THE USE OF EXPRESSIVE ARTS BY SOCIAL WORKERS AS AN
INTERVENTION WITH CHILDREN
Nicole L. Brogdon
B.A., California State University, Sacramento
PROJECT
Submitted in partial satisfaction of
the requirements for the degree of
MASTER OF SOCIAL WORK
at
CALIFORNIA STATE UNIVERSITY, SACRAMENTO
SPRING
2011
THE USE OF EXPRESSIVE ARTS BY SOCIAL WORKERS AS AN
INTERVENTION WITH CHILDREN
A Project
by
Nicole L. Brogdon
Approved by:
Committee Chair
Serge Lee, Ph.D.
.
Date
ii
Student: Nicole L. Brogdon_____________
I certify that this student has met the requirements for format contained in the University
format manual, and that this project is suitable for shelving in the Library and credit is to
be awarded for the Project.
______________________________________, Graduate Coordinator_______________
Teiahsha Bankhead, Ph.D., LCSW
Date
Division of Social Work
iii
Abstract
of
THE USE OF EXPRESSIVE ARTS BY SOCIAL WORKERS AS AN
INTERVENTION WITH CHILDREN
by
Nicole L. Brogdon
Scientific research consistently demonstrates that art has physical, cognitive,
psychological, and social benefits for children. These benefits increased when art was
applied in a therapeutic way (Cochran, 1996; Malchiodi, 1998; 2005; Schirrmacher,
2006; Nadkarni & Leonard, 2007). This has resulted in the development and popularity
of expressive art therapies by other helping professions. It is time for social work to do
the same. While social workers may use expressive art in their direct practice with
children, there is little literature reflecting this practice. The author tried to explain this
disconnection by surveying 61 social work graduate students on their knowledge,
utilization, and definition of art and art in therapy. The 52-item survey was comprised of
Likert-Scale and Yes-No format questions designed by the author. The researcher
concluded the disconnection between social workers’ knowledge and use of art in therapy
is because of a lack of exposure to it in their education. As a result social workers are less
likely to use this method in their practice and/or conduct research on this intervention.
Committee Chair
Serge Lee, Ph.D.
.
Date
iv
TABLE OF CONTENTS
Chapter
Page
1. THE PROBLEM…………………………………………………………………..…....1
Introduction……………………………………………………………….….…...1
Rationale………………………………………………………….……………….5
Theoretical Framework…………………………….……………………………...6
2. LITERATURE REVIEW………………………………………………………………8
Art and Art Classification…………………………………………………………8
Music…………………………………………………………….………..9
Visual arts…………………………………………………………..........11
Storytelling………………………………………………………………14
Drama……………………………………………………………………15
Dance…………………………………………………………………….17
Expressive Art Therapies………………………………………………………...19
Why Adopt Expressive Art Therapies…………………………………….....…..20
Psychosocial theory………..………………………………………....….20
Solution-focus brief therapy……………………………………….…….22
How to Adopt Expressive Art Therapies……………………….….………...…..24
Micro level practice…………………….……...…………………….......25
Mezzo level practice………………………………..…………………....26
Macro level practice……………………………………….………….....26
3. METHODS..…..…………………………………………...……………….….……..28
v
Research Design………………………………………………………………..28
The Participants…….……………………………...……...………………...….28
Testing Materials……………………...………………………………………..30
Human Subjects Protection………………………………………………….....31
Procedure………………………………………………………………............33
Data Analysis…………...……………………………………………………...34
Limitations………...…………………………………………………………...35
4. RESULTS ……………….…...………………………………………………..…....36
Demographics….………………………………………………………...…….36
Benefits of Art…………………………………………………………………39
Utilization of Art………………………………………………………………43
Definitions of Art……………………………………………………………...49
Inferential Statistics …………………………………………………………...53
5. CONCLUSION..…………………………………………………………….……..57
Major Findings…………………………………………………………….…..57
Social workers’ knowledge on the benefits of art…..…...………....….57
Social workers’ application of art in therapy……...……..…...…….…57
Social workers’ definitions of art and art therapy….......……………...59
Implications for Social Work………………………………………………… 59
Suggestions for Future Research………………………………………………60
Appendix A: Survey Questionnaire….………………………………………………...62
References……………………………...……………………………………………...6
vi
LIST OF TABLES
Page
1. Table 1: Gender of graduate students…………………………………….……...36
2. Table 2: Race of graduate students………………………………………..……..37
3. Table 3: MSW Classification of graduate students…………..……….…….…...37
4. Table 4: Received formal art therapy education……………………..…..……... 38
5. Table 5: Client population…………………………………………..….....…......38
6. Table 6: Art benefits motor skills………………………………….……..……...39
7. Table 7: Art benefits physical health…………………………………….....…...39
8. Table 8: Art develops critical thinking…………...…………………….…...…. 40
9. Table 9: Art strengthens the connections in the brain…………………..…...… 40
10. Table 10: Art adds to one's wellbeing…………………………………………..41
11. Table 11: Art benefits mental health……………………………………………41
12. Table 12: Art builds self-esteem………………………………………………...41
13. Table 13: Art’s role in a child’s development…………………………………..42
14. Table 14: Art improves academic-social success……………………………….42
15. Table 15: Tapping into spirituality……………..…………………………….…43
16. Table 16: Have their clients listen to music in therapy……………….………...44
17. Table 17: Have their clients draw in therapy……..…………….……….……...44
18. Table 18: Have their clients color in therapy…..………………………….….......44
19. Table 19: Have their clients paint in therapy…………………....………..…….45
20. Table 20: Have their clients do role play in therapy……………….………..….46
vii
21. Table 21: Have their clients use expressive toys in therapy………….………...46
22. Table 22: Have their clients dance in therapy………….…………..…….…....47
23. Table 23: Have their clients tell their story in therapy……..……...…………..47
24. Table 24: Have their clients journal in therapy………………………………..48
25. Table 25: Have their clients write in therapy…………….……………………48
26. Table 26: Art is common in all human societies………………………..……..49
27. Table 27: Art functions differently between communities…..………………...49
28. Table 28: There is a difference in art for pleasure and self-expression…..……50
29. Table 29: Music is a form of art………………………………….……………50
30. Table 30: Drama is a form of art………………………………………………50
31. Table 31: Dance is a form of art……………………………………………….51
32. Table 32: Visual Arts is the process of employing depictions…………...……51
33. Table 33: Storytelling is a form of art…………………….……..…….………52
34. Table 34: Story writing is a form of art………………………………………..52
35. Table 35: Storytelling is the use of words in therapy..…………….….……….52
36. Table 36: Arts' healing ability is supported by culture and science…………...53
37. Table 37: Chi-square test on art benefits to motor skills and mental health......54
38. Table 38: Chi-square test between students and art benefits mental health…...54
39. Table 39: Chi-square test on art benefits on critical thinking and social-academic
skills.…………………………………………………………………………...55
40. Table 40: Chi-Square test on the difference of art for pleasure and self-expression
and if art functions differently between communities…………………………56
viii
1
Chapter 1
THE PROBLEM
Introduction
Art therapy or “any therapy that uses self-expressive art as their primary therapy
activity” has existed within the American therapeutic community for decades (Crochan,
1996, p. 287). In 1940, Edith Kramer first observed the natural healing properties of art
activities with children (as cited in Waller, 2006). By the 1950s the concept of using the
natural coping mechanisms of drawing and play to reveal the unconscious mind of
children emerged (Vick, 2003; Malchiodi, 2005; Waller, 2006). With the 1960’s disfavor
of psychodynamic-based theories, new humanistic outlooks on art therapy were formed.
These new outlooks used the expressive qualities of poetry, storytelling, and story writing
to have children tell their narratives (Vick, 2003; Malchiodi, 2005; Waller, 2006). The
most recent evolution of art therapy is a postmodern approach known as the expressive
art therapies. Under this new form, therapists, educators, and child development
specialists employ the expressive arts of music, visual arts, storytelling, drama, and dance
to reach children (Malchiodi, 2005; Waller, 2006). It is time for social workers to adopt
expressive art therapies, so they too can enhance the lives of children through the
physical, cognitive, psychological, and social-academic benefits of art.
Since its establishment in the 1940s, the effects of art and art therapy has been a
popular topic in scientific research. While searching for literature to support this paper,
the author discovered that there are four benefits of using art in therapy. These are
classified as physical, cognitive, psychological, and social-academic benefits.
2
The simple action of creating and producing art has many physical benefits for
children. Robert Schirrmacher (2006) stated that art is important for a child’s physical
development because it allows them to use their gross and fine motor skills. Schirrmacher
added that art also provides a safe avenue for the sensory exploration needed for healthy
physical development.
Along with a child’s physical development, creating art (in any form) has
additional health advantages. In 1997, Matarasso found that 52% of participants in his
study (both children and adults) reported feeling better or healthier after participation in
art programs. The creation of art has also been proven to activate a person’s relaxation
response which is scientifically linked to reducing pain, stress, and fatigue (Councill,
2003; Malchiodi, 2005; Stuckey & Nobel, 2010).
Arts role in enhancing a child’s cognitive abilities has also been verified within
the literature. For example, Edwards (1984), one of the most famous researchers to
examine the cognitive benefits of art, complied, summarized, and expanded early brain
studies to measure the effects of art on the developing brain. At the conclusion of her
study, Edwards (1984) found that art education was vital in evolving the right side of the
brain in children because it is used to form symbolism, develop nonverbal expression,
and recognize patterns and shapes. More than a decade later, Sturiale (1997) expanded
Edward’s work by comparing previous studies on the relationship of art and the brain.
Her research revealed that art benefits both sides of the brain by strengthening the
interactions between them. Furthermore, Sturiale discovered that the right hemisphere is
involved in the complex functions of verbal processing and mathematical reasoning
3
which were once accredited to the left hemisphere. Among the latest studies, Riley
(2004) also found that the arts can strengthen the brain’s interconnections because
“making an art form involves movement, tactility, vision, and memory; therefore, all the
brains functions… are brought into play” (p. 187). Schirrmacher (2006) discussed this
important concept in his book. According to Schirrmacher, art increases a child’s ability
for critical thinking and whole brain learning by engaging him/her in a creative thought
process.
Along with the cognitive benefits, research has found that exposure to the arts can
improve a child’s overall psychological wellbeing (Crochan, 1996; Malchiodi, 1998;
2005; Schimmacher, 2006; Nadkarni & Leonard, 2007). The reason for this is because
dance, music, and other artistic activities can remove the barriers between the conscious
and unconscious mind so as to better assist the therapeutic process (Rueppel, 2002). The
1957 study by Wolf (as cited by Wilson & Saunders, 2005), for example, observed that
children with mental disorders who participated in art classes developed more positive
ways to express emotions and resolve conflicts than those who had traditional therapy.
Another early study conducted by Lantiz and Raiz found that abused and/or neglected
children who participated in art based therapy had quicker recovery times than those who
did not (as cited in Wilson & Saunders, 2005). Matarasso’s study (1997) also discovered
that 77% of children were more confident and 75% of all participants were happier since
becoming engaged in community art projects (p.vi). Recent studies have continued to
support the psychological benefits of art. Wilson and Saunders’ study (2005), for
example, revealed that participation in art classes, no matter the form, improved a child’s
4
self-esteem and self-expression. Participation in art programs has also been found to
increase a child’s self-efficacy in the sense that one has the power to change his/her
thoughts, behaviors, and future (Catterall & Peppler, 2007).
