Friday, December 14, 2018

Looking at Art Could Help Med Students Become Better Doctors

For decades, humanities and arts classes have been offered to medical students, in attempts to help them maintain empathy and develop skills necessary to accurately diagnose their future patients. Known as “narrative medicine” courses, they’ve covered topics from comic book–making to modern dance to Impressionist painting. Now, new research shows that looking at artworks can help future doctors hone their observation skills, maintain objectivity, and cope with moments of uncertainty. 

The study

Since 2005, New York–based artist Anna Willieme has been designing and teaching art courses for medical students and doctors (she’s also worked with students at NYU School of Medicine and residents at Massachusetts General Hospital). The new study, conducted by Columbia University School of Medicine and Weill Cornell Medical College, focused specifically on Willieme’s annual six-week course “Observation and Uncertainty in Art and Medicine,” and tracked the progress of 47 first-year med students who enrolled in it from 2014 to 2017. At the start and end of the course, students took tests to measure their reflective ability, tolerance for ambiguity, and personal bias awareness. “I was always fascinated, as an artist, with the ways that art could help me observe more,” Willieme explained. 

Inspired by the “cultivation of observation that happens in art,” she’s developed several courses over the years that focus on perceptual skills and present the art museum as a laboratory. “The goals here were to enhance their observation and self-awareness, and [their] capacity to have a certain sensibility in terms of point of view…[the] capacity to look out, look in, and look around,” Willieme said of her course featured in the study. In it, over the course of six weeks, students convened weekly for two hours at the Metropolitan Museum of Art, where Willieme guided them through a series of exercises that involved looking, sketching, and sharing their thoughts about specific works of art. Each week had a different theme, such as point of view, emotion, and self-awareness. One exercise for understanding point of view had students sketching Constantin Brâncuși’s abstract sculpture Bird in Space (1923). Every two minutes, they got up and moved to the next person’s sketchbook, then continued. “First of all, they’re discovering the complexity as they look at the piece a little longer, but as they are leaving their own sketchbooks for the next person to pick up, they also see how someone else has been seeing things,” Willieme explained. One student might have started with the base of the sleek, white piece, while another may have drawn something in the background; a third student might have realized they hadn’t noticed either of those things. 

The same concept can be applied to medical scenarios, such as examining a patient’s body or picking up on subtle cues from family members in an exam room. Exercises like this finished with discussion. “A lot of the teaching happens at that time,” Willieme explained. Students not only spoke about their observations, but also debriefed on why they or their peers might have made a certain observation, or focused on a particular facet of the artwork. “We’re seeing, and then seeing why we’re seeing,” Willieme explained. Often, students were led to identify their own biases—such as in an exercise where they were asked to look at Giorgio de Chirico’s Ariadne (1913), and then sketch the memories or associations that it triggered. “When we’re seeing something, it’s never neutral, it’s also filled with what we saw previously, our associations our inner world—all of this can come to the surface,” Willieme explained. 

What it found 

The data that was collected from four years of students taking the course suggested much of what the researchers had hypothesized: Students’ capacities for personal reflection, tolerance for ambiguity, and personal bias awareness had all increased. Most significantly, however, was their improvement in reflection—their ability to understand a situation from different points of view, to empathize with another person’s dilemma, and to acknowledge different ways of thinking. In course evaluations, students reported that the course helped them to stop, slow down, and be more intentional while seeing; to pick up on details that could easily be missed; and to better articulate descriptions of things that “at first seem indescribable.” 

They were more aware outside of class, and put greater thought into the meaning behind visual experiences. They also reported that they became aware of the benefits of multiple points of view by seeing what their peers noticed in a work of art, and learned how the observations of others could influence their own thoughts. Students wrote that they better understood how emotions, biases, and context could color perception—and in recognizing their own subjective opinions, they came to grips with facing situations of uncertainty. “Med school is a long journey through accepting uncertainty,” wrote one student. “I think this whole year for me has been a long process of being comfortable with being uncomfortable.…This class added to that.” 

What it means 

This study is an important vote of confidence in art-based classes that medical schools offer, and shows the potential for such courses to help future doctors develop key competencies—“observation, reflection, self-care, and tolerating uncertainty,” according to the study—that could help them practice medicine. Importantly, it shows that students are easily able to translate the visual observation skills of looking at art in a careful, thoughtful way to everyday scenarios. However, more research is needed to determine the feasibility of implementing such courses into other institutions due to the small number of students involved, as well as the resources and curricular demands it requires. Plus, there are other considerations, like a school’s access to an art museum and a qualified professor like Willieme. Specifically, the results underline that visual observation—be that looking at an artwork or examining a person—is a skill that can be honed (and shouldn’t be taken for granted), and that looking at art is an opportune exercise for developing this skill. 

The researchers acknowledge that while observation is at the heart of medical practice, there are few practical opportunities for teaching it in the typical medical school curriculum. The researchers noted that the theme of self-care in student evaluations—they wrote that the class was restorative and a “sanctuary”—was also promising, particularly given the high rate of burnout and decrease in empathy that students experience over the course of medical school. Willieme found that link exciting. “My sense has always been in my classes that paying attention to self-awareness is a form of self-care,” she explained, pointing to the honest, vulnerable experience of expressing what you see and feel in front of a work of art. “Being encouraged to be very authentic,” she added, “leads to a form of self-care.” She also noted the importance of recognizing one’s own emotions while making visual observations. “When it comes to empathy, I think a lot of medicine is about the emotion of the patient, which is natural,” she explained, “but when the physician can also be attentive to their own emotions, it opens up, I think, a greater capacity for empathy.” 

 Casey Lesser is Artsy’s Creativity Editor.

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Thursday, October 25, 2018

Lacy is Art Therapy Today's Featured Member!

I'm very honored to be chosen as the Featured Member in this week's Art Therapy Today, from the American Art Therapy Association.

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Thursday, October 18, 2018

Doctors, Patients Sing Art Therapy’s Praises. So Why Isn’t There More Support?

