Coming to the Studio, Going with the Flow: a Study on Artmaking to Enhance Flourishing Jaimie Burkewitz

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FLORIDA STATE UNIVERSITY

COLLEGE OF VISUAL ARTS, THEATRE, AND DANCE

COMING TO THE STUDIO, GOING WITH THE FLOW:

A STUDY ON ARTMAKING TO ENHANCE FLOURISHING

By JAIMIE BURKEWITZ

A Thesis submitted to the Department of Art Education in partial fulfillment of the requirements for the degree of Master of Science

Degree Awarded: Summer Semester, 2014

Jaimie Burkewitz defended this thesis on July 18, 2014. The members of the supervisory committee were:

David Gussak Professor Directing Thesis

Marcia Rosal Committee Member

Jeffrey Broome Committee Member

The Graduate School has verified and approved the above-named committee members, and certifies that the thesis has been approved in accordance with university requirements.

AKNOWLEDGEMENTS

I would like to thank my major professor and thesis advisor, Dr. David Gussak for believing in my out-of-the-box ideas and tendency to take on too much. By showing me he believed in my ideas, he also helped me believe in myself. Thanks are also extended to my other committee members Dr. Jeffrey Broome and Dr. Marcia Rosal for being there for the sprint to the finish line. I would also like to thank Dr. Teresa Van Lith for being the first one to hear about this project, and not immediately reject it. I thank my family for their unending support and willingness to talk through the struggles and endless paths I could have taken with this project. I would especially like to thank my father, Bart Burkewitz, for his passion and ability to relate his world of complex dynamic systems to me, and allow an exchange to happen between our fields. Finally, I thank the participants who attended the sessions- without them this study could not have taken place. Their enthusiasm and willingness to "go with the flow" made this study what it was, and made me want to continue to do research within this domain.

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TABLE OF CONTENTS

List of Tables ...... vi List of Figures ...... vii Abstract ...... viii

CHAPTER ONE: INTRODUCTION ...... 1

The Stigma of Therapy for the Higher-functioning Population...... 2 A Preventative Approach to Therapy ...... 4 Research Questions ...... 5 A Brief Definition of Terms ...... 5 Brief Overview of the Study ...... 7 Summary ...... 8

CHAPTER TWO: LITERATURE REVIEW ...... 10

Flourishing: A Measure of Well-Being ...... 10 The Science of Positive Experience ...... 12 Groundwater: Csikszentmihalyi's Creativity and Flow ...... 14 Art Therapy ...... 17 Creativity, Flow, Mindfulness, and Positive Psychology: How They Relate to Art Therapy. 20 How Flow, Mindfulness, Positive Psychology and Art Therapy Relate to Flourishing ...... 23 Brain Research and Implications for Efficacy of Art Therapy ...... 25 Summary ...... 26

CHAPTER THREE: METHODS ...... 27

Interpretivist/Constructivist Paradigm ...... 27 Research Questions ...... 30 Research Design...... 30 Procedures ...... 31 Summary ...... 35

CHAPTER FOUR: RESULTS ...... 36

Research ...... 36 Session Summary ...... 40 Quantitative Results ...... 57 Qualitative Results ...... 60 Summary ...... 67

CHAPTER FIVE: ANALYSIS AND DISCUSSION ...... 68

Art as Prevention...... 68 Healthy/Higher Functioning People can Benefit Too ...... 69 Breaking Down the Stigma of "Therapy" and Building New Theoretical Constructs ...... 70

Establishing a New Treatment Plan: Theoretical Implications...... 72 Art Provides a Pathway to Flow ...... 72 Limitations ...... 74 Future Research ...... 75 Conclusion ...... 76

APPENDICES

A. Session Structure ...... 79 B. Scale of Positive and Negative Affect Experience ...... 80 C. Flourishing Scale ...... 81 D. Informed Consent to Participate in Research Project ...... 82 E. Approval Memorandum for Research ...... 84

REFERENCES ...... 86 BIOGRAPHICAL SKETCH ...... 89

LIST OF TABLES

1 Participant Summaries ...... 38 2 Session Analysis ...... 62 3 Frequency of Sessions Voted Most Relaxing, Enjoyable and Challenging...... 63

LIST OF FIGURES

1 How Everything Relates Back to Flourishing ...... 25 2 End of Session Log Sheet ...... 39 3 Flow Challenges vs. Skills ...... 40 4 Breath Drawing ...... 41 5 Session One Art ...... 42 6 Session Two Art ...... 47 7 Session Three Art ...... 49 8 Session Four Art ...... 51 9 Session Five Art ...... 53 10 Session Six Art ...... 56 11 Averages: Change in Positive Affect Pre-Post Session ...... 57 12 Averages: Change in Negative Affect Pre-Post Sessions ...... 58 13 Averages: Change in Flourishing Pre-Post Sessions ...... 59 14 Average Scoring of Time ...... 65 15 How Time Seemed to Pass Each Session ...... 66

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ABSTRACT

The research in this study seeks to investigate the notion of flow theory and positive psychology and their correlating impact on the ability of people in a community setting to reach a higher level of flourishing by engaging in the creative arts. The study predicts that an observable positive change as recorded according to a scale that measures flourishing occurs when people engage in art therapy experientials. An introduction and literature review will be presented to aid in clarifying the source of inspiration for this study as well as supporting research that helped formulate the research design and methodology. Information describing how the data will be collected and analyzed will conclude the third section, explaining in detail the flourishing scale as well as other measures being used. In the remaining chapters, the data collected from the study will be presented and discussed as they pertain to the research questions. The study ultimately found positive improvement in the ability of the participants to reach a higher level of flourishing, experiencing more positive affect and less negative affect as a result of engaging in a series of 6 painting sessions.

Key terms: flow, positive psychology, flourishing, art therapy

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CHAPTER ONE

INTRODUCTION

Throughout the process of doing research for this study, I witnessed in wonderment as topics that began as intriguing, yet isolated ideas started forming complementary relationships.

Many disciplines have embraced the continuum, which has begun to emerge as the most natural way to categorize and relate ideas due to the ever-fluctuating dance that creates a sense of balance and clarity. Rather than seeing things in black and white, researchers in philosophy, theory, art, psychology and neuroscience are now more than ever, intrigued by the shades of grey.

The catalyst for this study were the collected consistencies observed in hundreds of painting classes in which the participants appeared to find success within the spectrum of controlled instruction and spontaneous "letting go." Somehow, while making art with other members of the community, the majority of clientele observed a change within themselves, of their ability to reach an unexpected potential. They were able to produce a painting even when never having picked up a brush since grade school. Over and over again, people would enter the studio with a skeptical attitude and not believe in their capability until they viewed their finished piece on the screen of their camera or phone, or until I encouraged them to gain some distance in looking at their piece.

Because this initial skepticism was so consistent, I wondered, "Why do people keep coming?" Not only do many enter the studio their first time feeling nervous, but many are frequently returning. I sensed that these people were coming because either they had already found value in the experience, or there is something innate within them telling them that a challenge may be good for them. It became apparent that something in each of these people told them to try, hinting that somewhere deep inside they believed in their own potential, or to satisfy

some inherent drive to express their creativity or even challenge themselves to experience something new alongside others like them. I thought my observations of this kind of community engagement could serve as a way to understand a population not often addressed in therapy; the type of people who are driven to challenge themselves and be creative.

I began my journey into the shades of grey at a painting studio, where I worked as a painting instructor for several years before the inception of this study. The painting studio is a local and franchised business, offering classes to the public in which "fun" is stressed more than

"fine art." People come having never painted, and are able to leave with a finished painting they created themselves after having received step-by-step instructions in a matter of two to three hours. Oftentimes families, friends and co-workers will come in groups to the studio, while others prefer to paint alone within a group in a public class. Regardless, it is one of the fastest growing franchises in the industry, and recently won the city's #1 award for both "Cultural

Institutions" and "Family Entertainment." This studio will be referred to in general terms throughout the study so as to protect the rights of the participants and business.

The Stigma of Therapy for the Higher-functioning Population

While on one hand I might observe this population as willing to challenge themselves, one of the most common reasons people say they come to the studio at first is on the opposite end of the spectrum. Many come in thinking it could be fun to do something different and creative with friends, not expecting to enjoy the actual painting as much as they do. Customers who have returned often described how art-making became meaningful in some way; “It’s nice to be away from everything and not worry about responsibility, to not have to think,” said one customer; “This is our therapy.” “I come here to basically clear my mind and get away from

everything,” said another. “It’s me time.” A rehabilitation counselor viewed the experience as her own form of treatment; “It certainly can be good mental health therapy,” she said.

People often begin feeling nervous, however within an hour of painting most reach a higher level of focus which tends to cause them to be surprised when the announcement is made that only a few more minutes remain. Time, has consistently over the years been noted by many as "passing unnoticed." Naturally, as I was studying art therapy and the concept of flow while working at the studio, I began noticing how these statements made by our customers correlated with many of the core concepts involved in each field of study.

According to the American Psychological Association's "Stress in America" findings

(2012), 1/3 of Americans know they lack the willpower to decrease stress in their life, which currently is at an average self-rated 4.9, where 3.6 is viewed as having a "healthy" amount of stress. The two top stressors people are reporting are money and job related. Dead last, is personal health. People who come to the studio are taking the initiative to try something new and creative in a social setting, coming to relax, spending money and doing something for themselves. Many of the most frequently returning customers also happen to have very stressful jobs or careers such as nurses, teachers and lawyers.

While being an instructor at the studio, I was able to see how my training in art therapy and experience of teaching how to draw and paint were able to positively affect my clients. In other words, under the guise of the "social entertainment industry" I was able to provide a population of more highly functioning clients the therapeutic benefits of art-making. It was made clear when listening to the statements made by the customers, that they too, were noticing the therapeutic benefits of being in the studio painting. I wondered if being more highly functional, any of them would seek to see a professional therapist, or if the stigma of therapy caused them to

seek "therapy" at a place like the painting studio. It occurred to me that whether people saw or recognized it as such, many were experiencing something therapeutic whether it be stress reduction, mindfulness, creative expression or socialization. Being a student of philosophy and therapy, I began to search for theoretical constructs in modern psychology that resonated with the transformative behaviors and attitudes I had observed. These ideas led me to my rationale, and methodologies.

A Preventative Approach to Therapy

While the field of art therapy is constantly expanding and being implemented into various untraditional settings, whether due to a personal interest or an attempt to make a more valid case for art therapy's legitimacy, the current outgoing research predominately focuses on treating very specific populations. This study will aim to address the need and/or potential benefit of treating those not necessarily deemed as "in urgent need" of therapy, or even assigned a diagnoses. If art therapists want people to recognize the therapeutic benefits art therapy can provide, why not have the majority of the population experience it for themselves? Especially considering that the

"majority" will not remain the majority for much longer; according to the WHO and CDC, 1 in 4 people currently have a mental illness and 50% of the population living in the United States will develop at least one mental illness in their lifetime. With so many already suffering or on the brink of mental illness, art therapy may be able to provide preventative support for those undergoing daily stress.

Something not being considered as much as it should be is art therapy as a preventative treatment modality as opposed to a causational response, in promoting the well-being of healthy individuals. These ideas also resonate with the more current trends of positive psychology and living mindfully, where the focus in therapy and mental health is beginning to shift from

diagnosing pathology to identifying and enhancing the client's pre-existing strengths (Chilton &

Wilkinson, 2009; Seigel, 2007).

This study will explore what it is people are experiencing when they go through the process of learning how to paint. Through further analysis, potential benefits people gain from working in the studio, and how art therapy techniques can be implemented into the experience to help individuals improve their ability to flourish will be discussed.

Research Questions

In this study I wanted to identify how people who are more highly functional were motivated and how I could record and measure the change in them, hoping to gain insight into what it was that made some want to return to the studio. They could sense something positive happening, enough for one to even tell a news reporter one night that it was "good mental health therapy;" but could they tell us why? This study seeks to understand the following questions:

 Can healthy or more highly functioning people benefit from engaging in art therapy

experientials?

 Can art therapy be used as a preventative treatment modality for healthy or higher

functioning people to increase flourishing?

 Does art therapy provide a pathway into the flow state, contributing to the optimal

functioning and happiness of the client?

 How can an art therapist design a treatment plan that effectively challenges a higher

functioning client?

A Brief Definition of Terms

The following section will offer a brief explanation of terms commonly referenced throughout this study to enhance understanding.

Art Therapy

Art therapy is defined by the American Art Therapy Association (2011), as a "mental health profession." There is often a stereotypical response when people hear the term "art therapy", that it is an interesting idea, but not a real form of therapy. Quite the contrary, art therapists are trained extensively in not only psychology and counseling, but in utilizing the media to engage the client using creative techniques. Terms such as, "non-traditional" or

"unconventional" are often used when describing art therapy, however art therapy was seen in some of the earliest work of psychoanalysts such as Freud and Jung. Art therapists have a unique skill in which creative strategies are employed to produce treatment plans that not only inform treatment verbally, but can help a client reach a deeper level of understanding through action and symbolic representation and analysis.

Mindfulness

Mindfulness as it relates to this study is the practice of being present. It is necessary in the process of refining ones' ability to relax, and become attuned to their present awareness

(Seigel, 2007). This includes paying attention to ones' breathing, emotions, physiology and direct surroundings including the physical characteristics of the media and tools being used in an effort to negate distraction and enter a state of flow.

