Individual Art Therapy Counseling with At-Risk Children in a School

Individual Art Therapy Counseling with

At-Risk Children in a School Setting

Margaret Ann Rastle

A Thesis Submitted in Partial Fulfillment of

The Requirements for the Degree of

Master of Arts in Art Therapy & Counseling

Ursuline College Graduate Studies

May, 2008

Ursuline College

Graduate Studies

We hereby approve the thesis of

MARGARET ANN RASTLE

candidate for the

Master of Arts in Art Therapy & Counseling Degree

Approved by:

______Dean of Graduate Studies

______Director of Master of Arts in Art Therapy & Counseling Program

Reading Committee:

______

May, 2008

Margaret Ann Rastle

iii

Acknowledgments

Thank you to all of the students, parents and teachers I worked with during my research study. This process was only possible through their willingness to participate. I would like to thank Sister Kathleen Burke and Kate Strazisar for their suggestions and encouragement throughout this study.

I would like to thank my fellow art therapy counseling students for their constant support over the past three years. Thank you to the Ursuline College Art

Therapy Counseling program faculty and staff. There is no adequate way to thank you for the knowledge and experience I have gained learning from all of you. I would also like to thank Sondra Radcliff and Heidi Larew for their guidance and support during my internship.

I would like to thank my family; especially my mother for always encouraging me to pursue my dreams. Thank you to my friends and coworkers at the Kirtland Temple for their support and flexibility during my graduate studies.

I would like to thank Cecile Brennan and Gail Rule-Hoffman for their editing skills and revision suggestions. A special thank you to Kate Strazisar for her supervision and insight during this study and also for serving as my thesis reader.

Abstract

Individual Art Therapy Counseling with

At-Risk Children in a School Setting

Margaret Ann Rastle

This mixed methods research study examined the use of art therapy counseling with at-risk children in a private inner city school setting.

The participants in this study attended 12 individual art therapy counseling sessions with an art therapy counseling student. Each participant, parent or guardian, and teacher was given pre and post-art therapy counseling surveys which were used to determine the effectiveness of the art therapy counseling sessions. A mixture of art making and psychotherapy was used with each participant and also used to evaluate the sessions.

The individual sessions gave the participants a chance to build a therapeutic relationship with an adult. The numerical data collected in this study is of limited statistical significance; however the qualitative data collected demonstrates the need that children have for undivided positive attention from trusted adults.

Table of Contents

Page

Approval Pages ii

Acknowledgments iv

Abstract v

List of Figures and Tables viii

Chapter I Introduction 1

Chapter II Research Design 7

Chapter III Review of Related Literature 15

Chapter IV Case Study: John 26

Chapter V Case Study: David 46

Chapter VI Results and Conclusions 68

References 74

Appendixes Appendix A: Individual Results 78

Appendix B: Overall Participant Results 96

Appendix C: Art Release Form 99

Appendix D: Pre-Art Therapy Counseling

Survey Cover Letters 100

Appendix E: Pre-Art Therapy

Counseling Surveys 102

Appendix F: Post-Art Therapy Counseling

Survey Cover Letters 105

Appendix G: Post-Art Therapy

Counseling Surveys 107

Appendix H: Survey Scoring Forms 110

vii

List of Figures

Page

Figure 1 Concurrent triangulation strategy 8

Figure 2 John's house 31

Figure 3 Lauren's bush 32

Figure 4 Ashley 33

Figure 5 John's drawing of his mother 35

Figure 6 John's kinetic family drawing 36

Figure 7 Rock 40

Figure 8 John's rescue drawing 41

Figure 9 John's bird family drawing 42

Figure 10 David's self collage 47

Figure 11 David's house drawing 50

Figure 12 David's train drawing 51

Figure 13 David's wooden cross 53

Figure 14 David's cheetah 56

Figure 15 Happy 57

Figure 16 Sad 58

Figure 17 Frustrated 59

Figure 18 Mad 60

Figure 19 Confused 60

viii

Figure 20 Excited 61

Figure 21 Dreadful 61

Figure 22 Tired 62

Chapter I

Introduction

Statement of the Problem

According to a report published by the National Advisory Mental Health

Council (2001), 1 in 10 children and adolescents has a mental illness severe enough to cause significant functional impairment. The Center for Disease

Control (2004) reported that only 1 in 5 children and adolescents with mental illness obtained services from qualified mental health professionals. Untreated mental and emotional disorders, as well as poor self-esteem, can be a barrier for children’s academic success (Becker & Luthar, 2002).

Without appropriate treatment, children and adolescents suffering from these disorders often display negative behaviors, caused by poor self-esteem and inadequate social supports (Lever et al., 2004). It is also believed that children who are having difficulties in school are more likely to display negative behaviors. The Institute of Medicine (1994) reported that 12 percent to 30 percent of school-aged children have severe educational problems due to emotional disorders.

Purpose of the Study

The purpose of this study was to better understand the impact of individual art therapy counseling on at-risk children in a school setting by combining both quantitative and qualitative data. In the study surveys were used to measure the

relationship between art therapy counseling, self-esteem and decreased negative behaviors. At the same time, effectiveness of the art therapy counseling was explored using interviews with clients and information provided by the student art therapists, as well as written feedback from parents and teachers.

Research Questions

This research addressed the following question: What effect does individual art therapy counseling have on children’s behavior and self-esteem?

Sub Questions

Did parents report positive behavioral changes in their children?

Did teachers report positive behavioral changes in their students?

Did children report positive behavioral changes in themselves?

Review of the Literature

An article in the Journal of Community Psychology suggests children with behavior problems are taught less (Arnold et al., 1999). These children are routinely removed from the classroom as a consequence for negative behavior.

Every suspension, timeout in the hallway and trip to the principal’s office is time away from classroom instruction. Behavior problems and their consequences often lead to academic failure and school dropout (Frick et al., 1991).

The Editorial Projects in Education Research Center reported that of those who should have graduated from high school in 2006, 1.2 million students did not graduate on time (as cited in Hardy, 2006). According to the United States

Census Bureau (2006), in the year 2005, 19.6 percent of 18-24 year olds who were not in school, were not high school graduates (included equivalency exam).

The same study showed that individuals with an income, who completed high school, had an annual mean income of almost $10,000 more than those who were not high school graduates (United States Census Bureau, 2006). The Alliance for

Excellent Education (2006) estimated that nearly 7,000 students drop out of high school every school day.

In 1988, the state of Maryland began the FUTURES Program (Lever et al.,

2004). This five year program was designed to reduce drop-out rates for at-risk youth. The program provided the participants with increased academic, employment, community and mental health support. Participants in the

FUTURES Program had access to school-based mental health professionals whose services could include family or individual counseling. The drop-out rate for participants in the program was 4% lower during the 1998-1999 school year than the average drop-out rate of the sponsoring school district. This program achieved success, not only for decreased drop-out rates, but also for focusing on the needs of the students outside of the classroom (Lever et al., 2004).

Sylwester (1994) suggests that emotions play a more important role in education and learning than previously thought. He notes that attention is driven by emotion, thus driving learning and memory. If, through early intervention,

3 children and adolescents were better equipped to handle life stress, their chances of staying in school would be greater.

Janet Bush (1997) acknowledges that children who do not respond well to conventional talk therapy often are more receptive to art therapy, which combines visual and verbal communication. Art is a natural communication tool, which is not often carried on past childhood. Bush (1997) also expresses that art therapy can be a catalyst for some children and adolescents to enhance their outlook on life.

Definition of Terms

Academic success takes place when a student is able to meet the standards for the educational institution, and that institution is able to meet the student’s individual needs.

Art therapy counseling combines the use of art and more traditional counseling approaches to maximize the effectiveness of counseling. Art is used as an additional tool to allow clients to communicate visually, as well as verbally.

Negative behaviors are any type of behaviors that impair the social, educational and emotional functioning of an individual.

Delimitations and Limitations

The delimitations in this study were that participants had to be referred to art therapy counseling by a parent or a member of the school’s staff. The school counselor then chose the participants from those referred and then only the

4 participants whose parent or guardian gave consent were accepted into the art therapy counseling program.

This study was limited by space and time. The student art therapists involved in this study were all at the school one day a week for the art therapy counseling sessions and all sessions took place during school hours. The student art therapists shared the room where the art therapy counseling sessions were conducted, this limited the number of student art therapists, therefore limiting the number of participants in the study.

The study was also limited by time; each participant was scheduled for a predetermined number of sessions, which took place at the same time each week.

It was not possible to makeup missed sessions. This included sessions missed due to school activities (field trips, assemblies, testing). School activities took priority over the art therapy counseling sessions. Absences due to illness, or other factors, by the student art therapists were another limitation. If a student art therapist was not able to attend a session, another student art therapist, or one of the supervisors, conducted a session with the participant. The participants did not miss their sessions due to staff absence; however, having a session with another student art therapist may have affected the continuity of this study.

