Contemporary Art Therapy with Adolescents. Shirley Riley

no longer believes in those ‘old fashioned’ ideas, but, in spite of the ‘American dream’ of equality, the girls are still taking a subservient stance and the men a macho role. Look at the gang model; the structured, double standard roles are alive and well. Although it may be dystonic to his or her belief system, the therapist must resist imposing his/her own convictions about gender defined roles on their clients.

      Figure 1.3 Today’s teen girl in yesterday’s image

      Figure 1.4 The Hollywood ‘Macho’ dream

      Adolescent creativity

      One of the sorely neglected, but dominant traits of adolescence is their creativity (Malmquist, 1978). Teenagers are willing to draw and create art as freely as they resist talking to an adult. How to engage this talent for creativity and channel it into therapy, is the skill of the trained art therapist. The author takes issue with the notion that structured pre-designed assessment and art directives can be relied upon to achieve therapeutic goals. Assessment is useful, but therapy is an opportunity to provide a creative outlet for conflictual material, an outlet designed to help the adolescent therapeutically. The following examples of interventions, vignettes and narratives will illustrate how the adolescent’s individualized creativity leads the therapist to a more successful conclusion of treatment.

      Art therapy with adolescents

      From the time I first studied adolescent development and clinical art therapy I was aware that the theory and the modality seemed to mirror each other. For example, the adolescent enters into the most creative time of their lives: art therapy is based on the notion that when creativity is introduced into problem solving, the art can provide fresh viewpoints and excitement. When thinking of adolescent creativity the traditional attachment to aesthetics must be broadened to include imagination and behavior. As an example of creativity, consider this common use of inventiveness: a teenager can invent more ways to avoid doing something they dislike then any adult can imagine. Tapping into the adolescent’s creativity is not difficult if the art therapist suggests expressive tasks in a manner which shows respect for their way of reinventing meaning and involves subject matter that is of interest to the teen.

      Continuing with the metaphor of the mirror; another dominant trait of adolescence is the desire to develop an individual personality. They prefer to create a personalized image of themselves, internally and externally, without discussing the process with adults. This desire is reflected in the art therapy process, where the method of creating is thoughtful, individualized, and non-verbal. An image becomes tangible in an art product. However, the process which transpired within the youth creating the image, and the subsequent choice of verbalizing, is voluntary.

      For every person, adult or adolescent, who makes a choice to produce a specific image, the selective mental process which is activated is extremely complicated. The mind must scan all memories stored in relation to the subject which is the focal point of the planned art expression; the client then decides which memory to retrieve, and determines why it is significant; finally, how to render the memory with media and discuss its significance. Many possibilities are reviewed, one is selected. All this is done in seconds. In addition, the image stimulates metaphorical conversation which enriches the possibilities of communication.

      The visual image informs the adolescent on two levels. First, an art product manifests the cognitively selected overt meaning of the trauma. Second, the art is a conduit for material which may unexpectedly surface through the representation. Visual images can slip by the barrier of ordinary defenses and provide information that has been inaccessible to the client. In spite of how complicated this process sounds, it is something that is possible for everyone, and can be accessed (without consciousness) when desired.

      Freedom and singularity are characteristics of the adolescent process and the art therapy process. An art expression is always ‘original’ since it is created by an individual. If the drawing is a ‘copy’ it is still a personal effort and displays some peculiar characteristics. Even stick figures are dissimilar, since they are drawn with a different stroke from a different hand. There are no restrictions to creativity and no ‘right way’ to make an art therapy drawing. If the expression conveys the client’s meaning it is ‘right’. The client is always free to change the ‘rules’ and reinterpret the directive.

      Finally, the quality of art therapy that is most appealing to the adolescent is that the art is non-threatening. If the therapeutic product comes from your own hand, and no one knows what it means until you tell, then how can it be threatening? That is not to say that often the art reveals material that the art maker had no intention of representing. However, this unintended revelation can be kept private or shared with the therapist at the will of the client.

      The early alliance

      It is essential and difficult to provide a non-confrontive, flexible form of therapy to the reluctant teenager who resents being in therapy. Imagery, as it is used in art therapy, is often the key to making an early alliance which is so essential in adolescent treatment. Art therapy must be offered in a manner that comfortably fits the adolescent; the teenager is wise about interpretations and projective tests. They will look with suspicion on art tasks unless the therapist understands how to engage them in the process and utilize the product. A false move of interpretation or an imposition of the therapist’s agenda on the relationship, will null the opportunity to join with the young client. Every relationship with an adolescent is in jeopardy in the early stages.

      Figure 1.5 Tracing of adolescent’s hand, therapist’s hand. Concretizing the relationship

      Malchiodi (1997) addresses the need to establish a relationship quickly with a client. Although she was referring to abused children, the skittish adolescent is no different: ‘the therapist must always remember that there is not much time to establish a relationship. In order to make any progress with a child, a rapport must be established quickly during the opening stages of intervention. A natural, nonthreatening approach that immediately conveys concern and respect is advisable’ (p.36).

      The form and shape of the therapy must conform to the adolescent world view. It is hopeless to attempt to approach the teen client with psychological techniques created for adults. In fact, the only workable therapeutic technique is for the therapist to enjoy working with this age group, be interested in their opinions, and be open to learning a fresh way of looking at society and behaviors. If the therapist attempts to inflict his/her belief systems on an adolescent, they will be gravely disappointed. If they are willing to listen to the teen view and exchange opinions, the adolescent is often tolerant and forthcoming in a dialogue.

      Identity and identifying adolescent codes

      Personality traits and behaviors, generally experienced during this period, are also essential factors that the clinician and parents must expect to encounter. The adolescent is in search of an identity first and foremost, and his/her search is conducted in a manner expressive of the youth’s personality. I have often said that the reason kids of this age stand in front of the mirror for an extraordinarily long time, is that they hope by peering at their reflection they will become acquainted with the stranger that is reflected back! Focusing on themselves exclusively is one of the mechanisms that fosters this search for identity. It is irritating for adults to deal with the extreme narcissism of this age, but it is less difficult if it is understood as a process toward adulthood and not a fall into pathology. The sense of self is so fragile that conforming to peer group dress codes, musical choices, vocabulary, and hair styles, are all attempts to find some reassurance and identity. In a personal survey I have interviewed about twenty youths in their adolescence, asking the question ‘What are teenagers most concerned about?’ Almost without exception they replied, ‘How they look’. The ‘look’, the dress, the jeans, the shoes, all identifies the clique to which the teen belongs. Without a peer group from whom the teenager can find support, they feel lost. Rejection by peers is the greatest threat. If therapists do