Flow

Flow as it pertains to this study refers directly to the happiness research and flow theory initiated by Mihaly Csikszentmihalyi who sought to find out "what makes a life worth living"

(2004). In his view, a balance of challenges vs. skills that engage the participant to a point of

"optimal functioning" can lead to a higher level of life satisfaction. The more a person can reach

and enter into the flow state, cultivating it in everyday activities, the more he predicts a person will experience positive affect and happiness.

Positive Psychology

Positive psychology is the practice of enhancing the clients' notion of their own existing strength and potential. It upholds a "positive" outlook on ideas such as diagnoses, by focusing not on the "problem" but on the solution. The concept of positive psychology was originally constructed and introduced by Martin Seligman (2011) as "authentic happiness," defined by positive affect or emotions; but has since developed into a modern theoretical perspective encompassing five measurable components. These include positive emotions, engagement, positive relationships, meaning, and accomplishment(s) (PERMA). These five components were re-named by Seligman as "flourishing," or ones' status regarding their well-being.

Well-Being

Well-being will be more specifically defined utilizing Seligman's (2011) notion of

"Flourishing" described in the previous definition of positive psychology. Again, flourishing builds on the idea that positive affect has the largest impact on happiness, including four other specific elements that can be measured on a Flourishing scale. An additional scale for positive and negative affect is often correlated with the flourishing scale to gain a more comprehensive understanding of what people experience. This study will use the Flourishing scale, as well as the

Positive and Negative Scale of Affect Experience to measure what participants experience throughout the study.

Brief Overview of the Study

The study will contain 6 sessions, each lasting approximately an hour and a half. During these sessions, participants will be learning technical skills while using acrylic paint, as well as

engaging in relaxing breathing/movement exercises. Every session will contain a different level of structure and guidance so as to continuously fluctuate between Csikszentmihalyi's continuum of challenges vs.skills, which will be explained in more detail in further chapters. All materials will be provided, and the groups will meet at a studio classroom on the university's campus.

The study will ask the participants to attend these sessions, in which two short questionnaires will be presented to them to fill out (1 x at the beginning and 1 x at the end) as well as create art. Participants will schedule a time to meet individually after they have attended all sessions for a semi-structured interview in which they will be asked a series of questions that may guide a more casual conversation reflecting their overall experience.

Summary

Overall, this research hopes to bring into awareness how art therapy may address the increasing levels of stress that affect the general population. It is disheartening to live within a society in which money and job related stress are self-identified as the most stressful factors and personal health the least, despite evidence that shows an alarming increase in stress leading to mental illness. A deeper look into what people need to lessen this affect is essential. With the pace of life increasing, an hour or two a week in which a person under consistent duress can take time to slow down mentally, to be expressive and creative and lose their notion of time by producing a work of art, is where this study begins in seeking out an answer.

The following section will reflect the enlightening journey I went on in search for constructs in various fields that resonated with my topic of research. Art therapy, flow, mindfulness, positive psychology and flourishing will be described in more detail as the literature is reviewed for each arena, and further discussed as they relate to each other in this study. The chapter will conclude with a brief section discussing modern scientific literature

regarding future collaborative potential between art therapy and the more biological based- sciences. The common thread connecting these concepts is systems theory, which was mentioned in different ways throughout much of the literature in these various writings. Csikszentmihalyi

(1996) called it "entropy" or "mental chaos," Frederickson and Losada (2005) referred to it as

"complex human dynamics" and Dietrich (2004) specifically looked at implicit/explicit systems of brain functioning. Either way, the continuum, or the journey from order to chaos and those shades of grey in between, became the central focus of the literature review and underlying structure incorporated into the methodology.

CHAPTER TWO

LITERATURE REVIEW

The following section will contain a review of literature that highlights three key constructs as they can be implemented into the practice of art therapy. Flourishing, flow and the science of positive experience, which include concepts such as mindfulness and positive psychology delineate how elements of positivity, acceptance, awareness and realizing one's potential through exploration of one's strengths instead of focusing on pathology can potentially increase their sense of overall well-being. (Didonna, 2008; Fredrickson & Losada, 2005;

Wilkinson & Chilton, 2009). The literature review will then discuss how these concepts may be employed by the field of Art Therapy to provide a positive and stimulating therapeutic atmosphere that has the unique ability to build on character strengths by increasing skills and challenges through mindful creative expression. Lastly, the chapter will outline how using the three key concepts in the Art Therapy arena resonate with the idea of flourishing, and help to justify why this study uses measures of well-being to record changes in participants.

Flourishing: A Measure of Well-Being

As defined by the World Health Organization (2012); "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity."

Mental health is defined as "a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community." What this study aims to focus on is not necessarily the realization of one's potential, but more importantly, the realization that one has potential, and wants to work on fulfilling it. Therefore, an imperative component to this research is that the participants are all voluntary. Flourishing expands on this notion of holistic

health to include a more specific definition of what being healthy and happy looks like, including feelings of motivation and purpose necessary for taking action to improve oneself (Seligman,

2011).

To flourish connotes functioning within a certain stretch of a continuum including languishing, or the degeneration of vitality and motivation on one end, and flourishing, which contains many core features such as, positive affect, curiosity, purpose, engagement, and meaning on the other (Seligman, 2011). The flourishing measure used in this study has incorporated multiple perspectives from the most esteemed pre-existing models and theories that postulate what exactly well-being may mean (Diener, Wirtz, Tov, Kim-Prieto, Choi, Oishi,

Biswas-Deiner, 2009). Of utmost importance as it relates to this study and well-being is

Csikszentmihalyi's (1991) concept of "optimal experience" including one's ability to engage in meaningful, creative expression as well as the ability to have meaningful relationships, self- acceptance, optimism and present awareness which all speak to Seigel's (2007) stance on

"mindful living." These are two of the main constructs that encapsulate characteristics explored and measured in flourishing.

Furthermore, the measure considers psychosocial implications including social- psychological prosperity; which originated from the humanistic theory that upholds competence, relatedness and self-acceptance are the key elements to well-being; it also addresses the importance of feeling that one has contributed to society or helped another (Brown et al., 2003).

The theory of flow and its relation to creativity in reaching optimal engagement added an emphasis on intrinsic motivation, curiosity and attention (Csiksentmihaly, 1990). Flourishing also measures for certain character traits such as optimism/positive affect (Diener et al., 2009).

This brief explanation of flourishing will be re-visited at the end of this section, as a more in-depth discussion will ensue discussing the remaining topics explored in the Literature review, which will surely shed more light on how they are all intertwined, or why they were chosen in relation to each other.

The Science of Positive Experience

The following section will discuss the theoretical concepts of both Mindfulness and its scientific counterpart, positive psychology in relation to the questions being addressed in this study.

Mindfulness

Mindful living is an imperative stride we must take in as many aspects of life as possible.

It has an important connection to our perception of time because there is currently a cycle being perpetuated, especially in Western culture of people being focused so intensely on their future goals, all the while unconsciously constructing impractical present realities by basing current experience on the regret, sadness and guilt of the past (Germer, 2005). All the while, the present lived experience is being neglected. People are constantly in fluctuating states of anxiety because all of their energy that could be dedicated to mindful awareness is being spent on ruminating on past/future events or attachments; usually regarding the questions, "What do I have to do to get to X" and rewarding or motivating themselves by then thinking, "What have I done so far?" Less commonly addressed are the questions; "What am I thinking about and why, how do I feel, and what do I need at this moment?" There have been numerous studies about social interaction and social psychology that have shown longevity and resilience to improve when meaningful relationships are healthily cultivated throughout the course of one's life (Seigel, 2007). Within these meaningful relationships, people learn the needs of the other through active listening in the present, by being mindful of the other's every signal they send consciously or unconsciously

through their body or in the tone of voice they use. In some of the most meaningful relationships, people can tell how the other is feeling without a word or even the slightest gesture. Siegel

(2007) calls this higher level of connectedness, "interpersonal attunement." In other words, when two people are attuned, they experience the present feeling of the other, as if their thoughts were synchronized. Sometimes one person may recognize the other's current emotion before they do.

There is often comfort in knowing that somehow, one is understood, felt, and inversely feel the other; an unspeakable connection that must be experienced to truly be known. Siegel (2007) suggests that there must then be similar potential benefits in transitioning from inter to intrapersonal attunement .

Mindfulness <---> Positive psychology

Mindfulness as it directly relates to positive psychology can function as an internal, individual process that a therapist may want to reference when practicing therapy; as an overarching theoretical framework for both the therapist and client, or as an exercise or intervention a therapist can teach the clients to use in their everyday living for a variety of reasons. Mindfulness has evident parallels to the humanistic theoretical concept often used as a framework in modern psychology and therapy. Positive Psychology, being a more recent construct naturally has roots, of which happen to originate from humanism (Germer, 2005(b);

Wilkinson and Chilton, 2007). Positive psychology is directly related to humanistic ideals in that it puts the client's strengths and potentialities first. It posits that if more emphasis is placed on the positive attributes instead of whatever the "issue" or "problem" is, whether it be a diagnosable pathology or wanting help in grieving over a loved one's passing; that drawing out the good will be able to overcome the negative experience. In a way, it can be thought of as similar to the art of

positivity and positive thinking, which are both measureable features of a person's ability to

"flourish."

Groundwater: Csikszentmihalyi's Creativity and Flow

The ability of people to be resilient throughout World War II was something of extreme interest to Csikszentmihalyi (1996), as he grew up watching how people with no money were able to find as much satisfaction in life as those that were able to live wealthily through those hard times. Csikszentmihalyi wanted to know what caused this. He carried out several investigations to answer this question and found out that one of the key ingredients to happiness and life-satisfaction was intrinsic motivation that led to creativity and novel ideas. He found people who enjoyed what they did resulted in the attainment of intrinsic rewards and self- actualization of potentialities.

Creativity has a wide range of definitions and interpretations because it is still in the process of being fully understood. Like consciousness, definitive explanations are difficult when the term is so unrestrictive and elusive. The question of whether a person is inherently creative or whether it develops mainly by cultivation is central to its mystery. Creativity’s comprehensive manifestations may be more easily understood if distinctions are made between the characteristics encompassed by a creative person, thought processes, and the external by- products which may themselves be deemed “creative.” These may manifest as ideas, discoveries or productions (Csikszentimihalyi, 1996). He further explained that the translation of memes, or the cultural version of genes from parent to child are imperative to re-establish anew with every generation, and that it is the creative person who not only relearns the meme but builds on it, improving it or altering it to evolve with an ever changing society. According to

Csikszenimihalyi (1996), “Creativity occurs in the interaction between a person’s thoughts and a

sociocultural context” (p. 24). He noted that a “keen curiosity about ones’ surroundings” describes the nature of a creative person (p. 156). This curiosity becomes the fuel for further fostering of one's’ cognitive processes such as; “sustained attention, working memory, planning and temporal ordering, and decision making” (Hinz, 2009, p. 169).

The main distinguishing factor between creativity and flow is that creativity is a systemic phenomena rather than individual; result from interaction between social constructs/individual thoughts. Flow utilizes a person's strengths and upholds that all hold the potential to develop and maximize the innate "psychic energy" necessary to live a creative life. Psychic energy refers to the ability of one to be conscious of and overcome both internal and external obstacles preventing them from utilizing their creativity. "Living the creative life" in terms of flow theory is to reach a state of optimal functioning that enhances feelings of happiness (Csikszentmihalyi,

1996). It promotes a way of living in which a person both emphasizes and develops an intrinsic curiosity and employs their creativity to actively pursue their interests and constantly challenge their abilities. It teaches the paradoxical binary constructs, of which more creative people tend to easily navigate such as learning to concentrate while inhibiting hyperfrontality or what some have called, relaxed focus (Dietrich, 2004); and of walking the line between control/worry, boredom/ arousal, and anxiety/ relaxation to peak stimulation leading to feelings of fulfillment and lasting satisfaction.

In an effort to enhance personal creativity, Csikszentmihalyi (1996) proposes that

"problem finding" is a vital component in the cultivation of flow in daily life because it "helps us focus on issues that will affect our experiences but otherwise may go unnoticed (p. 364). He further urges people to "find a way to express what moves you." Oftentimes people may come to therapy because they don't know what it is that ails them. Art making has the ability to

symbolically uncover unconscious or verbally/cognitively repressed emotions, and allows for the sublimation of negative energy attached to the issue. It sounds to me like Csikszentmihalyi is saying that to prevent having problems or not being able to achieve a more consistent and enduring way of living life via cultivation of creative energy; one must first problem-find.

According to Csikszentmihalyi, creative people tend not to easily accept what others automatically deem as truths. They question the obvious and anticipate obstructions. What better a pairing then, to match someone trying to problem-find with a method shown to enhance the ability to problem-solve; the very definition of the creative level of what art therapists have come to know as the Expressive Therapies Continuum. According to Rubin (1990), "Creativity is manifested through the ability to create order out of unstructured media." This concept also relates to Csikzentmihalyi's (1996) description of entropy:

“The Rebirth of curiosity doesn’t last long, unless we learn to enjoy being curious.

