7: Using Art in Play Therapy
Note: Play Therapy Across the Lifespan is created to be heard. If you are able, we strongly encourage you to listen to the audio so that you are able to appreciate the emotion and emphasis that cannot be captured by text alone. Transcripts may contain errors and differ slightly from the audio. Please check the corresponding audio before quoting it in print.
Resources and Links
The Lighthouse
This technique can be utilized to help a client find hope in a difficult situation or season. It can be used with someone feeling stuck, hopeless, lost, or alone. This technique focuses on the client’s ability to see the light, find the hope, and remember that their story isn’t over yet. The Lighthouse activity can be used in groups and with individual clients.
Materials Needed: Paper, coloring utensils (crayons, colored pencils, markers, etc.).
Description: Instruct participants to grab a piece of paper and coloring utensils of their choice.
Guide them in this brief visualization: Imagine you are lost at sea on a stormy night. You are alone in your boat. You are weary, cold, and wet. Somehow though, with no sight of land, you continue to muster up the strength to keep rowing in the darkness. Breath by breath, no matter how slow, you keep rowing. Without any idea what direction you’re heading, in faith and out of options, you just keep rowing. Unsure how long it’s been that you’ve been lost at sea or how long it will be before your feet touch dry land, you keep rowing. Over and over and over again, your oars push through the water and carry you on, somewhere, anywhere. Suddenly, you see a glimmer of light leading you to land. A lighthouse. It’s faint in the distance, but it pierces the darkness and illuminates your way. It guides you home where someone is waiting for you with a warm meal, dry clothes, a place to rest your head, and most importantly, a loving embrace – that human connection you’ve been craving all along on this long and lonely journey at sea. It’s all there waiting for your arrival if you only follow the light. Even when you were surrounded by darkness, stuck in what seemed a never-ending stormy sea, that lighthouse was there, standing tall and glimmering brightly to guide you home. The journey was long, lonely, and absolutely brutal. It’s not over yet, you still have to make your way to land. But in the light, everything feels different. You’ve found your way, you’ve rediscovered hope in a future, and you know this lonely life of rowing out here on your own is not forever. You pick up speed as the heaviness fades. Your muscles have found new strength to row. They feel less heavy, and the water seems to be working with you instead of against you. Your heart leaps for what feels like the first time in forever. You feel hope bubbling up inside you as you follow the light, journey on, and make your home.
Invite clients to draw, color, or paint an image of a lighthouse as a source of guidance in their life. Instruct them to depict themselves somewhere in the image, perhaps in a boat on the water or maybe already at shore near the lighthouse.
After clients have created their picture, encourage them to add words to represent the sources of guidance in their life. This could be people (family, friends), beliefs, sayings, or other sources of strength and hope. Ask, "Who and what guides you home when you’re lost or stuck?"
Ways to Adapt the Technique: This activity could be done with instrumental music in the background. Time could be spent identifying and debriefing places where participants tend to get stuck, feel lost, hopeless, or alone. Participants could also draw people who are a resource, support, and safe place for them near or inside the lighthouse to identify support systems.
Prologue
I am really jazzed about this season of Play Therapy Across the Lifespan. Thanks to those of you who have already shared our podcast and encouraged us with kind words about the quality. This season, we’re going to talk about incorporating expressive arts through the play therapy approach.
As a new-to-the-profession counselor, I learned quickly that traditional talk therapy had limited success with the kids I worked with. I didn’t have the benefit of a graduate class in play therapy when I stepped into the counseling profession, so my early training back in the ’90s was trial and error. I added some important toys to my office, which helped with the younger clients, but not so much with my adolescents. I wanted to be more effective with them, too.
That’s when I introduced art. I always had printer paper, colored pencils and markers available, so it was an easy place to begin. That’s where we are going to begin this season as well, incorporating art in therapy. We’re going to try a couple of new things this season, like interviewing professionals about techniques they use. We’re still going to talk about the theme of the show with children, adolescents, and adults, but this season we’ll break up that long-lasting adult category that spans decades and can be quite different at 18 than 80. Of course, we’ll keep the research segment, too. I love learning new things from Rachel.
Art in Therapy Disclaimer – Art Therapy vs. Art in Therapy
Before we begin, I want to differentiate art therapy and art in therapy. If you call yourself an Art Therapist, it means that you have specialized education and training and have earned the credentials to call yourself by that name. You have a graduate degree in art therapy and are trained in mental health issues since this profession combines the mental health and art fields. According to the American Art Therapy Association web site, their mission is to “protect the public by promoting the competent and ethical practice of art therapy through the credentialing of art therapy professionals.” If you are not credentialed, do not call yourself an art therapist.