Many of us are working hard to raise more awareness about art therapy and bring about equality to our discipline among the mental health field. Unfortunately, it takes time and education, but I'm sure we will get there eventually. One way of doing that is through licensing, though it's much more than that. Part of it is understanding what art therapy is, clarifying the misconceptions about our field, and changing mindsets about what we do and the value art therapy has in treatment. It's helpful to have advocates for our field.


Paulina Nieto, who grew up in Columbus, Indiana, was only 2 months old when she started to have heart problems due to a narrow artery.

“When I was about 6 months old, I had surgery to open the artery and that helped for a while until I started having problems again,” said Nieto.

She had her first heart transplant when she was two and her second when she was 16.

“That was something that was really scary because when I was younger I couldn’t remember anything,” said Nieto. “This time I had to go through the motions and the emotions. I can still remember going into the surgery room and having to wait there and not knowing if I was going to come out alive or not.”

Nieto is now 19 and healthy. She says art therapy, a psychotherapy that helps people express emotions through art, helped her get through the stress of that last surgery while at Riley’s Children Health in Indianapolis.

Art therapy is finding its place in the mental health profession, but most states including Indiana, don’t recognize it as its own profession. It’s often something licensed counselors use as a tool. But there’s been more of an effort to increase the number of art therapists in the state now that Second Lady Karen Pence has focused a spotlight on art therapy.

Pence, who’s from Indiana, helped to raise money to get two art therapists at Riley’s according to the New York Times. During her trip to Indiana this September, she visited Riley’s Art Therapy Studio to participate in an art therapy group session with some patients. They used syringes to paint on white canvases.

Riley’s art therapists use syringe painting to take the fear out of the medical syringes the patients often see.

For Nieto, one of her cardiologists, Dr. Randall Caldwell, suggested she try art therapy to help cope with the stress of undergoing a heart transplant.

“I started a couple of classes and we were just painting and talking about how I felt, just the emotions that I went through. I think it was a really beneficial way of letting my emotions out in a healthy way,” said Nieto.

Caldwell is the former director of The Riley Heart Center, and he’s noticed his patients who do art therapy have lower heart rates and blood pressure, and they are more relaxed. “There’re endorphins that are produced by these types of activities and you can decrease the use of synthetic drugs that help deal with pain.”

Emily Allbery is one of the art therapists at Riley’s, where the hospital offers art therapy to all patients. Allbery says she sees patients as young as two.

“They're here to get physically better but we also want to make sure emotionally they’re doing okay too,” said Allbery. “As they get older we are working on ‘what’s it like to have what we have? What’s it like to have a chronic illness?’ We are able to follow them as they grow older which is really great.”

Why Art Therapists Face Challenges

Art therapists are up against misconceptions that art therapy is like arts and crafts, or it’s as simple as taking some time to color or draw.

But one of the largest challenges is the lack of a state license, which makes it difficult for art therapists to bill insurance.

Eileen Misluk directs the graduate level art therapy program at the Herron School of Art and Design in Indianapolis. She believes Pence has helped to clarify some of these misconceptions, and she’s helped to advocate for licensure.

“I think Karen Pence has helped in that sense that she has brought this awareness, that it’s not just painting, not just making art. It goes on such a deeper level than that,” said Misluk.

According to Misluk, art therapists get around the billing hurdle by being trained and licensed as mental health counselors.  

“They are working a lot of times as a licensed mental health counselor who uses their training as an art therapist,” said Misluk.

But for the safety of the community, art therapists want a unique license to prove they have met the educational and clinical requirements.

This would afford them title protection, so that someone who passes themselves off as an art therapist could be fined if they don’t have the proper training.

But in Indiana, or in any other state in the midwest, the title “art therapist” isn’t protected. So someone could falsely say they are an art therapist and actually cause harm to a patient.

“There’s really nothing that states that they can’t do it. It is so dangerous,” said Misluk. “That has been our debate and we’ve tried with several different avenues to get them (state officials) to see this is, this could be scary.”

What’s Needed To Get Licensed

According to the Indiana Art Therapy Association, there are about 50 art therapists in Indiana. Misluk thinks there needs to be up to 250 art therapists in the state to make licensing possible.

She believes it’s going to take time to change Indiana’s lacks rules even with three universities graduating more art therapists.

That’s why Misluk is focused on educating the community and addressing misconceptions of art therapy.

“So whether you make great art by society standards or whether you happen to create stick figures, it’s the way of knowing that becomes the real therapeutic factor in art therapy,” said Misluk.

Nieto noticed those therapeutic benefits during her art therapy sessions.

“After my transplant I realized that life is just so beautiful. It’s so short,” said Nieto. “So, with every painting that I do, I try to put as many colors, bright colors as possible. I just love the brightness of life.”

Art therapy helped Nieto so much, she plans to study to become an art therapist.

“That’s something that I’m really looking forward to because being able to give back to the community in the same way that they did for me. I feel like that’s just kinda my life goal,” said Nieto.

Nieto hopes to one day return to Riley’s Children’s Health. She wants to use art therapy to help children through their recovery.

Editor's Correction: An earlier version of this story incorrectly stated that Eileen Misluk directs the masters of arts and art therapy program at the Herron School of Art and Design in Indianapolis. She directs the graduate art therapy program. This story has been updated to reflect this correction. 

This story was produced by Side Effects Public Media, a news collaborative covering public health.

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Monday, September 17, 2018

Virginia has voted to pass legislature for the licensing of art therapists

By Clara Keane  | August 30, 2018 | Advocacy

On August 23, 2018 the Virginia Board of Health Professions (BHP) voted to recommend licensure for art therapists in the state of Virginia.  Following years of advocacy work and a full year in the formal sunrise review process, a group of art therapists gathered to witness history unfold in the field of art therapy.  After the BHP’s Regulatory Research Committee made their final recommendations and “concluded that all criteria [for state regulation] were met,” the Committee voted unanimously to “adopt a separate license for Art Therapists to practice in Virginia.” Read the draft meeting minutes here.

