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A recent Center for Disease Control [CDC] study reviewed the effectiveness of art therapy and play therapy in trauma intervention with children. According to the authors, neither has been proven to work for children with posttraumatic stress disorder. But are these therapies effective—that’s the real question. Read More
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CBT therapists downplay art and play for kids with trauma.
So how is a CBT therapist going to access and develp a therapeutic relationship with a child victim of trauma? Through a behavior chart only? Of course they use art and play. Yes, CBT can be effective in the short term, but we are seeing CBT being "in fashion" at the expense of other forms of therapy. There is nothing wrong with CBT, it works for many patients, especially those with personality disorders (an offshoot, DBT is effective with many borderlines, for example, who have a history of trauma and abuse).
Let us not forget that CBT is favored by the managed care insurance companies, as is some drug treatments due to its short term treatment, they are the ones pushing this research. In their rush to secure a "lock hold" on entire mental health professon, the behaviorists are throwing out the natural language of how children communicate, art and play. How much concern does this show for the child victim of trauma, really? The prevalence of CBT is something we cannot escape from, due to financial reasons, but Cathy, you are right, art and play therapists need to advocate for our professions and for the natural language of our child clients.
Agree!
Thanks, Rita, for taking the time to comment. I use both CBT and DBT [am learning more and more about it and how it can be used with art therapy], and of course, those of you who know me, know I also am inclined toward narrative and solution-focused approaches, too. I always say when teaching about art and play in trauma intervention, how else are you going to communicate with children and vice versa? Meanwhile, we also now know that verbal language becomes impossible for some individuals [all ages] when the PTSD symptoms are severe.
But we in the fields of expressive therapies need to also start to step up to the research plate and do the investigations needed to advance understanding of these methods.
Thanks again for your observations!
Well said!
Very well said Cathy! I am so glad you wrote a response to this study and bringing attention to other thoughts that need to be considered. Thank you!
-gretchen
Art Making is a Cognitive Exercise
At last year's conference I heard you (Cathy) say that we should remember that making art is also a cognitive experience. I've been watching the discussion about this article on other forums. UNproven doesn't mean being DISproven. Thank you for continuing the discussion.
Art Making and Cognition
Thanks for reminding me, Susan! I am preparing a short talk on art therapy and returning military with PTSD for next week and revisiting a lot of the neuroscience research that supports the use of art in trauma intervention. One thing that I hope is put to rest in the field of art therapy is the notion that art is "a non-verbal right-brained process." No, you need your whole brain and some of art making process actually has to do with language and of course other higher functions.
CDC study on effective interventions for Trauma
My concern after reading the brief summary of the study by Wethington et. al. is that art therapy is identified as an intervention utilized by practitioners, or "personnel", as is play therapy and CBT. Art therapy is not a modality or an intervetion, it is a practice of psychotherapy that requires a Master's Degree and 2 years of post graduate clinical supervision. My question is this,
is the use of "art therapy" in the study by Wethington et. al. being conducted by trained clinical art therapists? Or are they taking evidence from practitioners who have no formal training in art therapy as a clinical discipline, but rather use it from time to time.
This would greatly effect efficacy outcomes and must be taken into consideration.
Many studies conducted as thesis and doctoral work have pointed to the effectiveness of art therapy when practiced properly with victims of trauma.
As mentioned earlier, the CBT techniques used with trauma victims is based on art therapy practices. Art Therapy is a profession long in existence. And what we have long understood regarding its effectiveness with reducing anxiety, containing and differentiating traumatic memory, restoring locus of control, is now being supported by research in neuroscience.
Thank you.
Art Therapy and Efficacy Studies
Dear Susan,
The art therapy study reviewed by the CDC involved a psychiatrist, nurses, and art therapist Linda Chapman who designed the protocol. If I understand it correctly, I believe that the nurses carried out the protocol. That is an acceptable way to conduct a study, to educate related professionals on how to implement a protocol, test them to see that they can perform the protocol correctly, and have them apply it to treatment. It can also remove some of the bias that an art therapist might bring to the protocol and makes the study "cleaner." The study's intent was to measure how well art therapy works; to see if there is a difference in art therapists versus nurses carrying out the protocol, well, that would make for another study that I would like to see, too.
We need more research on how art therapy brings about change and I welcome readers to let me know about any efficacy studies you know about-- I am always interested in reading them and highlighting them here!
Catharsis?
Hi there,
Your site was sent to me by a friend who is studying art therapy and is wanting an opportunity to present research (perhaps case studies) of instances where art therapy done by trained professionals has good outcomes for traumatized children. You have a blog obviously, so I'm not sure why she sent this one other than to present you as an expert, but I enjoyed reading it. I have a question regarding the below quote and I am wondering if you could clarify what you mean by ths?
"Getting out the sensory memories of trauma is where the real action is [along with a skilled professional who facilitates the experience];"
It sounds like you are referring to the outdated notion of catharsis, or perhaps some form of EFT (Emotion Focused Therapy) but I don't want to assume. So I thought you might have a moment to clarify.
Thanks so much!
Not catharsis
Hi Nicole,
Good observation! I try to keep my posts brief, so I don't explain everything as deeply as I do in books and chapters. Sensory memories are implicit memories-- so think of this way. Our bodies react to trauma in different ways and that is a sensory memory of that traumatic event. when these reactions last a long time, post-trauma, they can become problematic. Even more problematic, people have post-trauma reactions such as hyperarousal or avoidance, but they no longer remember or connect them to the traumatic events they experienced. Other similar events trigger those reactions-- and often sensory experience trigger them, such an image, sound, smell, etc.
Arts tap the senses and that makes them a valuable component of trauma intervention. I don't really believe that catharsis is particularly helpful in recovery, although the arts can also induce cathartic experiences. In brief, perhaps arts are useful in connecting the sensory/implict memory to the declarative/explicit memories [the story]; that is why sensory material is where the action is, in my humble opinion.
CDC Report
I wish more art and play therapists would express their views when news, like the CDC task force report branding art and play therapy as essentially "unproven", is announced. It is at such times that art and play therapy adherents must stand up tall and be heard!
CDC helps..
It sounds good to know about the Center for Disease Control. Surely it will help people in diverse ways and people will surely get good results out of their queries related to health issues. More information’s would help people in
handling their health issues.
Shelly Smith
Drug Intervention Washington
CDC
Nice article and very informative. Thanks for posting. Its a good thing what CDC can do to help people who have question regarding health issues.
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