The student art therapists were limited with discussion topics, due to the amount of privacy a shared room affords. Since the participants were taken out of class for these sessions and returned to class immediately afterward, the student

5 art therapists were mindful of session content and the possible affects it could have had on the participants.

Chapter II

Research Design

Characteristics of Mixed Methods Research

This was a mixed methods constructivist/interpretivist study. Mixed methods research combines quantitative research and qualitative research to obtain a better understanding of the phenomenon being studied (Creswell, 2003).

The funding for the program was provided through a grant. It was important to the researcher that quantitative data be gathered during this study. Quantitative data is more widely accepted and understood, and can help enforce the importance of this type of therapy for children.

This was a study on the effects of art therapy counseling, therefore a more traditional art therapy counseling research approach was taken by gathering qualitative data as well. The quantitative and qualitative data in this study was collected concurrently. The purpose for using the mixed methods research design was to gain a more comprehensive view of the participants.

Type of Mixed Methods Design

A constructivist/interpretivist research design was used in this study.

Creswell (2003) notes this design looks at the process of participant interaction, not only with each other, but also with their environment. A mixed methods concurrent triangulation strategy was chosen to gain a more comprehensive view of this study’s results. The mixed methods design combines qualitative and

7 quantitative data, and art therapy counseling combines visual and verbal communication. This triangulation design allows a more comprehensive view of the research findings (see Figure 1).

Visual Model and Procedures of the Design

Figure 1. Concurrent triangulation strategy.

Data Collection Procedures

Setting. The research for this study took place in a religious non-graded private urban elementary school located in a large city in the Midwestern United

States. The students were divided into class levels, rather than grades. Students worked at their own pace to learn the required material in order to move up to the next level. This school had a counseling program in place, which employed a full time counselor who conducted individual counseling sessions and groups with students. The school also had an art program in which all students participated.

Funding for this art therapy counseling program was provided through a grant.

The school provided the program with a well-lit classroom where the art therapy counseling sessions took place. This space was approximately 40’ by 30’, with one wall consisting of windows. The room had a sink and adequate storage space for the art materials.

Each student art therapist had her own table to use with participants; at each table was a chair for the participant and a chair for the student art therapist.

These tables were approximately 3’ by 6’ and scattered throughout the room.

Each student art therapist had two cardboard tri-fold display boards to place on the tabletop to maximize privacy. A loud ventilation fan made it difficult to hear within the room, which deterred the school from using the room for a traditional class. This fan added background noise and increased the privacy during the art therapy counseling sessions. The art therapy counseling sessions took place once a week for 12 weeks, each session lasted approximately 45 minutes.

Participants. This study consisted of 20 participants, who ranged in age from 5 years old to 14 years old. The sponsoring school had a culturally diverse student population and the participants were of various cultural backgrounds. All participants were referred to the art therapy counseling program because of social or emotional impairments.

Types of data. The types of data used in this study were self-esteem assessments, both arts oriented and written. General statistics about the school, the students, the behavioral issues of the students and discipline actions taken by

9 the school were also used. Feedback from clients, teacher and parents were also used to determine the effectiveness of the study.

Methods of gathering data. Pre and post-art therapy counseling surveys were given to each participant, the participant’s parent or guardian and the participant’s teacher. The surveys solicited information regarding the participant’s positive and negative behaviors and self-esteem. Surveys for clients, teachers and parents were given shortly after the study began and then again at the end of the study. Each of the five student art therapists worked only with four clients; the surveys were a way to acquire information about all 20 of the study’s participants. These surveys were created by the researcher, based on a survey written by Naomi Loges (2000) and the Hare Self-Esteem Scale written by Bruce

Hare (Corcoran & Fischer, 1987; Kelly, Denny & Young, 1997).

Common art therapy counseling assessments such as House-Tree-Person,

Draw-a-Person-in-the-Rain and the Kinetic-Family-Drawing were given to each participant. Client artwork was used to collect data for this study. A review of relevant literature was also used throughout the course of the study to assist with session planning and data analysis.

Data Analysis and Validity Procedures

The surveys were scored and each survey was given an overall numerical score. The surveys completed by the participant, the parent and the teacher were compared to increase accuracy and to assist in constructing the treatment plan for

10 the participant. Once the art therapy sessions finished, the post art therapy surveys were given to the participant, parent and teacher. After being scored, the post surveys of the participant, parent and teacher were compared to increase accuracy. These surveys and scores were then compared to the pre art therapy counseling surveys to determine any noted changes in the participant’s behavior.

The student art therapist working with each participant was asked to complete an information form about the participant and about the art therapy counseling process. That information was used to gain a greater understanding of the participant’s art therapy counseling experience and any changes that took place during the course of the sessions. Literature relating to art therapy counseling with children, specifically at-risk children and adolescents was reviewed to achieve a better understanding of the participants, their environments and the use of art therapy counseling with this population.

The participants’ artwork was analyzed for content, use of color, line variation, developmental stage of the participant verses chronological age and ability to follow directives. Participant artwork was individually analyzed according to the objective of the art task. Art assessments were analyzed according to the theoretical approach of the assessment’s creator, published research and the information given by the student art therapist who conducted the assessment.

Report Presentation Structure

The research study was organized using both quantitative and qualitative data. The quantitative data consisted primarily of the scores from the pre and post art therapy counseling surveys. These survey scores and feedback provided by the parents, teachers and participants, along with the student information forms determined the effect art therapy counseling had on the participant's behavior and self-esteem.

Role of the Researcher

In this study the researcher was involved with the participants by serving as the student art therapist to 4 of the 20 participants. The researcher was familiar to some of the participants, having served as a student art therapist the previous semester in the art therapy counseling program. However, the researcher’s previous clients were not participants in this study.

Anticipated Ethical Issues

Precautions were taken to protect the participants, the sponsoring school, as well as the student art therapists. The parent or guardian of each participant was required to sign a release form, which gave permission to attend art therapy counseling and allowed the student art therapists to anonymously show the participant’s artwork for educational purposes.

Parents and guardians were also asked to sign the pre and post art therapy counseling surveys with the understanding that their responses would be

12 anonymously included in a master’s thesis. Participants, parents or guardians, and the teachers were all made aware of the role confidentiality played in the therapeutic relationship and the limitations of that confidentiality.

Two registered art therapists supervised the art therapy counseling sessions. The researcher was also supervised off site by two additional board certified registered art therapists, one of which was also a licensed professional clinical counselor.

Significance of the Study

Although this study took place at a private school, most of the students were considered at-risk and did not have easy access to mental health services.

Even with a full time counselor at the school, these students were not receiving adequate counseling services. The study provided additional information regarding the effectiveness of art therapy counseling in a school setting.

Due to the rising costs of health care and educational budget cuts, it is rare to find an art therapy counseling program that conducts individual sessions with children, especially in a school setting. Although there was research available on art therapy counseling in school settings, it primarily addressed public schools.

This study serves as an example for future school based art therapy counseling programs, where art therapy counseling can increase self-esteem and decrease negative behaviors that often cause problems with academic achievement. This

13 study was significant in the lives of the participants, even if it is only because they received 45 minutes of positive undivided attention from an adult each week.

Chapter III

Review of Related Literature

Factors in Children's Academic Success

Negative behaviors such as classroom disruptions, defiance and aggression can interfere with academic success. These behaviors are often displayed in school; however, school is rarely the primary cause (Arnold, et al.,

1999). Inner city and low income students are especially vulnerable to academic failure. There is a strong relationship between academic failure and behavior problems. Although academic struggles can lead to frustration and noncompliance, the roots of those behaviors extend beyond the classroom

(Arnold, et al., 1999).

Students who display academic and behavior problems often are caught in a cycle where behavior problems increase as academic problems increase and vice versa. If a student displays negative behaviors in the classroom usually that student will receive negative attention from the teacher or the student will be removed from the classroom. Both of these consequences hinder academic success. Teachers are less likely to make continued attempts to teach students with behavior problems. This adds to their academic struggles, which can cause increased behavior problems, thus creating a cycle (Arnold, et al., 1999).

It is suggested that parental and community involvement is a key factor in combating academic and behavior problems. A program designed at the

University of Massachusetts at Amherst, promoted positive interaction with parents or caregivers as a tool to decrease behavior problems and increase academic success (Arnold, et al., 1997).

In the program, parents were encouraged to read with their child for at least fifteen minutes, three days a week. The children read the same books with their parents as they were reading in small groups at school. Teachers and parents were trained in limit setting and appropriate ways to respond when faced with aggression and other negative behaviors. The teachers and parents in the program met separately in groups once a week to discuss the program's topics.

The children were given assignments to take home relating to the skills they had learned in the program.

This program received overwhelmingly positive ratings. Over 90% of the parents who participated completed the program. Increased positive interaction with parents and teachers was found to be the key to decreasing negative behaviors and increasing the children's academic performance (Arnold, et al.,

1999).