Gretchen Graves; Carol Olson, LPC, ATR-BC, VATA President; and Leila Saadeh, MS, ATR-BC, VATA Vice President after attending meetings of the BHP Regulatory Research Committee and the Full Board on August 23, 2018.

The process began in August 2017, when the Virginia Art Therapy Association (VATA) submitted a 30-page application to the BHP Regulatory Research Committee requesting a review into the need to regulate art therapists in the state of Virginia, initiating what is known as a “sunrise review”, in which BHP staff conduct a study using seven criteria to determine whether lack of regulation of the profession in question poses harm to the public and to investigate the economic impact of regulation.  The BHP Regulatory Research Committee created a thorough Study Workplan, which involved several meetings, holding a public hearing and open comment period, and creating two editions of their report, “Study into the Need to Regulate Art Therapists in the Commonwealth of Virginia.”

Immediately following the BHP Regulatory Research Committee meeting on August 23, the full Board met and voted on the motion “to accept the recommendation of the Regulatory Research Committee to license Art Therapists in Virginia.” Eight members voted in favor and one in opposition to the motion.

Of the eight states in which AATA chapters have engaged in sunrise review processes, favorable results in two states were achieved without going through the full sunrise review process – with Arizona adopting legislation providing for state hiring and title protection for art therapists, and the Utah Division of Occupational and Professional Licensing determining that art therapy master’s training met the education requirement to qualify for the Clinical Mental Health Counselor license. However, Virginia is the first state were art therapists have undergone the full sunrise review process and received a determination that a separate art therapy license is necessary to protect the public!

The AATA is optimistic that this recommendation will not only pave the way for art therapy licensure in Virginia but also have a positive impact in other states where art therapists are pursuing licensure, and at least 4 states where art therapists are currently engaged in sunrise review processes.

Thank you to all the art therapists in Virginia for the sustained effort required to achieve this accomplishment for the profession! We look forward to continuing to collaborate with VATA as we push for licensure in Virginia, now with the endorsement from the BHP.

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Sunday, September 16, 2018

Healthline's Color for Calm Winners!

I had the privilege of being a judge for the nationwide coloring contest from Healthline.  Thanks for all the entries!  Many thanks to my publisher, Quarto Knows, in contributing some of my coloring books for the prizes, along with other sponsors.  Here are the winners!

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Monday, August 20, 2018

Color Me Calm #9 on HealthyWay's "40 Amazon Products for People Who Are So Anxious They Just Can't Even" List

40 Amazon Products For People Who Are So Anxious They Just Can’t Even

If you’ve got chronic anxiety or you’re simply dealing with a rough season of life, these products might help you find your inner calm.

Feeling anxious is much more than being a little nervous or having a little extra stress in your life. Anxiety can make it difficult to cope with the challenges that come your way and may even make normal everyday tasks feel daunting. 

Many people with anxiety need professional guidance for managing their symptoms. Some may need to explore medication, while others might find relief from therapy

Others may be able to find relief from anxiety by adjusting their routine or adopting healthier habits. Coping with anxious thoughts and feelings is often so much more than finding one solution; it can take multiple strategies working together to ease symptoms. If you’re feeling anxious and looking for new ways to cope, check out these amazing Amazon products that can help you bring more calm to your life.

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Wednesday, August 01, 2018

National Coloring Day - Healthline's "Color to Calm" Contest

Color for Calm 

I'm very excited to announce that I will be celebrating National Coloring Day this year by partnering up with Healthline in their Color for Calm contest. The contest is meant to shine a light on mental health by promoting the therapeutic effects of coloring for stress, anxiety, depression, and other mental health conditions.

Starting on August 2nd, you can participate in the contest by downloading one of four coloring pages at the link below. Simply color, snap a pic, and tag Lacy Mucklow - Art Therapist and Author and Healthline on Facebook to be considered!

I am one of 12 judges, and entries may begin on August 2nd, National Coloring Day. All entries must be submitted by midnight on August 30th. Winners will win prizes, some of which include one of my coloring books!

If you’d like to learn more about how drawing, coloring, and creating can make a positive impact on mental health, read on!

The Health Benefits of Art

Research shows that drawing, coloring, and other fine motor activities help to activate the parasympathetic nervous system and calm the fight or flight response, easing stress and unleashing creativity. Studies suggest that painting pictures, making music, sewing skirts, or creating cakes can have the following positive benefits for mental health.

A study called “ The Influence of Art Making on Anxiety: A Pilot Study ” suggests that a little time working on art can significantly reduce a person’s state of anxiety. Another study indicates that art allows people to forget about their condition for a while, allowing them to focus on the positive things in their life.

Being wholly focused on a craft project can have an effect similar to meditation, which research suggests can help in the management of anxiety and depression. Increased happiness
Dopamine is a chemical associated with the reward center in your brain. Among other things, it provides feelings of enjoyment to help you start or continue doing certain activities.

A study published in the Archives of General Psychiatry suggests that people with depression are lacking in dopamine. Crafting is a non-medicinal way to stimulate dopamine, which ultimately makes you feel happy. In a study of 3,500 knitters, researchers found that 81 percent of knitters with depression perceived that knitting made them feel happier.

More and more, research like the above is indicating that art, crafts, and coloring are an effective tool for promoting happiness and overall well-being.

If you’re ready to give it a try, check out Healthline’s coloring pages and Get Coloring!

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Friday, July 27, 2018

Interview with my former professor Tally Tripp on art therapy

Art Therapy Is More Than Just Making Nice Pictures

One art therapist explains how making art can save lives.

Priscilla Frank
Anyone who has ever put pen to paper, crayon to coloring book, or hand to wet clay knows the healing powers embedded in such creative endeavors. More than just a pastime, art can be an escape, a stimulus, a war cry or a tranquil reprieve.

Art therapy, defined as “a form of psychotherapy that uses art media as its primary mode of communication,” revolves around this principal of art’s immense power. Open to children and adults of any background and experience, the still-evolving field explores modes of expression, understanding and healing that occur when paint touches canvas. While too many schools today run under the assumption that art is extraneous, a diversion from traditional academic subjects, art therapists know better. They know that art has the potential to change lives, and, even to save them.

