More Than Just Coloring by Raceal McWhorter, MA, MFT/Art Therapist Intern

In this article, I intend to share some of the fun effective art therapy interventions I have used in the family preservation program at Valley Trauma Center, now Strength United, to which clients responded well and reported significant improvement in family relationships, substance abuse, and communication skills. I am primarily a solution focused brief therapy art therapist. Following are a few interventions I used most often to identify problem areas, create solutions, and record progress with my clients. These interventions were influenced by Bowen theory, dialectical behavior therapy (DBT), as well as clinical art therapy.

"I want the clients you get," remarked one of my colleagues at Strength United. "Your clients seem to be so cooperative and you get such great outcomes." We all work with the same demographic of clients; families with open DCFS cases, whose children have been removed from the home due to suspected child abuse, neglect, substance abuse and/or domestic violence. The children have since been returned on the condition the family complete the family preservation program; six months or more, depending on the family's progress toward reaching program goals. I believe my successful outcomes have been related to my commitment to hold my families in unconditional positive regard, my expectations for clients to do the work, and my practice of using art therapy in fun therapeutic ways. The families respond positively to my love and respect for them and everyone enjoys having fun. The children look forward to me bringing drawing materials and play items and parents look forward to feeling heard, understood, and learning new parenting skills.

As part of establishing rapport in the first few sessions, I like to assist the patients in creating a genogram of at least three generations, going back even further in the family history if the information is available. This process assists me, clinically, by allowing me to get to know the family of origin and provides the opportunity to explore and identify maladaptive behavior patterns and learned behavior from parents, grandparents, and other close relatives. Often looking back into his or her family history and recognizing the connections with past familial trends can help alleviate the guilt the patient may hold related to his or her own maladaptive behaviors; such as substance abuse and domestic violence and allows the patient, with the help of the therapist, to forgive and free themselves to develop solutions. From here the solution focused questions are posed:

• "How do you want your future family relationships to look?"
• "What small steps can we take to create that reality?"
• "How do you want to celebrate the successful completion of each step?"

A second intervention I use, nearly universally, is the three-part personal history drawing. The patient choses either an 8.5" x 11" or 11" x 14" piece of white drawing paper, a lead pencil, color pencils, color markers, or oil pastels. The patient is asked to fold the paper in thirds, and chose to use the paper in portrait or landscape mode. The patient is then instructed to draw the most notable events that happened in his or her life from the age of three to six in the first section, six to twelve in the second section, and twelve to present in the third section. This activity helps establish rapport as well as it allows the patient to externalize his or her deeply held feelings relative to experiences of trauma and triumphs in a timeline. The therapist can assist the patient in processing those events and putting them in proper perspective. This intervention can help move forward the therapeutic process and it allows the clinician to explore and identify the significant issues which may have influenced the patient's current behavior; in addition to providing a guideline for what concerns may need further processing and help reveal pertinent interventions to develop a treatment plan.

One of my favorite interventions to assess family dynamics is to have all members of the family work on an 18x24" canvas together, using color markers or color pencils. Each family member chooses a different color so as to be able to distinguish which parts of the drawing were done by whom. The family is instructed to draw the ideal home and neighborhood. Everyone must accept each family member's ideas and contributions to the home; however, negotiations are allowed to take place relative to the location of the drawings on paper and the amount of space to be taken up. These directives enable the therapist to observe family dynamics and communication patterns; noting who is dominant, passive, and/or confrontational. The therapist may have to remind the group that vetoing another's idea is not acceptable. Processing the drawing may be enlightening to the parents and children about how they interact with one another and the way they address one another's needs and wants. Most family members find they are happy to have their needs and desires acknowledged and verbalized for the first time and as well, they have a document as evidence of those desires. This drawing can be used throughout therapeutic journey to assess progress toward improving family dynamics and promoting unity.

Art therapy interventions can be useful to therapists as an assessment tool and can be cathartic for patients; encouraging them to explore underlying issues that affect current behavior. Artistic options in therapy can provide the backdrop needed for a patient to acknowledge, accept and process their pain; resulting in a celebration of growth. Art therapy can be a tool to help externalize those negative feelings and remove some of the sting. The record of their pain on paper or other media can be destroyed symbolically by destroying the image; or stored to be compared later with other images to illustrate the progress made toward healing in therapy. The therapist must be careful to allow the patient to interpret his or her images and not make judgmental statements. If a patient protests, "I'm not an artist, I can't draw," reassure him or her, the work is not to hang on a wall, it is simply to illustrate feelings and can even be abstract scribbles, shapes and forms. Ask questions such as: "What does that mean?" Why did you use that color?" These questions can encourage the patient to process the image, if they do not spontaneously share the information.

Art therapy practices can include a client drawing a safe place to use as a mental retreat as they work to process painful traumatic events. Advocating for patients to relive happy times and remember every detail of the scents, sounds, textures, feelings, people present, and words spoken can help him or her return to those memories as a conscious alternative when negative memories intrude into daily life or dreams. These artistic therapeutic activities are by no means fail-proof but a viable, interesting, and creative alternative to traditional talk therapy that can provide a positive, fun, expressive process which can bring about change.

Raceal McWhorter, MA, MFTI, Art Therapist, currently works at Tarzana Treatment Center's Youth Residential Facility with Probation Youth who have history of severe substance abuse and trauma ranging from child abuse; physical/sexual to CSEC (Commercial Sexual Exploitation of Children). Raceal can be reached at 714.679.0759 or via email, or website; racealmc@gmail.com; www.raceal.com.