Download The Use of Experiential Art Therapies within Prison

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Abstract
This paper discusses methods by which experiential art therapies have been implemented within
incarcerated populations. There will be a brief explanation as to why this particular population
has been selected in combination with this therapeutic approach. The therapies within this
approach that will be examined include: creating simple drawings to uncover more information
about the self, using the creation of art as a visual aid to explaining Cognitive Behavioral
Therapy, using dramatic exercises to build social skills, and using moral stories to reflect upon
one’s choices in the past and for the future. Studies of the development, implementation, and
efficacy of these therapies are examined to shed light on what techniques counselors can employ
in order to effectively treat this population.
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The Use of Experiential Art Therapies with Incarcerated Populations
‘Experiential art therapy’ refers to a therapeutic approach by which individuals create
expressive art in order to experience and convey complex psychological material in a simple
form. Gussak (2007) proposes that this approach to therapy is particularly useful when working
with an incarcerated population. Prisoners may be an especially difficult population with which
to conduct therapy because aggression and strict defenses are such hardened components of most
prison environments, and any deviation from that can be seen as a vulnerability that could
potentially be exploited by others (Gussak, 2007). In addition, Gussak (2007) points out that
social deficits and illiteracy among incarcerated individuals may prevent them from benefiting
from traditional cognitive or behavioral interventions. Experiential art therapy serves as a means
to break down those barriers while promoting pro-social cognitions and behaviors.
In order to be rehabilitated, prisoners must learn, enact, and maintain socially-acceptable
behavior (Shailor, 2011). Building psychological and social awareness can begin with
participation in the group process of therapy, creating and using art as a metaphor, and using
Bandura’s idea that modeling and its employment in drama can encourage pro-social skills
(Harkins, Pritchard, Haskayne, Watson, & Beech (2011). These are all prominent aspects of
experiential treatment which inspire further exploration of the therapeutic mechanisms which are
at work in constructing effective, creative therapies for prisoner rehabilitation (Gussak, 2007).
When looking to design treatment interventions for a population of inmates, Breiner,
Tuomisto, Bouyea, Gussak, and Aufderheide (2011) speculate that therapists should take into
consideration the different individuals’ abilities and learning styles. It is argued that art therapy
can be especially useful by creating visual metaphors when working with clients who may resist
or not respond well to verbal therapy (Malchiodi, 2005). Gussak (2007) notes that while verbal
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disclosure is often discouraged in prison for fear of vulnerability, artistic expression – as
evidenced in tattoo designs, graffiti in cells, and prison craft shops – appears to be a normal and
acceptable pursuit.
In their study of experiential art therapy with male prisoners, Breiner et al. (2011) found
that prisoners’ ability to create visual works of art (regardless of aesthetic quality or means)
enhanced their status within the group and built up respectful relationships, giving them a sense
of pride and belonging. Art allows inmates to express themselves in a way which is acceptable to
themselves, their peers, as well as the therapist; and, it promotes disclosure in the group setting
without demanding verbal explanation of potentially sensitive psychological material that has
been expressed (Gussak, 2007). Nearly all of the inmates reported feeling humanized, calmed,
and engaged by the art therapy (Breiner et al., 2011).
Utilizing art as a means of communication can assist in breaking down educational or
cognitive barriers to expression within groups (Shailor, 2011). In a study using art therapy with
aggressive juvenile offenders, Persons (2008) describes imagery as a simple, yet powerful, tool
which reveals how people view themselves and the world around them as they grow from their
experiences. He argues that because people process images before they even begin to develop
speech, their “affective lives become powerfully attached to imagery during the formative years”
(Persons, 2008, p. 434). Unlike verbal therapy, the use of art encourages individuals to grasp
their feelings and their experiences within themselves and in the world in a tangible way. By
creating something outside of the self, a person is encouraged to recognize, verbalize, and
critique the creation for what it is – a manifestation of their identity in some way (Harkins,
Pritchard, Haskayne, Watson, & Beech, 2011).
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Scott (1998) points out that these gradual glimpses into one another’s identities and
personal struggles do not go unnoticed by the other group members, but rather, are respected.
Nearly all of the experiential art therapies implemented in prison settings incorporate a group
dynamic which seems to be central to the therapy’s process (Breiner et al., 2011). In fact,
Persons (2008) recognizes that through the established ‘safe’ environment of creating art,
sensitive and personal conversation topics are discussed which, he believes, may not have arisen
otherwise.
Trust is built among the group members, sometimes artificially at first, through games or
team-building tasks led by the therapist (Rubin, 2008). Gussak (2009) relates an anecdote in
which one particular group was having a difficult time working together. The therapist came up
with the idea for each member of the group to create a unique puzzle piece which represented
them as an individual in some way. At the end of the session, the therapist had the group put all
of their individual pieces together into one cohesive design to demonstrate how each person
could add something important and unique to the group project (Gussak, 2009).
