Art on Trial

Confessions of a serial art therapist

Taking Flight: Art Therapy Research in Prison Part 2

The effectiveness of art therapy in prison—the follow up study

I hope everyone had a wonderful holiday season and that your 2014 is off to a great start. In looking forward to the New Year, I am curious to see where this blog takes me and anticipate hearing feedback from all of you.

The previous post summarized a pilot study that began exploring the effectiveness of art therapy in prison. Of course, once you have a pilot, you can take flight—and that’s just what happened.

Remember how I said at the end of the previous post [Please refer to that post here] that the prison's warden and the Director of Mental Health for the Florida Department of Corrections, Dr. Dean Aufderheide, thought highly of the results of the study? In fact, they were so pleased with the results, that they not only encouraged the follow up study but helped initiate the art therapy student internship program. So, along with grant funding from the Florida State University, the Florida DOC provided support and encouragement. However, certain methodological changes needed to be made.

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The follow-up

Recognizing both the importance and the limitations of a quasi-experimental design, the follow-up was devised to be much more robust. Building upon the conclusions of the previous study, the hypothesis for the follow up was more focused:

If inmates receive art therapy services, then they will exhibit marked improvement in their mood, socialization and problem-solving abilities within the correctional environment.

In this study, the pretest/posttest structure remained intact, although a control was added. Along with the FEATS (Gantt & Tabone,1998), the Beck Depression Inventory-Short Form (BDI-II) (Beck, Rial & Rickets, 1974; Beck & Steers, 1993) was included as a pre and posttest assessment to ascertain change in mood. Unlike the previous study, a single art therapist intern would be used to administer all sessions and assessments. Lariza Fenner, MS, ATR-BC (then a student with the Florida State University’s Graduate Art Therapy Program and now a faculty member with the Adler Institute of Chicago) was tireless in her contribution to this study.

The directives used for this study were consistent with those used in the pilot. However, using a single clinician and the amount of time we had to conduct this study did limit the number of participants.

The facility’s psychologist randomly assigned the participants to either an experimental or control group—those assigned to the control were provided art therapy sessions at a later date. Chosen from volunteers from the prison’s general population, 27 inmates were randomly chosen to receive sessions and 18 inmates were placed in the control group. Those who received services were divided up into groups no larger than eight. 

Rather than two sessions a week for four weeks, the eight sessions were spread out over eight weeks. The experimental and control groups completed the pre and posttests the same days—at the beginning of the eight-week period, and at the end. The types of directives used in the follow-up were similar to those used in the pilot.

Pre-test PPAT drawing
Pre-test PPAT drawing
Once again relying on the SPSS program, the change in BDI-II scores from pretest to posttest (i.e., posttest score – pretest score) was calculated. The differences were analyzed using independent-sample t- tests to find changes between the experimental and control groups. The deviations in FEATS scores from pretest to posttest (i.e., posttest score − pretest score) were calculated for each of the 14 categories, and the differences were separately analyzed using independent-sample t-tests to find variations between the experimental and control groups. (Gussak, 2006, 2007)

While the number of participants was less than ideal, and the results of the FEATS were underwhelming[i], the overall results indicated a strong support of the hypothesis:

Posttest PPAT drawing
Posttest PPAT drawing
The group of prison inmates who received art therapy services demonstrated a more significant change in mood than the group that did not receive such sessions.

In addition, the anecdotal data collected from observation and interviews with correctional staff supported that participating inmates demonstrated improved socialization and problem solving skills.

Thus far, the pilot and follow-up studies combined supports that art therapy can be effective with male prison inmates.

[As in the pilot study, the articles that documented these results are available for immediate download. To review this study, including methods, art therapy directives and statistical results, you may find this article in The Arts in Psychotherapy here. An article, published in the International Journal of Offender Therapy and Comparative Criminology combined the pilot and follow up into a single document—that can be found here. These articles are also available on the website www.arttherapyinprison.com.]

Is that all? Aren’t there other variables of mental health to examine? What about female inmates?

I’m glad you asked…

Because…

Coming up…

Ongoing studies were conducted and many changes were made to see if art therapy was effective in stimulating positive change with other issues in both male and female inmates. However, I don’t want to get ahead of myself. This will all be provided in the next post.

Reference

Beck, A.T., Rial, W. Y., Rickets, K. (1974). Short form of Depression Inventory: Cross-validation. Psychological-Reports 34 (3), 1184-1186.

Beck, A.T., & Steer, R.A. (1993).  Beck Depression Inventory manual. New York: Harcourt Brace.

Gantt, L. & Tabone, C. (1998). The formal elements art therapy scale: The rating manual. Morgantown, WV: Gargoyle Press

Gussak, D. (2006). The effects of art therapy with prison inmates: A follow- up study. The Arts In Psychotherapy, 33,188-198.

Gussak, D. (2007). The effectiveness of art therapy in reducing depression in prison populations. International Journal of Offender Therapy and Comparative Criminology, 5(4), 444-460.

 

[i] The resultant article does a great job—albeit incorrectly—in explaining the possible cause of these results and the assessments’ shortcomings in its use for this study. Again, that can be found here

David Gussak, PhD, ATR-BC, is professor and chairperson for the Florida State University Department of Art Education, and Clinical Coordinator of its Graduate Art Therapy Program.

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