While current research has not established a cause and effect relationship, there is
a strong correlation between art and improvements in a child’s social and academic
performance (Isaacs, 1977; Clemens, 1991; Cochran, 1996; Matarasso, 1997;
Schirrmacher, 2006; Boldt & Brooks, 2006). This correlation exists because the nature of
art gives children a positive alterative for expressing themselves, a better avenue for
relating to others, and an increased investment in one’s community (Isaacs, 1977;
Clemens, 1991; Cochran, 1996; Matarasso, 1997; Schirrmacher, 2006; Boldt & Brooks,
2006). One example is, again, Mastarasso’s study (1997) which examined the effects of
participating in community art projects on children and adults. He found that both
children and adults who were involved in these art projects made new friends, learned
new skills, and had a desire to become involved in future ventures (Mastarasso, 1997).
Another example of this phenomenon is provided by Eisner (2002) whom illustrated how
the arts teach children many important social skills such as an awareness of relationships,
flexibility, creative expression, linguistic proficiency, and the aesthetic perspectives of
culture. A final example of this correlation was a national study of 25,000 students which
found significant improvements in the students’ academic proficiency, social skills, and
community identity after attending classes in visual arts and theater (Boldt & Brooks,
2006). In addition, children from at risk populations who participated in art courses had a
dramatic reduction in disruptive behaviors such as aggression, absenteeism, and
5
impulsivity (Repress & Lutfi, 2006).
There is a new area of research regarding the benefits of art and art therapy for
children. This new area of focus is on spirituality or one’s “relational consciousness in
regards to self, others, the environment, and/or God” (Mountain, 2007, p. 193).
Nonetheless, research on art, art therapy, and the enrichment of a child’s spirituality is
limited. One reason for this limitation is the difficulty researchers have had in
scientifically defining and measuring the concept of spirituality (Malchiodi, 1998;
Mountain, 2007). Another reason is that scientific community had moved away from a
spiritual to a secular emphasis in the early 20th century so as to obtain more objectivity
(Malchiodi, 1998; Mountain, 2007). The lack of scientific research is why the author of
this Master’s project has not included enhanced spirituality as a major benefit of art. Yet,
she felt it was important to mention this growing field and the possibilities it implies for
children and those who work with them.
Rationale
This researcher has always been interested in the influence of art on a child’s
social, psychological, cultural well-being. She, herself, had experienced the uplifting
power of art as a child. Scientific research has repeatedly shown that art, in any form, has
physical, cognitive, psychological, and social benefits for children. These benefits
increased when art was applied in a therapeutic manner that facilitated self-expression
and self-examination (Cochran, 1996; Malchiodi, 1998; 2005; Schirrmacher, 2006;
Nadkarni & Leonard, 2007). This has resulted in the development and popularity of
expressive art therapies by therapists, educators, and child development specialists (Vick,
6
2003; Malchiodi, 2005; Waller, 2006). It is time for social workers to do the same. While
social workers may use expressive art in their direct practice with children, there is little
literature reflecting this practice. In the author’s search, for example, she found only three
articles by social workers referring to the utilization of art. Based on these findings, the
author wanted to examine social workers’ definition of art, knowledge of art‘s benefits,
and application of expressive arts in their work with children. The author also aimed to
highlight and explain the disconnection between social workers’ direct practices and their
research regarding their use of art in therapy. She would accomplish these goals by
studying the following objectives:
1. Discover social workers’ level of knowledge on the benefits of arts for children.
2. Find out if social workers apply expressive art forms (music, visual arts, storytelling,
drama, and dance) in their direct practice with their clients.
3. Reveal social workers’ definitions of art and art in therapy.
Theoretical Framework
Credible research must have some base in existing and accepted scientific theory.
After reviewing past research, one theory has consistently occurred in describing the use
of art in therapy, the psychosocial theory. Erik Erikson’s psychosocial theory (as cited by
Wagner, 2008) views human behavior in eight chronological stages which have specific
tasks that must be fulfilled throughout one’s lifetime. This applies to art in therapy
because “expressive toys and other art medias are useful for helping children express
thoughts and feelings, explore, and express feelings about relationships with family
members and others, conceptualize problems, and consider solutions, and express their
7
creativity and imagination” (Watts & Garza, 2008, p. 114).Thereby, helping the children
accomplish the various developmental stages (See Literature Review).
The author also examined how solution-focused brief therapy can be integrated
with expressive art therapies when working with children (See Literature Review).
Solution-focused brief therapy refers to when the practitioner helps the client to formulate
solutions to his/her problems rather than focusing on the client’s faults (Malchiodi &
Riley, 2003). Solution-focused brief therapy pertains to art in therapy because it can be
incorporated into expressive arts through its ability to develop self-expression, selfdetermination, and problem-solving skills within clients.
8
Chapter 2
LITERATURE REVIEW
Utilizing art to facilitate the healing process with children has a long history
within the helping professions of psychiatry, child development, and education (Vick,
2003; Malchiodi, 2005; Waller, 2006). It is now time for the social work profession to
adopt this approach as an addition to other evidence-based practices in their work with at
risk children. As stated previously, social workers may use art in their direct practice with
children; yet, the literature does not reflect this practice. Through this study, the author
illustrated the divide between social workers’ direct practice and the social work
literature. The next section provides insight into a basic definition of art and the forms it
can take within the therapeutic setting. The author also demonstrated the important
concept of expressive art therapies in relation to the four classifications of art.
Art and Art Classification
Art has existed as a universal mode of expression among all human societies.
Whether it is the stick figure depictions on cave walls or the idealized social icons of
modern advertisement, art plays an intricate role in our lives. And yet what is art? A
precise definition continues to elude society because art is not an objective matter, but
rather a subjective one. In other words, the definition of art is something that is based on
somebody’s opinions or feelings rather than on facts. This subjectivity, in turn, makes
art’s function, purpose, and status within a community different based on the cultural
values, perspectives, and context (Janlongo & Stamp, 1997). The largest amount of
scientific research on art has concentrated on or included music, for instance, because of
9
Western society’s cultural acceptance of music as an intellectually superior form of
expression (Thompson, Schellenburg, & Husain, 2001). However, for the purpose of this
Master‘s project, art will be defined broadly as the ability to make imaginative depictions
which are “enjoyed for the beauty they create, the way they present ideas, or for the
process in which they are formed” (Encarta, 2004). With this definition, one can include
any artistic expression no matter its cultural or societal interpretations.
Yet, there is a difference between art for pleasure and self-expressive art exercises
within therapy sessions (Cochran, 1996; Rogers, 2001; Malchiodi, 2005). While both
types have benefits for children, art for pleasure has limited amounts of self-disclosure
and self-exploration. This results in it having less therapeutic or healing effects on
children than self-expressive art exercises (Cochran, 1996; Rogers, 2001; Malchiodi,
2005). Based on this concept and the broad definition of art, the author examined four
classifications of expressive arts from the literature. These are: 1) music or any
therapeutic/healing application of arranging or exposing one to sound, 2) visual arts or
employing the depictions of images for therapy/healing, 3) storytelling or the symbolic
application of words, in either a written or verbal form, to promote healing/therapy, 4)
drama or any therapeutic/healing use of role play, enactment, or theater; and, 5) dance or
any healing/therapeutic work utilizing movement of an individual or group (Campbell,
1997; Jalongo & Stamp, 1997; Simmons, 1997; Malchiodi, 2005; Schirrmacher, 2006).
Music. Using music for medicinal purposes is an universal practice among human
societies. In India, the traditional Vedic healthcare system of Ayurveda uses musical yoga
or Nadopasma to promote healthy living among its citizens (Sundar, 2007). Raga
10
Chikitsa is another Vedic health custom in which a person is exposed to different musical
notes in order to reduce anger and induce relaxation (Campbell, 1997; Sundar, 2007).
Native American societies also use music as a conductor to the Great Spirits in order to
maintain the health and wellness of the tribe (Portman & Garrett, 2006). The spiritual
customs of Shamanism, Tantra, and Dzogchen also emphasize the importance of music in
the human experience when the shaman (or priest) draws upon the combination of chants,
music, and mediation to address the imbalances between a person’s mind, body, and
spirit (Gass, 1999; Rinpoch, 2002). These spiritual practices are effective because music
acts on a person’s mental state through mimesis or “the unique human ability to retrain
the body to external rhythms” (Winkelman, 2002, p. 1879).
Western societies also have a longstanding tradition of employing music within
the therapeutic and/or healing setting. A prime illustration of this practice with children is
the scientific confirmation of the Mozart Effect in which listening to classical music in
the womb and during infancy improves academic abilities (Campbell, 1997; Thompson,
Schellenburg, & Husain, 2001). This is done by providing infants and young children
with the needed sensory stimulation for expanding their central nervous system to
strengthen his/her ability to hear and to speak (Campbell, 1997; Jones, 2005; Etolie,
2008).
In addition to the Mozart Effect, music has been proven to continue to enhance
students’ cognitive abilities long after infancy. For instance, young children exposed to
musical instruction show better literacy skills including language reception, sequential
memory, vocabulary development, and critical-spatial reasoning when entering school
11
than their non-exposed peers (Jones, 2005; McIntire, 2007; Wiggins, 2007). Another
instance is that school-aged children who have had some form of music lessons are more
likely to exhibit long-term improvements in their IQ Scale than other students
(Schellenberg, 2004; 2006). Ivanov and Geake (2003) also found that school-aged
children did better on the Paper Folding Task (PFT) when listening to classical music
than with other background noise. Finally, students who took music classes in junior
and/or high school were more likely to have higher standardized test scores in
mathematics than those who did not (Ruppert, 2006).
Along with the academic boost, music has been shown to provide other benefits
for people. For example, there is an extensive research base supporting music as an
effective non-verbal method for emotional release with patients who have impaired or
undeveloped communication skills (Lefevre, 2008; Tubbs, 2008). Research’s
endorsement of music’s unique ability to create feelings of both nostalgia and cathartic
expression is another example of these other benefits (Campell, 1997; Gass, 1999;
Lefevre, 2008). A final example is the extensive scientific evidence on music’s capability
to create physiological changes in the human body including a significant decrease in
one’s blood pressure, heart rate, and ACH (stress) hormones (Campbell, 1997; Stuckey &
Nobel, 2010).
Visual arts. Akin to music, the presence of some type of visual art such as
jewelry, tattooing, and specialized clothing within healing rituals is common among
different cultures (Rueppel, 2002). The purpose of creating and exposing a person to
visual arts within these ceremonies is to symbolically facilitate the healing process;
12
thereby, generating physiological responses within the person (Rueppel, 2002;
Winkleman, 2002). The Seneca Indians, for example, carve masks as part of their
community’s healing rituals (Jones, 2007). Creating Mandalas or geometric circular
patterns among Middle Eastern cultures is another example of using visual arts for
healing purposes (Malchiodi, 2002). Within these cultures, Mandalas are used to help
promote relaxation, self-reflection, and self-awareness (Malchiodi, 2002). A key
demonstration of this practice was Carol DeLue’s study (1999) which measured the
physiological responses of skin temperature, blood pressure, and heart rate in school-age
children as they created Mandala drawings. She found that Mandala drawings produced a
reduction in autonomic arousal and an activation of the relaxation response in these
children which has, as stated before, been connected to a decrease of pain, stress, and
fatigue (DeLue, 1999; Councill, 2003). Mandalas have since been adopted into modern
art therapy as a visual method of documenting a client’s emotional state as well as to
reducing the clients’ anxiety over receiving counseling services (Malchiodi, 2002;
Councill 2003).
