The Use Of Art As Power: Using Art Therapy to Reduce the Power Struggle

Abstract

This paper explores a few different case studies which report on the effectiveness of Art Therapy on reducing behavioral symptoms. The symptoms discussed in the studies can be related to Oppositional Defiant Disorder.

Based on the findings of the studies, it is proposed that the client centered and strength based approaches to Art Therapy along with the atmosphere created which allows the client being in control of what is made, what is discussed, and the interpretation of their art, is conducive for treating children and adolescents with Oppositional Defiant Disorder.

Using Art Therapy to Reduce the Power Struggle

Caregivers and teachers are struggling to deal with some of the difficult behaviors associated with Oppositional Defiant Disorder (ODD) in children and adolescents including refusal to follow directions, testing limits, difficulty accepting responsibility, and difficulties related to compromising with others. Caregivers and teachers often find themselves engaged in a power struggle with the child and they can feel stuck in this endless battle.

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This puts them under high levels of stress and struggling to deal with several difficult behaviors especially since ODD has a high comorbidity rate with Attention Deficit Hyperactivity Disorder (Khadar, Babapour & Sabourimoghaddam, 2013). This paper examines the effective use of Art Therapy in the reduction of symptoms related to ODD.

Literature Review

Art therapy is comprised of various theories and treatment models but they are typically client centered and strength based models. Tyson and Baffour (2004) completed a study on 108 adolescents on acute-care psychiatric units in which 17 adolescents had a primary diagnoses of conduct disorder or ODD and 14 had a secondary diagnoses of conduct disorder or ODD.

In this study, Tyson and Baffour collected data on the top three strengths the adolescents self-reported during group as a way to cope with their struggles. 77 participants rated a creative art as their primary strength, 39 listed as a creative art as a secondary strength and 15 as a third strength. Tyson and Baffour (2004) concluded that:

These results show that some youth may naturally turn to the art for comfort and healing in times of crisis, and by supporting their creative intelligence for doing so, therapists not only further encourage this practice, but also affirm the value and worth of clients as self-directed individuals. (p. 233)

Since a significant number of children and adolescents indicate that creative arts is an interest to them and helps them cope let’s explore the benefits of using creative therapies in the educational setting. Children and adolescents with ODD have a higher rate of learning difficulties. Cobbett (2016) conducted an evaluation on 52 young people who participated in an arts therapy program at their school that specialized in social, emotional or behavioral difficulties (SEBD). He asked the teachers to rate the students based off of Goodman’s Strengths and Difficulties Questionnaire (SDQ) at the beginning of the arts therapy and after one year of treatment. Cobbett (2016) found that the arts therapy showed the most improvement in young people with conduct or emotional difficulties. It is also important to note that the study showed a high attendance rate (85%) for the arts therapy program.

Another study by Ottarsdottir (2009) worked on developing a concept that combined art therapy and educational coursework called ‘Art Educational Therapy’ (AET) in which the child had control over “how and what to work with in terms of art-making, art materials, and/or coursework” (p. 150). A group of 5 students were chosen to participate in AET based on their learning difficulties and the consensus that the learning difficulties could have been caused/exasperated by stress and/or trauma.

Ottarsdottir evaluated the success of AET based off of the students artwork, grades, and psychological tests performed before and after the therapy. 3 out of the 5 students showed improvement in their grades and IQ scores in correlation with longer periods of therapy. All the children showed improvement in the reduction of symptoms based off of the parents completion of the Child Behavior Checklist and the analysis of the Attention Deficit Hyperactivity Disorder Rating Scale-IV.

This lead Ottarsdottir to conclude that AET “successfully enhanced emotional well-being and, when it was of sufficient duration, facilitated coursework learning” (Ottarsdottir, 2009, pg. 157). Cobbett and Ottarsdottir show the potential benefit of including art therapy concepts and models in the educational setting. The AET model goes a step further and integrates art therapy and education into a new learning experience that allows the child to have control over their emotional and educational needs which lead to a 16 point increase in IQ scores for one of the participants.

Khadar, Babapour and Sabourimoghaddam (2013) completed a study on boys aged 7-12 with ODD who participated in painting therapy for 12 sessions. They found a significant decrease in symptoms of ODD and displayed an increase in adaptive behaviors and emotions through improved communication especially in relation to sharing their feelings (Khadar et al., 2013, p. 1875-1877). This study indicates the potential benefits of art therapy in relation specifically to ODD.

Discussion

The limitations to these studies are around the smaller sample sizes and lack of regional and cultural diversity. According to Ottarsdottir (2009), “the theory of AET is based on few case studies”(p.158). Each study was completed at a single location or region and have the opportunity to be replicated in other areas to determine if the same results will occur. Cobbett (2016) states “ the study’s limitations in that the quantitative element was not able to be randomized” (pg. 11). Cultural differences and level of supports were not included. This could affect the outcomes since the home/school environments play a large role in the development of children and adolescents. Although Art Therapy is primarily client centered, the encouragement or deterrent of creative outlets in other settings could affect the client’s response to treatment.

Conclusion and Future Study

The studies cited throughout this paper demonstrates that Art Therapy can reduce the symptoms related to emotional and behavioral concerns while increasing the amount of participation and attendance in therapy. The studies that obtained data specifically on behaviors related to ODD or conduct disorder showed more improvement in these areas than other behaviors. This leads me to conclude that Art Therapy can be used to significantly reduce the symptoms related to ODD but future studies need completed that include more participants and diversity.

Children and adolescents with ODD have a desire to be in control. Some think this stems from a trauma or experience where they did not have any control and, as a result, were significantly hurt emotionally or physically. Art Therapy can provide a structured setting that allows the child or adolescent to have a sense of being in control and allows them to discuss difficult emotions through the safety of symbols and metaphors while communication skills are being developed. I believe this is aided by the client centered approach that allows the child or adolescent to control what they create, what they disclose, and how they interpret their artwork which allows the child or adolescent to feel at ease and since the interpretations come from themselves it strengthens the meaning and motivation to make changes that align with their goals. Khadar et al. (2013) state:

Art therapy works on many different levels: through the absorption in the art-making process, through the dynamic of relationships, through the dynamic of conscious and unconscious and through reflections on the content of the image itself. At the centre of art therapy is the understanding that all of the above can lead to change. (p. 1874)

By having a multifaceted approach to art therapy, children and adolescents with ODD can be guided into self reflection without the hostility or power struggle that can occur in traditional talk therapy which promotes change by focusing on the child’s input and strengths. Art therapy allows the child to guide the treatment with the therapist there to support them through the journey.