Art Therapy in Residential Treatment – Laying a Foundation

I am continuing the conversation on art therapy in residential settings and this week focusing on laying a foundation.

Last month I set up the Art Therapy studio space and got ready to orient the residents to art therapy and foster creativity. I was eager to talk with the residents about how art and making art was communicative and expressive.

So the first week that I met the residents, outside of the group setting, I implemented an art icebreaker and played my version of Pictionary.  My goal was to begin to build a positive rapport with the residents and begin to develop the basis for their interactions with one another.  I was so impressed with the groups as they were eager to get involved and even began to self structure by developing rules and guidelines. Everyone worked together, without denigration of each other or the task (which happens a lot with children identified with Oppositional Defiant Disorder).  As the first week went  well I thought “I’ve got this!”  I planned to continue using art to communicate ideas and concepts with the goal of increasing the resident’s comfort so they would begin to express their own thoughts, feelings, and ideas.

The next week, I was prepared for MY group but not prepared THEIRS.  I dove straight in and planned a group focused on self regulation. This  seemed appropriate enough, most of my CBT work starts with developing skills for self regulation.  BUT MY hopes and goals for groups failed to take into account where the residents actually are developmentally and emotionally as well as the “honeymoon” phase that groups with this population have typically. The first groups of the week were a disaster, the residents became overly sensory stimulated quickly (despite the very structured materials provided) and became too emotionally labile to even handle discussion about themselves and their emotions. I planned a containment exercise but the residents became reactive and labile quickly and immediately turned to their only known way to deal with the situation – Act Out.

I felt like I should have known better as I have worked with this population before. I also felt overwhelmed and frustrated. I had planned to create a safe space for the residents but I feel that I failed to really help them feel safe with the art process. I had to go back to the basics and offer developmentally appropriate art interventions while helping the resident feel confident and, of course, safe.

Over the next few weeks I offered more structured materials (I always take into account the Expressive Therapies Continuum when approaching interventions) and very structured activities. I offered directives to help the residents feel secure and begin to feel safe in the structure of the space I provided. I met one-on-one with some of the group members to discuss their aggressive behavior from the week before and to build trust with them by showing them I would listen and be supportive.  And, lastly I began to offer an educational component to each session to help the residents learn new art skills, therefore building their confidence.  This, educational and developmental approach, may seem to basic or too structured to foster “true” self expression but I view it as building a strong emotional base with building blocks. I am laying a foundation of confidence, trust, and skill which will build strength and foster growth. I truly believe that meeting the residents where they are, and offering opportunities for change and growth, with result in improved self awareness and in turn self expression. We all have to start somewhere, this is where they are, so this is where I am too.

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