Entropy, the force behind the famous Second Law of Thermodynamics, applies not only

to physical systems but to the functioning of the mind as well. When there is nothing

specific to do, our thoughts soon return to the most predictable state which is randomness

or confusion…When this happens, a sort of mental chaos takes over…When we learn to

enjoy using our latent creative energy so that it generates its own internal force to keep

concentration focused, we not only avoid depression but also increase the complexity of

our capacities to relate to the world” (p. 348).

The flow of energy is never stable, however that seems to be where things are created. Like us, we defy the 2nd Law of Thermodynamics. Cskikszentmihalyi is saying our minds will most likely revert to states of higher entropy, if left un-stimulated or lacking a sense of curiosity about the world while Rogers, (2001) states that client-centered therapy upholds that people have an

“inherent impulse towards growth” or a natural desire to reach lower states of entropy. So our minds will revert to disorder if we aren’t stimulated in some capacity to remain curious, but a healthy brain inherently wants to reach order. Curiosity is the ignition, intrinsic motivation is the oxygen and creativity is the flame.

Expressive art therapy can be used to overcome internal obstacles to cultivate creativity and incorporate it into day to day activities, thereby increasing ones’ capacity for creative thinking processes and overall quality of life (Cskikszentmihalyi, 1996). More specifically, mostly internal personality characteristics that can be easily compared to common mental illnesses, personality disorders, defense mechanisms and manifestations of the ego oftentimes function as creative mental blocks. An art therapist can provide a safe environment in which people suffering from an inability to overcome internal difficulties, can learn coping strategies that will guide them to independently stride towards the “path to wholeness,” using creative expression as the driving force.

Art Therapy

Art therapy is defined by the American Art Therapy Association as, a mental health profession in which clients, facilitated by the art therapist, use art media, the creative process, and the resulting artwork to explore their feelings, reconcile emotional conflicts, foster self- awareness, manage behavior and addictions, develop social skills, improve reality orientation, reduce anxiety, and increase self-esteem. A goal in art therapy is to improve or restore a client’s functioning and his or her sense of personal well-being. Art therapy practice requires knowledge of visual art (drawing, painting, sculpture, and other art forms) and the creative process, as well as of human development, psychological, and counseling theories and techniques.

The Expressive Therapies Continuum

The Expressive Therapies Continuum is a theoretical model used as a cohort to art therapists in both assessing how a client is emotionally and cognitively functioning at a specific level (or combination thereof) on the continuum as well as facilitating the process of future treatment goals (Lusebrink, 1990). The most basic level includes the kinesthetic and sensory aspects as representative of one’s innate desire to actively and physically partake in the art making process, simply enjoying and concentrating on what the activity elicits from one’s senses. In the perceptual level the client embraces the media to explore more formal characteristics in their expression while the corresponding affective level also includes the client’s emotional response to the media and effectually, the forms produced. The cognitive level involves analytical thought processes in relation to problem solving while its partner, the symbolic level constitutes a new level of awareness and ability to relate symbolic formations with the thought processes or emotions behind them. Finally, when one employs creative thinking, they are able to negotiate the levels of the ETC with a heightened sense of stimulation

(Lusebrink, 1990).

Benefits of Using the ETC in Therapy

The ETC utilizes the dichotomy of emotional vs. cognitive thought processes as an integrative and self-actualizing experience for people in therapy. It can provide structure and a place to begin with a client when or if a therapist is ever unsure how to proceed. In many instances a therapist can employ the medium itself to help locate where a client may be functioning within the continuum in order to determine their next step of action, or which level would most benefit and progress the success of their client by having them choose which medium to use in an art experiential (Hinz, 2009). Because every client functions at a different

level and may have different goals, a continua structure is ideal. Furthermore, it may be beneficial for some clients to be regressed in the continua in order to better grasp reality and reform basic cognitive processes before adding the integration of affect or abstraction. For this reason a typical journey of a client in therapy to travel through levels of the ETC can take several sessions, in which they may never reach their full creative potential or enlightenment. This paper presents a hypothesis in which the stigma of the word “therapy” is replaced with the notion of an expressive art “experience” and applying it to the general population. The study proposes that making the ETC more applicable to different set of clients may yield positive results in the ability to manipulate a higher functioning sample through the levels of the ETC in just one session.

The ETC as a Facilitator of Creativity

Lusebrink (2011) established three main criteria for what makes art therapy as opposed to other therapeutic interventions unique; “the use of art media as a means of expression and communication, the multi-leveled meaning present in visual expressions and the therapeutic effects of the creative process” (p. 168). She further proposed that the ETC is a theoretical model in which art therapists can utilize the aforementioned criteria of which the structure is directly based. Clients’ movement among the varying levels of the ETC from the “bottom” of the scaffolding (kinesthetic /sensory) to the top stage (cognitive/symbolic) is representative of ability to function and process visual imagery at a higher level. The movement of the client from the left side levels, (kinesthetic, perceptual and cognitive) to the right side (sensory, affective and symbolic) or vice versa is representative of them engaging in either more contemplative cognition or emotional affect (Lusebrink, 1990). If they can engage and integrate both sides at

the same time or move vertically through the levels with ease; they ultimately demonstrate a higher employment of creativity (Hinz, 2009).

The Media Dimensions Variables

The Media Dimensions Variable (MDV) is a tool used to distinguish characteristics of media based on a continuum scale which include; fluidity, level of structural complexity and maneuverability (Lusebrink, 1990). An art therapist will use characteristics of the medium to help them manipulate the client through the levels of the ETC. For example, if a person was ready to go from a purely kinesthetic stage in which one would employ a very fluid medium such as poster paint; to the perceptual level, they may consider a more structured medium such as pastel or colored pencil in order to capture things that the client perceives with more clarity such as, light effect of dimension.

Creativity, Flow, Mindfulness, and Positive Psychology: How They Relate to Art Therapy

"Some creative arts therapists would go so far as to say that enlightened individuals seek out diverse experiences representing all components of the ETC in order to enjoy the flow, the self-actualizing properties of the creative process" (Hinz, 2009, p. 35). The ETC was chosen as the model to use for the proposed study because it provides a stimulating environment that encapsulates a balance of freedom of expression with being mentally and emotionally challenged. It offers a group experience that provides support and feedback and forces the clients to concentrate, as opposed to offering them an open studio in which not enough structure or direction could lead to higher levels of mental chaos and disorder, therefore not creating an environment conducive to the flow experience.

To think creatively, in terms of the ETC, requires the appropriate levels of “focus, motivation, spontaneity, expansiveness, openness and self-acceptance” (Lusebrink, 1990, p.109).

In short, a creatively-minded person may exhibit an ability to create a sort of order out of chaos

(Lusebrink, 1990). More recent research on creativity has shown that creative thought processes often involve front to back, convergent and divergent processes that call for a balance of concentration and reflective distance (Hinz, 2009). Implementation of the ETC and its correlation structure provides a framework for these processes to happen (Lusebrink, 2010).

Kramer and Wilson (1990) define creative art expression as; “characterized by economy of means, inner consistency, and evocative power” (as cited by Lusebrink, 1979, p. 109). Hinz

(2009) described how the creative product in art therapy can “represent the transformation or reformulation of a problematic issue or situation: it contains and explains the solution” (p. 182).

Moreover, it is an outward manifestation of successful internal integration of ideas. Regarding the ETC Kagin and Lusebrink (1990) acknowledged that creativity may occur on all levels and is a synthesis between; “inner experience and outer reality, the individual and media utilized, and different experiential and expressive components of the ETC” (as referenced by Hinz 1978, p.

170). Finally, Hinz (2009) described that when one is engaged creatively through utilization of the ETC:

What can emerge from such self-actualizing experiences is a profound sense of joy as

one realizes talents, capabilities and potentials. A new manner of knowing oneself can

prevail when creative experiences are internalized from self-actualizing growth. (p. 187)

Creativity is also important in lieu of the aging brain in all populations; tactile and haptic exploration of the senses engaged in activity has been shown to re-build lost connections and memories (Riley, 2011).

As one grasps how the creative level of the Expressive Therapies Continuum is able to help integrate two extremes of a continuum in a creative way; connecting meaning to thought through the manipulation of various art media. Being one of the most complex systems in existence; the brains’ systemic and individualized function will be compared to the corresponding levels of the ETC; with a concentration on how creativity specifically integrates cognitive and emotional processes. Singer (1974) believed the transition between levels of the

ETC can ultimately lead to a higher sense of “interest, motivation and joy” (as cited by

Lusebrink, 1990, p. 121). Because the central integrative function of the ETC involves one's ability to transition both horizontally and vertically, mimicking top-down/down-top and hemispheric movement seen in information processing in the brain, in a way in which self- actualization creative level; or to incorporate it in as many levels as possible then

Csikszentmihalyi’s theory of flow, an almost out-of-body experience and cultivation of creativity is relevant when discussing the ETC. Csikszenthihalyi (1996) described the process of achieving flow as having nine central components:

1. There are clear goals every step of the way.

2. There is immediate feedback to one’s actions.

3. There is a balance between challenges and skills.

4. Action and awareness are emerged.

5. Distractions are excluded from consciousness.

6. There is no worry of failure.

7. Self-consciousness disappears.

8. The sense of time becomes distorted.

9. The activity becomes autotelic (pg. 111-112).

Therapeutic Mindfulness (Mindfulness-Based Psychotherapy)

Recent studies by art therapists that incorporate mindfulness in some way into their therapeutic methodology whether it be intervention-based, a personal practice to remain non- judgmental, present and more aware with their clients, or explicit teaching of mindful practices in daily life for clients in need of cognitive-behavioral strategies, have sparked interest in the potential benefits of employing mindfulness as a theoretical basis for providing therapy (Germer,

2005a). Chilton & Wilkinson (2009, 2013) recently explored how positive psychology may be implemented into art therapy treatment by utilizing the existing framework consisting of focusing on strengths rather than pathology. The resulting practice is referred to as "positive art therapy."

How Flow, Mindfulness, Positive Psychology and Art Therapy Relate to Flourishing

"It is easier to diagnose what is wrong with one's life than to cure it" (Csikszentmihalyi, 1992, p. 261). The flow state and or/experience relates to flourishing in that the more experience one has with flow, the more "happy" and "satisfied" a person seems to be (Csikszentmihalyi, 1996).

A direct corollary associated with one's predicted ability to flourish, is the ratio of higher positive to lower negative affect. Affect encompasses both one's initial experienced emotions or moods as well as the resulting positive or negative outcome attitudes and behaviors. The way Frederickson

(2005), explains how affect functions as it relates to flourishing is comparable to positive and negative feedback loops as they relate to nonlinear dynamic systems. Responsible for either the amplification or stabilization of the feedback we receive, (+ or - attitudes we acquire) is the level of complexity or chaos in any given nonlinear system (Frederickson, p. 680). Variation within chaotic systems or its unpredictable nature, has shown to enhance resiliency and longevity by

nurturing adaptable and flexible qualities on multiple levels (neurological-->behavioral)

(Frederickson, 2005).

Csikszentmihalyi (1996) stated, "When we think intentionally, thoughts are forced to follow a linear, logical--hence predictable-direction" (p. 138). When only partial attention or semi-automatic activity is taking place, "part of the brain is left free to pursue associations that normally are not made" (Csikszentmihalyi, p. 138). What Csikszentmihalyi was suggesting, was that by inhibiting aspects of our consciousness, in which mindfulness also plays a part, we are essentially allowing chaos to take over. He also refers to entropy, the 2nd Law of

Thermodynamics several times throughout his writings, using it as a metaphor to illuminate the

"mental chaos" that occurs when order and disorder are involved in a perpetual battle as new experiences constantly re-shape and inform feedback or attitudes that influence behavior. Mental processing can then occur in fractal formations, creating novel connections and "broadening mindsets" (Frederickson, Losada, 2005). Freeman also stated, "Chaos underlies the ability of the brain to respond flexibly to the outside world and to generate novel activity patterns, including those that are experienced as fresh ideas" (Freeman as cited by Frederickson, 2005, p. 680). This relates to art therapy because in this study, art therapy directives will provide a certain level of structure (or chaos), causing participants who are novice artists to have to react flexibly and be creative. Csikszentmihalyi (1996), furthermore stated, “The process of discovery involved in creating something new appears to be one of the most enjoyable activities any human can be involved in” (p. 113). By building on the participants' ability to be more flexible and creative, the study upholds the notions introduced in positive psychology and utilizes mindfulness practices to simultaneously enhance focus needed for flow. How everything relates back to flourishing is stated simply in the table below.

Figure 1: How Everything Relates Back to Flourishing

Brain Research and Implications for Efficacy of Art Therapy

Within the span of art therapy's existence and acceptance into the therapeutic arena as a legitimate profession, the literature available connecting interventional art-making with other relevant disciplines such as neurology and physiology is unfortunately wanting. In doing research for this study I found that the more readings I did outside of our own arena, the more opportunities for collaboration with these other fields arose. Beyond opportunity, was even a call for interventionalists to help stimulate change in an effort to augment studies being conducted by professionals in both the biological and medical fields? Dr. Goldberger of Harvard Medical school suggested in his research that complexity, a type of physiological chaos that often manifests in the physiological structure as fractals, are indicators of healthy physiological functioning. Disease, illness and aging actually begin to form predictable patterns that are more easily recognizable by doctors. He suggests that in an effort to maintain and restore multi-scale

complexity there are therapeutic interventions that can promote flexibility and adaptability in these structures, or as Frederickson and Losada (2005) were saying, "broaden mindsets." What was it that he introduced as the key component to increasing complexity? None other than creativity, and its potential impact on generating health, seen on the molecular level.

