-
What is Art Therapy or Art Psychotherapy?
-
What happens in an Art Therapy session?
-
What is the difference between an art teacher/volunteer art facilitator and a qualified Art Therapist?
-
Do you have to be good at art or artistic to benefit from Art Therapy?
-
Who would be referred to an Art Therapist and why?
-
How do I find an Art Therapist for myself/my workplace?
-
What are the basic requirements to be able to provide an Art Therapy service in a palliative care setting and how much will it cost?
-
Where do I find out about salary structures for Art Therapists?
-
Now that Art Therapy is a State Registered profession, what do we need to do to bring our service into line with government guidelines?
-
Are there any resources to help in setting up a service or with training costs?
-
What sorts of services are already being provided?
-
What qualifications and experience do I need to train as an Art Therapist?
-
Can I observe an Art Therapy session in progress?
-
I am a qualified Art Therapist. What are the benefits of joining the Creative Response?
-
How is working with people with a life-threatening illness different to any other client group?
-
What happens to the client’s artwork after they die?
-
Could you recommend some books or articles on Art Therapy in palliative care, AIDS, cancer and bereavement?
There is increasing recognition of the contribution Art Therapy can make to the psycho-social component of contemporary holistic palliative care. The emotional roller-coaster of diagnosis, treatment regimes, symptom management, uncertainty and loss demands a professional intervention from the multi-disciplinary team.
The Art Therapist provides individual or group sessions where the patient (or their family/carers) can explore their feelings in a safe, supportive environment. Through the use of art materials, thoughts and feelings that may be too intense or painful to put into words can find expression. Exploring the creativity latent in us all allows for personal insight and discovery of our strengths.
A Registered Art Therapist is trained to provide the help and encouragement necessary to facilitate what can often be a difficult process, thus providing the possibility of release and resolution in a safe, supportive environment. Art Therapy can be offered in a variety of settings, whether on admission to a Hospice, as an out-patient through Day Services, at a Drop-In Centre or in the patients own home.
top
Because Art Therapy is non-directive and genuinely patient-led, what happens will be different for each client and in each session. The Art Therapist provides the widest possible range of quality art materials and will provide a safe space in which to work. They are able to do this even within the context of a busy ward or at the patients’ home, minimizing distractions and interruptions. There is usually a structure to the session, helping the client to get started and providing the opportunity for them to achieve any goals within the time available. The patient is then able to work at their own pace, drawing on the skills of the Art Therapist to explore the work and it’s personal significance as they feel able. There are several ways in which what happens in an Art Therapy session has been misunderstood however.
Whilst the patient may find real value in being distracted from their concerns through painting or working with clay for example, Art Therapy is far more than a mere diversionary intervention.
The Art Therapist also has the skills to facilitate working in a variety of materials to enable the patient to achieve any effect they may want, but equally Art Therapy is far more than a simple art class.
Probably the most common misconception is that the Art Therapist will interpret whatever the patient does and can virtually see inside the patient’s heart and mind just by their selection of colours or materials! Whilst the Art Therapist is trained to help the patient to explore the personal significance of both the process of art making and it’s final product, there is little value in imposing their own interpretations on the work. This would simply hinder the process, effectively disempowering the patient and needlessly impeding their development.
top
Many Hospices and palliative care services are fortunate in having the services of artists or art teachers who are keen to work with patients, helping them to develop latent skills in painting or sculpture as well as individual craft projects. There are also artists in residence who may collaborate with patients and staff in the production of a piece of art work. Both these activities aim to encourage creativity and active engagement in producing art which may be for exhibition or even sale, raising much-needed funds.
There is no doubt that patients who become actively involved in such projects derive enormous pleasure and satisfaction from the work, and it might well be described as ‘therapeutic’. In overcoming some of their inhibitions or blocks in the struggle to create something aesthetically pleasing or ‘good enough’ to exhibit, the patient may also start to explore deeper emotional or psychological issues.
There is a real danger here that the untrained, well-meaning facilitator will quickly get out of their depth if they attempt to support the patient through this process. Hospice patients are particularly vulnerable and readily trust those professionals around them to be able to respond appropriately to their psycho-social needs.
There are several Hospices in this country in which Art Therapists work alongside art facilitators, creative writers, film makers, poets and so on. There is no confusion in such venues as to where the boundaries lie between these activities. What is essential is that there is a recognition of these boundaries and staff are not asked to cross them.
Creative Response have produced a set of Guidelines for artists and art therapists in palliative care settings in conjunction with Help the Hospices.
top
Quite simply ‘no’!
