Affect regulating art therapy for children and adolescents experiencing psychosocial problems

ABSTRACT

Background:

The program Affect regulating Art(s) Therapy(ies) (ArAT) has been developed to address self regulation problems in children and adolescents with psychosocial problems. Therapeutic actions are hypothesised to be applied sequentially across three treatment phases: a tension regulation phase, an attention regulation phase, and an affect regulation phase. This study aimed to investigate whether the theoretical framework describing the phases of the ArAT program is observable in practice.

Method:

We collected film recordings of ArAT sessions. These recordings were viewed and rated using a checklist to explore whether the therapeutic actions were present.

Results:

There were no discernible differences in therapeutic interventions across the treatment phases. Therapists frequently utilised therapeutic actions from the tension and attention regulation phases throughout all stages of treatment. Moreover, the frequency of applied therapeutic actions were consistent across all treatment phases, with tension regulation actions being the most frequently applied and attention-improving actions and affect-regulating actions being the least frequently applied.

Conclusion:

The supposed phasing of the development-oriented ArAT program could not be detected in this research, indicating the need to reconsider the stage-wise description of the program. Art therapists need to recognise that reducing stress seems to remain important during all treatment phases.

Plain-language summary

An art(s) therapeutic program called ArAT has been developed in the Netherlands for children and adolescents with psychosocial problems. ArAT aims to improve the self regulation of emotions so that children and adolescents can better regulate their feelings and therefore have fewer psychosocial problems.

The therapist's therapeutic actions are theoretically supposed to be performed in three phases: a tension-regulating phase, an attention-enhancing phase, and an affect-regulating phase. This study aimed to examine whether the phasing could be observed in practice in this way.

For this, we have collected films of ArAT sessions from practice. These were examined whether the therapeutic actions were detectable using a checklist. No differences were discernible in the three different phases.

What was striking was that the therapists most often use tension-regulating and attention-regulating therapeutic actions. A similar pattern also became visible within each phase: stress-regulating therapeutic actions were used most, then attention-regulating therapeutic actions and affect-regulating actions were used least.

The presumed phasing of the developmental ArAT program could not be observed. This suggests that we should think again if and how we describe the different phases of the program. The least used are therapeutic actions intended to develop thinking and talking about feelings. For art therapists, reducing stress seems important during all treatment phases for children and adolescents with psychosocial problems.

KEYWORDS:

• Art therapy
• psychosocial problems
• self regulation
• developmental treatment
• phasing
• children
• adolescents

View correction statement:

Correction

Correction

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data is available from the first author.

Correction Statement

This article was originally published with errors, which have now been corrected in the online version. Please see Correction (http://dx.doi.org/10.1080/17454832.2024.2307132)

Additional information

Funding

This work was supported by NHLStenden University of Applied Sciences; Department of Practice Oriented Scientic Research (PWO).

Notes on contributors

Liesbeth Bosgraaf

Liesbeth Bosgraaf has worked for many years as an art therapist in various mental health care sectors in the Netherlands. She now works as a coordinator of the research curriculum, lecturer, and researcher for the art therapy program at NHLStenden University for applied science. She is also a member of the research cluster Small-n designs at NHLStenden. Liesbeth has been conducting research since 2016, specifically looking at the working elements of art therapy in children and adolescents within a Ph.D. Overall, in her work, her interest is in attachment, connection, and attunement themes.

Marinus Spreen

Marinus Spreen is professor of the research group Small-n designs at NHLStenden, Academy of Social Studies, and Academy of Healthcare at NHLStenden University of Applied Sciences, the Netherlands. His Ph.D. at the Interuniversity Center for Social Science Theory and Methodology, University of Groningen, addressed statistical inference problems in personal networks. His research focuses on experimental and naturalistic single-case methodology and statistics in health and social studies.

Kim Pattiselanno

Kim Pattiselanno is a research lecturer at NHLStenden University of Applied Sciences in the Netherlands. She obtained her Ph.D. at the University of Groningen and the Interuniversity Center for Social Science Theory and Methodology (ICS). Her research and teaching focus on research methodology and child and adolescent youth. She is currently a member of the research group Small-n designs at NHLStenden, Academy of Social Studies, and Academy of Healthcare.

Susan van Hooren

Susan van Hooren is a professor at the Open University of the Netherlands. She is head of the department of Clinical psychology of the faculty of Psychology at the Open University. She combined practice-based research with teaching activities and clinical work during her career. She has clinical experience with various psychopathological disorders (e.g. dementia, depression, ADHD, and sexual disorders). Her research, supervising (Ph.D.- & master students), and teaching focus on evaluating arts therapeutic interventions and their working factors and clinical psychology, resulting in many publications in high-ranking peer-reviewed journals and contributions to national and international conferences.