Visual arts, similar to music, is a leading concentration within Western art therapy
research because the term encompasses many different mediums such as painting,
drawing, and sculpture (Respress & Lutfi, 2006; Stuckey & Nobel, 2010). Participation in
any type of visual arts has been proven to improve a child’s physical, psychological, and
social state because it: 1) provides him/her a refuge from intense emotional states by
visually externalizing thoughts, feelings, and circumstances; 2) develops his/her physical
and social skills; 3) adheres to the academic needs of children who learn better from
13
visual and kinetic modes of study; and, 4) provides an alternative avenue of
communication to adults and peers (Anning, 1999; Wilson & Saunders, 2005; Boldt &
Brooks, 2006; Respress & Lutfi, 2006; Ruppert, 2006; Ahn & Filipenko, 2007; Catterall
& Peppler, 2007; Stuckey & Nobel, 2010). The reason visual arts are such a captivating
pursuit for children is because it can capture their perceptions, expertise, and
understanding better than words (Simmons, 1997). Furthermore, the visual arts act upon
more of the basic senses of seeing, hearing, smelling, touching, and tasting than the other
art forms. This ability to access the five senses makes visual arts not only more appealing
to children, but critical for their development (Jalongo, & Stamp, 1997; Simmons, 1997;
Schirrmacher, 2006).
Within this art form, drawing has been the most examined within the therapy
setting because it is the most versatile in regards to space, expense, time, and differences
in children’s developmental abilities (Malchiodi; 1998; Malchiodi, 2005). Drawing has
also been shown to “increase students’ learning potential and complements learning in
other disciplines” (Edens & Potter, 2007, p 282). These disciplines include reading,
linguistics, mathematics, problem solving, spatial reasoning, sequencing, and mental
stretching (Anning, 1999; Gradiner, 1999; Edens & Potter, 2007). Furthermore, the
scribble theory has become a popular assessment tool since writing and talking are less
important in childhood than drawing (Malchiodi, 1998; 2005 Anning, 1999; Coates &
Coates, 2006). Scribble theory is used to identify a child’s developmental stage based
upon the content and artistic ability of a child’s drawing prior to starting other mediums
or other art forms (Malchiodi, 1998; 2005; Coates & Coates, 2006).
14
Storytelling. Storytelling refers to when a person tells his/her own narratives
through the methods of poetry, lyric composition, journaling, letter writing, and bibilocounseling (Synder, 1997; Malchiodi, 2005). Storytelling plays an important role in the
human experience because it is used to teach children, convey wisdom, and impart an
oral history (Synder, 1997; Ahn & Filipenko, 2007). In addition, storytelling provides a
person a better understand of the story teller, the community, and oneself (Ahn &
Filipenko, 2007). In the Native American culture, for example, storytelling is viewed as a
method to uphold their community networks and cultural heritage (Portman & Garrett,
2006). These connections and identities are significant to Native American tribes,
according to Portman and Garrett (2006), because they help maintain tribal members’
mental, physical, and spiritual health. Another example can be seen in the spiritual
concepts of Dzogchen which includes storytelling (along with music) in healing because
it provides exposure to human speech, a critical aspect of sound (Rinpoch, 2002).
Western research has also supported the positive outcomes of storytelling, in any
form, for children. An early study by Eileen Buke (1986), for instance, found that
storytelling was critical for early childhood development because it is a great source of
information on social expectations, relationships, and coping mechanisms. She also
reported that storytelling stimulated language, imagination, and holistic growth in young
children (Buke, 1986). Buke’s finding were later support by Phillips (1999) who showed
that storytelling helps children form their interpersonal and intrapersonal skills through
the enhancement of their oral and written literacy. The most recent study on children was
by Ahn and Filipenko (2007) which revealed that “in telling, listening to, and reading
15
stories, children transform experiences into original compositions” which is used to help
them to better understand and respond to themselves, others, and the world around them
(p. 280).
Besides the specific benefits for children, storytelling has also been scientifically
linked to improvements in people’s emotional and physical health in general (Synder,
1997; Stuckey & Nobel, 2010). One of the best examples was the Dickerman (1992)
study which discovered that “when clients engage in creative storytelling, they often
report feeling a reduction in tension and anxiety” (as cited in Synder, 1997, p. 2). The
reason behind this is that storytelling itself leads a person to self-examination, selfawareness, and emotional release (Synder, 1997; West, 2002; Stuckey & Nobel, 2010).
This process, in turn, produces a physiological reduction in pain, exhaustion, and
nervousness (Synder, 1997; Stuckey & Nobel, 2010). Moreover, the utilization of
storytelling enhances the therapeutic relationship by promoting trust, increasing active
listening, and fostering reliance, optimism, and dialogue (West, 2002).
Drama. Drama, also known as theater, is the art form which relies on a person’s
ability to portray a complex character or event (Boldt & Brooks, 2006). Aristotle first
proposed the idea that “the function of tragedy was to induce emotional and spiritual state
of catharsis” (as cited in Jones, 2007, p. 24). In other words, drama aids the healing
process by providing people a safe area to have an emotional release. One of the earliest
examples of this principle was the creation of the popular form of Japanese theater,
Kabuki, in order to help relieve the common masses from the difficulties of life during
the Edo period (Lombard, 1928). Another early example was Caelius Aurelius, a French
16
physician whom advocated the use of drama to help the mentally ill communicate and
achieve a healthy equilibrium (Jones, 2007). It was Aurelius’ work that would inspire
other European professionals such as Nikolai Evreinov, Vladimir Iljine, and Moreno to
form drama therapy during the twentieth century (Jones, 2007).
Drama has a long history in European and Eastern societies as being applied in a
therapeutic manner. Yet, it was not recognized as an art or even a skill in America until
the rise of Hollywood in the 1920s. America’s cultural elevation of drama led to the
current scientific research on drama and therapy. In 2002, for example, Goodman (as
cited in Ruppert, 2006) found that when five year old children acted out their favorite
stories it helped them to develop better literacy skills, improved their understand of the
story, and increased their motivation to learn. Using drama in the classroom has been
proven to be an effective tool in improving children’s narrative writing (Ruppert, 2006).
Another example was the Bolt and Brooks (2006) study which discovered that students
who participated in a theater based program had a dramatic increase in linguistic skills
such as vocabulary and grammar. The Dickinson study (as cited by Respress and Lutfi,
2006) also found that drama expands “spontaneous thinking, problem-solving ability,
poise, and presence, concentration and both conceptual and analytical thinking skills” (p.
26). Drama is also useful within the healing process because it requires both the client‘s
and therapist’s involvement; thus, making it become a tangible form of communication
within the therapy session (Riley, 2004).
Experts in the field argue that role play (or therapeutic play) is a form of drama
because both require children to enact a character or event inside or outside themselves.
17
They provide children opportunities to examine new ideas, solve problems, practice life
skills, and expand their world view (Cochran, 1996; Jalongo, & Stamp, 1997; Synder,
1997; Malchiodi, 2005; Schirrmacher, 2006; Ahn & Filipenko, 2007). Thirdly, both role
play and drama permit children to reenact and revolve past traumatic experiences
(Cochran, 1996; Jalongo, & Stamp, 1997; Synder, 1997; Malchiodi, 2005; Schirrmacher,
2006). A final similarity is that drama and role play let children play imaginatively which
has been shown to make children happier and more involved in the learning process
(Wass, 1991). These similarities are important because the vast body of research
demonstrating the usefulness of role play in helping children to overcome the traumas of
abuse, natural disasters, or illnesses can also be considered as the therapeutic benefits of
drama (Cochran, 1996; Synder, 1997; Malchiodi, 2005; Nadkarni & Leonard, 2007,
Meersand, 2009).
Dance. Similar to drama, dance requires a person to perform. However, dance
relies on body language rather than dialogue to tell a story, evoke emotions, and further
develop and integrate one’s cognitive and physical states (Wilson & Saunders, 2005;
Malchiodi, 2005; Oliver & Hearn, 2008). For centuries, many civilizations have used
dance as part of the individual and group healing processes since it is considered to be
calming, to be energizing, and to be a good outlet for emotional distress (Rueppel, 2002;
Tortorra, 2006). A prime illustration of applying dance in a healing manner is the circle
or folk dances by Native American, Celtic, and Arabic communities for the purposes of
curing, increasing spirituality, and maintaining their cultural heritage and connectedness
(Rueppel, 2002; Portman & Garrnet, 2006; Tortorra, 2006). Some examples of these
18
healing dances are the Whirling Dervish, the Pan-Eu Rhythmy, and the Sun Dance
(Rueppel, 2002; Portman & Garrnet, 2006; Tortorra, 2006). These community rituals are
critical in traditional healing because they provide psychological influences of
community cohesion, positive expectations, and social support which have been proven
to improve recovery rates in both children and adults (Winkleman, 2002; Stukey &
Nobel, 2010).
Despite other cultures’ successful use of dance in healing, it has only recently
become a focus in Western art therapy and art research. The National Coalition of
Creative Art Theories Association (NCCATA), for example, only classified dance as a
type of art intervention after the current surge in research confirmed dance’s ability to
change children’s negative emotions, thoughts, and behaviors as well as improve their
physical functioning (as cited in Malchiodi, 2005). An explanation for this delay is
because while dance’s physical aspects are measurable concepts, its social and emotional
interpretations are not; hence, making a scientific study on dance which reflects all of its
components is difficult.
Nonetheless, dance has since been proven to be an effective nonverbal
communication technique with young or delayed children, youth, and adults (Tortora,
2006; Lorenzo-Lasa, Ideishi, & Ideishi, 2007; Oliver & Hearn, 2008). Dance has also
been shown to reinforce mathematical concepts, develop motor and cognitive skills,
activate sensory experiences, and create a sense of oneself and ones’ body in children
(Jalongo & Stamp, 1997; Ruppert, 2006; Tortora, 2006; Lorenzo-Lasa, Ideishi, & Ideishi,
2007; Oliver & Hearn, 2008). A prime example is Shari, MacGellivany, and Palmer’s
19
(2002) study which discovered that high school students who learned dance attained
better scores in all scientific measures of creativity including fluency, originality and
abstract thought than their non-dancing peers (as cited in Ruppert, 2006).
Expressive Art Therapies
Based on the knowledge of different types of expressive arts, it is important to
understand the concept of expressive art therapies verses traditional art therapy.
Expressive art therapies are “an integrative multi-model therapy with the emphasis on the
healing aspects of the creative process” (Rogers, 2001, p. 163). This means that unlike
the psychodynamic or the humanistic methods, expressive art therapies are not limited to
certain types of art forms or environments (Rogers, 2001; Malchiodi, 2005). Instead the
expressive art therapies encourage the counselor to employ all four classifications of art
within their therapy sessions (see details in previous sections). Expressive art therapies
also lend themselves to a variety of environmental settings including psychotherapy,
counseling, schools, rehabilitation, or healthcare. Along with this, expressive art therapies
incorporate both psychological and non-psychological concepts of human behavior and
development. These include, but are not limited to cognitive re-structuring, solutionfocused brief therapy, narrative approaches, developmental theory, and client-centered
theory (Rogers, 2001; Malchiodi & Riley, 2003; Malchiodi, 2005). Expressive art
therapies’ open-ended outlook on human behavior and development allows for other
helping disciplines, such as social work, to utilize expressive art therapies in their work
with at risk children.
20
Why Adopt Expressive Art Therapies
In Italy a small primary school named Reggio Emilia began to promote the use of
expressive art therapies with its students in order to promote learning (as cited in Anning,
1999). According to the school administration, for teachers and other helping professions
to effectively assist children they must be able to use “the hundred languages of
children…[including] role play, dance, music, and art for the children to explore their
open ideas and to communicate them to others” (as cited in Anning, 1999, p. 168). There
is a significant amount of information to show that expressive arts benefit children.