Social-emotional factors play a dominate role in children's coping strategies concerning academic success. An article written by Panayota

Mantzicopoulos (1997) discusses a study of children that was conducted to determine how coping strategies affected academic performance. This study consisted of 187 fourth and fifth grade students, ranging in age from 8 to 12 years

16 old. The split of male and females was fairly even, as well as the socioeconomic status of the students whose parents provided that information.

The subjects were measured on socioeconomic status, academic coping, intrinsic/extrinsic motivation, affective reactions, attributions to failure and self- perception. The children were asked to think of a time when they underperformed academically, why they should have performed better, how they felt after underperforming and why they underperformed on that particular academic task.

Then the children were given a self-perception assessment.

The results concluded that the children who displayed positive coping skills were more likely to enjoy doing well in school and placed personal importance on academic success. Those same children credited exterior factors as to why they underperformed academically, such as not being lucky or not studying enough. Children who displayed negative coping skills were more likely to self-blame for their underperformance. These children credited not being smart enough or lacking the skills to perform well. This study also found that negative emotions experienced after failure were harmful to the subjects rather than serving as motivation to improve academically (Mantzicopoulos, 1997).

Perceived academic support plays a prominent role in the likelihood that at-risk students will earn a high school diploma (Lever, et al., 2004). Middle and high school students often look to teachers for approval, academically and

17 personally. This need for support and approval from teachers has been linked to academic motivation and success (Wentzel & Asher, 1995).

Lack of institutional support and funding, not only affects students at risk for dropping out, but also academically motivated students. When school budgets are decreased based on student test scores and the need for additional school programs is increasing, it is suggested that all students suffer (Becker & Luthar,

2002). Furthermore, Kronick suggested the nation suffers when schools are not properly funded by having to bear the costs of the social services uneducated adults would use. He suggested that keeping a student in school until they earn a high school diploma would be six times less costly than maintaining an uneducated adult (1997).

In addition to the role public schools play in retaining students until graduation, drop-out prevention programs have also shown success at keeping students in school. One of these successful programs was the FUTURES

Program based in Baltimore, Maryland (Lever, et al., 2004). This five year program targeted ninth graders who were considered at risk for dropping out of school. Each year the program would accept 60 students who fit the criteria of failing at least one grade, poor school attendance or below grade level performance. The five areas emphasized in the program were enhancing basic skills, work experience, motivation and leadership development, student support and transition services.

The participants attended a summer program designed to not only increase familiarization with the program, but to also improve academic and life skills. The use of advocates assisted the participants in each aspect of the program from encouraging family involvement to exploring career options.

Mental health services were offered on a voluntary basis to the participants throughout the program. Based on assessments conducted on all participants for the 2000 school year, improvement in symptoms was not affected by participation in the offered mental health services. It was found that those who used the mental health services displayed an increase in emotional and behavioral problems (Lever, et al., 2004). This increase in problems may have been due to the participants stirring up deep emotional issues that had never been addressed before.

Positive interaction with teachers, advocates and mental health clinicians is credited for the success of this program. Overall evaluations found the program was able to reduce drop-out rates and displayed high rates of post graduation success among the participants (Lever, et al., 2004).

Florence Heller suggests that schools not only educate students academically, but are also responsible for the emotional and psychological health of students. For most children school is their primary social connection outside of their family. School staff and fellow students have the potential to impact a child's life tremendously. Faculty and staff are expected to notice warning signs

19 and behaviors indicative of social problems and mental health issues (Heller,

2000).

Schools must create a unique environment that is conducive to academic learning while being safe enough for the students to make known their non- academic needs. Heller states the need for school counselors to use boundaries in order to create that safe environment where students can share their needs and with the guidance of the counselor, discover ways to meet those needs. Adhering to regular session times and length is suggested as being critical for creating a safe space for the students who receive school counseling services (Heller, 2000).

Art Therapy with Children

Edith Kramer, a pioneer in the art therapy field, suggested art therapy with children should focus on helping the child become more goal oriented

(1998). Children are already in a world filled with play and fantasy. Through art making children can learn to invest in themselves by investing in their artwork.

Playfulness can however assist the client to explore ideas and possibilities for the art materials. Kramer wrote of children who used their playfulness to indirectly explore deeper issues (1998).

Productive play can allow the client to escape the harsh realities of emotionally stressful situations. Art making can also serve as a tool to explore deep emotions and to release negative energies in a positive manner. The job of

20 the art therapist is to recognize the boundary between helpful and harmful art making (Kramer, 1998).

Games have been especially effective when working with children in art therapy. The element of play in art and art related games can increase children's socialization and improve self-esteem. Vicky Barber wrote of using games with children in art therapy groups (2006). She described working with a seven year old boy, who was labeled a selective mute. Initially he would just show his art to the group. After feeling more comfortable he joined into the games with the other children. Eventually he started sharing a word or two about the art he'd created.

Eventually he felt safe enough to fully integrate into the group.

Like Kramer, Barber noted that children are able to quickly engage in the art making process. Art making can lead to increased self-esteem, social skills, self-awareness and confidence (Barber, 2006).

Art Therapy in Schools

Verbal therapy is difficult with young children. They often do not trust adults or are unable to verbalize emotions (Moriya, 2000). Art is a natural tool for children to express themselves. The communication style people are most familiar with is verbal communication, which can be accompanied by strong verbal defenses. Moriya suggested children have the ability to initially use art making as a way to internally dialogue before they are comfortable enough to speak with the art therapist (2000).

The purpose of art therapy in schools is to maximize the students' learning potential by meeting needs that are not, or cannot be, addressed in the classroom.

It is essential that school art therapists have the support of the school administration in order to create an environment where the staff and the art therapists work together to benefit the students. This can be challenging when emotionally charged issues are addressed in therapy sessions and the student, attempting to cope with that stress, acts out in the classroom (Moriya, 2000).

According to Janet Bush, as more disabled children were mainstreamed into traditional classrooms, the use and benefits of art therapy became better known throughout the United States (1997). Non-traditional therapy methods were explored to help with the changing composition of public schools (Bush,

1997).

Art therapy can be used to break down emotional barriers that have led to academic barriers. For example, a child with unmet emotional needs may seek negative attention by disrupting the classroom. That child could be sent out of the classroom, as to not disrupt the other students' learning. Increasing self-esteem and emotional stability can dramatically affect a child's behavior in the classroom.

The entire classroom can benefit when a student has control over emotions and undesirable feelings. Class disruptions due to behavior problems affect the learning of all students in that environment (Bush, 1997).

Along with Kramer, Bush wrote of children's natural energy and the need to physically engage students to promote academic learning (Kramer, 1998; Bush,

1997). The kinesthetic element of art therapy can reduce tension, relieve stress and redirect energy that was once used in negative behaviors. These benefits also affect the child's overall physical and emotional health (Bush, 1997). One way art therapy is used in school settings is to improve academic performance by addressing and treating the underlying issues contributing to academic difficulties

(Pleasant-Metcalf & Rosal, 1997).

Emotional stressors and family unrest can negatively impact a child's school performance. In the case of a 12 year old girl named Beth, academic struggles after her parents' divorce were addressed using art therapy. Beth was part of a pilot study conducted to measure the effects of art therapy on a child of divorced parents with decreased academic performance. The subject attended ten individual art therapy sessions over a five week period. The goal of her treatment was to increase problem solving skills and address self-concept issues (Pleasant-

Metcalf & Rosal, 1997).

The authors note Beth's artwork appeared impoverished and depicted a poor self-image. After discussing a family sculpture, which omitted her father, it became clear that many of the difficulties Beth was having related to her relationship with her father, rather than the divorce itself. It was presumed in the

23 beginning of the study that her parents' divorce was the source of Beth's decreased academic performance.

Through the art making in her art therapy sessions a deeper issue was discovered and addressed. The art therapy sessions appeared to have positively impacted her self-concept, which in turn increased her academic performance.

After ten sessions, Beth's grades increased in six of her seven classes (Pleasant-

Metcalf & Rosal, 1997).

Using art as an empowerment tool with at-risk youth can have dramatic effects. One community based program taught life skills through art making to truant seventh and eighth grade students (Wallace-DiGarbo & Hill, 2006). The art therapy portion of this program had 12 participants that regularly attended whose ages ranged in age from 13 to 16 years old. The art therapy sessions took place during school hours, decreasing possible extra-curricular conflicts.

However, no one attended all 10 sessions, scheduled over a six week period. The sessions were led by an artist and assisted by an undergraduate psychology student. The art tasks included creating mandalas, mask masking and scribble art.

The participants created a set of rules and expectations, which included having fun and experiencing respect. The group facilitator modeled positive behaviors, which was noted by the participants at the end of the program. The program was considered successful and positive changes were visible in the participants. The participants gained confidence and demonstrated teamwork

24 when creating group projects. Students who were considered at the highest risk, showed the most improvement (Wallace-DiGarbo & Hill, 2006).

