I like Twitter; I tweet it up as @arttherapynews a couple of times of day, spreading links to news, updates, and research on art, creativity, and health to followers. But I didn't notice that my Twitter box was filling up with messages from an anonymous tweeter named @im_inebriated* who was eager to make his opinions about art therapy known to me. I don't really know why @im_inebriated decided to make ridiculing art therapy a focus of his Twitter career. At first I dismissed him as a twitwit and even a bit of a twhiner. Once in awhile he was kind of a twannoying, tweeting that my professional field was a fraud. How dare he! "Art therapy schmart therapy! How about beer therapy? How about scotch therapy?" No logical rebuttal could persuade him to stop. Sometimes he included a colorful "mua-ha-ha-ha" at the end of his tweet [if he had some characters left to burn], just for dramatic effect. Those tweets actually started to make me laugh out loud--and make me think.
Could @im_inebriated be right? Could his daily micro-messages really have some truth? While @im_inebriated's comments may have hit a nerve, they also begged an answer to this question: Where is the data to prove art therapy's impact on health and well-being? Where is the evidence that art therapy is not a "fake?" @lm_inebriated uncovered something about art therapy that many do not know. Research to support art therapy's clinical application is scarce, despite 50 or more years of theory and practice.
Art therapy, today I am the bearer of some tough love about the field. Evidence to justify the efficacy of art therapy is seriously deficient. It's the 40th anniversary year of the national organization and there is not a lot to show for four decades. Leaders in the field of art therapy talk and talk and talk every year about the need for more large-scale outcome studies on posttraumatic stress disorder, autism, Alzheimer's disease, and the currently popular disorder du jour. Academics continue to churn out more chapters and articles on why art therapy research is needed while very few outcome studies are undertaken, nevermind verified by conventional peer review or published anywhere but in art therapy journals.
Lest you think I am the only naysayer, it's not just me making these observations. Do a Google search of the words "art therapy" and in the top five hits, you'll find Wikipedia's take on the situation. In brief, it says, "Scientific research into the effectiveness of art therapy is lacking." Apparently, an earlier version of the page has been removed [likely by someone who found the criticisms to be a little harsh], but you can still read it here or below. According to this version, art therapy has set itself up for failure by defining its methods as having inherent "healing power," a statement that cannot be proven false if one comes up with the right definition of healing to match outcome. And for most the part, art therapy literature and studies are reviewed by other art therapists, not external reviewers from other fields. On these counts, Wikipedia is correct, albeit as an Internet resource it is uneven in accuracy on other aspects.
Some art therapists will say, "Well, you just can't evaluate art making and creativity by any standard, accepted scientific measures." Not so. Music therapy, art therapy's closest relative in the creative arts therapies, has used accepted instruments to successfully evaluate the effect of music on physiology, behavior, and memory. Others note that arts in healthcare outcome studies indicate art making has positive effect on certain aspects of health, particularly mood, pain perception, and stress. But these studies do not establish the efficacy of art therapy, but instead underscore emerging data on the creative process of making art that may or may not be part of art therapy's scope.
There is some hope on the horizon in the UK [a country where art therapy is a regulated part of the national healthcare system in contrast to the US where it is not]. An initiative spearheaded by colleague Dr. Diane Waller was recently announced at an international confab of creative arts therapies in September 2009; you can learn some of the details here:
The UK art therapy initiative will take some time to yield evidence-based research and outcomes; even the best case scenario will involve years of focused effort, excellence in research design, and patience to tease out why [or if] art therapy makes a difference. But for now, I say to my American colleagues, put aside all the excuses and distractions once and for all and make research the prime directive in the profession so we can understand-- and preserve-- this field. Prove @im_inebriated to be wrong so I can tell him and any of his future Twitter relatives that art therapy is not a fake.
*In case it was not obvious, @im_inebriated is a pseudonym to protect the tweeter's identity.
Visit the growing community of art therapists from around the world at the International Art Therapy Organization [IATO]. One world, many visions...working together to create an inclusive and sustainable future for art therapy.
"Scientific research into the effectiveness of art therapy is lacking. Research into the effectiveness of art therapy is generally published in journals such as the Art Therapy Journal, which is maintained by the American Art Therapy Association, and is therefore evaluated primarily by practitioners and students of art therapy. Assessment of the effectiveness of art therapy by individuals independent from the art therapy community is lacking. Research studies that employ the scientific method by, for instance, randomly assigning participants to either an art-therapy group or a wait-list control group tend to find that art therapy has little or no beneficial effect on the severity of mental disorder. Meta-analysis has indicated that well-established therapies such as cognitive-behavioral therapy can produce successful outcomes in circumstances in which art therapy and other expressive therapies have no identifiable benefit (Wethington, Hahn, et al., 2008). The practice of art therapy therefore should not be considered a form of Evidence-based medicine or evidence-based mental health treatment.
One major difficulty in assessing the validity or effectiveness of art therapy and other expressive therapies is that the tenets and assumptions of art therapy do not meet the criterion of Falsifiability, or refutability. For instance, as indicated in the introductory section of this article, one definition of art therapy "involves a belief in the inherent healing power of the creative process of art making." This statement is nonspecific such that it could not possibly be proven false, and therefore can not be evaluated scientifically. This is because phrases such as "healing power" and "creative process of art making" have so many possible definitions that one could simply pick between them to accommodate any scientific finding to the contrary of the initial belief."
Cathy Malchiodi is an art therapist, visual artist, independent scholar, and author of 13 books on arts therapies, including The Art Therapy Sourcebook.