Summary

What this research proposes is that when one is able to engage in the act of creating, one may be more likely to experience something very similar to what Czikszentmihalyi described as flow. As suggested by Czikszentmikalyi (1991), the more one experiences flow, the more balanced they become in various areas because their level of happiness appears to increase. The similarities between the outcome of experiencing flow and the more modern psychological concepts including the practice of positive psychology and mindfulness-based living are being presented in this research as complimentary ideas. When combined, these concepts begin to form a new way to think about how to utilize a more preventative art therapy treatment modality to use in community settings with broad a broad range of populations.

CHAPTER 3

METHODS

The following chapter will explain how the concepts, theories and constructs discussed in the literature review will come to function simultaneously, as they are utilized in the practice of art therapy. First, the central paradigm that informed the theoretical framework for the proposed research design will be discussed. Subsequently, the research questions will be restated, procedures will be presented, including how the participants were chosen, details including specific features and examples of the scale and questionnaires to be used in the study, further insight into how the data will be both administered and collected and a discourse on the session structure. The section will draw to a close with the analysis of data, discussion on the use of triangulation to increase validity and the standard ethical protocols that will be adhered to. As a final point, limitations of the study will be addressed.

Interpretivist/Constructivist Paradigm

The overarching paradigm that epitomizes what this research hopes to accomplish is the

Interpretivist/Constructivist perspective. With philosophical roots in Husserl's phenomenology

(1859-1938) this paradigm upholds that the conscious experience with external phenomena in turn, forms resulting attitudes and behaviors. The interpretive component refers to a more hermeneutic investigation in which, rather than deny the existence of pre-established curiosities and experience the interpretivist or researcher acknowledges their interest and incorporates their familiarity with the phenomena being investigated. In turn, the analysis combines the researcher's interpretation of the data collected with insight into how the results might also be phenomenologically affected. Hermeneutic analysis is vital in the data analysis of this study because it offers a method for collecting and interpreting text, which will be an important aspect in drawing conclusions from the participant's recorded dialogue and commentary that is

transcribed for further inquiry. The intention of the Interpretivist/Constructivist is to observe and examine what constitutes "lived experience" as it relates to particular phenomena; extract patterns of similar responses from the participants and construct a thematic premise.

Consequently, in conducting research this study will rely heavily on qualitative thematic analysis. The guidelines proposed in Smith's (2008), Interpretive Phenomenological Analysis

(IPA) are utilized in the interviews conducted because they maintain both the interpretive and phenomenological undertones exhibited in the Interpretivist/Constructivist paradigm.

The constructionist component of the paradigm emphasizes the notion of external phenomena, or dynamic social interactions and systems having a large bearing on human experience. Because experience is so dynamic given that the "reciprocated causality" we receive as feedback causes our attitudes, behavior and overall experience to exist in a constant state of flux, it would be almost impossible to gain a holistic perspective using sole interpretive measures

(Frederickson, Losada, 2005). Frequently utilized within the scope of this paradigmatic research; quantitative analysis also serves to expand understanding of comprehensive data. In order to attain a deeper grasp on the human experience, this research employed a quantifiable module that measured more specific data relevant to the research question.

Interpretive Phenomenology

Because this study embraces several underlying constructs that assume and believe all humans contain the capacity and potential to reach a state of optimal functioning, then a main variable that is measured is the change in behavior or feeling from when the study began to when it came to an end, based on the experience in-between. The overarching Humanistic perspective supports the notion that every human has the ability to develop and sustain a more satisfying quality of life. This concept naturally transfers to the Phenomenological point of view, which

further delves into how various phenomena are experienced while maintaining the humanistic framework. Phenomenology attempts to interpret how these impressions, while in their purest form take immediate effect; consciously or unconsciously manifesting as a resulting attitude, thought, belief, sensation, memory or behavior. Art Therapy has the unique ability to extract unresolved feedback and emotion through sublimation and/or cathartic expression while operating on multiple levels of consciousness (Betensky, 2001). Consequently, phenomenology resonates well with this research, which seeks to observe human responses to new experiences and supports the standpoint that all humans reserve the capacity to transform and increase potentialities as they challenge themselves.

Going even further, this research uses a hermeneutic approach to phenomenology developed by Van Manen (1990) that emphasizes the interpretive nature of analysis in which the researcher is similarly focused on the lived experience as it pertains to a phenomena. However in interpreting the "texts" or various manifestations of the participants' responses to the phenomena, the researcher is contextually cognizant of possible predispositions that can influence both the outcome of expression by the participants such as, cultural variation and environment or the researcher's personal incentive for conducting the research, method of analysis, and academic caste. This is not entirely distinctive from the psychological or transcendental approach, in which the researcher utilizes "epoche," a concept developed by Husserl, where a comparable awareness of preconceived notions is gained, but for the purpose of then suppressing those notions so as to perceive the expression impartially, "as if for the first time" (Moustakas, 1994, p. 34). While the study highly supports the element of mindfulness included in the psychological approach, which involves non-judgment and acceptance, some of the data or "text" being analyzed is undeniably subjective, outlining the need for qualitative inquiry in data analysis. Likewise, because the art

therapy experience contained in this study aimed to facilitate a measurable change in a person's realized capacity to flourish, quantitative scales and measures are simultaneously employed and used in data analysis.

Research Questions

Taking into account the aforementioned theoretical perspectives and constructs as well as the research questions introduced in Chapter 1, the research design was composed. There is no current art therapy protocol for working with more highly functioning clients, looking to prevent the decline of positive affect and ability to flourish. Therefore, the following questions were established as guidelines for proceeding with conducting the study:

 Can healthy or more highly functioning people benefit from engaging in art therapy

experientials?

 Can art therapy be used as a preventative treatment modality for healthy or higher

functioning people to increase flourishing?

 Does art therapy provide a pathway into the flow state, contributing to the optimal

functioning and happiness of the client?

 How can an art therapist design a treatment plan that effectively challenges a higher

functioning client?

Research Design

A mixed-methods approach will be used in this study because features inherent in both quantitative and qualitative data-type and analysis are being measured and explored. By employing a qualitative methodology, this research implies that a value be placed on those aspects of immeasurable phenomena than cannot be recognized by the sole use of quantitative measures. At the same time, the scales will serve to more validly predict future outcomes, test

and measure specific features, and analyze relationships between certain variables. The questionnaires, observations and interviews will capture more of the felt essence of the experience as a whole, including the social interaction between participants (Johnson &

Christensen, 2008). While the theoretical orientation informing how the session was structured has more homology with the qualitative perspective; the measurement and statistical analysis provided by quantifiable research will supplement a more dynamic approach by adding validity to the conclusions and making it more generalizable to a wider population sample.

Procedures

Participants/Sample

The participants in this study will be consenting volunteers. Because the author has access to a local art studio, the majority of the participants will be procured at that location, resulting in a sampling of convenience. Therefore, the sampling is purposive; seeking to analyze responses of individuals with similar demographic profiles. The population contains a small sample size of normal to high functioning, persons interested and available to participate in 6 art experientials over the course of two months.

Flourishing Scale, + & - Affect Questionnaire

The Flourishing Scale (FS) consists of 8 items measuring the participant's self-reported levels of success as they pertain to the key components involved in flourishing such as; meaningful relationships, purpose, optimism, self-worth, competence, self-determination, vitality and resilience (Diener et al., 2010). The scale ranges from 1-7, with 1 being, "Strongly Disagree" and 7 being, "Strongly Agree." The lowest possible score would be an 8 if the participant selected, "Strongly Disagree" for every item, while conversely the highest score would register a

56. The higher the total score of the participant, the more positively they can be said to view

themselves as successful in the areas previously mentioned. As an example, the FS would ask the participant to use the 1-7 scale to indicate one's agreement with the statement such as, "I am engaged and interested in daily activities."

The Scale of Positive and Negative Experience, or SPANE; contains 12 items of which half measure for more positive experiences while the other half measure negative experiences.

The scale ranges from 1 being, "very rarely or never" to 5 being, "very often or always." The positive and negative scales are scored separately, and both the negative scale scores, or SPANE-

N, and positive scale scores, SPANE-P, can range from 6-30. To combine both the positive and negative scores, the SPANE-N can be subtracted from the SPANE-P. The resulting combined score, or SPANE-B ranges from -24 to 24. To help illuminate the process, the SPANE preludes the scale items by asking the participant to first consider what they have been experiencing within the last 4 weeks, and proceed to rate how often they feel the 12 mood-states provided.

Session Structure

The sessions are broken down in diagram which can be viewed in the appendices. Basic session structure includes a greeting and introduction to that day's theme, a warm up which consists of either a meditation, or breath drawing exercise; and art directive, and a closing reflection/meditation exercise. In both the first and last sessions, the participants will complete the Flourishing Scale and the SPANE scales.

Data Collection

Pre-experiential phase, consent forms as well as basic demographic questionnaires were collected and stored according to appropriate ethical considerations. Throughout the experiential phase of the study, observation notes taken by the researcher were documented and stored for further analysis. Pre and Post scales and measures were collected and stored to further analyze

for statistical thematical significance. Photographs of the participant's artwork as well as video recordings of the sessions were also collected and stored until final analysis procedures. Lastly, post-experiential semi-structured interviews will be conducted and recorded. In interviewing, the researcher utilized the guidelines created by Smith (2008) within the framework of interpretive phenomenological analysis. Guidelines and helpful instructions that were abided by included, using as little prompting as possible, asking neutral questions, not using field-specific jargon, asking open-ended questions, not rushing, not probing, monitoring the effect of the interview on the respondent and asking one question at a time (Smith, 2008).

Data Analysis

The qualitative data will be evaluated using interpretive phenomenological analysis

(IPA), which seeks to discover thematic significance. IPA was created by Smith (2008) to add in-depth qualitative research with proposed guidelines of how to achieve this within studies utilizing the interpretive phenomenological framework. Thematic analysis is consistent with the constructionist paradigm in which the researcher plays an active role in determining which themes to focus on (Brain & Clark, 2006). In this research, the personal experience of the researcher within the community studio for over 2 years effectually led to several pre-determined notions of what themes may emerge throughout the study. The researcher also will pursue deductive thematic analysis, in which latent themes can emerge in the process of conducting research. Themes will be examined and identified within the artwork, interviews, behaviors, scales and observation notes taken by the researcher.

The Flourishing and SPANE scales will be analyzed according to the guidelines proposed by Diener, et al (2010) in which the scales were both scored and further compared for psychometric statistical analysis.

Validity: Trustworthiness and Triangulation

In order to increase the internal validity for more qualitatively assessed outcomes, trustworthiness and triangulation will be highly considered throughout the process of analyzing data. Trustworthiness of genuineness of the participants in their responses must be taken into account and weighed as it pertains to both pre-post testing and in interviewing. For example, because the participants were receiving a free service which may have benefitted them in some way, or because they became highly familiar with the researcher, they may have modified post- experiential responses to help the researcher accomplish what they perceive as the researcher's intention. Therefore, the triangulation of data collected by the researcher will be incorporated in order to gain a more holistic and comprehensive view of the participant's experience from multiple perspectives.

Ethics

The proposal for this study was sent to and approved by the Florida State University

Internal Review Board (IRB) to ensure strict adherence to the ethical standards upheld by a valid research institution. Protocols were followed in regard to gathering and soliciting participants for the study, therefore participants were not contacted prior to the approval of this research by the

IRB. The research location and facility were carefully considered in regard to the safety and comfort of participants. Consent forms (see appendix) approved by the IRB prior to their distribution to the participants provided contact information of the principal investigator, supervising faculty and IRB, and claimed the right of the participant to discontinue the study at any time. Consent forms also included permission to use images of the participants' artwork for educational purposes only. Participants' names were changed to initials to conceal identifying information.

Summary

The method that will be used in conducting this research is highly reflective of the complex and unique human response to external stimuli, and how it may then be internalized and cultivated to inform future attitudes and behaviors. The aim is to capture the essence of this experience by collecting data on multiple levels and triangulate the results to attain a deeper understanding from various perspectives. Both pre-determined and latent themes will be examined using interpretive phenomenological analysis, which was driven by the theoretical constructs of flow and positive psychology and implemented into a therapeutic setting. Measures of how the participants' involvement in art therapy may affect specific components characteristic of flourishing will be included to evidence any positive change or outcomes. The method employed in this study seeks to provide the groundwork to help inform the measuring of future outcomes in different settings and populations.

CHAPTER 4

RESULTS

The following section will present the outcomes of the research study. This will include the procedure describing how the participants were gathered, the location of the facility in which the study took place as well as a more detailed account of what each of the six sessions entailed.

Following the session breakdown, quantitative results evaluated based on the questionnaires and qualitative analysis taken from semi-structured interviews will be provided including images of the participants' creations each session. Ultimately the results will reveal improvement in all measures for positive and negative affect experienced, and in all eight areas comprising flourishing but one.