Working with children can also involve working with more than just the child. Therapists could be required to communicate with numerous individuals for each child they see including family members, social workers and teachers.

There is great importance with keeping children's defenses intact until they are ready to let go of those protections. Trust within the therapeutic relationship can be jeopardized or injured if a child's only emotional protection is taken away too soon (Klorer, 2001).

Klorer wrote that children trust the art more than they trust words (2001).

She compared working with children to putting together puzzle pieces. Therapists are trained to follow treatment plans and conduct sessions based on meeting the set goals. Just as every child is unique, their treatment should be also. Each case is like a puzzle, the therapist's job is to take all the pieces and help the client create a healthy picture (Klorer, 2001).

Chapter IV

Case Study

This study took place in a religious non-graded private urban elementary school with students ranging in age from 5 years old to 14 years old. The school had a counseling program, which employed a full time counselor and all of the students participated in the school's art program. The philosophy of the school was to guide the development and growth of each student in the following aspects: emotionally, physically, spiritually, morally and academically. The school strived to help students achieve their highest potential and lead a well- adjusted life within their community and family. The purpose of the art therapy program was to provide each referred child with an educational and enjoyable therapeutic art experience.

The school provided the program with a well-lit classroom, which included a sink, to conduct the art therapy counseling sessions. Each student art therapist had her own table, a chair for the participant and a chair for herself. The tables were spread out in the room and tri-fold cardboard displays were used to maximize privacy. A variety of art materials were available for use, including paper in many sizes and colors, crayons, markers, colored pencils, paints, clay, tissue paper, magazines, mixed media items and other materials brought in by the student art therapists.

The participants were referred to the art therapy program by a parent (or guardian) or a member of the school's staff. Students were referred to art therapy counseling for a variety of reasons, including the loss of a family member, anger issues, family stress and poor social interaction. Participants in the study were chosen by the school counselor based on her knowledge of the student's need for art therapy counseling.

This study consisted of 20 participants who were each assigned to one of the five student art therapists. The following case studies are of two of the four clients I saw during this 12 session study.

John

John was a five year old male of African-American and Caucasian decent.

He was friendly, cheerful, cooperative and sincere. John's mother had been violently killed nine months prior to his taking place in this study, which was his reason for referral. He had seen an art therapist after his mother's death, although

I was unable to determine how long those sessions took place. John had no siblings and was living with his maternal grandmother. He had no contact with his father and once stated that he didn't have a dad. John had a large extended family, many of which lived near him and were often present in his home. John's weekly art therapy counseling sessions took place at 9:30 am and each lasted approximately 50 minutes.

Session one. The first art task was to create a self collage using construction paper, magazine images, scissors and a glue stick. The objectives of this session were to build rapport and to allow the client to express himself through a non-threatening art form, such as collage. The participant was asked to create a collage about himself, using images to depict who he was and what he liked. John quickly looked through the magazine images and picked out about a dozen he wanted to use in his collage. One image was of a garden with birds and cherub statues. Another image had angels resting on a cloud.

John slowly cut out each bird and cherub from the garden scene and each angel from the cloud. He said he wanted to use birds and angels in his collage because his mother was an angel. The birds and angels were glued onto the blue construction paper and John gave a satisfied look each time another flying figure was added to the collage. The 50 minute session ended before the collage was finished and John commented that he might want to work on the collage during the next session.

John was talkative during the first session, expressing his love for art and excitement about participating in art therapy counseling. He also expressed his love of painting, drawing, football, snowmen and motorcycles. John appeared comfortable with the idea of his mother being an angel and said he wanted to put the collage on the wall of his room when it was finished.

Session two. Due to inclement weather and school cancellation this session took place three weeks after the first session. John entered the art therapy counseling room with a smile on his face and immediately starting telling stories about his adventures over the past few weeks. He recounted his birthday party and went into detail about the football player he and his cousin made out of snow.

When asked if he wanted to finish his collage from the first session, John shook his head and mouthed the word "no." Then he smiled and eagerly asked what he would be making that day. The first task of the session was to complete the About Me survey. As each statement was read aloud John chose whether he agreed, sometimes agreed or disagreed with the statement. He commented that he did not have as many friends as other kids his age. He said he was picked on by other children and did not get enough attention from his grandmother. John stated he did not get angry anymore; however he used to get angry a lot. When asked why he was angry before, he shrugged his shoulders and said he did not know.

As he finished the survey the session was cut short by a school assembly. This session lasted 15 minutes.

The survey allowed plenty of discussion topics for this session; however, with the shorter session time I felt it was better to finish the survey and address those issues in another session. The surveys were designed to assess the participant's self esteem and resulted in a numerical score for each survey. The higher the score of each survey, the higher the reported self esteem of each

29 participant. John scored 52 out of a possible 66 on the About Me survey. John's grandmother filled out the My Child survey, which rated John's confidence and self esteem based on her observations. His score on the My Child survey was 50 out of 57. John's teacher filled out his My Student survey, which also rated his confidence and self esteem based on the teacher's observations. His score for the

My Student survey was 42 out of 45. Looking at all three surveys, John's grandmother and teacher rated him slightly higher in self esteem than he rated himself.

Session three. John was talkative from the beginning of the session. He discussed his weekend activities and favorite things to do on rainy days. The first art tasks of the session were to draw a house, a tree and then a person. This task was similar to the formal House-Tree-Person assessment, but it did not follow the formal assessments requirements for paper size or the requested direction of the paper for each drawing. The participant was given an 8 1/2" by 11" piece of white typing paper and a number two pencil. He was then asked to draw a house.

After the house was finished John added two trees to the drawing, one on each side of the house. He was asked if he wanted to add anything or change anything about the drawing. John replied that he liked it the way it was. He was then asked to title the drawing. He wrote his name at the top of the page and then asked how to spell the word house. He wrote the word house next to his name as

I spelled it aloud (see Figure 2).

Figure 2. John's house.

After the house drawing was moved aside, a new piece of 8 1/2" by 11" white typing paper was put in front of John and he was asked to draw a tree. He quickly drew a tree in the center of the paper and asked how to spell the name

Lauren and the word bush. He carefully wrote each letter at the top of the page as

I spelled the words for him. When asked if he wanted to add or change anything he shook his head.

A third piece of 8 1/2" by 11" white typing paper was set in front of John and he was asked to draw a person. He spent the most time on this drawing, erasing and redrawing the eyes three times. Finally he asked how to spell the name Ashley and carefully wrote the letters at the top of the page as they were

31 spoken. After the title was written he preemptively said he did not want to change or add anything.

We looked at the drawing of the house together and he was asked to talk about this house. He said it looked similar to the house where he lived and the window at the top of the house was his room. When asked how he got up to that room, which looked very far away from the rest of the house, he said there were a lot of stairs. He said his room was full of computers with fun games he could play all day. John was asked what was downstairs in the house and his reply was

"…not much, just the kitchen and stuff." John said the trees were very tall and they protected the house from the sun and the rain.

Figure 3. Lauren's bush.

John could not think of the type of tree he drew, although he said it was more like a bush than a tree. He explained the title by simply stating Lauren was his cousin and he thought she had trees like that in her yard. When asked how tall the bush was he said it was shorter than most trees, but taller than most bushes

(see Figure 3). John then asked what was next and appeared eager to move onto a new activity. I asked if we could talk about the third drawing before doing something new and he agreed.

Figure 4. Ashley.

With his attention span running short, only a few questions were asked about the person drawing. He said it was his cousin, Ashley, who was fifteen and babysat him sometimes. John said she had long hair and blue eyes, although she had no hair in the drawing (see Figure 4). He stated he liked Ashley and they

33 played computer games when she would babysit him. The hands on the person drawing were distorted and the face was missing a mouth and a nose.

The house drawing was disproportionally tall with a narrow base, a single door at the bottom of the house and three windows at the top of the house. The surrounding trees had long trunks with foliage at the top. The house and trees were distorted to fit the space available was common in the Pre-Schematic Stage, which Lowenfeld considered to be between the ages of four and seven years old

(Lowenfeld & Brittain, 1982).

After the three drawings were discussed, John asked to create another drawing of his choice. He wanted to draw a picture of his mother (see Figure 5).

The drawing of his mother included himself. His mother was depicted as a large head, which went off the edges of the paper. He said he was taking a nap and she was smiling at him. This discussion of the drawing started at the very end of the session. John said he liked to draw, but would rather to do something else during the next session. He mentioned his mother freely, but did not directly address her death.

Figure 5. John's drawing of his mother.

Session four. John arrived in a cheerful mood and talked about his weekend activities of playing tag and having snowball fights with his cousins.