Tally Tripp is the art therapy clinic director of George Washington University, specializing in individuals who have experienced trauma. Entering the field in its nascent phase, in the 1970s, Tripp was elemental in shaping the field as we know it today.

Continuing The Huffington Post’s coverage of the often misunderstood field that is art therapy, and the pioneers who continue to sculpt it, we reached out to Tripp to discuss the details of her career’s past and present.

How did you become interested in art therapy? How did you learn about the field?

When I first learned about art therapy it was definitely a field in its infancy. Personally, I have always loved art making and combined that with an interest in working with people. In high school I spent summers in New York working for the Children’s Aid Society with disadvantaged children in a camp program. It was there, as a counselor in the arts and crafts program, I came across one of the original art therapy journals: the Bulletin of Art Therapy (edited by Elinor Ulman and produced between 1961-1970).

For many years, that journal was the only art therapy publication available. At the same time, in 1971, Elinor Ulman and her colleague, psychologist Bernard Levy started an art therapy program at the George Washington University. Pretty quickly my goal became to study art therapy in the master’s program at GW, which I did between 1978 and 1981. Now, full circle, I am a full time professor in the art therapy program at GW and the director of the GW Art Therapy Clinic.

How did art therapy look when you first immersed yourself in it?

In the late 1970s, art therapy was still an emerging profession. It was definitely an exciting time for the field as we students were taught by some of the early pioneers: Elinor Ulman, Edith Kramer and Hanna Kwiatkowska — innovative thinkers developing clinical approaches that were based largely on intuition coupled with psychoanalytic thinking that was popular at the time. Also in those days there were few texts or research studies on art therapy to guide us, so we learned primarily by our experiences and our clinical work. As art therapy was a relatively unknown profession, we all put time and effort into spreading the word and educating others about its value.

The field is more established now, and more often than not, people have heard of art therapy and have some understanding of how it works. Art therapists now have licenses in some states as well as levels of professional credentialing and board certification. Beyond that, we have a lot of art therapy literature at our fingertips including research studies supporting the efficacy of art therapy and describing how it is utilized across many settings and populations. Art therapists can now be found in various settings — from medical and psychiatric hospitals, to schools, geriatric facilities, community and studio settings, and in private practice.
What are your areas of interest in the field?

I have maintained a private practice in art therapy for over 30 years. My specialization is working with individuals who have experienced trauma. I find these clients are excellent candidates for art therapy precisely because the art can provide a means for expressing the inexpressible feelings that are often shut down or pushed away from consciousness in response to traumatic events. It has been exciting in the last 25 years to see that neuroscience research has validated the kind of work we do. Through brain imagery, we now know that the cognitive and executive functioning of the brain is for the most part “off line” when people are recalling their traumas, rendering them essentially “speechless.” This helps explain why traditional verbal therapy is often not enough when working with trauma, and why art (imagery) and other experiential therapies are so effective.

I reached out to you in part because of Suicide Awareness Month. In your private practice do you work with many patients grappling with suicidal thoughts? What are some of the methods you practice in such circumstances?

Any therapist in private practice will have to deal with patients who are struggling with suicidal thoughts from time to time. Negative beliefs and hopelessness can render the individual helpless to combat the urge for self-harm. To work with suicidal thoughts, a clinician must first assess how developed the plan is, and, if the patient is truly in imminent danger of self-harm, hospitalization may be required. But hospitalization has its limits and is only one step.

Are most of the patients you encounter already involved in art? Are they ever skeptical?

It is true that most people think of going to an art therapist because they enjoy making art and are already involved in it somehow. But that is not the only kind of person who will benefit from art therapy.

For example, one man I worked with was also being seen in marriage therapy and was referred to me because it was determined that he needed to access more emotional depth. This man had no apparent interest in art, but agreed to see me as an experiment because art therapy had been recommended. I invited him to work on a picture of simply lines and shapes and just “see what happens.” His first picture, a simple downward sloping line was created in a matter of seconds. But when we held the “picture” up and explored it from a distance, he became struck by the downward motion and then exclaimed: “This is exactly what I have been trying to describe. It looks like my mother’s lap. Empty. She was never able to really hold me!” The image and description of not being held as a child became a fundamental theme in our work together. And within a few months, this patient enrolled in a painting class and began a new appreciation for art.

Brigitte Wodicka via Getty Images

Can you explain what you hope to achieve with a suicidal patient through art therapy? What changes are you looking to make?
Often the artwork will convey a suicidal feeling of hopelessness or despair long before words are consciously available. The image can provide a means for discussing feelings that are either unclear or difficult to verbalize. Art works tend to be self-referential so we work actively with the images and themes that are produced.

For example, an image of a desolate landscape might signal an empty feeling and suicidal state in the artist. While I do not interpret the image, the patient and I will work together to explore the metaphor and any personal meaning or feelings that are attached. Because the picture is something we can look at together, it gives both artist and therapist an opportunity to “do” something with it. Art therapy can empower the individual to find a solution or create a “preferable ending” in the art. It is interesting to note that creating artwork that challenges the initial feelings of hopelessness will actually affect the neural firing in the brain. The more practice a person has exploring “preferable endings” for example, the more this will result in the brain finding alternatives to self-destructive behavior. So making art can be a good practice for seeking solutions and reducing negative thoughts.

Is there a certain type of patient you think is more suited to art therapy as opposed to other therapy methods?

Anyone who is willing to explore feelings through the process of making art can benefit from art therapy. Some people will naturally be drawn to this kind of therapy — children in particular where their natural language is through art and play.

Adolescents are also good candidates for art therapy because they may be resistant to traditional talk therapies and usually will enjoy working with art materials. I work with adults, however, and maintain that they are still children inside, as it is often an adult embodying that child state coming in to my office. The art helps bypass the defense and intellectualization inherent in verbal language. When a new (adult) patient is referred to me, I often start by asking, “Why do you think art therapy will help?” Right there, I am getting an alliance with the patient by suggesting that I believe that the experiential and creative nature of making art, in the company of an attuned art therapist, will make a difference.