However, is the implication that expressive art therapies are necessary in better serving
children theoretically supported? In this section the author examined two theories that
support this claim. These are Erik Erikson’s psychosocial theory and solution-focused
brief therapy.
Psychosocial theory. As mentioned before, psychosocial theory describes human
behavior as eight sequential developmental stages with specific goals that must be
completed during their lifetime (Ferrara, 1991; Wager, 2008). Erikson’s theory also
states, however, that each of the eight stages is influenced by a person’s unique
biological, psychological, and social factors (Ferrara, 1991; Wager, 2008). While the
eight stages span from infancy to late adulthood, this project concentrated on the early
and middle childhood phases.
The first phase will be the toddler period, know as the autonomy versus shame
and doubt stage, when a person is meant to gain willpower, self-control, and motor skill
development (Ferrara, 1991; Wager, 2008). If a person does not complete this stage;
21
however, they will have higher impulsive tendencies (Ferrara, 1991; Wager, 2008). This
stage is vital when studying art in therapy because mastery of any art skill develops a
child’s motor skills and self control. One example is the studies by Wilson and Suanders
(2005) which found children who are involved in art courses learn how to articulate and
control themselves better; thereby, enabling them to balance impulsivities, feel empathy,
and solve quarrels. Another example is a study conducted by Represses and Lutfit (2006)
which discovered that children involved in art programs have a decrease in disorderly
behaviors and “an increased internal locus of control” (p. 30). In addition, art also
provides children a safe environment in which they can develop their autonomy through a
full range of sensory exploration (Simmons, 1997; Jalongo & Stamp, 1999;
Schirrmacher, 2006).
Another important milestone which is meant to be accomplished within one’s
preschool years is classified as the initiative verses guilt stage (Wager, 2008). Through
exploration and play, completion of this stage gives a person a sense of purpose or
direction whereas failure will result in extreme inhibitions (Ferrara, 1991;Wager, 2008).
Once again this stage is influential in childhood art therapy since, as stated before, art
increases a child’s self-efficacy, self-esteem, and self-expression (Wilson & Sanders,
2005; Catterall & Peppler, 2007). By gaining skills in these areas, children are more
likely to find direction and overcome inhibitions such as a fear of failure (Boldt &
Brooks, 2006). Moreover, the act of creating and producing completed art can provide
children with a sense of accomplishment (Jalongo & Stamp, 1999; Schirrmacher, 2006;
Tortora, 2006).
22
The final stage that must be considered when examining art in therapy is called
the industry versus inferiority stage (Wager, 2008). During this segment, school-age
children are meant to develop friendships and focus on academic and social achievement
(Ferrara, 1991; Wager, 2008). Hence, failure in this stage results in a sense of apathy
(Ferrara, 1991; Wager, 2008). Similar to the earlier stages, art in therapy can help
children complete this stage because “at this last childhood stage, art is emotionally
satisfying and seems to have special value” (Ferrara, 1991, p. 46). Art can also help
children in: 1) expanding their worldview with an introduction to different art forms; 2)
increasing their social skills by providing them with more confidence and avenues of
expression; and 3) raising their community investment with art projects such as murals
that require multiple people to complete (Matarasso, 1997; Jalongo & Stamp, 1999; Boldt
& Brooks, 2006).
Solution-focused brief therapy. Solution-focused brief therapy was first
conceptualized by Steven de Shazaer in the 1980s (Malchiodi & Riley, 2003). This
approach is used by social workers as a short-term and evidence-based intervention
strategy that is useful for any population. Solution-focused brief therapy pertains to
expressive art therapy because the expressive arts of music, visual arts, storytelling,
drama, and dance are “designed to assist clients to recognize the voices from the inside,
so they can find their way clearly and negotiate successfully through the hazards and find
alternative routes” (Synder, 1997, p. 5). In other words, the expressive arts encompass
many of solution-focused brief therapy’s core principles such as self-expression, selfdetermination, and problem solving (Malchiodi & Riley, 2003). Solution-focused brief
23
therapy, according to Malchiodi and Riley (2003), takes the form in expressive art
therapies through the activation of three principles by the practitioner. This first principle
is that clients want and have the ability to make changes in their lives. Secondly, the
practitioner must realize that the clients are the experts about their life stories and
problems in order to neutralize resistance. The final principle is for the practitioner to
guide their clients with visual portrayals of the excepting and miracle questions. Through
this process, clients can access their own situation, identify their own strengths, and
formulate their own solutions (Malchiodi & Riley, 2003).
Solution-focused brief therapy has been proven in several studies to be effective
with children. One of these studies was conducted in 1996 by LaFountain and Garner (as
cited in Gingerich & Eisengart, 2000) who studied the effects of solution-focused groups
on 311 school age children. LaFountain and Garner (1996) found that students who
participated in the solution-focused group had higher self-perception, better coping skills,
and more confidence in non-academic areas than those in the control group who received
traditional therapies (found in Gingerich & Eisengart, 2000). In 1997, Frankin, Biever,
Moore, Clemons, and Scamardo did a study in which they had several teachers evaluate
their fifth and sixth students’ behavior before and after participating in solution-focused
brief therapy. Franklin and colleagues found that after ten therapy sessions, teachers
reported less behavioral problems than before the intervention.
Another important study was done by Corecoran (1999) who compared 239
school age children, who exhibited behavioral problems, based on their assignment to a
solution-focuses brief therapy group or a traditional cognitive behavioral therapy group.
24
Corecoran discovered that while the solution-focused therapy group had lower drop-out
rates (42 versus 73 percent), both groups showed equal improvement in students’
behavior. Corecoran’s study was later supported by Williams (2000) who began to apply
the solution-based brief therapy in his counseling of troubled students and families
referred from schools. Williams observed that students (and their parents) were more
likely to return for further counseling when he used solution-focused brief therapy over
standard cognitive behavioral therapy. These two studies are important for they illustrate
that solution-focus brief therapy reduces student drop out rates from counseling; hence,
increasing the likelihood of long term changes in the students’ overall emotional state.
Until recently, solution-focused brief therapy has been used only in traditional
dialoged-based interventions. This makes research on its effectiveness in art therapy
incomplete. Yet, there have been several studies which have shown the effectiveness of
solution-focused brief and art therapy with children separately (see previous sections).
Moreover, Elinor Ulman (as cited in Councill, 2003) found that in her work with the
chronically mentally ill art therapy has the innate ability to highlight the client’s
strengths, a key component in solution-focused brief therapy. This similarity improves
the successful combination of solution-focused brief therapy and expressive art therapies.
How to Adopt Expressive Art Therapies
Within the last section one gains a grasp of why social workers should adopt
expressive art therapies. Social workers have a solid theoretical foundation for embracing
this evidence-base practice. It has been proven to benefit children’s overall wellbeing and
to be an effective tool in therapeutic relationships around the world. Yet, without a way
25
to apply expressive arts into social work practice, it will simply remain a good theory. In
this next section below, the author will provide a few examples of how social workers
can incorporate expressive art therapies into their practice. This will be divided between
the micro, the mezzo, and the macro level.
Micro level practice. Using expressive art exercises within both direct practice
and research is the first method for how social workers can begin to adopt expressive art
therapies. This is important because “storytelling, plays, drawings, and paintings
encourages a social validation of objective data that can not be obtained through the
orthodox processes of survey and fieldwork” (Huss & Cwikel, 2007, p. 172). This means
that art can help humanize empirical data for the researcher, the social worker, and the
general public. The second method is through arts’ ability to embody existing social work
concepts such as the as if technique, the solution-focused brief therapy, and the clientcentered theory (Rogers, 2001; Malchiodi & Riley, 2003; Rasmussen & Garza, 2008).
The utilization of creative genograms which focus on letting the client express his/her
concerns about the family rather than the predetermined issues identified by the therapist
is a third method (Huss & Cwikel, 2007). This is done by allowing the clients to choose
their own symbols, colors, shapes, and textures to represent family members, family
dynamics, and family events in relation to themselves, the family, and the outer world
(Huss & Cwikel, 2007). Finally, social workers refer parents and/or guardians to expose
their children to various art forms outside the school setting by visiting museums, taking
art classes, and/or incorporating the arts in everyday life (Bolt & Brookes, 2006). This
not only benefits the child, but can also strengthen the child-parent relationship.
26
Mezzo level practice. Along with direct or micro level practices, art can be used
at the mezzo level as well. Using art as a therapeutic tool in groups, for example, has
been shown to enhance children’s social skills including sharing, cooperation, and
tolerance (Isaacs, 1977; Clemens, 1991; Cochran, 1996; Matarasso, 1997; Schirrmacher,
2006; Boldt & Brooks, 2006). Art in a group setting has also been linked in various
studies to enhance community identity and investment in children, adolescences, and
adults (Matarasso, 1997; Boldt & Brooks, 2006; Ruppert, 2006). Finally, employing art
in therapeutic groups can make it easier for participants to express their emotions and
experiences than the traditional dialogue based approaches.
Macro level practice. With the help of organizations such as Americans for the
Arts, American Teachers Association, and National Assembly of State Art Agencies
there has been an increase in the research on and the promotion of the importance of art
for children within and outside of school. Nonetheless, the arts and their place in public
schools continue to be precarious. While there is a higher public demand for art
education, schools are still being forced to cut or completely remove art programs
(Ruppert 2006). If there is no change soon, art will be lost in schools. This will be
detrimental to children, especially those from disenfranchised groups, because school is
the primary avenue that most children receive exposure to the arts (Ruppert, 2006).
Social workers are ethically obligated as social justice pioneers and advocates to take
action to save the arts in schools. Social workers can help in this matter by becoming
involved in education-based legislation which supports reforms to the No Child Left
Behind Act (NCLB). One reform is the Strengthening Art Education in the Elementary
27
and Secondary Education Act which requires a revision of core academic subjects under
NCLB to include the arts (Strengthening Arts, 2007).
The other way social workers can help recover art education is to fight for an
integrated art curriculum in which students can learn about and practice various art forms
as they relate to social studies and history (Eisner, 2002). According to Eisner (2002), an
integrated art curricula is important because “it is extremely difficult to know what the
music of a period sounds like without being able to listen to it or to understand the form a
painting took during a particular period without being about to see it or to experience the
forms of dance or theater that were created in a particular period” (p. 154). In other
words, people cannot comprehend or appreciate the art from a particular time period or
culture unless they themselves experience it. This integrated curriculum would also
enhance cultural competence and ethnic representation within the classroom by
addressing difficult topics like racism, fostering more in-dept class discussions, creating
more teacher to student relatedness, and increasing the understanding between students
of differing backgrounds (Eisner, 2002). Thirdly, this new curricula would be effective in
helping teachers and social workers to reduce high dropout rates by creating a positive
school environment and increasing students’ motivation to learn and continue his/her
education (Wass 1991; Ruppert, 2006).
28
Chapter 3
METHODS
Research Design
Scientific research has repeatedly demonstrated that art in therapy has physical,
cognitive, psychological, and social benefits for children. These benefits have resulted in
use of expressive art therapies by therapists, educators, and child development specialists
(Vick, 2003; Malchiodi, 2005; Waller, 2006). Even though other professions have
demonstrated the benefits of art therapy for children, the social work profession has
barely begun to realize these benefits. This is reflected in the gap between the
profession’s direct practices and its literature regarding the therapeutic use of art with
children. It is time for social workers to do the same. Therefore, the main objective of this
study was to obtain social work graduate students’ perceptions about using art therapy
and the potential benefits it has for social work practices. By doing so the researcher
hoped to pioneer the use of expressive art on her professional practice in the future. The
author illustrated the gap in the social work profession’s direct practices by using
exploratory design for her research focus area. This choice is supported by Rubin and
Babbie (2010) who found that research areas (e.g. art therapy) which have not been very
well research by social workers are best measured with the exploratory research design.