The art tasks for the sessions were to create a Kinetic Family Drawing and then start working on a clay animal. In the previous session John asked for this session's art task to be something other than drawing. After learning he would be using clay that day, he was open to creating one drawing first.

He was given an 8 1/2" by 11" piece of white typing paper and a 10 color set of pencils. John was asked to draw his family doing something together. He quickly finished the drawing, having only used the black, brown and green pencils. When asked if he wanted to add or change anything he shook his head.

We looked at the drawing together and he was asked to describe who was in the drawing and what they were doing (see Figure 6).

Figure 6. John's kinetic family drawing.

He said the drawing was of his grandmother, his aunt, his uncle and himself going to a relative's house in West Virginia. They were walking up the sidewalk to the house. Everyone was carrying a suitcase except for John, his uncle was carrying John's luggage too. When asked if this drawing had actually taken place, he said it had. His family had gone to this house for Thanksgiving last year and stayed for four days. He said it had been a fun weekend and he played outside with relatives his age.

The people in the drawing were stick figures without faces or clothing.

The lack of detail in the figures and the house could be attributed to the participant's desire to move forward with the session and work with a more

36 stimulating material. The disproportion of the house and the omission of body parts on the figures were considered to be the typical of children John's age

(Lowenfeld & Brittain, 1982).

John appeared excited to move onto the next task of our session. We talked about animals and how sometimes people can have similar characteristics to animals. He said he knew a boy who acted just like a hyper puppy and he also knew a man who walked like an elephant. Feeling that he understood the concept,

John was asked to think of an animal that was similar to himself and then make that animal out of clay. John chose to create a tyrannosaurus named Rock.

During the initial kneading of the clay, I asked John why he chose this dinosaur.

He explained how the tyrannosaurus fights all the time. When reminded this animal was supposed to be similar to himself, he responded that he fought all the time too.

He then told a story about defending his cousin to a boy who was making fun of her. John said he jumped on the other boy, who was his age, and punched him in the stomach. He said after he punched the boy twice, the boy ran away crying. I asked if anyone else had seen this fight and he responded that no adults were around when the fight took place. When asked if he told any adults about this fight, he smiled and shook his head.

John created a two dimensional animal, which is typical for his age group

(Lowenfeld & Brittian, 1982). The dinosaur was fairly well proportioned and had

37 little facial or body detail. He used a drinking straw to make holes for the eye and the nose. He then made two additional holes, one in the head and one in the center of the dinosaur's chest. When asked what those holes were, he simply said they were just holes.

The session time ended as he was shaping the claws and putting the finishing touches on his air-dry clay animal. The extra holes he included in the animal's head and chest were particularly interesting to me considering his mother's violent death. I had been told by the school counselor his mother was shot in the head, although she did not know if John knew the details of his mother's death. He was closed when asked the purpose of the holes, which as unusual for him. This may or may not have had any relation to his mother's death, and he did not give further insight into his mother's death in future sessions.

Session six. John was excited to come to art therapy that day. His teacher commented that John had been checking the clock and eagerly waiting for it to be time for his art therapy counseling session. When he entered the art therapy counseling room he gave me permission to sit in the black chair, which was his favorite and where he normally sat. He expressed how much he loved coming to art therapy and how fun it was. He stated he wanted to live in the art room with me. I felt we had built a therapeutic relationship and John's desire to live in the art room reassured me that he felt safe during our sessions.

The art task for this session was to paint the clay animal John made two sessions prior. The fragile dinosaur was glued onto a piece of cardboard to increase its chances of survival once it left the art room. This mounting gave John the chance to create an environment for the animal, in addition to adding color to its body. John painted the body black and gave it a red mouth. He explained the red was actually blood on its teeth from eating a jaguar. John told a story about he and his grandfather killing a jaguar and eating it, although he could not remember where they got it from, he did remember it tasted bad. When asked if that story was true, John smile and shrugged his shoulders.

He commented numerous times that jaguars bleed a lot even though they are small. John said the dinosaur in the picture only ate the jaguar because he was starving. A pterodactyl had taken the tyrannosaurus's food and he would have died if he had not eaten the jaguar. He then painted a cave on the cardboard and the jaguar (see Figure 7). John asked me to paint the word Rock on the background, which I did. The session ended with John expressing his happiness with the finished animal and environment.

Figure 7. Rock.

Session seven. John came into the session distracted and had difficulty staying on track throughout the session. The art task was to create a layered sculpture within a small cardboard box using ordinary objects. The sculpture would then be spray painted a solid color to enhance the layers and textures of the objects. John was engaged with picking out objects to use in his sculpture and where he wanted to place them in the box. He quickly became uninterested in the project and began playing with the objects. We talked about what the objects would look like if they were painted a different color, which kept his attention for a short time.

When John finished with his sculpture he asked to create a few drawings of his choosing. He was given 8 1/2" by 11" white typing paper and a set of 64 colored crayons. The first drawing appeared to be random geometric shapes, which he said was an alien girl without a real body. He drew circles around the girl and said a snake had come and strangled her. I commented that it was sad she had been strangled and asked what her family would do without her. John then drew more shapes and circles (see Figure 8).

Figure 8. John's rescue drawing.

He said he was one of the new shapes that had come to rescue the girl and kill the snake. When a comment was made that he had saved the day, he quickly drew more circles. John said those circles were his sword killing the snake, but the sword had also killed the girl and himself. John did not appear upset by these killings and quickly picked up another sheet of paper. The session time expired

41 before he could start another drawing. As he left the room he said how much he enjoyed coming to art therapy counseling.

Session eight. John came to this session distracted and seemed disinterested in the art task planned for the session. He asked to draw instead and tell stories. John chose to use 11" by 14" white drawing paper, pencils and a box of 64 colored crayons. He was struggling to draw a bird and asked for help. I drew a bird family flying while John drew another portion of the picture. He drew peanuts at the bottom of the page, which he said the birds would eat. He said they were flying to get food, the brother was leading the group, behind him was the mom, then sister and the father was in back. John said the "Daddy Bird," was in back to protect the family in case something tried to hurt them (see Figure

9). He said a bad bird might try to attack them for no reason.

Figure 9. John's bird family drawing.

John said the "Daddy Bird," would kill the bad bird with his long beak.

He would stab the bad bird in the head and the eyes repeatedly. I commented it was sad for any of the birds to die; he laughed and said he wasn't sad the bad bird was dead. He said he wouldn't even be sad if the bad bird was part of his own family. John said he would be sad if the dead bird was part of the good family, that is, if he was one of those birds. He went back to drawing sharp beaks.

A few moments later the session time was over. As John put away the crayons and pencils, he laughed and said it was funny to think about birds being stabbed with long beaks. He giggled as he walked back to class. I had mixed feelings about John's response to the birds being stabbed. My initial reaction was concern over his lack of empathy for the birds. During our sessions John often spoke of violent video and computer games he enjoyed playing. John's desensitized response to the birds being injured may have been caused by his everyday exposure to violence toward fictional characters, rather than a complete lack of empathy.

During the ninth and tenth sessions John and another participant created a seasonal art piece focusing on spring and new birth.

Session eleven. John completed the post art therapy counseling survey

About Me; his score was 57 out of 66. His post art therapy counseling survey score for the My Child survey was 42 out of 57 and his My Student survey score was 45 out of 45. John stated that art therapy helped him feel better. His

43 grandmother wrote on the My Child post art therapy counseling survey that John was excited about art therapy counseling and was happier on days he attended.

His teacher wrote on the My Student post art therapy counseling survey that the program gave him a sense of stability and something to look forward to each week. The teacher also commented that he loved the special attention he was given during his art therapy sessions.

Session twelve. John entered the art therapy counseling room in a cheerful mood as usual. He talked about his plans for the weekend and his excitement over a cousin's birthday party just a few days away. When the subject of this being the last session was approached, he said with a smile on his face, that he was pretty sure the next week was the last session. He asked repeatedly if this really was our last session and why couldn't he just stay all day in the art room.

To continue the termination process, we viewed all of the artwork John made during the eleven previous art therapy counseling sessions. His collage of birds and angels was half finished, although it did not seem to bother him. He laughed when looking at his person drawing, which he decided looked nothing like this cousin. John appeared excited when Rock, the T-Rex, appeared and John said he had told his grandmother and his cousin about his dinosaur.

When the drawing of the flying bird family was put on the table, John said he forgot about those birds. When asked if he remembered what the birds were doing, he said they were going to eat the peanuts drawn at the bottom of the page.

As the session ended I had a few gifts for John. He was given a small sketch pad and a set of crayons to continue his drawings and storytelling. Then John was given a small glass pebble to remind him of our time together, the art he made and the things we talked about. The pebble appeared to be the favorite of all the gifts.

He quickly put the pebble in his pocket and asked if I would tell his teacher it was a gift, he was afraid if the teacher saw the pebble it would be taken away. When we walked back to John's classroom he expressed his love of art and art therapy counseling.