Research

The data for the study was gathered over a course of approximately one month. Nine participants joined for two sessions a week, Tuesdays and Thursdays for three weeks for a total of six sessions. Seven participants were female and two were male. Each session lasted approximately one hour and fifteen minutes, with some extra time allotted at the end to finish if needed.

Participants also each completed a post-study semi-structured interview with the principal investigator. They also completed the pre-post session measures as well as a brief reflective log recording their level of comfort, control, interest and notion of how fast time passed at the end of each session.

Participants

All but three participants attended a class at the local painting studio open to the public that teaches painting classes in a relaxed and casual atmosphere and on a one-time basis. During their class, they were presented with the opportunity to take part in the study. Over 20 attendees signed up for the study in one day. Seven of the studio attendees were chosen to participate; 5

women and 1 man. An additional male participant and two females who did not attend the studio but heard about the study, volunteered to participate. All nine were agreeable in the times they would be available to meet for the sessions and thus, were included in the study. All participants accepted the terms of consent.

Because several of the participants came from the studio and were informed of the study on the same night, several of them knew each other. TO came to class and signed herself and her daughter, AO up to participate in the study. TO indicated she was grateful and excited for the opportunity for herself and her daughter to engage in art therapy experientials. Both women had recently been in a series of car accidents, leaving them with resulting minor brain damage and dysfunction in fine motor skills, especially the mother, TO. BR had come to the class, signed up to participate and told her friend, MV about the study. AO and MV both wanted to come despite not having taken a painting class. CM and JW attended a class together and both signed up to come, as well as CF and DU who came to another class the same day.

The majority of the participants had very minimal experience with painting or doing art on a regular basis. The participants from the painting studio had taken 2 classes or less before the study began, except for TO, who claimed doing art on her own had been a way for her to relax since the accidents and resulting complications due to her injuries. The participants not from the painting studio had no art experience since elementary or middle school. The fact that the large majority of the sample comprised of novice artists or painters is important to note because this is a point of departure from Csikszentmihalyi's concept in flow. Csikszentmihalyi discusses the need for a person to exhibit a certain level of mastery over an activity to be able to reach the flow state (1996). I do not think he was stating that it was necessary for a person to be a "professional" however, in his view; one must reach a level of understanding in which the activity is familiar or

learned enough that it has become an automatic process. In this case, this research challenges this notion and suggests even a novice can enter the flow channel with the proper structure and environment by an art therapist.

Participant summaries.

The following section outlines the participants' background information. Sex, age and occupation is listed next to the participants' pseudonym. In order to attain a more detailed description of the participants, additional comments and/or characteristics regarding the participants' history or personality that may have affected the study are included.

Table 1: Participant Summaries

Pseudonym Sex Age Occupation Subjective Comments (Identifier) CF Female 39 Educator "This was amazing, I want to paint now."

JW Male 39 Office manager "I liked when you gave us free reign."

CM Female 33 Scientist "I can be like, yay I'm not working...!"

TO Female 49 Former Registered Nurse "I am currently on disability due to injuries resulting from series of car accidents."

AO Female 19 Student, office assistant "I don't paint, I sketch."

MV Female 21 Student, resident assistant "Did you take into account left brain/right brain?"

BR Female 21 Student "The most stressful thing was the unknown."

DU Female 37 Director of Admissions in "I was most worried about whether or not I a University would finish in time."

JR Male 34 Massage Therapist "I've never attended an art class as an adult."

Facility

The research study took place in an art therapy studio classroom within Florida State

University's Department of Art Education. Nine large tables were set up in a circle for every session. Upon entering each session, the participants found a 12' x 18' canvas set up on an easel, an apron, painting utensils, paint, paper towels, a rinsing cup and a log to note their observations.

The log, filled out at the end of each session, was used to depict each participants' current state.

An example of the log updated each session is shown in Figure 2.

Figure 2: End of Session Log Sheet

Session Structure

The sessions for the study were first described to the participants as a painting lesson with acrylic paint on a canvas. Each session introduced a specific directive using these materials.

The participants did not know ahead of time exactly what each session would encompass, other than that they will learn how to do something different each time. Each session was planned to

contain varying levels of control and structure so as to affect the level of difficulty, anxiety, engagement and notion of time. These components related directly to Csikszentmihalyi's (2004)

"flow channel", seen in figure 3, in which one may be said to reach flow when maintaining a balance between challenges and skills. One of Csikszentmihalyi's central observations, is that time passes "differently" for those who experience flow, in that it becomes distorted or suspended. There is little sense of how fast or slow it progresses. In order to begin to look at how this relates to what people experience when people are painting, I asked each participant to reflect on time at the end of each session, as well as to put the sessions in order from slow to fast in their final interview. The participants were always given the choice whether they wanted to follow instructions/suggestions or paint freely in their own style.

Figure 3: Flow Challenges vs. Skills

Session Summary

The following section will describe how each session was structured, as well as what occurred throughout, through record of the paintings created, and objective/subjective observations made by the researcher. Responses noted by the participants, through their session

logs, comments and behaviors will follow each description of the sessions. Subject or content of the artwork created will not be discussed at great length due to the scope of this study, however the level at which they participants were functioning in regard to the ETC as a response to the structure will be explored, and should be explored further in future studies.

Session 1: Painting the Vortex & Body Scan-Some Structure/Some Control

Session 1 began with the participants completing the Scale of Positive and Negative

Affect Experience (SPANAE) and Flourishing Scale (FS) as defined in Chapter 3. The participants were then shown how to complete a short exercise in which they were asked to create a breath drawing using Mr. Sketch scented markers on newsprint paper. Drawing one's breath involves using a drawing utensil to illustrate how the inhale/exhale is experienced by steering a line towards the top of the surface and back towards the bottom for the exhale, similar to peaks and crevasses in a mountain scape. The drawings are considered complete when the participants have gone across the paper three times breathing in and out. An example of a participant's breath drawing is shown in figure 4. The intention was to ground the participants before engaging in the art making process by having them focus on their breathing, placing them in the present moment. These particular scented markers were chosen for this exercise to further engage sensory pathways and increase present awareness.

Figure 4: Breath Drawing

Participants were then instructed to paint a "vortex" for the next 45 minutes. For this, they were asked to choose three colors and begin in the center of the canvas creating concentric circles from the center outward toward the edges. Without picking their brushes up, they were taught how to transition from one color to the next, and how best to begin moving from the center to the outer edges while continuing to only paint in a circular motion. Participants were encouraged during the last 30 minutes to switch colors as many times as they wanted. The participants were informed when there were 10 minutes left to paint. The paintings completed by the nine participants are shown in figure 5. Once the paintings were finished the group was led through a "body scan", ending in a brief guided visualization in which they were asked to picture themselves in their "happy place." This provided a calming atmosphere.

AO BR MV

MV CM JR

TO CF JW

Figure 5: Session One Art 42

The participants were guided in how to consciously think about how they were feeling physiologically by scanning from their head to their toes. They were asked to focus on points of pressure and letting go of tension by compressing certain muscles on the inhale, and relaxing on the exhale. An example of this would be raising ones' shoulders up towards their ears and holding while they inhale, fully releasing and relaxing their shoulders on the exhale. This would be repeated up to three times prior to moving to another part of the body.

Participants were instructed to use each sense to experience and be present in their respective happy places. For example, I made statements such as, "In this place, what do you smell, what do you feel, what do you see and what do you hear. What are you doing? Who are you with?" The session came to a close and participants were asked to reflect on a sheet of paper their levels of anxiety, interest and control. Throughout the session, relaxing music was purposely played to also add an element of serenity and comfort.

Participant responses. During the initial session, the participants arrived on time. There was a sense of tension and anticipation among many of the participants before directions were presented on how the session would progress. This may be seen as not knowing what the sessions would entail. This was later corroborated in the post-session interviews. They seemed to become more relaxed as they painted the vortex, focusing on the transition from color to color.

The participants that knew each other sat next to each other. Many of them joked and laughed to ease the tension before the session began. Although not asked to refrain from talking, the participants barely spoke to each other while they were painting and doing the breathing exercises. They felt comfortable to ask questions when unsure of the directive, such as during the breath drawing. Some of the participants also commented on liking the "relaxing music" playing in the background. One participant wrote that she felt more anxious than relaxed during this

session in their log at the end of session 1, and two rated that they felt more worried than in control. Five participants indicated in the end that painting the vortex was the most relaxing session.

The three participants that stated having felt most anxious and worried appear in the left hand column in Figure 5. In AO's, the colors are predominantly taken over by very dark black smearing of the paint. MV put too much effort in trying to control the paint. Although she wanted the colors to transition smoothly into each other, she continued dividing the colors instead of letting them blend, unsuccessful in getting her desired result by not being able to relinquish control. In TO's, the colors again are not being allowed to blend as instructed, but very fast paced short strokes were layered on top of each other instead of keeping the brush on the canvas without picking it up to create a gradient. The painting in the top left corner, created by the participant who overall rated the most negative scores at the end of the session was the only one who kept painting after the body scan. She was a 19 year old student, the youngest in the study. She claimed to "only do sketches." However, by the end of the session she was smearing the black paint around the canvas with her hands exclaiming, "I'm finger painting!"

CF, a 39 year old female educator claimed that the vortex was not only the most relaxing to her, but something that she would like to continue to do on her own. She later indicated that painting "helped to forget everything else stressful." At the end of the study, JR commented that his "..favorite part was the breathing exercises and body scan. I wish they were incorporated into the beginning of all the sessions."

Session 2: The Collaborative Painting- The Most Structured/Little Control

The participants were instructed to begin this session by doing another breath drawing, this time painting them onto their canvases instead of using paper and markers. They were then

instructed to place their brushes in their water cups, take their paint and palette and shift one seat to their right. I explained that the participants would be shifting every 5 minutes to the next canvas until they returned back to their own for a total of nine rotations. At every canvas they were instructed to complete one step of what would become a painting of a tree. They received a notification when there were two minutes remaining at each canvas.

During the first two rotations the participants covered the remainder of the background.

During the next four rotations, participants began painting the tree, starting with the trunk and expanding it outwards. Each time they switched they were shown how to complete the next set of "splitting fractals" or the point where the branches split off. The last three rotations the participants were shown how to add leaves to the branches. When the participants returned to their painting they were allotted extra time to "finish" them, in which they were given the choice of keeping certain things or painting over them. Upbeat music was again played in the background, familiar hits from the 1990's. Participant's paintings are shown in Figure 6 below.

Participant responses. The participants arrived and, without prompting or direction, sat in the same seats as the prior session. They initially did not seem as tense as the first session and were eager to hear what they would be doing. They all engaged in completing another breath drawing, using paint on their canvases instead of markers on paper. I could see that most of them were truly making an effort to take deep breaths and focus. After I announced that they were to switch and paint on each other's canvases they immediately became more tense. Many participants looked surprised and apprehensive, however, they were willing to try the exercise.

Towards the end when they were told they could decide if they wanted to change anything on their own canvases they could, three out of nine of them made major changes. The remainder of the participants kept their paintings as they were.

Many of them agreed that it was stressful painting on someone else's canvas in fear of

"messing them up." Contrarily, in the post-session interviews many of them individually told me they were actually stressed about their own paintings getting "messed up." CM later commented that she would have been less anxious if they were not taking the paintings with them at the end of the study. "Ownership really came into play" when they had to experience others' painting on their canvas as well as having to paint on others'.

Five participants indicated on their log that they were closer to feeling anxious and worried at the beginning of the session; by the end however, they felt relaxed and in control. The variable of engagement remained constantly high. One participant marked relaxed, engaged and in control throughout the session. Another became more worried and anxious, commenting in the post session interview that she actually felt angry after because she did not like her painting. A third felt more in control, less engaged and less relaxed. Finally, one participant felt more in control but less relaxed.

Four participants later indicated that this was the most challenging session, two chose it as the most enjoyable, and one found it to be the most relaxing. The participant who chose this session to be the most relaxing, is one out of two participants who commented that time seemed to pass slowly. The other participant, who rated time as passing slowly, also claimed that this session was the most enjoyable. When averaged, this session ranked as the fastest session overall, meaning time was perceived as passing the fastest by the majority of the participants.

Coming into this session, I anticipated the lack of control and drastic increase in structure would cause the participants to react strongly. The majority of participants audibly gasped when they were asked to change canvases; they looked very surprised. Many of them glanced at each other and then at me as if I were joking. When they first learned they would be switching

canvases, many grew more anxious and became hesitant and unsure in how they would continue painting on others' paintings. Participants commented on having a difficult time deciding if they should paint what they wanted, or try to paint in the style that already existed on the canvas when they got there. Several participants also mentioned feeling the most self-conscious during this session because they were indirectly forced to compare their ability or technical skill to others'.

This session also became paradoxical as the results were gathered; it was viewed as by the majority when averaged as the most challenging session overall, however two individual participants rated this session as their most enjoyable. MV and CM, the two participants who thought it was the most enjoyable also thought it was challenging, however they perceived a challenge to be enjoyable. This notion will be revisited in the Chapter 5 discussion.