The Participants
There are currently 220 MSW I and II students attending California State
University, Sacramento. The author planned to collect data from approximately 100 (first
and second year) or 50% of the graduate students enrolled in the Social Work Master’s
29
Degree Program. The recruitment of students was done by first gaining consent from
social work instructors that were teaching SWRK 204A/B and/or 204C/D. There were
two reasons why the researcher decided to survey SWRK 204A/B and/or 204C/D classes.
One reason is that all graduate social work students are required to take this course; thus,
the researcher could potentially reach all the current students. The other reason was that
the students must take the same class section each semester. This stipulation would
prevent redundancy because once a class had participated it would not longer be eligible
to participate again. This action was important in protecting the validly and reliability of
the study.
The actual number of participants in the study was influenced by three factors.
The first one was whether or not the faculty members gave the researcher permission to
distribute the questionnaire in his/her class during the fall semester. Out of the eleven
instructors teaching the SWRK 204A/B and/or 204C/D course, the researcher received
permission from six of them. Out of the five remaining instructors: three instructors never
responded to the email, one instructor refused to participate, and one instructor gave
initial permission, but never confirmed a date for the distribution of the study.
The student’s attendance on the day of the researcher’s in-class presentation was
the second factor because if the student was not present then s/he would not receive the
testing materials. The final factor influencing the number of surveys completed was the
researcher’s choice to have the students mail back their survey. According to Rubin and
Babbie (2010), the longer the gap is between the distribution and completion of a
questionnaire the less likely a participant is to complete it. Therefore, out of the
30
possibility of 100 participants, 96 surveys were distributed and 61 completed surveys
were returned to the researcher by the deadline.
The participants themselves were selected based on their enrollment in graduate
social work practice courses, SWRK 204A/B and/or 204C/D, during the 2010-2011
academic year. Since all MSW students who were willing to participate in the research
project were eligible as subjects, the researcher took care to avoid redundancy. As stated
before, a SWRK 204C/D course that is taught by the same instructor would no longer be
eligible if the researcher has already presented in his/her class. By distributing the
questionnaire in only the practice classes, the researcher was creating a confidential and
internal method for preventing students from participating in the project twice. This
works as a type of checking system because the graduate students stay in the same
practice class for the entire 2010-2011 academic year.
Testing Materials
The setting the author used was the classrooms hosting graduate students (both
first and second years) at California State University Sacramento, Division of Social
Work. In order to explain the gap between social workers use of expressive art in their
direct practice and the social work literature, she distributed a self-created questionnaire.
This questionnaire had 52 statements based on a Yes-No and Likert-Scale formats. It is
estimated by the researcher to have taken the participants up to twenty minutes to
complete.
Six of these statements were used to obtain relevant demographic information on
the participants such as their age and gender. The other 46 statements in the questionnaire
31
were divided into three sections entitled art benefits, art utilization, and defining art and
art in therapy. These questions were developed by the researcher. The Art Benefits
section was designed to assess the participants’ knowledge on the benefits of arts based
on the four major benefits: physical, cognitive, psychological and social-academic. The
second section, titled Art Unitization, was meant to measure the participants’ use of the
art forms music, visual arts, storytelling, drama, and dance within their current and
potential clients. Defining art and art in therapy was the final section of the survey and it
was designed to find out the participants’ view of what art is and how it takes shape in the
therapeutic setting. This information would, in turn, allow the author to gain insight into
the participants’ answers in the previous sections of the survey.
The other testing material the researcher used was an informed consent form that
underlines participants’ rights, confidentiality, and possible risk and benefits of
participation. Based on the knowledge of the researcher, the questionnaire used in this
study has no risk since it focused only on graduate students’ perceptions towards
expressive art therapies as a therapeutic technique.
Human Subjects Protection
The researcher began the IRB application process by working on the drafts with
her thesis advisor. As a part of this process, an initial email of interest was sent out to all
the practice instructors. Based on their feedback, the researcher changed from the in-class
completion to outside of class completion of the survey through traditional mail. Once the
application was approved by her thesis advisor it was submitted to the Human Subject
Committee. The application was initially “approved with condition” so long as the
32
researcher: 1) adjusted the risk level from minimal to no risk; 2) explained the internal
checking system used by the researcher; and, 3) stated how the participants would receive
a copy of the consent form. These corrections were made and approved by her thesis
advisor. Then the application was re-submitted. Human Subject Protection Approval was
granted to her research on November 4th, 2010. Her approval number is 10-11-022. This
approval is good for one-year from the date stated above.
Under human subject protection, there were three ethical standards that are
essential to research. The first is the presence of informed and voluntary participants. In
other words, the participants should not be forced or coerced into participation.
Furthermore, the researcher must have obtained written consent from each participant
stating that s/he is aware of his/her rights, that s/he has a basic understanding of the
study’s purpose, and that s/he gave his/her consent to the researcher to collect the data.
This researcher has fulfilled this standard by gaining consent through both a verbal and
written permission. A verbal consent was gathered from the participants when the
researcher asked the prospective students if they were interested in participating in the
study. Those who stated their interest were the only students given a packet containing a
written consent form and the questionnaire. Most importantly, the researcher stated that
students who wanted to volunteer needed to complete the questionnaire and return the
packet to the researcher on the address given on the envelope; and, those students that
had initially volunteered but later declined to participate were asked to destroy the packet.
The written permission was obtained through the participants’ signature on and return of
the informed consent form which detailed information about the researcher, the voluntary
33
nature of the researcher project, and other necessary contact information. As stated
before, the participants could receive a copy of the consent form for their records via their
instructors.
Another critical aspect was confidentiality or the right to be anonymous and to
have their identifying information such as their names, addresses, or phone numbers
protected. In order to secure confidentiality, the researcher avoided collecting identify
items such as names of the participants and the name of their instructors. She also kept
the questionnaires and consent forms separately and within secure locations when out of
her possession. Moreover, all information was destroyed after the data analysis was
complete.
A final concern which was upheld in this study was the rule of no or minimal
harm to the participants. This means that the researcher did everything possible to
eliminate and/or decrease the risk of causing the participants negative physical, financial,
and/or psychological harm. Some efforts to reduce these risk factors by this researcher
were to: 1) avoid giving out compensation, 2) work around transportation and possible
scheduling conflicts, and; 3) briefly describe the study’s purpose and provide information
on resources for psychological assistance if the participants should need it on the consent
form although the study was considered to be a “no risk” study.
Procedure
Once the IRB application was approved, the first step in receiving data for this
research study was to gain access to social work graduate students. This was achieved by
gaining consent of the graduate practice instructors (SWRK 204 A/B or SWRK C/D) to
34
introduce the research project and distribute the questionnaire packets within their
classes. This process was done through email correspondence with the faculty members.
Once the researcher received permission from the prospective class instructors, she went
into their classes at their scheduled times. During her visits, the researcher took
approximately five minutes of the class time to give a quick orientation about the
research’s purpose and review the consent form. Afterwards she instructed the students
who were willing to participate in the study to take home the questionnaire packets which
included an inform consent form and the questionnaire. Once both were completed, she
asked that prospective participants mail back the questionnaire packets in the stamped,
pre-addressed envelope, provided by the researcher, within two weeks of its distribution.
Those packages which were not returned within the two-week time period were reported
as incomplete in the findings chapter. The students were also told that an electronic copy
of the consent form was available to any participants who were interested via their
instructor once the in-class presentation was completed.
Data Analysis
The data for this research project was obtained from the 61 completed surveys.
Each survey was given a number 1 to 61. Then the survey questions and answers were
numerically coded and entered into the SPSW data system for analysis. The author
compared and analyzed the scores using the computer program PASW. Inter-observer
agreement was not necessary for the study did not rely on any observations. This score
revealed the participants’ definition of art, familiarity with art’s benefits, and application
of different art forms in their work. Moreover, these scores highlighted a disconnection
35
between direct practice and research literature regarding the use of art by social workers.
Limitations
There are two limitations to the experiment. The first limitation lies within the
sample used for the study. By having a small sample size and using only graduate level
college students, the experiment was not representative of the overall social work
population. This means that the results only apply to social worker graduate students
from California State University of Sacramento and not to the overall social work
population. The other limitation to this study was the author’s choice to not use a preestablished survey to collect data. This is a limitation because the questionnaire has no
precedence to support its reliability and/or validity; therefore, the questionnaire needs
further testing to confirm its results.
36
Chapter 4
RESULTS
Demographics
The demographic characteristics of the participants are described in tables one
through five. These characteristics include their gender, race, MSW classification, formal
art instruction, and the client population they serve. The purpose of this data is to provide
background information on the participants which may have had an impact in the
findings described later in this section.
Table 1: Gender of graduate students
Variable
Valid Male
Female
Transgender
Total
Frequency
7
Percent
11.5
Valid
Percent
11.5
53
1
61
86.9
1.6
100.0
86.9
1.6
100.0
Cumulative
Percent
11.5
98.4
100.0
When examining the gender of the participants, 11.5% (n=7) indicated that they
were male and 86.9% (n=53) said they were female. These numbers are reflective of the
overall social worker population as the profession is currently a female dominated field.
37
Table 2: Race of graduate students
Race of students
Valid
Frequency Percent
25
41.0
7
11.5
Valid
Cumulative
Percent
Percent
42.4
42.4
11.9
54.2
White/Caucasian
African
American
Hispanic/Latino
Asian American
Other
Total
Missing 999
Total
15
24.6
25.4
79.7
7
5
59
2
61
11.5
8.2
96.7
3.3
100.0
11.9
8.5
100.0
91.5
100.0
The racial division of the graduate students is diverse. The highest concentration
of graduate students stated Caucasian as their race with 42.4% (n=25). Around 25.4%
(n=15) of students reported to be of Hispanic decent. Students who considered
themselves as African American or Asian American had an equal percentage of 11.9%
(n=7) in this study. The least amount of students reported “other” as their racial identity
with 8.5% (n=5).
Table 3: MSW Classification of graduate students
Frequency
Valid MSW I
MSW II
MSW III
Total
17
43
1
61
Percent
27.9
70.5
1.6
100.0
Valid Percent
27.9
70.5
1.6
100.0
Cumulative Percent
27.9
98.4
100.0
In regards to the social work graduate students’ current level of education, 27.9%
(n=17) of the participants reported to be a first year master student whereas 70.5% (n=43)
38
reported to be a second year master student. This number may have been affected by
which classes permitted the researcher to present her study. Four of the six classes
surveyed were second year practice classes and two were first year practice classes.
Table 4: Received formal art therapy education
Frequency Percent
Valid Yes
No
Total
Valid Percent
6
55
9.8
90.2
9.8
90.2
61
100.0
100.0
Cumulative Percent
9.8
100.0
Approximately, 90.2% (n=55) of graduate students had no formal instruction in
art therapy and 9.8% (n=6) had formal instruction in this field. Understanding the
participants’ background around art and art therapy was important because their level of
usage on this technique may be influenced by the participants’ previous exposure to it.