With the facilitation of cooperation and productivity by a therapist, the individual – and
the group – can use self-expression in a cathartic and constructive manner. Reviews of both
quantitative and qualitative analyses have supplied a great deal of evidence that experiential art
therapies may improve the mood and social skills of inmates (Persons, 2008). A study conducted
by Bell and Robbins (2007) compared groups who produced art versus those that viewed and
sorted existing pieces of art. The State-Trait Anxiety Inventory and the Profile of Mood States
measures were administered to all participants both before and after their task (Bell & Robbins,
2007). The results demonstrated that those who produced a piece experienced a significant
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decrease in negative mood while those who had sorted pictures showed little to no changes in
mood (Bell & Robbins, 2007).
Additional studies examining the implementation of art programs in prison settings have
shown that their use is significantly correlated with reductions in violence and violations of
prison rules (Persons, 2008). One of many robust statistics was found in an examination of the
California Arts in Corrections program from 1980 to 1987, with an eighty percent decrease in the
number of disciplinary reports filed on participating prisoners (Gussak & Ploumis-Devick,
2004). The California Department of Corrections also found evidence for favorable long-term
outcomes in that there was a significant decrease in recidivism for those inmates who had been
active in an art therapy program as compared to non-participants in the same prison system
(Gussak & Ploumis-Devick, 2004).
Experiential art therapy programs can also be particularly useful in helping inmates who
are about to be released to transition more adaptively into the greater society, thus helping to
reduce the risks of recidivism (Harkins et al., 2011). Many inmates have poor adaptive
functioning, particularly in the areas of social skills, empathy, coping, and emotional regulation
(Breiner et al., 2011). Breiner et al. (2001) suggest that an integrative drama therapy and
Cognitive Behavioral Therapy (CBT) approach can shape more appropriate recognition of, and
responses to, social cues. In creating an anger management program for male prisoners by means
of art therapy, Breiner et al. (2011) found that prisoners use aggression to defend themselves or
to antagonize others as a manifestation of hostile, mistrustful, or predatory cognitions. Because
the researchers found that this often comes as a result of misinterpreting others’ behavior, they
devised this combination of therapies to increase recognition of social cues and promote
effective evaluation of the consequences of various responses (Breiner et al., 2011).
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Intertwining experiential art therapies with CBT offers the flexibility to engage prisoners
(no matter what their social, cognitive, or academic abilities) via an appealing artistic endeavor
while utilizing the art as a visual aid to explain the cognitive processes that influence their
behavior (Breiner et al., 2011). Experiential art therapy ‘shows’ rather than ‘tells’, and can
therefore serve as a tangible model of social skills and interpersonal problem-solving.
Therapists play a key role not only in facilitating the experiential activity, but also in
helping the prisoners to understand the symbolism being used (Breiner et al., 2011). In Breiner et
al.’s (2011) study, prisoners were asked to view different drawings depicting the same location,
but different scenarios. In one drawing, there was a clean stream running down from a grassy hill
past trees; in the other was the same location, but with the absence of the trees and with a factory
pouring out smoke standing on the hill (Breiner et al., 2011). The therapist guided the prisoners
through a discussion of the problem as it was depicted, and then asked them to draw how they
thought the scene would change based on the changes in the environment. After completing the
new drawing, the prisoners were asked to think about how this scenario related to their CBT
lesson on anger and attitude. One of the prisoners used his drawing to observe that just as he
predicted the pollution would follow the coming of the factory, the buildup of his anger also
predicted the pollution of many areas in his life (Breiner et al., 2011).
In another exercise within Breiner et al.’s (2011) anger management program, the
‘choices cycle’ (including escalation of anger, eruption of anger, and the consequences following
it) was presented to prisoners during an artistic endeavor. They were asked to create a model of a
vehicle out of paper, and to imagine themselves driving that vehicle along a road. Then, they
were to imagine that the road ended and they were faced with a large body of water to cross. In
response, they had to make changes to the actual model in order to meet the new requirements of
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the situation. Nearly all of the men became extremely frustrated by the unforeseen obstacle
(Breiner et al., 2011). However, when everyone had completed the exercise, the prisoners
became aware of how the choices cycle had been at work during the project. One of the inmates
noticed that one of the key ingredients of the task had been to counteract the desire to allow
frustration to escalate. The task had challenged them to capitalize on the ability to think calmly
about a problem and to work through it in a creative way (Breiner et al., 2011). One participant
commented that he was encouraged by his own drive and ability to not give up, and to complete
the task. He also felt encouraged that if he could be effective in accomplishing a small, yet
challenging task like this one without losing his temper, then he really may be able to change his
behavior in other small, yet effective ways (Breiner et al., 2011).