Art Therapists are extremely familiar with working with clients who do not consider themselves artistic in any way. They will encourage the client to explore a variety of materials and are accomplished at putting the client at their ease so that they very rapidly lose their inhibitions and any feelings of inadequacy or foolishness.
Working with an Art Therapist is not about producing some picture or object for exhibition. The work is private and will generally be stored between sessions by the Art Therapist under lock and key.
When a practicing artist is referred for Art Therapy they will find it completely different to any previous way of working and may well be surprised at the changes of direction and insight a session can bring.
top
Any patient, carer or family member might find working with an Art Therapist beneficial.
Usually referrals come via the multi-disciplinary team in response to some perceived difficulty the individual has encountered. Occasionally patients refer themselves, having heard about the work perhaps from a fellow patient.
Reasons for referral are as varied and complex as people themselves. However, referrals are commonly made at various points in the illness as a result of specific issues such as: Anger at what is seen as late or problematic diagnosis, frustration, despair, hopelessness, anxiety, clinical depression, withdrawal, body image, fear, pain, insomnia, loss or occasionally from a desire to explore their positive, creative side and integrate that into their present circumstances.
top
Since State Registration of the profession, in order to practice as an Art Therapist it is now necessary to be registered with the Health Professions Council (formerly the Council for Professions Supplementary to Medicine).
In addition the British Association of Art Therapists (BAAT) maintains a Directory of qualified Art Therapists throughout the UK. Members are listed regionally with a nominated Regional Co-ordinator who will liaise with members in your area. You can contact BAAT by emailing info@baat.org.
The Creative Response is a sub-group of BAAT whose members are specialised in working in palliative care, AIDS, cancer and bereavement. The Creative Response Secretary may also be able to put you in touch with a member working in your area or at least the BAAT Regional Co-ordinator.
Following these routes will ensure you are connected to a fully qualified practitioner who has been trained at an accredited school, subscribes to the professional Code of Ethics and whose work will meet the highest possible professional standards.
Specific Jobs may also be advertised to BAAT membership via the Appointments Memorandum at BAAT headquarters.
top
First it is essential to check that the Art Therapist you employ is State Registered. They will need a basic kit of art materials – a budget of approximately £250 per annum p.a. should be enough to get started and if asked, local companies may well donate paper etc. Some venues are fortunate in having a designated room for Art Therapy, but at the least, the Art Therapist will need a room with a table, a sink and good natural light. A modest area will need to be made available for the secure storage of art work and process notes.
Most Art Therapists will organize workshops for staff so that they are aware of how and why to make referrals. This also provides an opportunity to establish the need for confidentiality in the therapeutic process.
It will be essential that there are no interruptions to sessions and that the privacy of the artwork is respected. The Art Therapist is trained to work as part of a multi-disciplinary team and will contribute to team meetings and give verbal and written reports within their confidentiality guidelines.
Professional supervision – ideally with another Art Therapist – will be essential to the welfare of patients and staff alike. This would usually be a minimum of one hour per month, or more depending on the caseload. Art Therapists may be paid a salary or sessional fees. Enquiries about on salaries and fees may be accessed via the British Association of Art Therapists Website.
top
Through the British Association of Art Therapists (BAAT) – payscales are re-negotiated annually and published in the BAAT Newsbriefing.
Sessional fees should be negotiated with the individual Art Therapist and will naturally reflect both the particulars of the service required and the experience the therapist brings to the work.
top
State Registration ensures national standards of training and practice, offers guidelines on supervision and caseload and negotiates payscales for all Registered Arts Therapists.
Primarily it is essential to ensure that any employee or volunteer offering an Art Therapy service is indeed State Registered. Check www.baat.org or www.hpc-uk.org for further information.
top
Yes! The Corinne Burton Memorial Trust funds scholarships for Art Therapy students hoping to work in a palliative care setting.
The Macmillan Fund are also willing to consider applications to seed fund Art Therapy services, usually for a fixed period to enable the service to be evaluated whilst permanent funding is sought.
Help The Hospices will also consider training costs and can help with the costs of continuing professional development through funding attendance on appropriate courses etc.
Colleges may be able to place Art Therapy students in appropriate venues, providing supervision through the College tutorial system, provided there was some undertaking to create a more permanent position once training is completed where the value of the service had been clearly established.
Ongoing costs can usually be met quite easily. Local businesses for example are often looking for a particular project to sponsor and the creative focus of Art Therapy seems to hold a special appeal. When patients have found Art Therapy of particular benefit, families and friends have often come forward to ensure that the service will be made available to others in the future.
top
Art Therapists are working in palliative care in-patient units in Hospitals and Hospices, in specialist oncology or AIDS clinics, in Day Services, Drop-In Centres or even within a prison, indeed anywhere services may be accessed for people living with a life-limiting illness.
