to be other characteristics that can impede developing healthy relationships.
There are many issues related to sensory processing that affect most if not all diagnosed with autism. Sensory processing disorder (SPD) is a neurological condition that affects the ability to process information from the five senses. Those who suffer with this condition have sensitivities that can cause great distress, discomfort, and confusion leading to behaviors that are seen as “unacceptable” to the outer world. Because of their sensory processing challenges, art making can be a particularly effective therapy for people with autism. Because autistic individuals tend to have difficulty processing sensory input and are often nonverbal, they respond well to visual, concrete, hands-on therapies. Many people who work with this population know this and whether or not they have art therapy training, including art making in their clients’ activities.
There are limitations to our knowledge of why and how therapeutic art making actually works for autistics. These limitations of understanding result from the difficulty of standardized assessments, the near impossibility of quantifying the experience of making art, and the small number of art therapists publishing on the topic. Nonetheless, the abundant amount of research literature explicates that art making is an effective, clinically sound treatment option for autism when supplemented with studies from the fields of art, art education, psychology, and other creative arts therapies (Martin 2009).
Art therapy when used appropriately with individuals with autism can help increase communication, build better social skills, develop a sense of individuality, build more purposeful relationships, and facilitate sensory integration (Betts 2005). Children in particular who are diagnosed on the autism spectrum struggle with these challenges to varying degrees, but communication in general is probably the most difficult of all (Ullmann 2010). The distinct feature of art therapy is the nonthreatening, unpressured environment that it offers to those who are nonverbal. Engaging with art media can be a fulfilling experience that can often help the individual with autism start to feel relaxed with their therapist. In addition, art therapy can incorporate strategies to help individuals build a sense of accomplishment and self-esteem which then may lead to more refined expression and desire to communicate.
Determining the appropriate art interventions for any given autistic individual relies on assessing the developmental level as well as their functionality. Within the broader developmental context, art therapy can be used to engage an autistic individual’s relationships to the areas of communication, socialization, and imagination. Art therapy is known to tap into emotional issues; however, the client will probably need to work in the above three domains, before they can be successful in accessing this higher functioning and deeper area. This can be somewhat counterintuitive for a majority of art therapists who have extensive experience with other populations which are more capable of insight. Therefore, it is important that the therapist recognize this and do a full assessment of developmental and functioning levels at the beginning of treatment of an autistic child or adult (Ullmann 2010).
One must also keep in mind that children or adults with autism do not ignore others intentionally, but they will tune out in order to help them make sense of their world and regulate their over- or under-stimulated sensory channels. Therapists need to respect this plain fact and resist any impulse to change the process and force the individual to engage before they are ready to. Art therapy can be an excellent intervention when adapted appropriately and when the therapist has a good understanding of the needs of the population. Treatment must be flexible and open, remembering that each individual with Autism is quite different and requires a customized approach.
References and Reading
- American Art Therapy Association. (2013). Art therapy as an intervention for autism. Art Therapy: Journal of the American Art Therapy Association, 143–147. www.arttherapy.org
- Betts, D. J. (2005). The art of art therapy: Drawing individuals out in creative ways. Advocate: Magazine of the Autism Society of America, 26–27. Retrieved from http://www.art-therapy.us/images/art-therapy.pdf
- Dubowski, J., & Evans, K. (2001). Art therapy with children on the autistic spectrum: Beyond words. London: Jessica Kingsley Publishers, LTD. Retrieved from http://www.amazon.com/Art-Therapy-Children-Autistic-Spectrum/sim/1853028258/2.
- Martin, N. (2009). Art as an early intervention tool for children with autism. London, England Therapy Association, 21(3), 143–147.Google Scholar
- Ullmann, P. (2010). Art therapy and children with autism: Gaining access to their world through creativity (Vol. 2, #1). Arlington: Fusion, A Publication of the Art Therapy Alliance and International Art Therapy Association.Google Scholar