CF JR MV

JW AO MV

DU CM BR

Figure 6: Session Two Art

Session 3: Structured Landscape Lesson-Semi-structured

In this session, the participants were guided through a step-by-step lesson on how to paint a landscape beginning with the background sunset, foreground and ending with a tree with hanging moss. I carefully timed each section, giving advanced notice every time we would begin to work on another section. I gave advice and guidance on how the participants could paint each portion throughout the session, answering any questions they had along the way. The participants completed a breath drawing while their backgrounds were drying towards the middle of the session, completing the tree in the foreground at the end. The breath drawing was again completed using Mr. Sketch scented markers on paper. I gave less guidance for the tree, letting them try to remember from the previous session how to put all the steps together on their own canvas. This session was designed to be in the middle of the continuum for structure and control; providing the participants with guidance while allowing them freedom to venture away from instruction, making their own decisions as far as color, composition and details was purposeful.

This session also most closely resembled the structure in place at the painting studio, in which an instructor stands on a stage with a completed painting to their left and a blank canvas to their right. The instructor goes through the painting step by step with the students until they all have a finished product like the example painting. An example painting was not provided for this session so as not to indicate to the participants that their painting was "supposed" to look like anything. I did paint alongside the participants in order to teach them how to do certain things, however I encouraged them to make their own decisions, and stressed the unimportance of how it looked in relation. Participant's paintings are shown in Figure 7 below.

JR CF

TO BR AO CM

Figure 7: Session Three Art

Participant responses. Participants seemed less talkative through this session and seemed to maintain a more constant balance between focus and relaxation. JR commented, "Last week felt rushed and this week not at all." All participants marked that they felt more relaxed rather than anxious, more interested than bored and more control than worry during this session.

A few participants commented that the only thing that made them anxious were their expectations to create a "good" painting in their own standards. CF commented in the final interview that not seeing what the painting was to look like helped make it less stressful; "Less structure was helpful, seeing what a final product should look like is more stressful in beginning.

The more realistic the more stressful-when it's not realistic it's not as stressful because it doesn't have to look like anything, I can be more creative when there is less structure."

The post session interviews revealed that one person rated this session highest in each of the three categories; most relaxing, most enjoyable and most challenging. Compared to the other sessions, participants did not seem to take special note of this class as being memorable as it was only regarded one time when participants were asked to rate the most enjoyable, relaxing or challenging, and time for many passed more slowly. In my opinion, anytime a facilitator paints 49

or teaches something to a group, the student is going to compare what they are painting to the teacher's painting. Although some participants commented on liking the fact that there was no example, I think they were more focused and quiet during this session because they were paying close attention to trying to model aspects of their painting to match the example. This seemed to cause some, especially JW (top left corner) to not be as invested in the session because they would rather be painting something less specific, while the participants who really wanted to learn and perhaps were more competitive with others worked harder to create a "better" end product.

Session 4: Introduction of other Tools- Little Structure, Little Control

This session began by introducing other tools to paint with other than brushes. The participants were first instructed to use their sponges to paint their breath onto the canvas as a grounding exercise as well as to acclimate to using something different. The participants were then instructed to continue to use the sponges to create more of an abstract background, meaning it did not have to look like anything specific but just to not be afraid to play and experiment.

After painting with the sponges for about 30 minutes I introduced Q-tips as the next tool they were to paint with. I mentioned several things that could be painted using Q-tips as well as how some artists used only dots in their paintings. Participants were encouraged to paint whatever they wanted for the remainder of the session, urging them to be more expressive. Structure and guidance were purposely less clearly delineated than in the prior session as to continue to challenge their levels of anxiety, control and engagement. Participants' paintings are shown in

Figure 8 below.

Participant responses. In the final interview several people really enjoyed using the other tools because it allowed "whatever was inside me to come out." JR commented, "The time

passed quickly without any sense of it. In a 'time flies when you're having fun' kind of way." Six other participants agreed that time went "very fast...smoothly and quickly." Two participants thought time went slowly and noted in their log, that they felt more bored and anxious than in previous sessions. While most of the participants seemed to have fun experimenting with the new tools and became focused as the session wore on; one participant grew more frustrated.

About half way through the session MV stopped painting and stared at her canvas for several minutes. She claimed she did not know what to do when given a free choice of what to paint.

MV's painting is on the top left, a green and pink abstract painting with little detail and energy.

AO, the other participant who rated the session as going more slowly completed the "wish" painting to the right of MV's. She referenced a stereotypical aspirational painting, depicting text along with a genie lamp.

MV AO BR

JR CF Figure 8: Session Four Art

Session 5: Painting to Music/ Mandala-More Structure Less Structure

When the participants came to the 5th session, there was already a circular shape taped over the center of their canvas. The participants were asked to ignore that piece of paper and paint the background of the canvas around it. They were then asked to listen carefully to the first several songs and to try to visualize the colors the music elicits. The participants were asked to paint those colors onto the remaining canvas. For the next set of songs the participants were again asked to listen carefully, however this time to picture what type of shape or movement a particular sound within a song would look like, and to paint that on the canvas as well. After those songs had ended the participants were asked to remove the circular shape, leaving an empty white circle in the middle of their canvas. Participants were then instructed to paint within the circle for the remainder of the session. Several participants requested using the sponges and

Q tips during this session. Participants' paintings are shown in Figure 9 below.

Participant responses. Participants indicated in their written log; "Time flew by, time went by way too fast, FAST, moderate, REALLY ENJOYED; pretty fast, especially when we got to the center thingy; fast, and SLOW." Three participants later indicated that the session in which they are asked to paint music was one of the most enjoyable. One participant found the mandala center to be the most challenging out of all tasks in the study because they went from

"having free reign" to "having to focus on symmetry."

Several participants seemed to not understand exactly how painting to music would work at first. When I described that it would be similar to one of the opening scenes in

Fantasia, where the different instruments created different movement and vibration, many nodded their heads. I also used the phrase, "If it is still too challenging, focus on one tone or

instrument and imagine, if what that sound could look like", which also seemed to help them begin the painting more easily.

When they were told they could begin working on the blank white circle to create a mandala, some were able to go into the painting easily, while others became more anxious. Some stated they felt they were being reintroduced to intimidating blank space by being given free choice as to what to fill it with. Some stated that the idea of making things symmetrical was stressful while for others it seemed to make it easier.

CM MV

BR AO

DU TO

JR JW

Figure 9: Session Five Art

Session 6: Response Piece-No Structure (open studio)

When the participants entered the final session, all of their paintings completed in prior sessions were laid out on their tables for them to review, along with their easels and painting supplies. Participants were instructed to spend the first several minutes looking at their paintings.

They were then asked to reflect on their experience over the past three weeks in the painting sessions. They were told they could use what they had learned, inspiration from one or many of their previous paintings or anything that came to mind when reflecting on the sessions to complete a response painting. All tools were available, including sponges and Q-tips, and no structure regarding what to paint was in place. I told the participants if they needed help or advice on how to technically paint something to ask. Music was put on to play as background sound. At the end, clients filled out the same measures as they had before; the Scale of Positive and Negative Affect Experience and the Flourishing Scale. They also filled out their session logs and noted how fast or slow time seemed to pass. The participants' paintings are shown in Figure

10 below.

Participant responses. The participants were surprised when they entered the room to see all of the paintings they had completed together. Many of them seemed to enjoy looking at them, while others immediately stacked them before they were told they would be using them to create the final piece. Initially voicing her dislike of the absence of structure, MV fully embraced more expressive marks by making handprints all over the canvas (top left corner). This could be a rebellious act against another session devoid of structure, or perceived as her ability to let go of her need to control the paint.

JR wanted to use elements from each of the paintings as a starting point; he added one component from each into the final piece. He chose something he found significant in each of his

prior paintings to add into the final piece, this led to a highly symbolic final painting. JR stated feeling, "confident" due to having "technical references from which to work." DU began with a similar chevron pattern as the painting she completed in session 4.

In the final interviews BR named this session as the most challenging because it had no structure, and therefore caused time to go slower than usual for her. Conversely, AO rated this session as the most enjoyable, for the opposite reason. She preferred there to be no structure, and claimed that she could concentrate more when she felt she was working by herself.

Some of the participants learned to reach a symbolic level. For example, DU, was always preoccupied with having a beautiful finished product. She claimed that whether or not she thought she would finish, determined her level of anxiety. She was one of the few participants who stayed later to re-work her collaborative painting, covering what others had done. She began painting a stereotypical chevron pattern during this session, one of the painting studio's most requested classes. Although originally intending to put a "monogram letter" in the center she changed her mind and instead painted a chart filled with her family's birthdays.

JW put a lot more effort into this painting, creating a landscape with a path disappearing into dark mountains with the sun setting behind them. Although he seemed disinterested in some sessions, he really focused throughout the entire hour and fifteen minutes. In the interview he explained how he would be moving to a new state within a few weeks. Although the stress of having to move was high, he stated being grateful to take time to paint because it helped him relax. CM, either consciously or unconsciously painted using sponges and Q-tips, something that looks like what she would likely find under the microscope. This seemed appropriate, as CM was a neuroscientist. She chose once again, to use the sponges and Q-tips despite the availability of the brushes after having realized her increased ability to be more expressive with those materials.

MV JW

JR AO

CM BR

DU TO

Figure 10: Session Six Art

Quantitative Results

The following section will present the quantitative findings from the various scales used in this study. This includes the Scale of Positive and Negative Affect Experience and Flourishing

Scale.

Positive and Negative Affect Scale

In order to gain a clear visual of the results, the positive and negative elements within the questionnaire were separated and coded numerically from 1-5. One represents being the least experienced and 5 was experienced "very often or always." These feelings were; positive, joyful, contented, happy, pleasant and good. Each participants' pre-session response was averaged for each measure and compared to the post session response. The results are shown below in Figure

11. Positive affect responses increased on every measure, meaning that each of these emotions was experienced more from pre to post session in daily activities and life outside the study.

Figure 11: Averages: Change in Positive Affect Pre-Post Sessions

Similarly, the negative feeling-states were coded from 1-5. These feeling states were, angry, unpleasant, afraid, bad, negative and sad. As shown in Figure 12, the negative affect experienced decreased on all measures but one, which remained the same over the course of this study. The measure that remained the same was "unpleasant."

Figure 12: Averages: Change in Negative Affect Pre-Post Sessions

Flourishing Scale

The flourishing scale was also numerically coded from 1-7, one being "strongly disagree" and seven being "strongly agree." The pre-post session responses were then averaged and plotted to view the differences. Over the course of the study, flourishing measures showed to have increased in all measures except one. The statement, "My social relationships are supportive and rewarding" decreased by .44 having been rated an average of 6.22 pre-session and 5.78 post session. A chart indicating these responses is shown below in Figure 13.

Figure 13: Averages: Change in Flourishing Pre-Post Sessions

In the post session interview, the participants were asked if they thought their experience was affected by knowing another participant. The participants who did know another were also asked if they thought they would have still come to the sessions had the other not signed up as well. This question was added to the semi structured interview in order to look at the impact of social settings on one's ability to reach a state of flow and increase well-being. Every person who was asked this question, responded that they did not think it affected the results, and that they would have continued to come to the sessions had they not known someone else. CF and DU agreed that knowing someone did help with feelings of anxiety regarding coming to the initial session, when they did not know what to expect.

Qualitative Results

The following section outlines several predominant themes which were found through cross-analysis of both the quantitative findings and the post session interviews, observations and comments collected throughout the sessions.

Motivation, or Something Else?

When asked why he participated, JR commented "I felt it was a new opportunity to express myself." He also reflected on how he noticed that everyone who participated seemed naturally excited about painting; that this type of session called for people to have a desire to learn and express themselves. He wondered what would happen if there were participants who did not care about learning these skills or painting.

This idea was mentioned in chapter one, as I had recognized that it would probably take a person like those who frequent the painting studio to want to engage in the process of art therapy; a person who has an innate drive or intrinsic motivation to want to challenge themselves; those who recognize that they are stressed and want to try something to alleviate it.

For example, the rehabilitation therapist mentioned in chapter one, is a frequent client at the studio. She had stated, "Well, it certainly is good mental health therapy." As a therapist, she is familiar with the nuances and correlation between physical and mental health. While many assume that painting at the studio is more of a physical and social activity, she, and many others have referred to its mental health benefits. The people who most often refer to painting at the studio as therapeutic, are people who have stressful jobs in the helping professions such as teachers, nurses and therapists.

Of course not everyone who could benefit from art therapy is going to want to or be willing to come to a therapy session, however as evidenced in this study, having a system of

acquaintances or friends who have a similar desire to try something new has an impact on a person's willingness to participate-or more importantly, take the first step.

Binary Relationships: The Perfectionists vs. the Expressionists

During the post session interview, MV asked whether I had considered if left brain/right brain thinking made a difference in the outcome of the study. Her observation was that people who she considered more type A personalities, had a more difficult time when structure was not as defined, and people who were more expressive and type B preferred working with little limitation. She wondered if that was part of the study. This was an extremely intuitive response given that I have also noticed and changed the style of my instruction when painting depending on how people with more perfectionist tendencies seem to need an extra bit of encouragement to be expressive and flexible. This comment was also especially interesting given that MV, having labeled herself as a left brain, type A personality was able to so completely let go in the last session-using her hands to stamp paint all over the canvas.