While creating visual art as a practice or a symbol of a cognitive concept can be valuable,
another experiential therapy – drama – uses Bandura’s approach of directly modeling appropriate
behavior (Harkins et al., 2011). In the 1920s Psychiatrist Dr. Jacob Levy Moreno founded the
practice of ‘psychodrama’, – that is, the use of theatre and acting as a therapeutic tool
(Malchiodi, 2005). Moreno believed that through honing the acting tools of improvisation,
creativity, and spontaneity, individuals would become prepared for responding just as
spontaneously and creatively to unpredictable situations in real life (Malchiodi, 2005).
Psychodrama techniques can help inmates in expressing and addressing a range of issues
including self control, perspective-taking, stressors, self-confidence, and maladaptive thought
and behavior patterns (Harkins et al., 2011). Some programs implement ‘role reversal’
techniques in which the actor playing the protagonist and the actor playing the antagonist switch
halfway through the scene to gain an appreciation for the other character’s perspective (Harkins
et al., 2011). The technique of ‘doubling’ (having an alter-ego speaking to the protagonist) seeks
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to promote self-awareness by confronting the protagonist with the effect of his words and actions
on others (Harkins et al., 2011). Some of the more common methods used to encourage the
individual’s expression of themselves are the use of masks – to allow them to be whomever they
choose to be – and soliloquies, in which a deeper empathy and understanding for the character is
encouraged (Harkins et al., 2011). When all of these methods were implemented, Harkins et al.
(2011) found significant increases in participating prisoners’ self-efficacy (t (59) = 3.6, p < .001),
motivation to change (t (46) = 2.5, p = .015), and self-confidence (t (35) = 3.6, p < .01) after only
three intensive sessions (Harkins et al., 2011, p.557).
Psychotherapy is based upon the idea that when people role play, they discover and
expose aspects of themselves through the lens of a character. The National Drama Therapy
Association describes drama therapy as a process which “ ‘helps the client tell his or her story to
solve a problem, achieve a catharsis, extend the depth and breadth of inner experience,
understand the meaning of images, and strengthen the ability to observe personal roles while
increasing flexibility between roles’ ” (Malchiodi, 2005, p. 3). In this way, the characters, as well
as the predicaments in which they find themselves, serve as the basis for developing a model of
coping with challenging situations (Shailor, 2011).
Inmates are guided by a therapist to integrate their own experiences into their characters,
to recognize constructive versus destructive patterns of thoughts and behaviors, and to set
realistic goals for changing their own cognitions and behaviors (Harkins et al., 2011). By playing
roles which may resonate with or contradict their own views, and by finding strategies for how
their character might cope with different situations, the client becomes actively engaged and
invested in this therapy process (Malchiodi, 2005). For example, Scott-Douglass (2007)
interviewed one male inmate who was incarcerated for murder, and stated that he was
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profoundly challenged, but learned a great deal about remorse and empathy, by being selected to
play the Shakespearian character of Othello. As Persons (2008) explains, the experience must be
internalized in order for a change in behavior to occur.
Rubin (2008) believes that the personal histories and experiences that the inmates bring
to the drama sessions are often more potent than any metaphors that may be created by a
therapist. To tap into the rich psychological matter of their own experiences and desires,
prisoners have sometimes been encouraged to create or re-create their own fairytales (Scott,
1998). They are asked by the therapist to use their own experiences with good and evil as a place
to start; then, as the story develops, they express possible outcomes, solutions, and lessons
(Scott, 1998). Since “fairy tales are rich cultural communications that contain insight into culture
and highlight universal psychological dilemmas”, these stories can carry powerful themes that
may be important to the prisoner’s worldview (Rubin, 2008). Many prisoners expressed themes
such as regret, sadness, anger, and the lessons that perhaps they wished they had learned earlier
in life. However, the majority of the stories ended with positive lessons that spoke to developing
self-esteem, appreciating resilience, forming a new identity, or coming home (Rubin, 2008).
Through engaging in techniques of creating different forms of art, prisoners have been
shown to react well to experiential art therapies. These therapies are unique in that the raw
therapeutic materials used are the individual’s basic expressions of psychological processes, their
expressions of themselves and the world as they see it. While experiential therapies can certainly
take many forms, their aims are all the same: to provide a non-traditional therapy setting in
which individuals are given an amount of freedom to create, and to learn from their creations and
from each other. This form of expression provides a unique opportunity for prisoners who may
otherwise be resistant to treatment whether for lack of interest or perhaps for fear of being seen
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as vulnerable by their fellow inmates. Experiential art becomes a socially acceptable way of
expressing oneself; and, simultaneously, individuals who engage in this process are taking the
first steps towards improving numerous skills which can assist them when they return to the
greater society.
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