Table 5: Client population
Valid
Infants (0-4 yrs old)
Children (5-12 yrs old)
Adolescents (13-18 yrs old)
Young Adults (18-30 yrs old)
Middle Adults (31-50 yrs old)
Older Adults (55+ years old)
Total
Missing 999
Total
Frequency Percent
2
3.3
9
14.8
6
9.8
1
1.6
3
3
24
37
61
4.9
4.9
39.3
60.7
100.0
Valid Cumulative
Percent
Percent
8.3
8.3
37.5
45.8
25.0
70.8
4.2
75.0
12.5
12.5
100.0
87.5
100.0
When surveying which client populations are served by graduate students, 70.8%
39
(n=16) reported working with minors (clients under the age of 18) while 29.2% (n=7)
reported working with adults (clients over the age of 18). Yet, 60.7% (n=37) of
participants choose not to respond to this question. This high number of non-response
could have been influenced by a variety of factors such as the participants’ concern with
confidentiality and those participants who work with multiple age groups within their
field placement.
Benefits of Art
The first section of the questionnaire focused on assessing the participant’s
awareness of art benefits. These benefits were physical, cognitive, psychological, socialacademic and spiritual. The questions are based on the Yes/No format.
Table 6: Art benefits motor skills
Frequency Percent
Valid
Yes
No
Not Sure
Total
Missing 999
Total
58
1
1
60
1
61
95.1
1.6
1.6
98.4
1.6
100.0
Table 7: Art benefits physical health
Frequency Percent
Valid
Yes
No
Not Sure
Total
Missing 999
Total
37
3
20
60
1
61
60.7
4.9
32.8
98.4
1.6
100.0
Valid Percent
96.7
1.7
1.7
100.0
Valid Percent
61.7
5.0
33.3
100.0
Cumulative Percent
96.7
98.3
100.0
Cumulative Percent
61.7
66.7
100.0
When discovering the participants’ views regarding arts’ impact on physical
40
health, 61.7% (n=37) agreed that art enhances children’s overall physical health. Only
5.0% (n=3) did not agree and 33.3% (n=20) were unsure about arts’ role in improving a
child’s physical health. This can be compared with 96.7% (n=58) of participants who felt
that art can improve motor development versus only 3.4% (n=2) who did not agree or
were not sure if art helps in this area. The difference in these results may have been
created by the ambiguity of the term physical health. If the author had listed specific
enhancements, such as stress reduction, the results could have been more aligned. Still, a
noteworthy percentage of participants felt that art had physical benefits for children.
Table 8: Art develops critical thinking
Frequency Percent Valid Percent Cumulative Percent
Valid
Yes
45
73.8
76.3
76.3
No
3
4.9
5.1
81.4
Not Sure
11
18.0
18.6
100.0
Total
Missing 999
Total
59
2
61
96.7
3.3
100.0
100.0
Table 9: Art strengthens the connections in the brain
Frequency Percent Valid Percent Cumulative Percent
Valid
Yes
45
73.8
77.6
77.6
No
2
3.3
3.4
81.0
Not Sure
11
18.0
19.0
100.0
Total
Missing 999
Total
58
3
61
95.1
4.9
100.0
100.0
When assessing for participants’ knowledge on the cognitive benefits of art,
83.3% (n=50) felt art enhances critical thinking while 16.6% (n=10) did not or were
41
unsure of this affect. In comparison, 77.6% (n=45) of students’ believed that art
strengthens the connections within the brain and 22.4% (n=13) did not agree or were
unsure about this event. While there is a slight variance, both questions prove that the
majority of the students believed that art provides cognitive growth in children.
Table 10: Art adds to one's wellbeing
Frequency Percent
Valid
Yes
Not Sure
Total
Missing 999
Total
Valid Percent
Cumulative Percent
54
88.5
90.0
90.0
6
60
1
61
9.8
98.4
1.6
100.0
10.0
100.0
100.0
Table 11: Art benefits mental health
Frequency Percent Valid Percent Cumulative Percent
Valid
Yes
57
93.4
61.7
61.7
Sure
Total
Missing 999
Total
3
60
1
61
4.9
98.4
1.6
100.0
5.0
100.0
100.0
Table 12: Art builds self-esteem
Frequency Percent Valid Percent Cumulative Percent
Yes
37
60.7
62.7
62.7
No
3
4.9
5.1
67.8
Not Sure
19
31.1
32.2
100.0
Total
60
98.4
100.0
Missing 999
2
3.3
Total
61
100.0
Graduate students had a relatively consistent view of the positive benefits art has
42
on children’s psychological state. When asked if art can enhance one’s overall emotional
well-being, 90.0% (n=54) of students agreed and 10.0 % (n=6) were unsure. Again these
high numbers were repeated when 95.0% (n=57) of students agreed and 5.0% (n=3) were
unsure if art improved one’s mental health. In both instances, no students disagreed with
the concept that art has psychological benefits for children. Yet, only 62.7% (n=37) of
participants agreed that art improves one’s self-esteem versus 37.3% (n=21) who were
unsure or disagreed. This discrepancy may be caused by the fact that self-esteem is a
western concept.
Table 13: Art's role in a child’s development
Frequency Percent Valid Percent Cumulative Percent
Valid
Yes
56
91.8
93.3
93.3
Not Sure
4
6.6
6.7
100.0
Total
60
98.4
100.0
Missing 999
1
1.6
Total
61
100.0
Table 14: Art improves academic-social success
Frequency Percent Valid Percent Cumulative Percent
Valid
Yes
45
73.8
76.3
76.3
No
3
4.9
5.1
81.4
Not Sure
11
18.0
18.6
100.0
Total
59
96.7
100.0
Missing 999
2
3.3
Total
61
100.0
Whether or not art can play a critical role in formulating a child’s academic and
social skills was another benefit of art assessed by this survey. In regards to a child’s
overall development, 93.3% (n=56) of participants believed art enhances childhood
43
development and only 6.6% (n=6) were not sure if it helped in development. On the other
hand, only 76.3% (n=45) of students felt art can help in improving a child’s academic and
social success and 23.7% (n=14) did not believe in or were unsure of this event. This
inconsistency could have been shaped by the participant’s definitions of development.
The term development is often associated with only physical milestones (gross/fine motor
skills) versus emotional or cognitive ones.
Table 15: Tapping into spirituality
Frequency Percent
Valid
Yes
52
85.2
No
1
1.6
Not Sure
5
8.2
Total
58
95.1
Missing 999
3
4.9
Total
61
100.0
Valid Percent Cumulative Percent
89.7
89.7
1.7
91.4
8.6
100.0
100.0
When discovering participants’ views on art and spirituality, 89.7% (n=52) of
students felt that art can be used to tap into one’s spirituality while 10.3% (n=6) did not
agree or were unsure about this property. These numbers were higher than predicted
because spirituality is a new concept in the field art therapy. Moreover, the goal of being
“secular” has dominated scientific research in the western world since the 19th century.
Utilization of Art
Discovering which expressive art forms the participants’ utilized in their work
with clients was the second portion of the survey. The expressive art forms examined
were music, visual arts, storytelling, drama, and dance. These questions were based on a
Likert-Scale formatting ranging from always using to never using in their work.
44
Table 16: Have their clients listen to music in therapy
Frequency Percent Valid Percent
Valid
Always
1
1.6
2.2
Usually
4
6.6
8.7
Rarely
18
29.5
39.1
Never
23
37.7
50.0
Total
46
75.4
100.0
Missing 999
15
24.6
Total
61
100.0
Cumulative Percent
2.2
10.9
50.0
100.0
Considering music, 10.9% (n=5) of students regularly have their clients listen to it.
This is low when compared to 39.1% (n=18) who rarely use and 50% (n=23) who never
use music. Music’s low numbers is odd since the bulk of research on art included music.
Table 17: Have their clients draw in therapy
Frequency Percent Valid Percent
Valid
Always
Usually
Rarely
Never
Total
Missing 999
Total
3
11
22
10
46
15
61
4.9
18.0
36.1
16.4
75.4
24.6
100.0
6.5
23.9
47.8
21.7
100.0
Cumulative Percent
6.5
30.4
78.3
100.0
Table 18: Have their clients color in therapy
Frequency
Valid
Percent
Valid Percent
Cumulative Percent
Always
4
6.6
8.7
8.7
Usually
9
14.8
19.6
28.3
Rarely
23
37.7
50.0
78.3
Never
10
16.4
21.7
100.0
Total
Missing 999
46
15
75.4
24.6
100.0
Total
61
100.0
45
Table 19: Have their clients paint in therapy
Frequency Percent Valid Percent
Valid
Always
3
4.9
6.5
Usually
8
13.1
17.4
Rarely
10
16.4
21.7
Never
25
41.0
54.3
Total
46
75.4
100.0
Missing 999
15
24.6
Total
61
100.0
Cumulative Percent
6.5
23.9
45.7
100.0
Out of the students’ surveyed, 6.5% (n=3) report that they always use drawing in
their work with clients whereas 23.9% (n=11) usually use and 47.8% (n=22) rarely use
drawing in therapy. Only 21.7% (n=10) have never used drawing with their clients.
Similar numbers continued with other visual art mediums despite drawing being the most
researched in art therapy. For example, 8.7% (n=4) of participants always use and 19.6%
(n=9) usually use coloring in therapy whereas 50.0% (n=23) of participants rarely applied
and 21.7% (n=10) never applied it with their clients. Again, these numbers are seen with
painting with 6.5% (n=3) of participants’ reporting to always utilize and 17.4% (n=8) to
usually utilize painting. This is compared to 21.7% (n=10) who rarely used and 54.3%
(n=25) who never used painting. The similar range of numbers among the visual arts
medium is influenced by social definitions of “art” in terms of visual depictions. In
addition, therapists, social workers, and other helping professionals are more likely to
have access to the supplies used to create visual arts.
46
Table 20: Have their clients do role play in therapy
Frequency Percent
Valid
Always
4
6.6
Usually
8
13.1
Rarely
19
31.1
Never
15
24.6
Total
46
75.4
Missing 999
15
24.6
Total
61
100.0
Valid Percent
8.7
17.4
41.3
32.6
100.0
Table 21: Have their clients use expressive toys in therapy
Frequency Percent Valid Percent
Valid
Always
3
4.9
6.5
Usually
5
8.2
10.9
Rarely
15
24.6
32.6
Never
23
37.7
50.0
Total
Missing 999
Total
46
15
61
75.4
24.6
100.0
Cumulative Percent
8.7
26.1
67.4
100.0
Cumulative Percent
6.5
17.4
50.0
100.0
100.0
One of the first social work techniques that social workers learn in their formal
education is the process of role play in which the practitioner and the client act out and
solve a particular dilemma. Yet of the students surveyed, only 26.1% (n=12) always
apply or usually apply role play as a therapeutic technique. In contrast, 73.9% (n=34) of
students’ reported to rarely utilize or to never have utilized role play with their clients.
These types of numbers continue with the students’ use of expressive toys, such as
puppets. Only 17.5% (n=8) of participates stated to always employ or usually employ
expressive toys compared with 82.6% (n=38) who rarely employ or never employed
them.
47
Table 22: Have their clients dance in therapy
Frequency Percent
Valid Percent
Cumulative Percent
Valid
Usually
3
4.9
6.5
6.5
Rarely
13
21.3
28.3
34.8
Never
30
49.2
65.2
100.0
Total
46
75.4
100.0
Missing 999
15
24.6
Total
61
100.0
When asked whether or not they use dance with their clients, 6.5% (n=3) of
participants reported to usually use it. Whereas, 28.2% (n=13) of participants surveyed
rarely use and 65.2% (n=30) have never used dance within their work. The significantly
higher percentage of participants who reported to rarely utilize or never utilized dance
may be affected by a variety of environmental factors such as a lack of space in offices to
allow for dance and the relative “newness” of research on dance’s therapeutic benefits.