CF, also a self-identified "perfectionist" succinctly stated in her interview that less structure helped her more because the less focused she was on "making it look the way it was supposed to," the less anxious she felt and more creative she could become. Her favorite two sessions were painting the vortex and being given the sponges and Q tips because it allowed

"whatever was inside to come out." She recognized after the 4th session that it was more valuable to her to be able to be expressive and relaxed when painting, than having a professional, aesthetically pleasing final product. The vortex, also rated as one of the most relaxing and enjoyable for her to paint, happened to also turn out to be her favorite, aesthetically. She claimed the vortex was peaceful to look at, and brought back the feeling she had when she painted it.

Final Session Analysis

In an effort to attain a comparative view of how the participants rated the sessions, I asked each of them in the interview tell me what they thought was the most relaxing, most enjoyable and most challenging session throughout the study. Table 5 below signifies the responses:

Table 2: Session Analysis

Furthermore, we can consider specifically the frequency of votes per session for each of the three categories, to see which were most common for each category. Some of the sessions

most voted for were rated highly in more than one category. For example session 4, using new tools was voted the most enjoyable and the second most relaxing, yet was also voted the second most challenging out of all sessions. This indicates that while four people thought it was the most enjoyable, two thought it was the most relaxing and two thought it was the most challenging.

Similarly, the collaborative session, aimed to have the most structure out of all sessions was voted the most challenging by four participants; however there were 2 participants who also ranked it as the most enjoyable. The vortex, voted the most relaxing did not appear to be considered for the other categories.

These opposing responses support Csikszentmihalyi's view on challenges vs. skills because it supports that the sessions that are viewed as challenging are just as frequently viewed as enjoyable/relaxing. A chart indicating these responses is shown below in Table 6.

Table 3: Frequency of Sessions Voted Most Relaxing, Enjoyable and Challenging

Decreasing Self-consciousness.

In Csikszentmihalyi's research on flow, one of the clear principles in achieving flow is allowing ones' self-consciousness to decrease. This means one is no longer afraid or worried

about what others may think of them for experimenting or working in a certain style or manner.

Others are almost completely irrelevant. In JR's post session interview, he claimed that during the last session, he felt he had "pushed through a wall." He was referring to feeling self- consciousness in regard to the level of his artistic technique and ability having changed from the beginning to the end of the study. CF commented on how she "was so rigid... I took a walk to see what the others were doing and fed off their creativity." She was able to essentially "loosen up" by seeing others going through the same process without hesitation. When she saw that others were making their own decisions while painting, some painting whatever they wanted, while others were more controlled she did not feel as pressured to make a "good" painting. During the interview she discussed wanting to paint an entire series of vortexes, not only because she liked how they looked, but because she liked how she felt while painting them.

Time.

Most participants also believed that how engaged they were influenced how time seemed to pass. However, there were 2 participants who although rating their engagement as very high, would also consistently rated time as passing slowly. This would be an area to explore further as it relates to flow theory because although in Csikszentmihalyi's research, time has been described as "a lost notion" and "suspended", even a researcher cannot deny the subjective experience of the participant. If one is in a state of flow when they are asked to stop working, as in a research study, and asked how fast or slow time seemed to pass, they technically should have a really difficult time describing what they experienced. To some if time is suspended it may seem to pass slowly, to others; extremely quickly. It relies solely on the individual's perception of time.

As part of the post session interview, each participant was asked to put in order from 1-6, the speed of how they perceived the sessions to pass from slowest to fastest. The averages of

what the participants rated each session is listed below in figure 7. Interestingly, a staggered pattern emerged from session to session which correlated with the amount of structure and guidance provided for each activity.

Figure 14: Average Scoring of Time

The participants' average scoring of how they perceived time passing was then placed in order from the slowest to the fastest. A chart showing these results is shown below in figure 8.

Session 2, the collaboration and most structured session was the fasted perceived session for the group as a whole. As noted earlier, the collaboration was also voted by most participants to be the most challenging.

The session rated by the participants as seeming to go the slowest, was session 1, the vortex. The vortex was also the session rated by the participants as being the most relaxing session. Session 4, voted the most enjoyable was closer on the continuum to time seeming to pass more quickly, but not the fastest.

These results show the potential correlation between how participants perceive time to pass and the challenge vs. skills concept involved in flow. The structure provided (or not

provided) can possibly be utilized to predict how challenging, relaxing and enjoyable the session will be for the participant.

Figure 15: How Time Seemed to Pass Each Session

Music.

Music was noted by the majority of the participants as having had played a major role in determining how time seemed to pass. Many agreed that it was very relaxing in that it further helped them not to think about other things that were stressful, allowing them the ability to "zone out." Many participants sang together throughout the sessions. JR commented that "slow music gave me a feeling of presence, like I had all the time in the world." CF stated that music "had a very positive impact." Six participants when asked in the final interview what factor influenced how fast or slow time passed, agreed music being played had the largest impact.

With these statements taken into consideration, music was not an intended element or factor involved in the research design, with the exception of the 5th session which involved painting what music looked like and during the first session, in order to help the participants relax by playing slow, mainly instrumental songs. Music did however, have a large positive impact on the participants' experience as noted by each of them, and should be taken into consideration in future studies related to this one.

Summary

While this research was part of a pilot exploration, the results are encouraging as they show improvement on all measures except one in people who were already more highly functioning. This study indicated that people who are functional, but suffering as so many do of daily stressors causing some physical or mental impairment: can increase their positivity; decrease negativity; be more engaged in everyday activities and feel a heightened sense of capability by participating in an art therapy group that also teaches techniques for continued individual practice. If improvement is possible in this population over the course of one month, it is likely that others may benefit as well, indicating the need for more research in approaching therapy in a similar manner for varying populations.

The following chapter will re-examine the initially proposed research questions, taking into consideration both the qualitative and quantitative outcomes of the study. Theoretical implications for the field of art therapy will be discussed, and potential research for future endeavors related to this research and its findings will be explored further. The chapter will also delve into limitations of the study and examine how they may be addressed in the future.

CHAPTER 5

ANALYSIS AND DISCUSSION

In the initial stage of predicting a focus for this study, it was estimated that there would be a positive change from pre to post session in the participants' well being. After analyzing the responses of the participants on the scale of positive and negative affect and overall flourishing, it has become clear that there was indeed a positive change. Over the course of one month the self-rated scales showed a significant increase of positive affect and overall flourishing on all measures except one statement on the flourishing scale regarding the impact of social relationships. Negative affect was experienced less over the course of one month on all measures, remaining the same for "unpleasant." The following section will address the research questions asked in chapters 1 and 3.

Art as Prevention

The question of whether or not art therapy can be used as a preventative treatment modality to increase positive affect and flourishing for those individuals who may be deemed higher functioning cannot be answered definitively with one pilot study. However, the results for such a small sample and short study seem to indicate a positive outcome.

Before the study began, I wanted to identify how people drawn to the studio, despite their lack of experience/skill, were motivated. As shown in the discussion in chapter 4, the concept of what motivated them to attend the classes was addressed, without prompting, in the semi- structured interview. JR, who never painted at the studio, seemed to think that all participants in the study were "excited about painting." He had witnessed the same change seen by those who instruct at the studio on a daily basis. It included a change from nervous to excited, from self- conscious to confident, and from rigid to flexible. He also was self-reflective enough to be able to describe that his motivation for attending the study sessions was "a desire to learn and a new

opportunity to express myself." This may have been true for JR, but for others who originally came to "support research at the university", like those who come to the studio, they enter with pre-conceptions and doubts of being able to "be successful" and leave feeling better.

CF was able to identify by her last session that although having disliked the type of instruction at the studio, as she felt pressure to perfectly emulate the painting being taught, she now wanted to take up painting after realizing "perfect" was not the point. Normally having

"obsessive-compulsive tendencies," she was able to discover through experiencing the varying levels of structure that she was able to relax and be the more creative. When encouraged to play and experiment instead of being shown a finished product and feeling as if she was "doing it wrong" by not making it look exactly the same, she came to enjoy painting. By the end of the fourth session, in which I only allowed the participants to use sponges and Q-tips, a

"perfectionist" was telling me this was her favorite session: "whatever was inside me came out...this was amazing."

To truly seek a more definitive answer to this question, it would be necessary to continue this study, utilizing a longitudinal method. By doing a longitudinal study in which there are control groups who do not receive art therapy, we could begin to measure the outcomes of flourishing and positive affect over a longer period of time. This would enable us to further pursue the possibility of more preventative strategies.

Healthy/Higher Functioning People can Benefit Too

I stated initially that I wanted to be able to measure an identifiable change from pre to post sessions in order to gain insight into what made people want to continue painting. I also sought to answer the question: if and how can healthy/higher functioning people benefit from art therapy experientials, and if so, what specifically can increase their ability to flourish? What I

found was that the results from both of these explorations may be related. The results demonstrated an improvement on all measures of flourishing except meaningful relationships.

This indicates that well-being was improved overall, but more importantly, the specific components that increased the most. The statements describing "engagement in daily activities",

"competency and capability in the things that are important to me" as well as "optimism about my future" increased the most over the course of the study. With more time, it would be important in further studies to have questioned the participants ahead of time, asking what they wanted to improve upon before the study began as well as what they thought improved, if anything by the end of the study.

Breaking Down the Stigma of "Therapy" and Building New Theoretical Constructs

An additional concern in the initial stages in this study was the stigma of therapy for people within this spectrum of undiagnosed clients. Because many uphold firmly to the notion that "there is nothing wrong," it can be difficult to find people willing to take art therapy seriously. What was enlightening was how so many people were interested in participating. I initially thought one of the hardest things about this study would be to gather enough people willing to participate in six sessions. In one day, over 20 people signed up, and several more called over the next few weeks to ask if they could participate after hearing about it from their friends. As in any business, when there is a high demand for something, the manufacturer must consider their product's attainability. These painting studios are becoming extremely popular among the United States; the franchise has expanded over the last few years, opening new locations every month. Because so many people were unexpectedly open to the idea of what they experienced at the painting studio being comparable to therapy, we as therapists need to

recognize ourselves as the manufacturer in this case, and make our product more attainable by reformulating our theoretical constructs.

Another thought considered before the study began, was how so many people were saying the same thing in so many different ways in the studio. In chapter one, I noted many of the common phrases regarding how people viewed the painting studio as their personal form of therapy; many of them using the actual word, "therapy" despite the perceived stigma. I wondered if they could further describe why they felt it was therapeutic if given the opportunity to explore it further. What I found was that with a series of carefully constructed sessions, each varying in their level of structure and potential for anxiety-interest, boredom-engagement and worry- control, that participants could more articulately describe how each session affected them. They did so by rating how they felt at the end of each session and further discussing it in the interview.

It felt like I was watching each of them use the art process to become their own therapist. They reflected on such notions as, "I was so rigid at the beginning, I did not like having to give up control, but when we did the Q tip one, it was like whatever was inside me came out...a balance of some instruction and just music was ideal...it's like a release....sometimes it was like, 'where did the time go' other times, it gave me a feeling of presence, like I had all the time in the world."

Essentially, allowing for the opportunity and appropriate environment to help them to actualize needs, characteristics and potential for development, the art provided a clear means of self- awareness.

As pointed out in Chapter 4, the majority of people who claimed they were gaining mental health benefits from engaging in the painting classes were involved in the helping professions. Within certain fields, although emphasis is placed on self-care to prevent burn-out or exhaustion, many professionals do not take the time to maintain their own mental health. The

people coming to the studio were, in their own way, seeking to find an outlet to be expressive, relax, and be social. They returned, because there was also a mental switch being turned on somehow that they were not expecting. Emulating a painting takes concentration and fine motor skills; it challenges ones' level of self-consciousness and is even stressful at times. What they were initially looking for and what was actually happening when they were painting were two different things with some overlap. Regardless, they were noticing the benefits.

Establishing a New Treatment Plan: Theoretical Implications

I had also hoped, after completing the study to better be able to answer the question;

"How can an art therapist design a treatment plan that effectively challenges a higher functioning client?" I believe this study has offered insight into how everyone has the potential to develop further. Although the participants all rated themselves medium-high on the flourishing scale before the sessions began, almost all of them showed improvement on every measure within a month of participating in the sessions. It was important to have had the participants rate their levels of interest, control and anxiety each session. In the end it showed that offering a series of fluctuating art experientials designed to each specifically challenge one, several or all of those factors using the structure and media, that the participants were allowing themselves to trust the process, and gain positive results. Taking knowledge from Csikszentmihalyi's 9 components for achieving Flow, challenges vs. skills, the Expressive Therapies Continuum, and the results from this study, it is possible to begin theorizing a new approach for a treatment plan.

Art Provides a Pathway to Flow

The final question stated in the initial proposal for this study was whether art therapy offered a unique pathway into the flow state by cultivating ones' technical skills in painting,

mindfulness and positivity. In this case, I was met with results that speak to the infamous saying,

"The more I learn the less I know."

It was very interesting to see how people rated how fast or slow time seemed to pass, but it became clearer as the study progressed that responses varied. In the same session, while the majority of participants would rate time passing very quickly or very slowly, another one or two would rate the opposite. However, when all of the participants' time ratings were averaged, the results correlated precisely with the level of structure present during that session. As discussed in

Chapter 4, Csikszentmihalyi often described time as being suspended or passing effortlessly.

What exactly this feels like for the individual experiencing it needs to be researched further and corroborated with brain scan technology in order to gain both a physiological objective perspective, as well as a subjective description from the participant. Discovering why there were such opposing experiences of time when given the same task would be an interesting research question all on its own.