What makes art therapy so powerful?

Art therapy is more than just making nice pictures. In fact, art therapy is more often a process of making ugly or messy pictures that depict a feeling state, not a final product that is all neat and tied together. Art therapy is about that creative process where the client, in the company of an art therapist, is working and re working problems via a range of fluid and variable art materials.

In private practice, I find the spontaneously created art pieces are the most meaningful and often help a person find resolution for specific traumatic experiences. The benefit occurs when the art made facilitates a sense of mastery over the problem. For example, a patient who has experienced years of abuse or neglect in childhood may be able to finally express feelings that had been avoided or pushed out of conscious awareness because they were overwhelming at the time. The images often speak more loudly than words. With the encouragement of the art therapist, difficult feelings can be expressed through making art.

The process varies widely so there is no one way to describe what happens in a session. When a person first faces a blank piece of paper, there might be some resistance or hesitancy to explore feelings so the resultant images may appear tight and controlled as in a line drawing or pencil sketch. But after some trust is established in the therapeutic relationship, the art process can move towards more expressive activity, which would suggest the patient is accessing stronger emotion. Often the patient will begin experimenting with more evocative materials at that point, for example using paint or clay to express feelings like anger, shame or fear. The art therapist is knowledgeable about psychological problems and the use of various art media; the process is flexible and individually focused to support the patient to find materials and techniques that connect with the issues at hand. And as a patient becomes more open to the process and discovers more creative resources within, the art product will also change. In art therapy, there is always that creative edge that keeps the process dynamic and contributes to the process of healing.

Need help? In the U.S., call 1-800-273-8255 for the National Suicide Prevention Lifeline.

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Monday, July 02, 2018

2 states pass laws to require mental health education in schools

New York, Virginia become first to require mental health education in schools

On Sunday, New York and Virginia became the first two states to enact laws requiring mental health education in schools.

New York’s law updates the health curriculum in elementary, middle and high schools to include material on mental health. Virginia’s law mandates that mental health education be incorporated into physical education and health curricula for ninth- and 10th-graders.

The New York law says that mental health “is an integral part of our overall health and should be an integral part of health education in New York schools.”

Both laws come into effect amid an increased focus on mental health and suicide. In June, two prominent figures — Kate Spade, a fashion designer, and Anthony Bourdain, a chef and CNN host — died by suicide within the same week.

Suicide is the second leading cause of death among people ages 15 to 24 and the 10th leading cause of death overall in the United States, according to the Centers for Disease Control and Prevention. The suicide rate in the country has also dramatically increased in recent years, up 30% since 1999, according to the CDC.

According to the New York law, which was written in 2015, “90 percent of youth who die by suicide suffer from depression or another diagnosable and treatable mental illness at the time of their death.”

Virginia state Sen. Creigh Deeds sponsored his state’s mental health bill after he listened to a presentation from high schoolers in Albemarle County in 2017. The students had proposals for addressing mental health issues in schools, including increased counseling staff. They worked with Deeds to create the legislation, passed in April.

“I was impressed by their thoughtfulness, because a lot of these young people had seen bullying. They had seen depression. They had seen classmates that had died by suicide,” Deeds said. “It’s part of tearing down the stigma and providing some equality with those that struggle with mental health.”

He also has a personal connection to the issue: His son, Gus Deeds, died by suicide in 2013 at age 24. Gus was taken to a hospital for a mental health evaluation, but released because there were no open psychiatric beds across the western part of the state. The next day, Gus stabbed Deeds and then turned a gun on himself. Deeds later said that the Virginia system failed his son.

Since his son’s death, Deeds has advocated for mental health reforms in many aspects of state laws.
The Virginia law mandates the state’s Board of Education update the health Standards of Learning with mental health material for ninth and 10th grades.

The New York law does not mandate a specific curriculum; it instead updates the health curriculum to include mental health in its definition and purview.

Under the new law, health education in the state “must recognize the multiple dimensions of health and include the relationship of physical and mental health,” according to the New York State Department of Education.

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Wednesday, March 14, 2018

Lacy's Relaxation CD - Lavender Dreams - Available for Pre-Order!

After being inspired by my clients at work as an art therapist, seeing how relaxation helps some of them immensely, I set forth to create my own relaxation album so that they could benefit from the relaxation methods I use with them far beyond their treatment, as well as with the world as a whole. When I posited the idea about doing such a project, I was amazed at not only the overwhelming sense of support to do so, but also by the offers of high-caliber professionals around the world to contribute to make it happen. I took that as a sign to move forward, and here we are now!

 It is well-known that people find it hard to relax, and increasing numbers of people find it difficult to sleep well also. Using original guided imagery, I take you through soothing scenarios to help your mind focus on something calming, and the original music that supports these scripts are created by world-class musicians, who bring their gifts of composition and performance to perfectly punctuate each visual detail to help your mind and body relax and become calmer.

Go to my Kickstarter to pre-order the album, and look to see what reward level appeals to you. You might want it for yourself, or for your clients or practice as well.  Pre-order ends on April 13th, so get your order in early!

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Friday, January 12, 2018

Adventures in Art Therapy selected a Top 100 Alternative Health blog

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Saturday, December 30, 2017

Maybe humans should still be in charge of naming colors....

Saturday, December 09, 2017

Sweden's PassionistaColorista features Lacy on her podcast!

EPISODE 4: Lacy Mucklow, about Color Me Calm, and her other coloring books 

 "They had no idea that their coloring books would make success around the world, when they released Color Me Calm and Color Me Happy back in 2014. In this episode I talk to Lacy Mucklow, art therapist, and the author of these books. She talks about how it started, which one that is her own favourite, what pencils she uses when she is coloring, why mandalas are so calming, how different colours affect us, and much more!"