John came to each session excited and ready to create art. The sessions focused around transitions and positive ways to express emotions. Violence and death were common themes in his artwork, which continued to be a concern.

John completed numerous art pieces and verbally expressed his love of art during each session. He was willing to try any type of art task, even those unfamiliar to him. John showed improvement in identifying emotions surrounding times of transition and appropriate ways to express those emotions. John was a talented and creative boy with a vivid imagination.

Chapter V

Case Study

David

David was a 13 year old male of African-American decent. He had a flat affect; he had trouble making friends and was bullied by other students. He was referred to art therapy counseling for poor social skills and being a "loner." This was David's second year at the sponsoring school. He lived with his parents and three younger siblings, ages nine, three and one year old. David said his mother was a medical assistant and his father worked for a small information technology business. The school counselor described his family's income as below the poverty level.

Session one. David was initially quiet then became more talkative as the session progressed. He was unanimated while speaking and had almost no facial expressions. The art task was to create a self collage using construction paper, magazine images, scissors and a glue stick. The participant was asked to create a collage about himself, using images to depict who he was and what he liked.

While David picked out magazine images he talked about his family and an uncle who was in prison. His aunt had recently passed away from a drug overdose and her children were now living with other family members. David was curious about how he was chosen to participate in art therapy counseling.

His wording of that question gave the impression he felt this was an honor to be

46 chosen to receive this treatment. He said he liked art, especially drawing and felt he had a unique style of drawing. David also noted he did not always like being the oldest in his family.

After selecting and gluing the images of his collage, he was asked to share about the collage. David described how the images of athletes represented his love of sports, the cars and money were what he wanted in life and the animals showed how much his loved his dog that had passed away the year before (see

Figure 10). As the session ended, David said he thought was going to like doing art therapy if the other sessions were like this one.

Figure 10. David's self collage.

Session two. David came into the session quiet and less engaged than the

previous session. The first task was to complete the About Me survey used to measure progress within this study. He filled out the survey and had no questions about any of the statements. When questions were asked of him, he gave one or two word answers and his affect remained flat. The art task for this session was to paint an 8" wooden cross in any style the participant chose, keeping in mind this could be a reminder of God's love.

David chose to paint the cross like an American flag. He painstakingly measured and drew out the lines for each row of red and white stripes. He then started painting at the very top of the cross, carefully staying within the lines he had drawn onto the cross earlier. He had trouble with keeping enough paint on the brush. He would dip the brush in the paint, then wipe the brush off, flatten it out and attempt to paint the stripe. He continued to struggle, even after I gave a few generalized tips on painting, until the session time expired. David cleaned up his work space and thanked me for the session as he left the room. His score for the About Me pre-art therapy counseling survey was 48 out of 66. His pre-art therapy counseling score for his My Child survey was 41 out of 57 and his score for the My Student survey was 26 out of 45.

Session three. David was talkative from the start of the session. He told stories about the weekend he had just spent in Kentucky with his family. They visited friends and went to hear a religious motivational speaker. He continued to

48 have a flat affect, although the words he used where those of excitement. The first art task for this session was to create three drawings, a house, a tree and a person. David was given an 8 1/2" by 11" piece of white typing paper and a pencil. He was told he would be making three drawings during the remaining 40 minutes of the session. He was then asked to draw a house. David asked if it had to be a real house and I responded it could be any type of house he wanted.

He lightly sketched the basic outline of the house, drew a door, windows and a chimney. He then divided the house vertically down the middle. On the left he started drawing rows of detailed patterns. David erased and redrew the patterns a dozen times; he wore down the entire eraser on a new pencil. After twenty minutes he was given a reminder that there were two more drawings to complete during the session. Five minutes later he was asked to start thinking about how he wanted to finish the house before the session ended. Another five minutes passed and David was asked to leave the drawing and possibly he could work on it during another session (see Figure 11).

Figure 11. David's house drawing.

He stated he was not sure of the other patterns he wanted to use. He said his plan was to make a house that was split down the middle, one side would be a

"different type of house," with patterns and the other side would be normal looking.

David was then given a new piece of 8 1/2" by 11" white typing paper and asked to draw a tree. He was asked to draw the best tree he could in the 10 minutes remaining. David looked confused and said he had never drawn one before and then asked what kind he was supposed to draw. He was told he could draw any type of tree he desired. Feeling like he needed further direction, I told him he could draw a tree like the type he had seen outside or something he imagined. David quickly starting sketching, he stopped a few times to erase and commented that he was not sure what he was doing.

After a few minutes it became clear the tree he was drawing was actually a train (see Figure 12).

Figure 12. David's train drawing.

He carefully drew the tracks under the train and a stop sign at the end of the tracks. David said he thought the train ran on gasoline and then added the name initials "SGT" and "Small Gas Train" to the side of the engine. When asked where the train was going, he appeared satisfied and stated twice that he had never drawn a train before.

The session ended with David asking if he could take the train home to show his brother. He was asked to leave the drawing in the art room and at the end of the art therapy counseling sessions he would be able to take home all of his artwork. David complied and left the session with his usual parting words of thank you. After this session a variety of questions surfaced about David. Did he

51 have a hearing problem which led to the confusion about the tree drawing? Was he so engaged in the house drawing that he just was not paying attention when it came time to draw the tree? These were issues that would need to be addressed in other sessions.

Session four. David was quiet when the session began. He answered questions about his weekend and mentioned he had a snowball fight with his brother. The art task for the session was to continue working on the wooden cross he had been painting in session two. During his painting there was no spontaneous verbalization. He appeared completely consumed with the stripes and trying to stay within the lines he had drawn.

David was meticulous when painting and his preparation was always ritualistic. He would fully immerse his brush into the paint, and then wipe most of the excess paint onto the right and left sides of the palette well. The brush was made completely flat before it made contact with the wooden cross. The steps of removing paint and flattening the almost dry brush made it very difficult for

David to paint a crisp line. He appeared frustrated and was asked if he liked the way the cross looked thus far. He said he always had a fascination with the flag and even could recall his first memory of seeing a flag in school.

Along with struggles to paint a crisp line, David had trouble seeing and remembering which paint wells on the white pallet contained paint. He dipped his brush into empty wells numerous times and after rinsing the brush he would

52 check two or three times to make sure he was going after the correct color for the next stripe. David would paint one stripe at a time, cleaning his brush after each stripe, alternating between white and red. When he dipped his brush into an empty well he would comment that he thought that was the white paint.

The final step to finish the cross was the application of silver stars to adorn the solid blue portions of the cross (see Figure 13). The silver stickers came on black adhesive paper. David had trouble distinguishing between the silver stickers and the white star shaped space that was left after a sticker was removed.

He did not appear upset or frustrated by this; however, he did remain quiet for the remainder of the session.

Figure 13. David's wooden cross.

After this session with David, I spoke to the school counselor about a possible vision or depth perception problem he might be having. She said she would look into it and announced she had something else to discuss about David.

The counselor said another student had written a letter in defense of David and had given it to the school's director. This student wrote how others picked on and bullied David. The student was upset and wrote that nothing was being done even though the school had a no bullying policy. The letter explained that David was coming to the end of his rope and it nothing was done he would probably commit suicide.

The school counselor said she talked to David about the letter and had also spoken to the author of the letter about the situation. The student was a friend of

David's and very upset that the teachers were not paying attention to the behavior taking place in the classrooms. The letter named individuals and gave examples of the actions they had taken against David.

It was decided between the school counselor, myself and the on-site supervisors that I would not address the letter unless David told me about it.

Having just built a rapport with David I felt it could hinder our therapeutic relationship if he thought I was openly discussing our sessions with members of the school's staff.

Session six. David spoke freely during this session about events and activities he had attended. His flat affect continued even when using words which conveyed joy or excitement. In the previous session David was asked to think of an animal with whom he shared similar characteristics. He was then asked to sculpt the animal out of clay. David chose a cheetah, stating they were quick and

54 observant. He sculpted the cheetah, paying special attention to the tail and the paws. He also sculpted a ball for the cheetah to use as a play toy, much like a kitten would have.

The art task for the sixth session was to paint the clay animal. Similar to the painting styles he exhibited while working on the wooden cross, he diligently dipped and wiped his brush after each stroke. David did not display the same confusion with color choice or empty wells that he had in session four. While he painted the cheetah he shared stories of a trip his family took to visit relatives. He told of fishing trips, frog catching and mice in their cabin. Each story portrayed his family and their relationship positively. Through the session and the sometimes humorous stories, David retained his flat affect.

David had commented in other sessions, as well as this session, that he did not like having to try to control his younger brothers. He did not appreciate their desire to spend time in his room and their careless treatment of his belongings. I asked David why his brothers wanted to be in his room rather than their own rooms. He responded that he had a big television and video games in his room.