Table 23: Have clients tell their story in therapy
Frequency Percent Valid Percent Cumulative Percent
Valid
Always
20
32.8
42.6
42.6
Usually
17
27.9
36.2
78.7
Rarely
3
4.9
6.4
85.1
Never
7
11.5
14.9
100.0
Total
47
77.0
100.0
Missing 999
14
23.0
Total
61
100.0
In regards to storytelling, 42.6% (n=20) of students always have their clients tell
their story in therapy and 36.2% (n=17) usually have the clients tell their story. Only
6.4% (n=3) of students’ surveyed reported to rarely have and 14.9% (n=7) to never have
48
their clients’ tell their story as a part of therapy. This higher rate of usage is reflective of
the popularity of client-centered approaches, such as Narrative Therapy. It may also be
affected by storytelling needing no supplies or a certain environment.
Table 24: Have their clients journal in therapy
Frequency Percent Valid Percent
Valid
Always
4
6.6
8.5
Usually
Rarely
Never
Total
Missing 999
Total
18
13
29.5
21.3
38.3
27.7
46.8
74.5
12
47
14
61
19.7
77.0
23.0
100.0
25.5
100.0
100.0
Table 25: Have their clients write in therapy
Frequency Percent Valid Percent
Valid
Always
Usually
Rarely
Never
Total
Missing 999
Total
Cumulative Percent
8.5
6
19
6
16
47
14
61
9.8
31.1
9.8
26.2
77.0
23.0
100.0
12.8
40.4
12.8
34.0
100.0
Cumulative Percent
12.8
53.2
66.0
100.0
When looking at story writing, the survey showed that 46.8% (n=22) of students
always or usually employ journals in therapy and 53.2% (25) rarely or never use
journaling with clients. In comparison, 53.2% (n=25) of students reported to always or
usually have their clients write their story versus 36.8% (n=22) who rarely or never had
their clients write in therapy. These similar numbers among the different elements of
story writing is significant because they show consistency in the participants’ responses.
49
Definitions of Art
The final section of this survey was designed to find out the participant’s
definition of the overall concept of art. It also looked at the participants’ view of specific
categories of art. The questions in the section are also based on the Yes/No format.
Table 26: Art is common in all human societies
Frequency Percent Valid Percent
Valid
Yes
No
Not Sure
Total
Missing 999
Total
41
67.2
68.3
68.3
9
10
60
1
61
14.8
16.4
98.4
1.6
100.0
15.0
16.7
100.0
83.3
100.0
Table 27: Art functions differently between communities
Frequency Percent Valid Percent
Valid
Yes
No
Not Sure
Total
Missing 999
Total
Cumulative Percent
44
2
13
59
2
61
72.1
3.3
21.3
96.7
3.3
100.0
74.6
3.4
22.0
100.0
Cumulative Percent
74.6
78.0
100.0
When asked whether or not art is common among all human societies, 68.3%
(n=41) of participants said yes. Yet, 21.7% (n=19) of participants reported they did not
agree with or were unsure if art is common among all human cultures. Similar trends
continued with 74.6% (n=44) of students agreeing that art’s functions differs based on the
community versus 25.4% (n=15) who did not agree with or were unsure about this
difference.
50
Table 28: There is a difference in art for pleasure and self-expression
Frequency Percent Valid Percent
Cumulative Percent
Valid
Yes
28
45.9
46.7
46.7
No
14
23.0
23.3
70.0
Not Sure
18
29.5
30.0
100.0
Total
60
98.4
100.0
Missing 999
1
1.6
Total
61
100.0
Out of the students surveyed, 46.7% (n=28) agreed that there is a difference in art
for pleasure and self-expression. Yet, 53.3% (n=32) did not agree or were unsure if this
difference existed. The near fifty-fifty split of the participants’ answers is a critical
finding since it shows that the participants were less aware of this difference. This
unawareness may explain the overall lower rates of utilization of art forms of visual arts,
music, and drama by the participants than anticipated by the researcher (see last section).
Table 29: Music is a form of art
Frequency Percent
Valid
Yes
58
95.1
No
1
1.6
Not Sure
1
1.6
Total
60
98.4
Missing 999
1
1.6
Total
61
100.0
Table 30: Drama is a form of art
Frequency Percent
Valid
Yes
58
95.1
Not Sure
2
3.3
Total
60
98.4
Missing 999
1
1.6
Total
61
100.0
Valid Percent
Cumulative Percent
96.7
96.7
1.7
98.3
1.7
100.0
100.0
Valid Percent
Cumulative Percent
96.7
96.7
3.3
100.0
100.0
51
Table 31: Dance is a form of art
Frequency Percent
Valid
Yes
60
98.4
Missing 999
1
1.6
Total
61
100.0
Valid Percent
Cumulative Percent
100.0
100.0
When assessing what art forms the participants accepted as art (a part for visual
arts) the author looked at music, drama, and dance. The author hypothesized that what
mediums the participants accepted as art would influence their use of these arts. In
regards to music and drama, 96.7% (n=58) accepted these as art while only 3.3% (n=2)
disagreed and/or were unsure. The numbers slightly increased with dance as 100.0%
(n=60) agreed it was an art form. This discovery shows that while the participants accept
music, drama, and dance as art, it does not affect their level of utilization in therapy.
Table 32: Visual Arts is the process of employing depictions
Frequency Percent Valid Percent Cumulative Percent
Valid
Yes
41
67.2
68.3
68.3
No
2
3.3
3.3
71.7
Not Sure
17
27.9
28.3
100.0
Total
60
98.4
100.0
Missing 999
1
1.6
Total
61
100.0
When asked if visual arts in therapy is a process of employing depictions for
healing, 68.3% (n=41) of those surveyed agreed with this statement. Only 31.6% (n=19)
did not agree or were unsure about this definition. This finding was important because it
allowed the term visual arts to encompass both the client’s exposure to and creation of
52
visual art works. Based on the results, the majority of students agreed with the author’s
definition for visual arts.
Table 33: Storytelling is a form of art
Frequency Percent Valid Percent
Valid
Yes
55
90.2
91.7
No
1
1.6
1.7
Not Sure
4
6.6
6.7
Total
Missing 999
Total
60
1
61
98.4
1.6
100.0
100.0
Table 34: Story writing is a form of art
Frequency Percent Valid Percent
Valid
Yes
58
95.1
96.7
No
1
1.6
1.7
Not Sure
1
1.6
1.7
Total
Missing 999
Total
60
1
61
98.4
1.6
100.0
Cumulative Percent
91.7
93.3
100.0
Cumulative Percent
96.7
98.3
100.0
100.0
Table 35: Storytelling is the use of words in therapy
Frequency Percent Valid Percent
Valid
Yes
55
90.2
91.7
Not Sure
5
8.2
8.3
Total
60
98.4
100.0
Missing 999
1
1.6
Total
61
100.0
Cumulative Percent
91.7
100.0
When defining storytelling as a person’s use of words in either a written or oral
form, 91.7% (n=55) of students surveyed agreed versus 8.3% (n=5) being unsure about
the definition. None of the participants reported to disagree with this definition of
storytelling. In regards to whether or not storytelling is an art form, 91.7% (n=55)
53
reported yes while 7.4% (n=5) reported no or unsure. Similarly, 91.7% (n=58) of students
agreed that story writing was an art form compared to 3.4% (n=2) who did not or were
unsure. These three questions are linked because they all center on storytelling as a
therapeutic technique. Moreover, the consistency among these questions adds validity to
the survey’s findings in regards to storytelling as an accepted art form by participants.
Table 36: Art’s healing ability is supported by culture and science
Frequency Percent
Valid Percent
Cumulative Percent
Valid
Yes
52
85.2
86.7
86.7
Not Sure
8
13.1
13.3
100.0
Total
60
98.4
100.0
Missing 999
1
1.6
Total
61
100.0
The confirmation of art’s healing abilities by culture and science is highly
accepted by the participants in this study as 86.7% (n=52) agreed with this statement.
Only 13.3% (n=8) reported to not be sure and none reported disagreeing outright with
this statement. This means that the majority of participants believed that art’s facilitation
of healing is supported. Yet, many of them still do not fully use these art forms in their
work with clients as found in the low utilization rates (see previous section).
Inferential Statistics
In this final section of the results, the author did some cross-tabulations using chisquare testing. The purpose of this cross-tabulation was to assess for any correlation
among four key variables. These were: 1) art benefits to motor skills and mental health;
2) level of student education and view on art therapy; 3) art benefits for critical thinking
and academic-social skills; and, 4) if there is a difference in art for pleasure and self-
54
expression and arts function differs between communities.
Table 37: Chi-square test on art benefits to motor skills and mental health
Count
Art benefits mental health
Yes
Not Sure
Total
Art benefits motor
Yes
55
3
58
skills
No
1
0
1
Not Sure
Total
Pearson Chi-Square
Likelihood Ratio
Linear-by-Linear
Association
N of Valid Cases
1
57
Chi-Square Tests
Value
Df
a
.109
2
.209
2
.096
1
0
3
1
60
Asymp. Sig. (2-sided)
.947
.901
.757
60
The chi-square of independence shows no association between the perceptions
graduate student have about the use of art to improve motor skills and mental health
conditions. The result indicates that graduate students perceived art has having equal
capacity to improve psychological conditions (chi-square=.109, p> .947).
Table 38: Chi-square test between students and art benefits mental health
Count
MSW Classification of
graduate students
Total
MSW I
MSW II
MSW III
Art benefits mental
health
Yes
Not Sure
15
1
41
2
1
0
57
3
Total
16
43
1
60
55
Pearson Chi-Square
Likelihood Ratio
Linear-by-Linear
Association
N of Valid Cases
Chi-Square Tests
Value
Df
.116a
2
.163
2
.098
1
Asymp. Sig. (2-sided)
.944
.922
.755
60
a. 4 cells (66.7%) have expected count less than 5. The minimum expected count is .05.
Similarly, the chi-square of independence illustrates that there is no significant
difference in the perceptions graduate student have about the use of art therapy. MSW I,
II, and III have similar views regarding art therapy in social work (chi-square= .116,
df=2, p> .944).
Table 39: Chi-square test on art benefits on critical thinking and social-academic skills.
Count
Art benefits critical
thinking skills
Yes
No
Not Sure
Total
Art benefits social and
academic skills
Yes
Not Sure
49
2
6
57
Chi-Square Tests
Value
Df
Total
1
0
2
3
50
2
8
60
Asymp. Sig. (2-sided)
a
Pearson Chi-Square
7.789
2
.020
Likelihood Ratio
5.021
2
.081
Linear-by-Linear
6.956
1
.008
Association
N of Valid Cases
60
a. 4 cells (66.7%) have expected count less than 5. The minimum expected count is .10.
Table 54 proves that there is a significant association between students’ views on
56
art benefits for critical thinking skills and social-academic success (chi-square = 7.789, df
= 2, p < .020). In other words, graduate students believe that art is strongly associated
with critical thinking and academic skills.
Table 40: Chi-Square test on the difference of art for pleasure and self-expression
and if art functions differently between communities
Count
Art function differs between
communities
Yes
There is a different in
art for pleasure and
self-expression
Yes
No
Not Sure
Total
No
20
13
11
44
Chi-Square Tests
Value
Df
Pearson Chi-Square
Likelihood Ratio
Linear-by-Linear
Association
N of Valid Cases
a.
7.125a
10.773
.349
Not Sure
0
1
1
2
7
0
6
13
Total
27
14
18
59
Asymp. Sig. (2-sided)
4
4
1
.129
.029
.554
59
5 cells (55.6%) have expected count less than 5. The minimum expected count is .47.
