Therapist art making as a means of helping service users with anxiety problems

ABSTRACT

Background

Therapist art making in individual sessions with adult service users has received little attention in the art therapy literature. Similarly, art therapy’s efficacy with anxiety problems has not been established.

Context

NHS Criminal Justice Community Mental Health Team, long term weekly individual art therapy.

Outcomes

Service User reported marked reduction in anxiety, CJCMHT observed significant reduction in anxiety and increased social functioning leading to discharge from forensic services.

Conclusions

Therapist art making helped reduce anxiety by increasing trust. The ambiguity of the artwork challenged black and white ways of relating to self and others. Therapist artmaking functioned as a non-verbal form of psychoeducation. Three styles of therapist art making can be described, all of which are characterised by improvisation: Alongside the Service User; Jointly with the Service User; Under the gaze of the Service User.

Implications for research

Art making can be helpful in 1:1 therapy with adult service users because it magnifies the art therapist’s ostensive (i.e. non-verbal) communications and increases trust. Making art alongside service users provides a unique way to engage with complex psychological and interpersonal material. It is the ambiguity of therapist artwork that seems particularly helpful, and it should be considered as a promising way to address black and white thinking in common mental health problems like anxiety and depression.

Plain-language summary

This paper describes the benefits of therapist art making in individual sessions with an adult user of mental health services. Lived Experience feedback is used to show how therapist art making helped reduce severe anxiety and improve social functioning. The paper describes the clinical reasoning for three art-based interventions; how they built and maintained trust, meaning and hope for both therapist and Lived Experience Author. The paper suggests that the ambiguity of therapist artwork can be thought about in terms of the presenting problem, particularly to reframe black and white ways of relating to self and others.

KEYWORDS:

• Therapist art making
• anxiety
• ambiguity
• trust
• black and white thinking
• improvisation
• ostensive communication
• psychoeducation

Acknowledgements

As well as acknowledging the courageous way that Phil revisited a difficult time in his life to help write this paper, I want to thank Neil Springham, Ioanna Xenophontes and the two anonymous Peer Reviewers for their clear, constructive and collegiate feedback; this paper would not have been possible without them. My thanks are also due to Ken Wright and Maggie Batchelar for making supervision a safe, rigorous and imaginative space where thinking about difficulty was valued. And lastly, I want to thank Jacqueline Marshall-Tierney who, through her own practice, knows about difficult material in art therapy, but who also has the grace and understanding to help me not think about it too much outside of work.

Disclosure statement

No potential conflict of interest was reported by the author.

Additional information

Notes on contributors

Andrew Marshall-Tierney

Andrew Marshall-Tierney has 35 years' experience as an art therapist, mostly in NHS adult mental health services. He also has 15 years' experience as an art therapy educator and is currently Programme Leader for the MA Art Therapy at the University of Hertfordshire.