When asked if there might be reasons other than the television, David said he knew his brothers wanted to spend time with him and looked up to him. He also stated that he knew they did not mean to be careless. They were just too young to properly use some of his things.

When the session time had expired the cheetah was almost finished. All

David said he had left to do was to paint the spots and the eyes. He cleaned up his work space, as usual and said thank you as we walked out the door.

Session seven. The sessions started with small talk about the events of the past week. David had little to say and appeared excited to continue working on his clay cheetah. He started painting the cheetah's spots and quickly stated they did not look right. Although he appeared frustrated, he repainted the spots remaining calm and composed. Unsure how to finish the cheetah's face, he asked to start another project commenting that he would look at photographs of cheetahs to have a better idea of how to finish it for the next session (see Figure 14).

Figure 14. David's cheetah.

The second art task for his session was to paint emotions using watercolor.

David was first asked to list as many emotions as he could. He listed happy, sad,

56 frustrated, mad, confused, excited, dreadful and tired. He was then given a 4 1/4" by 5 1/2" piece of white drawing paper and asked to paint using shapes and colors what he thought happy looked like. When he finished the happy painting, he was given a new piece of paper and asked to create a painting for the next emotion on his list. This process continued until he had created a painting for all eight emotions he had named.

For each emotion painting David was asked to explain the significance of the colors and shapes in relation to the emotion. Then he was asked to give an example of a time he felt that emotion. His happy painting was brightly colored, and he said it made him think of sunny days and active people (see Figure 15).

He felt happy when his family took a vacation to Disneyworld.

Figure 15. Happy.

His sad painting contained blue drops he said were like rainy days and storms (see Figure 16). He said he felt sad when his dog passed away. David had mentioned the death of his dog in previous sessions and commented that losing his dog was difficult for him.

Figure 16. Sad.

His painting for frustrated he said represented being bothered and made him want to fight (see Figure 17). The example he gave of his own experience with frustration was being pushed during a basketball game and his books being thrown on the floor. He said the person that pushed him said it was an accident, although David did not believe that was true.

Figure 17. Frustrated.

The mad painting was gray. He said it did not turn out like he had planned it. He wanted the sky to appear mad like a storm (see Figure 18). David said that he felt mad when his brother created a mess in his room just after he had cleaned it.

Figure 18. Mad.

The confused painting he said showed what it was like when you do not know what to do or you are new to an activity (see Figure 19). The example

David gave was the first time he played soccer and was unsure of the rules.

Figure 19. Confused.

The painting for excited was the most colorful of the eight (see Figure 20).

He described it as a burst of happiness, something new or getting something he

60 really wanted. He said it was blowing out color. His personal example of excitement was opening gifts on Christmas morning.

Figure 20. Excited.

Figure 21. Dreadful.

The dreadful painting he described as feeling sick, not wanting to be around people or feeling left out (see Figure 21). The example he gave was when

61 he was in the fifth grade and his friends stopped talking to him. He stated he did not know why they suddenly excluded him and they would not respond to his questions regarding the ordeal. David said after a few days they started talking to him again and the issue was never brought up again.

The final painting represented tired; David said this was the feeling of wanting to go to sleep while not wanting to miss out on anything (see Figure 22).

His personal example was when his family drove to Florida and he wanted to see everything outside, although he was tired and eventually fell asleep.

Figure 22. Tired.

David's emotion paintings were colorful and expressive. He easily gave explanations and personal examples of times he had experience those emotions.

He was more responsive during this art task than any prior to this session. When the session concluded he stated he liked this project and was pleased with the paintings.

Session ten. David did not arrive in the art room when his session was scheduled to begin. I went to David's classroom looking for him, when I arrived

David quickly marched out of the room. He was breathing heavily as he passed me in the hall and did not make eye contact. A few yards behind him followed another student, also scheduled for art therapy counseling at this time. She called his name, asked if he was alright and said she saw what the other student had done to David. Without response, David walked down the hall and immediately entered the art therapy counseling room. He sat down at the table, clearly upset and physically agitated.

When asked what happened, David's breathing became heavy and tears filled his eyes. He said while sitting in class the boy behind him repeatedly hit

David in the back of the head with a ruler. David asked him to stop three times and finally grabbed the ruler out of the boy's hand, breaking the ruler in the process. The teacher saw David grab and break the ruler, which belonged to her.

According to David and the other art therapy counseling participant in his class, the teacher did not see David being hit. The teacher told David he would be disciplined and had to buy her a new ruler. He said he tried to tell the teacher why he grabbed the ruler, but the teacher would not listen to him.

Tears rolled down David's face and he was having trouble sitting still in the chair. He was asked to take a few deep breaths, which appeared to calm him.

When asked if he wanted to continue talking about this incident or work on

63 something else, he said he wanted to work on something else for a while. A few options of art tasks were presented, none of which interested David. Given his mention of having trouble with friends in the past, I started a discussion about approval from others and how someone can gain approval from others.

David was asked to list people in his life that he thought it was important approved of him and his behavior. The first on the list was his mother; David was asked how he could win his mother's approval. He responded his mother is always happy when he gets good grades. Next on the list was his father, he said he could do things to show his father he was dependable. His brothers were also on the list, he said the best thing he could do for his brothers was to make sure they did not get bored, which usually led to trouble while he was watching them.

He listed his friends as people he wanted approval from and stated he could win their approval by making sure they could trust him with their belongings. The last on the list was his teacher, whom he said would approve of him if he turned in his schoolwork earlier than he usually does. David was asked what one thing he would tell his parents and teachers to help them understand him better. He said he would tell them it was hard to keep up with all of the things he was expected to do.

David then went into a lengthy discussion about his parents' expectations and how they prevented him from doing activities he would enjoy. He said having to watch his brothers did not allow him ample time to spend with his

64 friends. He said he felt his mother was overly protective and her worries prevented him from being allowed to socialize with other boys his age. David stated he knew his mother had good intentions and was worried about his safety in their neighborhood, although he thought there were safer places he should be allowed to go with friends.

He openly displayed his love for his family, while expressing his frustrations with feeling trapped at home by the amount of responsibility he felt he should not have. David said he told his mother these feelings and she agreed he needed to be able to go out with his peers more. The session time was through and David said he felt much better than he had when he arrived. He said he might write a letter to his teacher explaining what happened. David also said he was going to ask his mother again about a time he could go out with his friends.

Before David said his usual thank you and headed out the door, he smiled and told me to have a good week. This was the first smile I had seen from David in the eleven sessions, in fact this was the first session he had facial expressed any emotion.

Session eleven. In the eleventh session David completed the post art therapy counseling About Me survey his score was 47 out of 66. David wrote on the survey he thought art therapy had helped him to be able to talk about his feelings with someone he knew would not tell everyone. His post art therapy counseling score for the My Child survey was 43 out of 57 and his score for the

My Student survey was 30 out of 45. David's teacher wrote on the post art therapy counseling My Student survey that David liked art therapy because he had a chance to express his feelings.

Session twelve. David entered the art therapy counseling room with a smile and said his mother had allowed him to go to a local arcade with his cousin and some friends over the past weekend. He said he felt good about asking her permission rather than asking why she would not let him go anywhere. When asked if he wrote a letter to his teacher about the broken ruler incident, he said he had not and he was not disciplined for the event either. David talked about the arcade trip, laughing and smiling as he recounted the antics of the teenage boys.

In the previous session his flat affect had disappeared and in its place was an expressive boy who laughed and smiled freely.

In this final session David looked at all of the artwork he had created during the eleven previous sessions. When looking at his collage from the first day, he stated he almost forget he had made that. He looked at the house drawing and said he realized he did not need to add anything to it. David said he liked the way his red, white and blue wooden cross had turned out. He already had a space for it on a shelf in his bedroom. His cheetah still had no eyes, although he thought he had some paint at home to finish it.

When his emotion paintings were spread across the table he recalled what each emotion was and said he liked that art task. As the session drew to a close, I had a few parting gifts for David. He was given a small sketch pad and a set of colored pencils to continue his drawing outside of school. He smiled and said thank you. David was then given a small glass pebble and told that the pebble would serve as a reminder of our time together and the things we discussed. As I handed him the pebble his eyes lit up and he said a heartfelt thank you and placed the pebble in his pocket. He then said his final thank you as he walked out the door with his arms full of artwork.

David came to art therapy with a love of drawing. The sessions focused on improving peer relations and increasing verbal communication. He attended each of the twelve sessions and was willing to attempt any task asked of him, including the use of unfamiliar art supplies. With each session, David showed much improvement in verbal communication. He was a talented and mature young man.

Chapter VI

Results and Conclusion

This chapter will summarize the results of the research study, including the scores of the pre and post-art therapy counseling surveys. Comments by the participants, teachers and parents are also included to provide a more subjective look into this study. Possible reasons for this study's success will be provided and overall themes will be discussed.