In this final table, there is no significant association between students’ beliefs that
art functions differently among communities and no difference of art for pleasure versus
self-expression. Again, these results indicate that graduate students’ perception that while
art serves many purposes art for personal pleasure and self-expressive art has the same
value. This is important for it indicates that students are unaware of the difference
between these types of art. The author will describe this in more detail in chapter five of
this Master’s project.
57
Chapter 5
CONCLUSION
Major Findings
At the beginning of this project, the author set out to highlight a disconnection
between direct practice and research regarding the use of art by social workers. In order
to accomplish this goal, she looked at three objectives. These were: 1) to discover social
workers’ level of knowledge on the benefits of arts for children; 2) to find out if social
workers apply the expressive arts in their work; and, 3) to reveal social workers’
definitions of art.
Social workers’ knowledge on the benefits of arts. The survey’s findings
revealed that graduate social work students are generally knowledgeable about the
benefits of arts for children. As discussed in chapter four, 60% or more of the students
surveyed agreed that art can enhance physical health, increase cognitive and socialacademic growth, and improve psychological well-being. Ironically, the majority of
students surveyed have not had formal education in art therapy. This information was
significant towards discovering if there is true disconnection between research and
practice for two reasons. One reason was it helped to eliminate the possibility that the gap
was created by a lack of knowledge on the benefits among the population surveyed. The
other is that the amount of knowledge the participants had could have affected their rate
of art usage. If social workers are unaware of this helpful intervention, then they are less
likely to use it within their practice and/or do scientific research on its effectiveness.
Social workers’ application of art in therapy. Based on the high rate of students
58
who were aware of art benefits, it would be reasonable to assume that they would have
greatly utilized art with their clients. Yet, the survey revealed this was not the case for the
majority of the expressive art forms. Less than 30% of students, for instance, used drama
and visual arts with their clients. These numbers continued to decline as approximately
10% of students who often utilized music. Dance was the least used with around 6% of
students employing this technique in their practice on a regular basis. These low numbers
are important because they demonstrate that while the majority of the students surveyed
are aware of the benefits, only a minority of them applied these four expressive art forms
in their work with clients.
On the other hand, storytelling was the most utilized of the expressive art forms
with an estimated 80% using oral storytelling and 50% using written storytelling
techniques with their clientele. The discrepancy in the levels of student utilization of
storytelling and the other expressive art form may be influenced by four external factors
as mentioned briefly in chapter four. One factor is the rise in the popularity of Narrative
Therapies which is centered on the client telling his/her story in the social work
profession. Secondly, storytelling requires less space and materials than the other art
forms. A third factor is how the social work students define art (see the next section for
details). The final influential element is the lack of exposure students have to the practical
application of art therapies during their social work education. The author believes that if
students are not exposed to these techniques and allowed to practice them within the
academic setting, then they will be less likely to use them within the field.
Again this information is important in illustrating whether or not a disconnection
59
exists. These findings show that the disconnection between research and practice goes
beyond an overlooked direct practice techniques as first hypothesized by the author.
Instead, it illustrates a significant lacking in social work education around art therapy.
Social workers’ definitions of art and art in therapy. By understanding the
participants’ view of what art is and how it takes shape in the therapeutic setting, the
author hoped to gain insight into their answers in the previous sections. One example is
that the participants’ high knowledge about art benefits correlates with their agreement
with the statement that art’s healing ability is confirmed by culture and science. Another
example is that while participants accepted all the expressive arts as a form of art, dance
was overall not considered to be a therapeutic technique. This definition of dance as a
non-therapeutic art form is evident by it having one of the lowest numbers of usage by
participants with their clients. A final example is that nearly 50% of the participants felt
that making a craft project had the same affect as expressive art assignments. This is
significant because if the participants believed art for pleasure and self-expressive art
have the same therapeutic value, then they are less likely to use their limited time and
resources on these types of activities. This unawareness among students, as stated before,
is due to their lack of exposure to the practical applications of art therapy within their
educational experiences.
Implications for Social Work
Once a study is completed, researchers must ask themselves are how this
information is relevant and what impacts it has for future research. In this section, the
author will look at the implications her finding have for the social work profession.
60
The social work profession strives on capitalizing upon the evidence-based
practices. This means that social workers must use intervention strategies which have
been proven to be effective with helping the populations they serve. As stated previously,
there has been a significant amount of research to confirm that the arts benefits children
and adults physically, cognitively, psychologically, and socially. When social workers'
application of this technique increases, they will be in compliance with their professions’
goal of using evidence-based practices.
Moreover, this focus of this study is still a pioneer concept within current social
work research. As social workers become more exposed to art therapy, the social work
based research on this subject will increase. This type of research is important because it
will lead to an integration of social work concepts and ideology into art therapy
techniques such as solution-focused. In turn, this will develop all new dimensions to
social workers direct practices and provide them with additional skills, assets, and
expertise.
Finally, if social workers continue to explore art therapy, then demand for and
enactment of changes in the social work curriculum will include art therapy. Along with
these academic changes, there will also be an increase in the profession’s involvement in
educational reform. An enhanced understanding of the arts vitality to childhood success
will make social workers become more ethically obligated to fight to reestablish art
education in public schools.
Suggestions for Future Research
There are two major areas in which this study can be expanded in future research.
61
The first area is the population surveyed. For instance, the researcher could look at social
workers who are currently in the field. These social workers may have more experience
working with clients; thus, have explored different techniques outside the standard ones
taught in the CSUS Social Work Program. Another instance could be to look exclusively
at social workers who work with children. Again, these social workers are more likely to
use art with their clients since children are more open to non-traditional based therapies
than adolescences or adults (Malachodi, 2005). A final instance is to survey other
helping professions such as psychology and education on their use of expressive art
therapy so as to compare their results with those in social work.
Alterations to the questionnaire are the second area in which this research could
be enhanced in the future. One element would be add the options of “I serve multiple
age-groups” or “I work in a macro-level setting” under the client population in the
demographic portion. This way the survey could better account for those participants who
serve multiple age-groups such as families or are in macro level placement. This need is
evident as only 24 of the 61 participants answered this question. Another element would
to be to add a question to assess for social work students’ desire to learn art therapy under
demographic data. Adding this question would allow the researcher to see if social
workers are interested in this type of training and its implications for future social work
curriculum and research. The final element that could enhance this study is to expand the
section on spirituality as it is a merging field within art therapy research.
62
APPENDIX A
Survey Questionnaire
Dear participant,
Scientific research has repeatedly shown that art, in any form, has physical,
cognitive, psychological, and social benefits for children; yet, there are gaps between
social workers use expressive art in their direct practice and the social work literature. In
order to explore the issues, this research project will examine social work graduate
students’ perceptions about the benefits of art for children, their utilization of art with
clients, and their definitions of art and art therapy. Please answer the following questions
to the best of your knowledge. I appreciate your participation very much.
Demographic Information: Please circle the answer that best applies to you.
1) Your Gender Identification
1. Male
2. Female
3.Transgender
4. Transsexual
2) Your Race
1.White/Caucasian
2. African American
3. Hispanic/Latino/a
4. Asia American
5. Pacific Islander
6. Native American
7. Other (Please specify)
3) Your Age Category
1. 18-27 years old
2. 28-37 years old
3. 38-47 years old
4. 48-57 years old
5. 58+ years old
4). MSW Classification
1. MSWI
2. MSWII
3. MSWIII
.
63
5) Have you received any formal art therapy training in the past?
1. Yes
2. No
3. Decline to State
6) This question only applicable to MSW students who currently have clients on
caseload. In case you do not have case assigned to you in your internship, skip this
question.
Age Group of Client Population
1. Infants (0-4 year old)
2. Children (5-12 year old)
3. Adolescences (13-18 years old)
4. Young Adults (18-30 years old)
5. Middle Adults (31-50 years old)
6. Older Adults (55+ years old)
Art Benefits: The statements asked for your perceptions regarding art benefits. Please
put in the number on the blank which best corresponds with your knowledge in this area.
Skip items that are not applicable to your work in social services experiences.
1= Yes
2= No
3= Not sure
.
.
.
.
.
.
.
.
I believe that participation in any art program can help a child overall well-being.
I believe that art develops a child’s gross and fine motor skills.
I believe that art can improve a child’s physical health.
I believe that art can improve a child’s psychological health.
I believe that art can assist children in their social and academic lives.
I believe that art is useful for children at all levels of development.
I believe that art can develops a child’s critical thinking skills
I believe that a child’s relaxation response is activated when s/he participates in art.
I believe that art helps children to see symbolism, develop nonverbal expression,
and perceive overall patterns.
.
64
.
.
.
.
.
I believe that children who participate in art classes have improved self-esteem.
I believe that arts can help improve children’s academic and social success.
I believe that art provide children with an alternate form of communication.
I believe that arts can develop a child’s community identity.
I believe that a child’s spirituality can be tapped into with art.
I believe that art is important to the physical, cognitive, psychological, and socialacademic development of children.
.
I believe that art strengthen the connections between the right and left hemispheres
of a child’s brain.
.
.
I believe that art helps in academic disciplines of language arts and mathematics.
Art Utilization: This section of the questionnaire is only applicable to those participants
who have or had clients who have utilized social service programs. In case you have not
worked with clients in this area, please go to the next section. If you have worked with
clients, please read the statements and place the appropriate number that corresponds to
your work experience with your clients. There is no right or wrong answer.
1= Always
2= Usually
3= Rarely
4= Never
.
.
.
.
.
.
.
In my work I have my clients listen to music as a part of the therapeutic process.
In my work I have my clients make music as a part of the therapeutic process.
In my work I have my clients write song lyrics as a part of the therapeutic process.
In my work I have my clients draw as a part of the therapeutic process.
In my work I have my clients color as a part of the therapeutic process.
In my work I have my clients paint as a part of the therapeutic process.
In my work I have my clients look at pictures as a part of the therapeutic process.
65
.
.
.
In my work I have my clients do sculpting as a part of the therapeutic process.
In my work I have my clients use drama as a part of the therapeutic process
In my work I have my clients do role play as a part of the therapeutic process.
In my work I have my clients I use expressive toys, such as puppets, as a part of
the therapeutic process.
.
.
.
.
.
.
In my work I have my clients dance as a part of the therapeutic process.
In my work I have my clients tell their story a part of the therapeutic process.
In my work I have my clients use books as a part of the therapeutic process.
In my work I have my clients do journaling as a part of the therapeutic process.
In my work I have my clients write a part of the therapeutic process.
Defining Art and Art in Therapy: Please put in the number on the blank which best
corresponds with your knowledge in this area.
1= Yes
2= No
3= Not sure
.
I believe that using art in healing is a common aspect of human societies.
I believe that there is a difference between art for pleasure and self-expressive art
exercises.
.
.
I believe that art is hard to define because it is subjective rather than objective.
I believe that art’s function and status within a community are based on its cultural
values and context.
.
I believe that music is a form of art.
I believe that visual art in therapy is the process of employing the depictions for
healing.
.
.
I believe that storytelling is a form of art.
66
.
I believe that story writing is a form of art.
I believe that storytelling in therapy is the use of words, in a written or verbal form,
to promote healing.
.
.
.
I believe that drama is a form of art.
I believe that dance is a form of art.
I believe that dance in therapy is any work utilizing movement of an individual or
group for healing.
.
I believe that both cultural traditions and scientific research verifies the healing
properties of music, visual arts, storytelling, drama, and dance.
.
67
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