However, you can use art techniques with a generalist degree, like mental health counseling, marriage and family, or social work. This is more than semantics. It is important in protecting our scope of practice and the general public. You also cannot call yourself a play therapist unless you have earned the Registered Play Therapist credential, but you can use play therapy as you are learning. If you are interested in learning more about becoming an art therapist, go to arttherapy.org.
What Is Art in Therapy?
So, what is art in therapy? It’s simply using any kind of visual art to explore emotions, self-express, develop social skills, manage addictions, reduce anxiety, build self-esteem, or work on any treatment goal that you have. It can be used for wellness and prevention, but also for mental disorders and trauma. You could possibly use it in crisis work, but safety always supersedes any technique.
Art includes any visual art medium, so drawing, sketching, painting, sculpting, collage, woodworking and so on all fit in this category. You can even combine mediums. I’ll talk about a few here, but this isn’t intended to be a comprehensive, everything-you-need-to-use-art-in therapy, how-to list.
Also, I’d warn you about trying to add too much. You’d need to be an art supply store to have everything, and that’s way too much for clients. Just a few choices are plenty. You could always have other options that are put away and pulled out when needed. It’s helpful to test out a few things to see what works for you and the clients you see before collecting too many materials.
Okay, that’s a little about what art in therapy is, so now what materials are needed?
What Materials Are Needed?
You can use anything you would use to create art. If you are a beginner at incorporating art, I recommend starting with basic drawing supplies. You can pick up colored pencils, markers, and crayons at your favorite big box store or market, but higher quality supplies may help older clients who are new at this to see it as more credible and have a better experience.
You are probably going to need something foundational for the product, so you’ll need paper, a canvas, a board, a blank book, box or base for a collage. There are few rules around this, so feel free to be creative. For example, you don’t have to just use blank paper. You can use scrapbooking paper, watercolor paper, colorful cardstock, or a journal.
Next, you’ll need whatever you are using as an art medium. You might want thick, permanent markers, acrylic paint, pastels, watercolors, charcoals, clay, papier-mâché, pencils, etc.
Then, you’ll need the other supplies that go with your medium choice, things like brushes, sponges, water containers, glue, paint trays, an easel, scissors, yarn, beads, pipe cleaners, crepe paper, crafting supplies, shaping sticks, erasers, and so on. Choose ones that are age-appropriate. You also want to be able to organize materials with containers that make it easier to find and group materials
Finally, you’ll need supplies to clean up the client and the space. So, you’ll need access to handwashing supplies like soap and water, hand wipes, paper towels, an all-purpose cleaner, and trash bags to hold any liquid mess. Obviously, it’s best if you have a sink in the space where you do the art, but if not, have a way for them to clean up without needing to leave the space. This may be deep, emotional work.
Now that you know some options for art in therapy and what kinds of supplies you might need, and how do you help a client to use them?
To Prompt or Not To Prompt?
Prompting is sometimes a hot topic for those using play therapy. Theoretically, those in the child-centered camp would very rarely prompt, instead letting clients decide whether to use the art supplies available, and if so, how they want to use them. Those in cognitive or Adlerian camps would probably prompt often, and they may have a specific reason for including the art.
I am very solidly on the child-centered side, but when it comes to incorporating expressive arts, and especially with older clients, I include prompts. While I trust clients to do the work they need to do, adults sometimes struggle with too much ambiguity, so providing enough structure to give them a framework is helpful. But I also keep my prompts open enough for them to use the prompts as suggestions for starting, not an expectation for how to do the work. So, approach prompting in a way that is congruent with the way you use play therapy. If you are directive, prompt. If you are non-directive, rarely prompt. But keep in mind that very few play therapy practitioners are purely one way or the other.
If you want to use a prompt, consider why. Maybe you want to introduce the art supplies and see how the client works with them. Let that guide you. “I really want to understand what you are telling me, so I’m wondering if it would help for you to show me that. I have some sketching supplies over here, and I wonder if you can show me on paper what that was like for you.” Or maybe you want to explore emotions or concepts that are hard to explain with words. You could say something like, “You mentioned feeling out of control, and I heard you mention anger, disappointment, and fear. I have this watercolor set, and watercolor is hard to control, too. Would you paint something to show me what it is like to experience those three emotions at the same time?” You can do that with sounds, too. “It’s hard to put that in words. What if you try using something in the art corner to show me what [groans] is?”
I have other suggestions that I want to share with you, but I’ll be talking about prompting more as we cover other expressive arts, so I’ll save some for those episodes.
Art Across the Lifespan
So, how do you adapt art with clients across the lifespan?
Children
Let’s start with children. Include supplies that are age and developmentally appropriate. With very young children (or other clients) who do not have great fine motor skills, bigger supplies, like chunky crayons or large paintbrushes might be easier to maneuver. Bright colors are visually stimulating, which helps with cognitive development, but if your clients tend to be over-stimulated, you might want calming colored options for easels, paintbrushes, and containers instead. If you are replacing materials often, go for quantity over quality. You don’t want to be irritated about how much is being used and how much it will cost you when you are engaged in therapy.