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Sunday, November 19, 2017

Lacy Interviews with The Wellness Design Podcast

How can an adult coloring book create a memorable experience in your waiting room and offer next level service to your peeps? In today’s episode I interview Lacy Mucklow, the author of the wildly popular adult coloring books “Color Me” series. You’ll learn how coloring instantly calms the brain regardless of your age and what’s so unique about these coloring books your patients (and their families) will love! 

Healthcare interior designer Cheryl Janis interviews big-hearted industry professionals, designers, artists, and creatives who share their must have design resources and tools for your patient-centered medical, dental, healthcare practice or beauty business. Stop feeling overwhelmed by all the design choices out there. Learn the best options for you, your staff, patients and clients, and how to use them intelligently in your own wellness space. 


 Subscribe in iTunes

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Wednesday, October 18, 2017

Karen Pence Advocates for Art Therapy as Her Cause

Beyond Arts and Crafts: 

Karen Pence Preaches Art Therapy

By Published on October 18, 2017 

WASHINGTON (AP) — When Karen Pence found out that an art therapist in hurricane-ravaged Puerto Rico couldn’t afford the clay her clients needed, she sprang into action.

A trained watercolor artist and advocate of the little-known mental health profession, Vice President Mike Pence’s wife went to the Virginia art supply store she frequented when they lived in the state during his tenure in Congress, bought 120 pounds of self-drying clay and packed it aboard Air Force Two for their flight down to survey the damage.

“She cleaned him out,” the vice president said of the store’s owner.

Mrs. Pence made art therapy her cause ever since she first learned about it more than a decade ago. She has visited numerous art therapy programs, both in the U.S. and abroad, and on Wednesday in Florida, nine months into the administration, she planned to formally announce the goals for her art therapy initiative.

She wants to help people understand the difference between art therapy and arts and crafts, and to grasp that art therapy is a viable option for treating trauma, injury and other life experiences. She also wants to encourage young people to choose art therapy as a career.

“I don’t think that a lot of people understand the difference between therapeutic art and art therapy,” Mrs. Pence, a trained watercolor artist, told The Associated Press in an exclusive interview before the announcement at Florida State University in Tallahassee. The school has an art therapy program she described as “tremendous.”

Blabbing to a girlfriend can be therapeutic, she explained, but it is not the same as art therapy, which has three elements: a client, a trained therapist and art.

As passionate as she is about raising art therapy’s profile, other issues help make Karen Pence tick, too.

One of them is helping military families, especially spouses. Her only son, Michael, is in the Marines.
There’s also her interest in honeybees. Mrs. Pence installed a beehive on the grounds of the U.S. Naval Observatory, where the vice president’s official residence is located, to help call attention to a decline in managed bee colonies that officials say could negatively affect U.S. agricultural production. She had a beehive at the Indiana governor’s residence for the same reason.

Now 60 and married to the vice president since 1985, Mrs. Pence has long been viewed as one of her husband’s most trusted political advisers. They’re often together on trips, at the White House, or at the observatory, almost always holding hands.

Since returning to Washington in January (the family lived in the area when her husband served in Congress), she has accompanied the vice president on goodwill tours of Europe, Asia and Latin America, as well as trips to survey recent hurricane damage in Texas, Puerto Rico and the U.S. Virgin Islands. She tries to visit art therapy programs wherever she goes. Journalists who travel with Pence often keep an eye out for his wife; she often brings them cookies when he ventures back to the press cabin for small talk.

She’s even done a little campaigning, urging Virginians to vote next month for Ed Gillespie in what’s viewed as a tight gubernatorial race.

“It really makes a difference, I can tell you. Nobody thought that we were going to win,” she said, an apparent reference to the Trump-Pence ticket.

The vice president often refers to his wife as the family’s “prayer captain.” She has led congregations in prayer during their hurricane-damage trips.

“We’re people of faith so we just try and approach everything with prayer,” Mrs. Pence said from her sunny, second-floor office in the Eisenhower Executive Office Building in the White House complex, where she and her staff enjoy coveted views of the Washington Monument and Jefferson Memorial.

Art therapy drawings given as gifts adorn the outer office.

She proudly displayed several of her paintings, including of the Capitol dome, the vice president’s residence, a Ball canning jar-turned-flower vase, a cardinal bird and a pink peony. She turns many of her watercolors into prints and boxed notecards that she gifts to art therapists she meets.

Except for myriad pets, including two cats, a dog and a rabbit named Marlon Bundo, the Pences are empty nesters. Their son and two adult daughters are off on their own.

“I think for us this is a good time in our life for this role because our kids are out of college. They’re living their own lives,” Mrs. Pence said.

She’s also launching a blog in conjunction with Wednesday’s announcement to chronicle her visits to art therapy programs.

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Wednesday, July 26, 2017

Adventures in Art Therapy selection among Feedspot's Top 30 Art Therapy Blogs!

I was contacted to discover that this blog was selected to be among the Top 30 Art Therapy Blogs and Websites by Art Therapists.  I'm in very good company with other esteemed colleagues.  Thanks Feedspot!  Check out the great list!

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Monday, May 08, 2017

Guest Blog: Joan Stanford on Creative Expression

Joan Stanford, author of "The Art of Play," has graciously written a guest blog for Adventures in Art Therapy!  Read ahead for her wisdom and insight about the importance of expression through artmaking.

The universe is full of magical things patiently waiting for our wits to grow sharper.
—Eden Phillpotts

I recently attended the NORCATA (Northern California Art Therapists Association) conference in Berkeley and just watched A Beautiful Remedy, a documentary on PBS about arts in medicine so am feeling very connected to the healing power of art expression. While I have worked with various populations (and for several years in the local public schools) I now work mostly for and with people without a client/patient designation. I offer play shops and creative retreats. My intent is to invite anyone to explore with playful art making and through that to connect to themselves, to others and to the world around them with more authenticity and compassion. My book, The Art of Play, released this June, relates my story: how I, a busy innkeeper, wife, and mother found my way to expressive arts and how that opened up a whole new world.

