Art therapy is growing in popularity as a modality of therapy for seniors. I have been hearing of more community-based healthcare institutions employing more art therapists.
Every art therapist has a unique approach. In general, an art therapist will explore the therapeutic goals of the sessions in consultation with the client and the healthcare professional who referred him or her.
The therapist and client develop the therapeutic relationship within the confines of the art therapy space, which that enables clients to share their reflections in a calm and safe environment.
For myself, there are generally four stages for an art therapy session: check-in, artmaking and reflection/verbal processing, and check-out (closure).
The Stages of A Session
I generally start with a check-in. This can be a verbal check-in, or a non-verbal check-in (like a simple doodle, or hand gestures). It is a time for clients to warm up and ground themselves, and it is an opportunity for me to see where the client is at, as well as discuss goals with them.
The therapeutic goals and the clients’ comfort level with artmaking will influence the artmaking process. We can categorise the artmaking generally into unstructured and structured sessions. In unstructured artmaking, the client leads the art process based on what they would like to focus on. In structured artmaking, art therapists would provide directives or prompts to guide the clients.
I will usually try to involve my clients in some form of reflection and verbal processing of their artworks, and to see what came up for them from the artmaking. They might share their tactile experiences, or perhaps even some feelings that might have been prompted or aroused as a result.
At the end of the session, I will also try to have a check-out activity, so that the clients can be supported to transit back to their everyday lives. Sometimes, this might involve talking, or it might mirror a more physical check-in activity. I consider it as a closing ritual, and it is a means for clients to physically and mentally “close” the session.
How Art Therapy Benefits Seniors
Art Therapy encourages creative expression through the use of the art process and materials. It improves non-verbal communication, and seniors are provided a safe physical and metaphorical space to explore their thoughts and feelings, from which they can receive psychosocial support to help them manage fatigue, reduce anxiety and resolve other psychological conflicts.
Specifically for our current generation of seniors, most of them would not have had many prior experiences of artmaking. Hence, there is often fear and resistance to what they perceive as an activity that requires educational qualifications, and many of our seniors would share that they “have not studied before”.
How Art Therapists Guide Seniors During The Sessions
Often, I see myself drawing on the principles of developmental art therapy, which uses normative creative and mental growth as a guide to understand the individual. The approach references the stages of artistic development and expression, and by utilising this, I am better able to support clients with developmental art stage-appropriate interventions or prompts.
Sometimes, the artmaking done by some seniors will mirror the type of artwork made by children, because they are at a similar developmental art stage.
However, what may differ for seniors is the type of directive offered to them. They are better able to respond to more complex prompts; the level of verbal processing and reflection would be different too for seniors as compared to younger children.
As for the reflections, some of the guiding questions that I might ask could be, “how does depicting this make you feel?”
Often, the guiding questions will relate to the artwork that they are making, or it might start off as something that I observed in session. An example of this could be, “I noticed that you were a bit hesitant when working on this area of your artwork? Can you tell me how you feel about this section? What would it take for you to be more confident?”
How to Measure the Success of Art Therapy
Art therapy should be done at least once a week, if not once every two weeks. The results vary, but generally by the fourth session, if the clients can sustain their participation, we will be able to observe some growth or change for them.
At St Luke’s Hospital, our occupational therapists conduct therapeutic artmaking in the wards as well, so that complements my art therapy work and contributes to our vision for a supportive framework for patients through arts in health practices within St Luke’s Hospital.
Generally, when we talk about “successful” personal growth or positive results for art therapy sessions, we are looking at: reduced symptoms or issues concerning the problem presented; an improvement in relationships; more positive body language; a better outlook regarding the future, and improvements in overall functioning.
In the community hospital setting, often the patients are discharged once their physical rehabilitation goals are met, therefore I usually plan for the termination of art therapy after knowing the patients’ discharge dates. I help to foster a sense of closure at the end of therapy by reviewing the metaphorical (and actual) art tools/skills that they have at their disposal and explore with them how equipped they are to handle what comes their way post-discharge.
Personal growth is an ongoing process, however, and some seniors return to art therapy to maintain good mental health. They might choose to continue formal art therapy sessions by seeking art therapists in private practice.
How St Luke’s Hospital Incorporates Art Therapy
St Luke’s Hospital introduced art therapy to our clients in February 2017. The art therapy sessions are open to all clients, but generally we focus on patient referrals from my rehabilitation department colleagues as a targeted intervention for patients. I often list these possible reasons for referral to Art Therapy services:
- Client has behavioural challenges such as difficulty creating and/or maintaining positive relationships with social interaction
- Client has sudden or ongoing physical health challenges
- Client is profoundly and emotionally affected by a significant event
Our clients are surprised that Art Therapy is available as part of their rehab journey, and they have expressed their appreciation for the chance to explore some of their emotions and feelings.
Family members have also shared that they were grateful for the opportunity to work on legacy work with their family members in the palliative ward. Through art therapy, we provide form to words that might not be easily spoken between family members. Family members who worked with their loved ones on an art project or projects found that it is a meaningful way to spend time together. Sometimes the art product or the memory of making art together becomes something tangible for family members to hold on to, and can provide healing and comfort for many years.
Tips for Other Community Care organisations
Community Care organisations can consider a framework in which they provide art therapy services, therapeutic art making, and art making.
For artmaking, they could engage art trainers or volunteers to support their clients to concentrate on improving artistic skills.
For therapeutic art making, they can consider having their staff to be trained or supervised by art therapists to facilitate therapeutic art making that is focused on meeting clients’ present needs-in-the-moment.
As for art therapy services, they would need to engage a trained and qualified art therapist as it involves psychodynamic work with the clients; it is also important because sometimes the art therapy work brings up and unlocks trauma that people need to process in the presence of the art therapist.
Lee Sze-Chin is a senior art therapist at St Luke's Hospital.