Being an Art Therapist: a matter of degree
With great power comes great responsibility
I often wonder if other people see Art Therapists as being a bit precious and protective over our profession. We do seem to have to constantly differentiate ourselves from artists, art educators and arts in health practitioners, emphasising our Master’s degrees and our state registration.
I’ve written previously about the confusion over Art Therapy and ‘art as therapy’ and why this can be confusing for the layperson. Given the lack of knowledge about Art Therapy it may seem strange to some people that Art Therapists train for two years full-time or three years part-time at Master’s level and need to be registered with the Health & Care Professionals Council (HCPC) in the UK.
In the UK ‘Art Therapist’ and ‘Art Psychotherapist’ are protected titles meaning that only those who have completed an MA in Art Psychotherapy from a recognised training provider and are registered with the HCPC can practise using those titles. (Many other countries have their own state registration policies).
Here I’d like to give an insight into what our training involves and why we need to train as long as we do to work as Art Therapists.
If art is powerful, then there can also be risk.
“Art can help people because it has power, but that power is not innately helpful. Psychological knowledge and skill is required to keep the practice safe”.
“The recognition of the power of art to make inner states real is the basis of the art therapy profession itself”
These quotes are from an article that was published in the International Journal of Art Therapy by Art Therapist, Neil Springham. The article is interesting because it describes an issue that is rarely talked about by Art Therapists outside of the mental health profession — the potential for harm if art making with vulnerable people is not properly assessed and managed.
Briefly, Springham writes about his experience of being called as an expert witness in a clinical negligence case involving a man who injured himself during an art group which had been described to him as ‘art therapy’ (the lack of clarity regarding the intervention and no evidence of informed consent were key issues in the case).
The claimant had been encouraged by the art group faciliator (who was not an Art Therapist) to make a piece of art portraying all the bad things in his life and everything negative about himself in animal form. He was later encouraged to talk to the animal in the picture and ‘go with the feelings’. The claimant (who had a history of addiction and mental health problems) began hitting, scratching and punching the image on the floor in front of him, culminating in him head butting the picture causing spinal injury.
The claimant won damages after it was proven that both art and art making carries risk of harm if applied beyond the competence of the practitioner with vulnerable people.
I write this, not to scare, but to highlight why Art Therapists study at Masters Level. They learn about various mental health conditions and interventions and learn how to assess and manage risk through lengthy clinical placements.
Art Therapists must know how to adapt their practice to the needs of the client group. An example is the treatment of clients with Borderline Personality Disorder (BPD). Whilst Art Therapy has a strong psychodynamic background, Art Therapists know that this theoretical orientation is not helpful, and can be harmful, to BPD clients. Think classic Freud — the therapist as a blank screen, “So how do you feel about that?”, “Why are you asking me that?” approach.
It would be negligent of Art Therapists to use this approach with BPD clients. Due to the nature of their condition it is now known that these clients cannot cope with this type of therapy that concentrates on unconscious symbolism in art — rather Art Therapy based on mentalization can be much more beneficial.
Art Therapists in the UK are required by the HCPC to undertaking continuing professional development (CPD) throughout their working lives in order to stay up to date with the latest evidence on interventions for particular client groups. It is also important to note that HCPC registration for Art Therapists exists to protect the public, not the Art Therapist. An Art Therapist who is found to be acting negligently or beyond the scope of their knowledge can be found unfit to practise and be struck off the HCPC register.
We need to have extensive Art Therapy or therapy ourselves
“Only by experiencing what it is like when an image continuously signals its unnerving similarity to one’s subjective reality can one understand, or even believe [that an image can seem real].”
Art Therapist Neil Springham’s writing illustrates how powerful art can be. Indeed, many Art Therapists would testify that, when running art workshops or experiential groups for the public or for clinical staff, that considerable skill and care needs to be used. This is because, as Springham notes: “people are routinely awestruck by the vivid ‘realness’ of the experience of their own art”.
I experienced this first hand on my Art Therapy course, and in fellow students. Making and discussing artwork, particularly about a personal theme in experiential groups can tap into very raw feelings and bring up issues that were long buried. Myself, and other students, have sometimes been reduced to tears by our own, or sometimes others’, artwork and discussion of that artwork.
As Art Therapists, we recognise that we have great responsibility and we would never ask a client to go where we ourselves haven’t been before. We have felt the vulnerability, the exposure, the ‘milk white panic’ of the empty page, at being asked to make art in the presence of others, often about very personal issues. We have at least two years of personal therapy, preferably Art Therapy, to identify what may come up for us in countertransference to our clients, and to know what our issues are as separate from our clients. It seems unfair to ask a client to open themselves up to a therapist and do a lot of hard work, without an insight into what therapy feels like. That is why personal therapy and experiential art groups are requirements of all Art Therapy Masters degrees.
We need to learn to be reflective practitioners
A ‘reflective practitioner’ is someone who, at regular intervals, looks back at the work they do, and the work process, and considers how they can improve. They ‘reflect’ on the work they have done.
As Art Therapy is psychotherapy using art it should come as no surprise that Art Therapists undertake supervision regularly and reflect on their practice. Also, Art Therapists are generally state registered and must satisfy their regulatory body that they can assure the quality of their practice. This is done through various means such as attending supervision (as mentioned above).
As you can see these skills take time and practice to develop which is why masters level study is usually required. The reason for such study requirements is not to be an exclusive profession — but because working therapeutically with art carries responsibility.
Art Therapy: it really is a matter of degree.
