DBT-Informed Art Therapy by Susan M. Clark

DBT-Informed Art Therapy by Susan M. Clark

Author:Susan M. Clark
Language: eng
Format: epub
ISBN: 9781784501037
Publisher: Jessica Kingsley Publishers
Published: 2016-09-09T16:00:00+00:00


Heckwolf et al. (2014, p.331) state:

The containment of all visual expressions of thoughts and feelings is a hallmark of the practice of art therapy and the soothing and distracting nature of containment is particularly effective in trauma work. Formal elements of visual expression (that of lines, shape, color, composition, etc.) become the safe place to contain symbolic content that can hold deep meaning and intense feelings for the patient. Physical safety/containment must be included while making art and Rubin (2010) described a “framework for freedom,” which includes physical conditions free from intrusion, adequate working conditions, and sufficient room for the storage of art supplies and artwork.

All of the previously described characteristics and practices contribute to a sense of safety. A competent, adequately trained clinician who validates clients and treats them with respect is essential to this work, as is the establishment and cultivation of a radically nonjudgmental stance. However, it is also vital that the DBT-informed art therapist take special pains to foster a highly dependable clinical environment. Clients with BPD, especially those with trauma histories, seem to crave familiarity and habit. Consistency helps to regulate these individuals’ emotional states to the extent that they become better able to experiment with taking steps toward greater autonomy—for example, making decisions regarding what creative activities to work on, and selecting their preferred media. Therefore, safety includes a strong sense of containment in the art room, with well-organized and maintained supplies. This modeling of structure and predictability may, over time, be something that clients with BPD can internalize (Huckvale and Learmonth 2009; Lamont et al. 2009; van Lith 2008). Masino Drass (2015a) starts new art therapy clients out with art materials they are already comfortable with, believing that this aids in fostering “safety and trust…and lays a foundation to build rapport with the therapist” (pp.168–169).

Alas, many art therapists do not enjoy the luxury of a committed work space. For most of my career I have had to settle for multipurpose group rooms and rolling “art carts.” In partial hospital settings, sessions may be frequently interrupted by colleagues pulling clients for other appointments (one-to-one therapy, psychiatric consults, and so forth) during program hours. I use my interpersonal effectiveness skills to request any changes that are possible within the particular system, then practice radical acceptance and flexibility around that which I cannot change (i.e., strong environments; Linehan 2015a and 2015b). This may require coming in earlier to prep for a group and choosing interventions that require less time to execute (and perhaps clean up afterward). I strive to manage my frustration skillfully and model a calm, willing demeanor for the clients. I may be somewhat transparent about the limitations of the environment and how I am adapting in order to “participate effectively”/“do what works.” That having been said, I will set firm limits if the environment that I and my clients are being asked to work in is unbearably therapy-interfering.

Safety applies to other clinician behaviors, as well, as far as her duty to respect and uphold ethical/professional boundaries, client confidentiality, and so on (Heckwolf et al.


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