However, I do believe that art therapy has the potential to help guide people towards the flow state based upon the subjective experience as witnessed during this study. I also think there needs to exist a firm distinction between an art instructor and an art therapist facilitating these kinds of sessions. It is an art therapist that is trained with the knowledge of how media and structure will and can potentially effect clients. Art therapists also have extensive knowledge of the theory and history of mindfulness and positive psychology strategies, and how to employ them appropriately during the sessions. Using the media and structure to maintain the correct fluctuation and balance of Csikszentmihalyi's core concepts within the "flow channel," art therapy is a promising field for further study in attaining higher levels of flow for the inexperienced and experienced alike.

Limitations

Due to the brief time available, and small sample size, there are definite limitations that call for further study and analysis. Each of the themes established in the qualitative results could be separately tested and measured in more detail. The majority of the sample was women, demonstrating a ratio of 7:2 [women to men]. This study could have benefitted by having more time between pre-post session questionnaires in order to attain more reliable results.

Participants could also be gathered from different locations using a different method, in order to expand the reliability of the results by not limiting the sample to those who visit the painting studio. A survey could be mailed, or flyers posted around art studios, craft stores and even more commonly visited locations calling for participants who may be interested but do not currently pursue artistic endeavors. An even ratio of men and women would be ideal as well in order to control for gender related biases or skewed results. Because stress is such an important component to the future of this research, a stress-related measure would also be added to the pre- post session questionnaire in order to specify whether these sessions increase positive affect and flourishing as well as decrease negative affect experienced and stress levels.

The log filled out by participants each session only measured their status upon leaving the session. In the future, a measure at both the beginning and end of the session would ensure a more accurate depiction of change experienced. The participants were also asked to write how time seemed to pass subjectively each session. It was suggested by one of the participants in the final interview that a pre-drawn continuum similar to the others on the log sheet was provided.

Also discussed in the interviews, was the idea of participants being more perfectionist or expressive/creative personality types and whether this affected their experience. It may be

beneficial to look more deeply into how that came into play by asking the participants to rate themselves as one or the other before the study begins.

Lastly, every experience and perception of a phenomenon will naturally be different in some way, and influenced by the interaction that occurs in varying environmental, social, and cultural systems. Because this is a pilot exploration that incorporates specific methodologies and measures the complexities of the human experience, there arises a question of whether or not this study can be easily replicated.

Future Research

Possibilities for future research have been discussed throughout the previous sections.

However, the research intended to be carried out as a follow-up study would include a larger sample size, a longer time period of approximately six months and collaboration with a neuroscientist in order to attain brain scans to cross-reference with qualitative results. I would like to measure using fMRI and EEG technology and analyze with the help of a neuroscience professional, how the brain responds to a similar set of structured and unstructured sessions.

Regarding flow, an interesting follow up study would be to introduce the concept of group flow. Because the results showed a decrease of positive and rewarding social relationships,

I would design a study with three groups; a group with similar dynamics to the group in this study, a group who would begin to work together on the same pieces each session, and a group in which no participant knew another and they worked separately, but in the same room.

It was also unintended for music to play as large of a role in the sessions. However, because every participant commented positively on the impact of the music, it would be necessary to control for this in the next study, or a study in the future by having a group doing the same sessions without music.

Conclusion

Although one begins a journey in research to ultimately seek an answer, this study was invaluable in the sense that I realized the value of not the answers, but asking the right questions.

Art therapy research often suffers from the dilemma of subjectivity, which makes methodologies difficult to replicate and black and white results almost impossible. However, as mentioned in the opening paragraph introducing this research proposal, researchers in the sciences are becoming increasingly intrigued by the shades of grey along a continuum of overlapping ideas.

Within these shades of grey lies the future of Art therapy research, where direct subjective experience can corroborate quantitative data gathered from collaborative partnerships with other scientists asking similar questions.

Speaking the Same Language

Referring back to Chapter 2 in which feedback loops and nonlinear systems were compared to the way people function and behave given different environments and/or challenges, this study built on the capability of structured and unstructured art therapy experientials to enhance flexibility in individuals. There are three basic categories for feedback.

An optimal loop takes the least amount of effort and tweaking to reach the desired effect. For example, consider a water pump for a fountain. An optimally functioning feedback system will efficiently adjust the level of water passing through the pipes so the flow remains stable. An unstable loop may eventually reach the goal; however it takes longer and overcompensates at times. Lastly, there is an unsuccessful feedback loop that leads to a fountain that does not function well because it is constantly overcompensating; this fountain will be seen constantly shooting out too much or too little water.

People's ability to adapt can generally fit into similar categories or levels of success. I believe art therapy has the potential to teach people how to build an optimally functioning feedback system, by mimicking real-world situations in which we are forced to constantly re- adjust in order not just to be happier, but to survive. Participants found increased engagement in daily activities outside of making art when presented with the challenge of having to adapt to differently structured art sessions. They found more positive affect and felt more capable.

In order to understand the different languages scientists use so that collaboration is possible, it is necessary to develop these concepts or systems as they relate to our own therapeutic models. Just as we want the client to improve their feedback systems, we have to first model how a successful loop works by constantly measuring and readjusting the structure of our sessions. By purposely over- or under-compensating, by adjusting levels of control and structure, perhaps participants can find their own optimal level of functioning.

From this study, it is evident that more research targeting higher functioning clients is an area ripe with the possibility for improvement. The attitudes of many towards "therapy" and

"seeking help" have been changing, with many not sure where to go or what to try. The

Substance Abuse and Mental Health Services Administration (SAMHSA) has documented a steady increase in the number of people seeking treatment in the US since 2004 (National

Institute of Mental Health, 2008). This is further confirmation that more people seem to be open to the idea of helping themselves to feel better, as levels of mental illness and stress have also increased.

Because so many are seeking the therapeutic benefits of engaging in new activities to lower stress and have fun at places like the painting studio, it is our job as therapists to find out what these benefits are, and how to implement a similar strategy into the conception of a new

treatment model. Theoretical constructs should be constantly re-examined when considering populations with a growing need for preventative treatment. This study took something that seemed to truly be helping a lot of people, sought to find out what they were experiencing and measured the resulting changes. After observing significant positive results, further steps should be taken to continue examining how flow, and art therapy have the potential to increase flourishing.

APPENDIX A

SESSION STRUCTURE

Session Structure

Session 1 Sessions 2-5 Session 6 (1.5 hrs) (1 hr) (1.5 hrs) Check in Check in Check in

Introductions Brief Brief Introduction Introduction Complete Scales & Questionnaire Warm-Up Warm-Up Warm-Up Art Making Art Making Art Making Closing Reflection Closing Reflection Closing Reflection Complete Scales & Questionnaire

APPENDIX B

SCALE OF POSITIVE AND NEGATIVE AFFECT EXPERIENCE

Please think about what you have been doing and experiencing during the past month. Then report how much you experienced each of the following feelings, using the scales below.

I have Very Rarely Rarely Sometimes Often Very Often or felt... or Never Always

POSITIVE

ANGRY

UNPLEASANT

JOYFUL

CONTENTED

AFRAID

HAPPY

BAD

PLEASANT

NEGATIVE

GOOD

SAD

APPENDIX C

FLOURISHING SCALE

Below are eight statements with which you may agree or disagree. Using the scale below, indicate your response by placing an "X" in the appropriate box.

Statement Strongly Disagree Slightly Mixed or Slightly Agree Strongly Disagree Disagree Neither Agree Agree

I lead a purposeful and meaningful life

My social relationships are supportive and rewarding

I am engaged and interested in my daily activities

I actively contribute to the happiness and well-being of others

I am competent and capable in the activities that are important to me

I am a good person and live a good life

I am optimistic about my future

People respect me

APPENDIX D

INFORMED CONSENT TO PARTICIPATE IN RESEARCH PROJECT I freely and voluntarily and without element of force or coercion, consent to be a participant in the research project entitled “Coming to the Studio, Going with the Flow: A Study on Art- making to Increase Flourishing.” This research is being conducted by Jaimie Burkewitz who is a Graduate Student attaining her Master's in Art Therapy at Florida State University. I understand the purpose of her research project is to determine the therapeutic benefits of creating art in a semi-structured group environment. I understand that I will be asked to do some art work and that I will be asked to complete paper and pencil surveys administered by an art therapy student. I understand that the study is comprised of six sessions, each lasting an hour and a half over the course of three weeks. I may also be asked to participate in an individual interview with the student once the sessions have ended. During this process and interview the graduate student will be available to discuss my response to the experience, answer my questions, or she will refer me to a knowledgeable source. I understand my participation is totally voluntary and I may stop participation at anytime. All of my personal information, responses, and answers to any survey and interview questions will be kept confidential to the extent allowed by law. My name will not appear on any of the results and I will be identified by a subject code number. I understand there is a possibility of a minimal level of risk involved if I agree to participate in this study. I might experience anxiety during the drawing procedures, or the actual completion of the art may result in uncomfortable emotional expressions. I am also able to stop my participation at any time I wish. I understand there may be therapeutic benefits for participating in this project, and that, through the artwork, I will have the opportunity to express myself fully. I understand that this consent may be withdrawn at any time without prejudice, penalty or loss of benefits to which I am otherwise entitled. I have been given the right to ask and have answered any inquiry concerning the study. Questions, if any, have been answered to my satisfaction. I understand that I may contact the graduate student if questions or issues arise at any time during the study. Ms. Burkewitz may be reached by phone at 860-501-0777 or by email, [email protected]. Dr. David Gussak, Ph.D., ATR-BC who is a Professor of Art Therapy/Art

Education at Florida State University in the Department of Art Education, will also be available periodically, for answers to questions about this research or my rights. Dr. Gussak can be reached at 850-645-5663. As well, if I have further questions, I can contact the Florida State University, Human Subjects Committee at 644-7900.

Artwork

I also agree to allow the graduate student, to use my art work and photographs of my art work(s) for research purposes. I understand that my art will not contain any identifying information. I understand that I may revoke this consent and authorization at any time. I understand that I will be participating in art therapy interventions with the graduate student to address mutually agreed upon goals relating to the research study.

I have read this Consent and Authorization Form, understand the terms used in it and their significance, and have signed it voluntarily.

______participant date

APPENDIX E

APPROVAL MEMORANDUM FOR RESEARCH

The Florida State University Office of the Vice President For Research Human Subjects Committee Tallahassee, Florida 32306-2742 (850) 644-8673 · FAX (850) 644-4392

APPROVAL MEMORANDUM

Date: 5/12/2014

To: Jaimie Burkewitz

Address: 721 E 6th Ave, Tallahassee FL 32303 Dept.: ART EDUCATION

From: Thomas L. Jacobson, Chair

Re: Use of Human Subjects in Research Coming to the Studio, Going with the Flow: A Study on Art-making to Increase Flourishing

The application that you submitted to this office in regard to the use of human subjects in the proposal referenced above have been reviewed by the Secretary, the Chair, and one member of the Human Subjects Committee. Your project is determined to be Expedited per 45 CFR § 46.110(7) and has been approved by an expedited review process.

The Human Subjects Committee has not evaluated your proposal for scientific merit, except to weigh the risk to the human participants and the aspects of the proposal related to potential risk and benefit. This approval does not replace any departmental or other approvals, which may be required.

If you submitted a proposed consent form with your application, the approved stamped consent form is attached to this approval notice. Only the stamped version of the consent form may be used in recruiting research subjects.

If the project has not been completed by 5/11/2015 you must request a renewal of approval for continuation of the project. As a courtesy, a renewal notice will be sent to you prior to your expiration date; however, it is your responsibility as the Principal Investigator to timely request renewal of your approval from the Committee.

You are advised that any change in protocol for this project must be reviewed and approved by the Committee prior to implementation of the proposed change in the protocol. A protocol change/amendment form is required to be submitted for approval by the Committee. In addition,

federal regulations require that the Principal Investigator promptly report, in writing any unanticipated problems or adverse events involving risks to research subjects or others.

By copy of this memorandum, the Chair of your department and/or your major professor is reminded that he/she is responsible for being informed concerning research projects involving human subjects in the department, and should review protocols as often as needed to insure that the project is being conducted in compliance with our institution and with DHHS regulations.

This institution has an Assurance on file with the Office for Human Research Protection. The Assurance Number is FWA00000168/IRB number IRB00000446.

Cc: David Gussak, Advisor HSC No. 2014.12334

The formal PDF approval letter: http://humansubjects.magnet.fsu.edu/pdf/printapprovalletter.aspx?app_id=12334

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BIOGRAPHICAL SKETCH

Jaimie Burkewitz grew up in New England attending the Norwich Free Academy of Fine Arts until beginning her undergraduate career at Florida State University in 2007. Having family members involved in engineering, physics and molecular biology, Ms. Burkewitz has always had a passion and affinity for science. At Florida State University she was able to find a way to combine both her love of science with her passion and talent in art to become an Art Therapist. She began attending the Florida State Graduate Program for Art Therapy in 2012. Since attending the program, Ms. Burkewitz has worked among varying populations including dementia, Parkinson's and Alzheimer's patients, female inmates, and children with varying developmental disorders. Ms. Burkewitz hopes to continue doing research in the field of art therapy, in an effort to bridge qualitative arts research with neurology-based scientific analysis.