They are also attached to community-based services, with referrals coming from Macmillan or Marie Curie teams in the community or direct from GP, district nurses or Consultants, working in the patients own home. Most of the latter are in 1:1 sessions with overall feedback to the referrer (within the confidentiality component of the Code of Ethics).
Day Services and Drop-In Centres also offer the possibility of working in small groups, structured to meet the particular needs of it’s members and the service provision – for example a support group for women, people with motor neurones disease, carers and so on.
top
Currently in the UK, training starts with a post-graduate Diploma in Art Therapy at one of the five accredited colleges listed on our training page.
Qualifications usually include a first degree – usually in fine arts or social sciences – as well as experience working with what would be regarded as an appropriate client group (e.g. people with learning difficulties, young offenders, mental health, bereaved etc) and evidence of the candidates personal artwork development.
Specific details for each college may vary but generally speaking more mature students with varied life experience are considered favourably. Most of the Colleges also run short introductory courses and summer schools which allow candidates to get a taste of what the full training might involve.
top
Many would-be Art Therapy students try to gain some first hand experience of what happens in an Art Therapy session through sitting in on a session as an observer.
As a form of psychotherapy, the process is necessarily totally confidential. The presence of a third party, no matter how discreet, would inevitably alter what happens, potentially compromising the benefits to the client irreparably.
Very occasionally an Art Therapist may co-work a group with a student where the client is aware of this possibility from the outset. Otherwise it is simply not possible to satisfy the student’s curiosity without harming the therapeutic process.
top
The Creative Response facilitates networking with other Art Therapists working in the same field; encourages continuing professional development through regular study days which incorporate a journal club;organises events such as conferences and workshops; produces promotional materials such as the information pack which can be particularly useful in setting up a service amongst colleagues unfamiliar with Art Therapy; represents the interests of members on BAAT Council; provides access to and support with research and liaison with colleagues with shared specific areas of interest; provides support and informed solutions to particular employment difficulties; offers guidelines on practice and much more. Membership is free to all Registered Art Therapists.
top
Clearly there are many ways in which Art Therapy in palliative care is no different from that in any other field. There is no reason why the issues that are paramount for this set of people should be any different than for the population at large. People with mental health problems, learning difficulties, eating disorders or substance abuse for example will all present as part of the population in palliative care settings.
As in the population as a whole however, this represents a minority of people. The vast majority of palliative care clients are perfectly ordinary people faced with their own mortality with all the psychological and emotional trauma that that entails. From the point of diagnosis onwards, people live with uncertainty and loss through difficult treatment regimes, symptom management and dramatic life changes.
Art Therapy offers an opportunity to work with the issues this raises as the client feels ready and at their own pace. This empowering experience can enable the patient to rediscover their sense of self determination, facilitating decision-making and the resolution of conflicts. For the Art Therapist the principal difference lies in the timing and duration of sessions. The implications of a missed session for a patient experiencing the exhaustion that often follows a chemotherapy treatment are clearly different to those for a physically healthy person for example.
The frequency and duration of sessions will therefore tend to be negotiated one at a time – particularly for the acutely ill patient. Periods of remission or relative health may equally mean unpredictable breaks in contact. In Day Services or Drop-In Centres attended by clients with less acute symptoms, the Art Therapist may organise small groups where shared issues can be usefully explored. These will tend to be either open groups with a fluctuating membership or closed groups of relatively short duration – possibly in response to a particular need. The one distinctive feature of working with people with a life-threatening illness is time.
top
This will be negotiated by the Art Therapist with the client. Most images made in Art Therapy sessions are highly personal and never intended for a wider audience. Indeed to allow such work to be distributed amongst the patients’ other belongings would be in direct contravention of the confidentiality which is basic to our Code of Ethics.
Occasionally a client may ask that a specific piece be handed on to a particular individual after their death. The Art Therapist would of course respect such a request. Where no such request has been made, the distribution or disposal of images would be at the discretion of the Art Therapist in accordance with the BAAT Code of Ethics.
top
Details of the Creative Response Information Pack and how to buy it can be found on the recommended reading page along with details of our book ‘Art Therapy in Palliative care – the creative response’, published by Routledge.
Barry Falk’s OMEGA Literature Search lists reviewed and cross-referenced books and articles specifically on Art Therapy in palliative care and bereavement and may be accessed by emailing us.
The Art Therapy professional journal Inscape which regularly features articles and reviews on these subjects may be accessed through libraries at the Colleges listed on the Training Page or purchased through BAAT by emailing info@baat.org.
top