Many of the people who play with me have not touched art materials since preschool or elementary school. Some were more actively engaged previously in some “artistic” pursuit but abandoned that as their adult working lives took over and, now, jump at the chance to reactivate those interests. Others are just curious.  Some consider themselves totally “non-creative” but want to see if they can discover something new. Of course, signing up is completely voluntary so that is a huge plus. We have all encountered resistance when clients are mandated to work with us. But my playmates bring their own fear-based resistance. Facing a blank page creates anxiety for most of us. Being asked to trust the process, to let something emerge from within is not easy. That is why I use the word “play.”

We begin with conversation; they may say why they came and what they hope for from the experience. I always stress that play is experimentation—there is no judgment, no mistakes. I offer total permission with the hope that the carefree child part will join in with a sense of curiosity and excitement. We do some warm-ups to stimulate free association, to activate imagination. This allows a shift—visibly sensed—from the outer world to the inner that the safe space provided facilitates. Safety allows risk-taking and the experimentation necessary for discovery. I display a variety of art materials to entice engagement of the senses by attracting the eye and piquing interest.

Self-expression through art making is a birthright of all and evident in the first traces of human existence. I want to help make the process accessible and available so people have a tool for introspection that they will turn to as easily as journaling. When we allow imagery to speak to us we learn something new. Images are our first language and evoke feelings, memories, and associations that our analytical left-brains may not have access to.

My personal practice is creating spontaneous collages in a small six-by-six spiral bound journal. I paste the collage on the right side, and then record the conversation on the left. I might ask, “Who are you?” or “What do you want me to know/remember?” Sometimes I create the collage in response to something happening in my personal life or world events. 

After the Paris shootings I did this:

And, later, after the Orlando shootings:

When strong feelings of grief, sadness, helplessness, or anger overwhelm me, the page is a good container. As I create these, the energy is released and can be transformed.

Another more playful image:

People I work with often cannot commit a lot of time or space to playing with imagery so this is a doable option. Tearing words and images from magazines is easy and can be done anywhere—even on a plane. No fancy materials are needed so there are fewer excuses, less avoidance. The words that come are surprising, often poetic and insightful.

As I just read, “The world speaks to us. We just need to learn how to become better listeners.” —Steven D. Farmer, Ph.D.

Hopefully by stressing the playful nature of this powerful work I can invite the wider population to try expressive art making. I know for me it is the key that unlocks insight, healing, and joy!

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Thursday, May 04, 2017

Movie - Nise: The Heart of Madness

This looks like a very interesting movie. It looks like Dr. Silveira was coming on to the idea of art as a form of therapy/treatment at the same time it was burgeoning in America (with Margaret Naumburg and Edith Kramer) and Britain in the 1940's, as their counterpart in Brazil. Cool! 

The territory couldn’t be more delicate, but “Nise: The Heart of Madness,” a mesmerizing drama from Brazil, navigates it skillfully to create a portrait of a real-life doctor who found an alternative to some of the more cruel trends in psychiatric treatment in the middle of the last century. 

Glória Pires stars as Dr. Nise da Silveira (1905-1999), who as the film opens is taking up a post at a psychiatric hospital near Rio de Janeiro in 1944. She settles into a seat in a lecture hall where the benefits of lobotomies via thin spike are being extolled, then witnesses a cruel demonstration of another favorite technique, electroshock therapy. 

“I don’t believe in healing through violence,” she tells colleagues, but, especially since she is a woman, they are dismissive. They assign her to what they think is busywork. 

She transforms the insult into opportunity, creating a unit in which patients who had been written off are given a chance to express themselves through painting and other art forms. The results are startling. 

The movie, full of characters behaving erratically, could easily have taken on the aura of a freak show, but the director, Roberto Berliner, somehow stays respectful of the subject matter even while depicting extreme psychiatric conditions. It’s a study of courageous innovation against an entrenched medical orthodoxy. 

“Our job is to cure patients, not comfort them,” one colleague chastises. 

“My instrument is a brush,” Dr. Silveira replies curtly. “Yours is an ice pick.”

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Tuesday, May 02, 2017

Astrid Lindgren Memorial Award winner states "Children need much as they need love and food and fresh air and play."

Philip Pullman, who received the Astrid Lindgren Memorial Award for Children's Literature in 2005, had words of wisdom with this that he wrote for the 10th anniversary of the Award in 2012:

Children need art and stories and poems and music as much as they need love and food and fresh air and play. If you don’t give a child food, the damage quickly becomes visible. If you don’t let a child have fresh air and play, the damage is also visible, but not so quickly. If you don’t give a child love, the damage might not be seen for some years, but it’s permanent.

But if you don’t give a child art and stories and poems and music, the damage is not so easy to see. It’s there, though. Their bodies are healthy enough; they can run and jump and swim and eat hungrily and make lots of noise, as children have always done, but something is missing.

It’s true that some people grow up never encountering art of any kind, and are perfectly happy and live good and valuable lives, and in whose homes there are no books, and they don’t care much for pictures, and they can’t see the point of music. Well, that’s fine. I know people like that. They are good neighbours and useful citizens.

But other people, at some stage in their childhood or their youth, or maybe even their old age, come across something of a kind they’ve never dreamed of before. It is as alien to them as the dark side of the moon. But one day they hear a voice on the radio reading a poem, or they pass by a house with an open window where someone is playing the piano, or they see a poster of a particular painting on someone’s wall, and it strikes them a blow so hard and yet so gentle that they feel dizzy. Nothing prepared them for this. They suddenly realise that they’re filled with a hunger, though they had no idea of that just a minute ago; a hunger for something so sweet and so delicious that it almost breaks their heart. They almost cry, they feel sad and happy and alone and welcomed by this utterly new and strange experience, and they’re desperate to listen closer to the radio, they linger outside the window, they can’t take their eyes off the poster. They wanted this, they needed this as a starving person needs food, and they never knew. They had no idea.

That is what it’s like for a child who does need music or pictures or poetry to come across it by chance. If it weren’t for that chance, they might never have met it, and might have passed their whole lives in a state of cultural starvation without knowing it.

The effects of cultural starvation are not dramatic and swift. They’re not so easily visible.