Adolescents
Kid supplies are great for kids, but adolescents may appreciate ones with a less juvenile feel. In fact, they may resist child-like materials. You could still use similar supplies, but you might increase the quality or use older feeling containers to present the materials. Crayons, as an example, look different dumped in primary-colored cans than they do in smaller canisters sorted by hue. Re-sorting after every child client would be time-consuming, but adolescents tend to put things back where they belong.
Young Adults
Young adults may be striving to establish a professional identity, so they may like engaging in professional quality supplies. This population generally cares for the supplies, and aren’t extravagant with the quantity they use. When I worked with the emerging adult population, this was some of the feedback I received, along with some brand name recommendations. Quality materials increased the value they perceived of the therapeutic work. Although you could make the argument for art supplies helping clients access an inner child, which is why I always keep regular old crayons available.
Older Adults
Adulthood can span decades, and some authors of development split adulthood into four categories. Here, I’ll just mention that at some point in older adulthood, you’ll want to again consider things like fine motor skill and cognitive ability, and adjust the supplies accordingly. Using the crayon example again, you might include the larger crayons, but perhaps with the paper removed and lined up in a non-juvenile plastic or metal container that is easy to open. Give older adults dignity and respect while still providing materials that are appropriate.
Interview with Jessie Risman
My guest today is going to share an art technique with you called The Lighthouse. Jessie Risman has worked with university students, refugees, and the general adult population. She enjoys cooking, eating and writing. Jessie is going to share an art technique combined with a short, guided imagery exercise. If you want the script, we’ll link to it in the show notes.
[The interview portion of this episode was not transcribed. To listen to the interview click the episode link at the top of the page.]
Research Summary
Hi! I am so excited and honored to be back for Season 2. Today’s content is going to be slightly divergent in that I’m not going to summarize an article. Instead, I’m going to talk about why I like research and why I think it’s important for our field.
So, I didn’t always like research. In fact, I never really liked science, and I’d always equated the two. It was boring, dry, and intimidating. As a kid, I was much more of an abstract, creative thinker. But, eventually, my curiosities about the mind-body connection, the implications of trauma, and counseling led me to research. And what I began reading opened my eyes to new realities and understandings about the world and how humans heal. I began to realize that without research, without having some way of testing an idea or a hunch and without advances in science, we would be stuck in old ways of knowing and thinking and we may not be open to new ideas. Now, don’t get me wrong, research is flawed and imperfect, and what we know to be true instinctually, on an experiential level is also valuable.
But, imagine where our field would be if it wasn’t for people like Mary Ainsworth, who studied attachment, and Stephen Porges who has vastly expanded our understanding of the nervous system. The advances he’s made in a separate but related field have profound implications for the way we conceptualize and treat our clients in therapy. As are the advances in Interpersonal Neurobiology and the work of Dan Siegel. His entire body of work says that there is real science behind what the pioneers of our field have known intuitively for years—that relationships heal.
Sometimes, when I tell people that I’m studying to be a play therapist, I get some odd looks. Sometimes I think their furrowed brows are asking me, “So you just play with kids, and that somehow heals them?” Yes, yes it does. And it works! And we know it works because we can test it! In a recent meta-analytic review, Bratton, Ray, Rhine, and Jones show that play therapy demonstrates itself to be an effective intervention for children’s emotional and behavioral problems.
Research in play therapy is fairly new and it’s growing. It faces several research design challenges, like having small sample sizes which impact generalizability to different populations. Generalizability is just a fancy word to describe if results from a single study can be said to apply to all or most people. Sometimes the sample size in a study is really small or isn’t diverse enough, which impacts researchers’ abilities to be able to say that what they found in the study and with this specific sample is true for most or all people outside the sample.
But regardless of the challenges that research in the field faces, it is still crucial that it continues to be done. Mainly because it concretizes and validates what so many of us know intuitively about our work as therapists. We know that these modalities and techniques are effective with our clients because we’ve seen it in the playroom. We see the wins and the growth for our clients. And research and science give us credibility in the field of counseling and psychotherapy.
So, for this season, I will continue talking about recent research and the expressive arts in a way that is relatable, digestible, and applicable to your work with clients!
Conclusion
That wraps up today’s show. Now you know why I am so excited about this season. We’ll have seven episodes for you released in the spring semester of 2020, each on a different expressive art. Try this today: Pick one kind of art, get a few materials, and try it out with a client. See what happens. Some clients will love it and some will be uncomfortable with art, but learn your own preferences using it. Practice a way to introduce it in advance to help you feel more prepared. Thank you to our Expressive Arts Technique guest, Jessie Risman.