And, as I say, some people, good people, kind friends and helpful citizens, just never experience it; they’re perfectly fulfilled without it. If all the books and all the music and all the paintings in the world were to disappear overnight, they wouldn’t feel any the worse; they wouldn’t even notice.
But that hunger exists in many children, and often it is never satisfied because it has never been awakened. Many children in every part of the world are starved for something that feeds and nourishes their soul in a way that nothing else ever could or ever would.

We say, correctly, that every child has a right to food and shelter, to education, to medical treatment, and so on. We must understand that every child has a right to the experience of culture. We must fully understand that without stories and poems and pictures and music, children will starve.

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Friday, April 28, 2017

Art Therapy vs. Art Class

Here is a great article by Ruby Garyfalakis that talks about the differences between art education and art therapy.  There really is a difference, and this could help clear up misconceptions between the two.

If you’re interested in art therapy or thinking about checking it out, you may be wondering what the difference is between art therapy and an art class. In fact, this is a question we are asked all the time, so we wanted to share some thoughts about it here on our blog. From our perspective, these are the main differences between art therapy and an art class: 


a. Art therapy involves a therapeutic relationship. This is the most important element of any type of therapy and what makes it unique from other kinds of activities. There are specific boundaries and elements to a therapeutic relationship. The therapists at Art as Therapy follow the ethical guidelines established by the Canadian Art Therapy Association and the College of Registered Psychotherapists of Ontario. Only those who have received the appropriate graduate training can offer art therapy. Although art therapy usually involves art-making, it is first and foremost a form of therapy, similar to talking to a social worker, psychologist, medical doctor, or psychiatrist who offers psychotherapy.  

b. An art class may involve relationships but it does not involve the intentional therapist – client relationship. A teacher or instructor’s role is different than a therapist’s role, and the student-teacher relationship has very different dynamics than the therapeutic relationship. Art teachers are required to be skilled and competent in the areas that they teach, but they do not receive the same training required to practice as an art therapist. 


a. Art therapy takes place in a confidential contained space. This is very important whether it’s individual or group art therapy. This means that the space has a door that can close, and has frosted windows or curtains to ensure privacy. Confidentiality is essential to creating a safe space where clients can express whatever is on their mind. Clients are free to share with anyone they like about their art therapy sessions and what happens during those sessions, but it is important that they have the option of anonymity and confidentiality if they so choose. 

 b. An art class may take place in a more open space, it doesn’t have to be confidential. Art classes may happen in a classroom, in an art studio, or at a community centre. Parents or friends may watch or participate in the class. The class members may be friends or may change from week to week. 


a. The main goal of art therapy is self expression. The goal is to express or communicate something, and art-making is often one way of doing so. Since the goal is expression, this impacts how art supplies and artwork itself are viewed. Read more about this below. 

b. The main goal of an art class is to learn something or to experiment with a new technique. The goal is usually to make something specific. Students may be replicating an example or following the instructor step by step. This goal of learning and creating something specific impacts how art supplies and artwork are viewed as well. 


a. In art therapy, art materials are viewed as one possible tool for self expression. The therapist is familiar with the art materials based on a continuum from controlled to less controlled. For example, a pencil is easy to control and requires fine motor skills. Watercolor paints or acrylic inks are much harder to control and tend to require larger movements. They work best with bigger paper. Oil and chalk pastels are somewhere in the middle between controlled and less controlled. When viewing art materials in this way, the art therapist may provide or suggest specific art supplies for their expressive potential depending on the client’s therapeutic goals. In art therapy, there’s no right or wrong way to use materials or to make something. If the directive is to draw a tree, whatever the client does in response is accepted and explored within the therapeutic relationship. 

b. In an art class, art materials are viewed as tools to be used in a specific way to accomplish the task. They are manipulated to achieve certain effects. There are sometimes “right” and “wrong” ways to do things or to use art supplies. There may be rules. Often there is a focus on the principles and elements of design. Students are taught different ways to draw a tree, and there is a specific expected outcome. 


 a. In art therapy, the artwork is viewed as an extension or reflection of some part of the client. It can act as a mirror, reflecting the client’s thoughts or feelings about something. The emphasis is on what the artwork communicates for or about its creator, not necessarily on how it looks or whether it turns out as expected. The therapist and the client focus on the process and experience of making the artwork. The process can be just as important as the finished artwork. The client decides what the artwork means to them. 

b. In an art class, the focus is usually on the product. The goal is to make a specific piece of artwork. Every part of the class builds towards creating that finished product. Often the goal is to make something visually appealing, beautiful, or interesting. Students may wish to display their creations or frame them. This is not to say that artwork created in art therapy cannot be beautiful, aesthetically pleasing, or pride-worthy. It just means that this is not the goal or the expectation during an art therapy session, while it often is the goal during an art class. The main point is that art therapy is a form of therapy, and an art class is not. This doesn’t mean that an art class can’t be helpful or even therapeutic. However, a specially trained therapist must be present and there must be some kind of formal agreement to engage in a therapeutic relationship in order for something to be considered therapy. Art therapy and art classes can both be beneficial. Here are some ideas about the potential benefits of taking an art class, versus the potential benefits of attending an art therapy session. 


1. You can learn new skills, building a sense of mastery and competency. This can boost self esteem. 

2. You can build and develop technical abilities that can be used for visual self expression.

3. You may have the opportunity for social interaction, and may be able to build peer relationships with other students in the class. 

4. You may learn about yourself indirectly through the process. 


1. You will have a safe place to express whatever is on your mind. 

2. You may experience catharsis through self expression. You will be encouraged to express your feelings, and you may use art materials for this process. Art-making can be an excellent way to unload or release emotions. 

3. You will be part of the therapeutic relationship which is a unique relationship. The therapist will function as a witness to your art making process. The therapist can validate your experiences and emotions, reflect your emotions back to you, and observe the whole process with curiosity and compassion. 

4. The art therapy session provides an opportunity for intentional self reflection and discovery. You may feel empowered as you get to know yourself better and discover how your inner strengths can help you to face challenges and overcome obstacles.

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