Results of the Study

During the second week of the art therapy counseling sessions each participant was asked to fill out a pre-art therapy counseling survey entitled About

Me. The homeroom teacher of each participant was asked to fill out a pre-art therapy counseling survey about the student entitled My Student. A parent or guardian of each participant was also asked to fill out a pre-art therapy counseling survey about the child entitled My Child. This method was used to get a baseline for all participants in order to track their progress during this study.

After the 12 weeks of art therapy counseling, each participant, teacher and parent or guardian was asked to fill out post-art therapy counseling surveys. The post-art therapy counseling surveys were identical to the initial surveys; however, there was additional space for feedback and comments. These post-art therapy counseling surveys were compared to the participants' pre-art therapy counseling surveys to determine progress of the clients and success of the study.

The study collected complete data for 15 of the 20 participants and at least partial data for three more of the participants. The study was not able to gather adequate data for Hannah and Norman; therefore those participants were not included in the results of this study.

At the end of the About Me survey the participants were asked, "Has art therapy helped you? How?" The My Child post-art therapy counseling survey asked a similar question, "Has art therapy helped your child? Please explain."

The My Student post-art therapy counseling survey also included an open ended question, "Have you noticed any changes in your student since he/she started art therapy? Please explain." In the My Student post art-therapy counseling survey space was also available for additional comments from the teachers. The responses to these questions are included below the table for each participant.

Tables representing the pre-art therapy counseling survey scores and post- art therapy counseling survey scores are included for each participant along with comments from the post-art therapy counseling surveys (see Appendix A). Three of the My Child post-art therapy counseling surveys were not returned and that portion of the table was left blank.

The surveys were scored by assigning a number value to each response. A positive response to a positive statement received three points. A response of

Maybe/Sometimes received two points. A negative response to a negative statement received one point. The points for each response were added together

69 to determine the participant's total score for each survey. The higher the score meant the higher the reported confidence and self-esteem of the participant.

Overall Results

The results of the About Me pre and post-art therapy counseling surveys showed the 18 participants scores improved anywhere from -7 points to 18 points

(see Appendix B). The average increase in scores from the pre-art therapy counseling survey to the post was 3.33 points. The results of the My Child pre and post-art therapy counseling surveys showed the 15 participants scores improved anywhere from -8 to 9 points (see Appendix B).

The results of the My Student pre and post-art therapy counseling surveys showed the 18 participants improved their scores anywhere from -7 to 14 points

(see Appendix B). The average improvement for this post-art therapy counseling survey was 4.27 points. When the pre-art therapy counseling survey scores were compared to the post-art therapy counseling survey scores, the participants averaged an increased score of 2.48 points.

The data for the participants whose post art-therapy counseling surveys were not returned does not appear on the correlating chart and was not included in the averaged data.

Overall Theme

The overall theme shown in the study's results was the participants' appreciation of the one-on-one interaction with a trusted adult. Eight of the 18

70 participants responded that art therapy helped them express their feelings, or that being able to speak with someone confidentially helped them. The My Child post-art therapy counseling survey results showed that six parents responded that they saw positive behavioral changes in their child after starting art therapy counseling. The My Student post-art therapy counseling survey results showed that 8 teachers responded they had seen positive behavioral changes in their students since the start of art therapy counseling.

Challenges and Recommendations for Further Study

The biggest challenge of this study was gathering complete survey data for each participant. All but one pre art therapy counseling surveys were returned, however eight of the post art therapy counseling surveys were not returned. This lack of data led to the removal of two participants' results and the partial removal of data from three additional participants in the study's final results.

Another challenge was session attendance. All school sponsored activities took precedence over art therapy counseling sessions, absences by the participants and the student art therapy counselors could have also affected the study. The limited privacy in the art room affected the depth of the sessions, as well as the participants' school schedules before and after each session.

Further study could give a more thorough look into the background of each participant and the possible causes for their behavioral issues. Requiring each participant to complete 12 sessions rather than running a 12 week study

71 would also give a more complete view of each participant's progress. Conducting the art therapy counseling sessions in a private room I believe would also have an effect on the results.

Personal Reflection

This study challenged me in unexpected ways. Working with an unfamiliar population was challenging, especially adolescents. Looking back there are things I would have done differently with John and David, the two individuals highlighted in this study. John would have been a good candidate for play therapy and role playing, possibly even sand play. We did a bit of role playing during some of his drawings, although I wish I would have taken it to the next step.

With David I wish I had been more direct about some of his socialization issues. I should have tactfully addressed the issue sooner rather than tiptoeing around it until half way through our sessions. My bluntness could have dramatically impacted our sessions positively or negatively. At times I felt frustrated when a typically one session art intervention turned into a three session project.

Throughout this study I learned that at times there is a fine line between encouraging a client and pushing them, often I was unsure of which to do. This study was rewarding and heartbreaking. Some of the participants' responses to the pre and post-art therapy counseling surveys were unsettling. In some cases

72 each survey for the same participant painted a different picture of their life. At times it was difficult to know which was more accurate. I enjoyed working with the participants, although a few times I felt distracted by the surveys and needing to gather data. In the end, as cliché as it may be, I am sure I learned more from the participants than they learned from me.

Conclusion

From the improved art therapy counseling survey scores, it is believed this study showed that individual art therapy counseling can be beneficial to at risk children in a school setting. Although the numerical data from this study is not statistically significant, the overall theme shown in the study's results was the participants' appreciation of the one-on-one interaction with a trusted adult.

The comments from the participants, teachers and parents suggested that the positive interaction was the most important feature of these sessions. The student art therapists commented that the art was what fostered the relationship between the participants and the student art therapist. The positive interaction was important, but without the art it may not have happened. Although the art therapy counseling sessions were only one hour per week, the most rewarding aspect of this study was discovering that one hour per week can and did make a difference.

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Appendix A

Individual Results

Results for Ann

70 63 60 53 48 50 42 38 40 29 30 20 10 0 About Me About Me My Child My Child My Student My Student Pre-test Post-test Pre-test Post-test Pre-test Post-test

Ann

About Me: "I don't know how art therapy has helped me. It's helped me to learn how to do art. It's just fun."

My Child: "I'm not sure if art therapy helped - Ann didn't really open up with her therapist."

My Student: "Ann seems happier at school and is missing fewer days."

Results for Beth

60 54 51 50 43 41 39 40 31 30

0 About Me About Me My Child My Child My Student My Student Pre-test Post-test Pre-test Post-test Pre-test Post-test

Beth

About Me: "Yes it has, because it helped me calm down a little and not get so mad lately."

My Child: "Beth is a little more understanding and calmer."

My Student: "I have never had a behavior or academic problem with Beth, at least none that I have observed."

Results for Conner

60 48 50 50

40 33 29 30 30 23 20

0 About Me About Me My Child My Child My Student My Student Pre-test Post-test Pre-test Post-test Pre-test Post-test

Conner

About Me: Yes, helps control anger because he can get thing off his chest.

My Child: "Unsure if Conner has had art therapy, nothing much has changed this year with Conner."

My Student: "For a while, I thought he was doing okay. He seemed to like art therapy. Then yesterday he got in a fist fight and was suspended."

Results for Dena

50 45 43 39 40 35 35 35 32 30 25 21 20 15 10 5 0 About Me About Me My Child My Child My Student My Student Pre-test Post-test Pre-test Post-test Pre-test Post-test

Dena

About Me: "Yes, I have somewhere to go with problems and I know it won't end up with the whole school."

My Child: "Noticed no difference."

My Student: "Not noticeable changes. Maybe somewhat less negative than earlier this year."

Results for Elizabeth

60 55 48 48 50 45

40 33 30 26

0 About Me About Me My Child My Child My Student My Student Pre-test Post-test Pre-test Post-test Pre-test Post-test

Elizabeth

About Me: "I don't know."

My Child: "Yes!! Elizabeth says it helped her to relax and she loves art more.

Thank you!"

My Student: "I have not noticed any outer changes in Elizabeth."

Results for Fran

60 52 50 43 41 42 40 35 32 30

0 About Me About Me My Child My Child My Student My Student Pre-test Post-test Pre-test Post-test Pre-test Post-test

Fran

About Me: "Yes it has because we have talked over a lot of things and she gave me some ideas how to help me out."

My Child: "Fran has been getting along with other children better. She struggles to stay organized."

My Student: "Motivation has increased a little. She seems to care more about herself and being more responsible. She doesn't seem as overwhelmed by family issues."

Results for Gwyneth

50 44 45 43 40 37 35 30 30 24 25 20 15 10 5 0 About Me About Me My Child My Child My Student My Student Pre-test Post-test Pre-test Post-test Pre-test Post-test

Gwyneth

About Me: "To make good choices and find other ways to deal with anger."

My Child: (unreturned)

My Student: "Gwyneth's behavior has remained mostly consistent through this year, one major upsetting experience observed by me. Art therapy has benefited her and is one of her strengths."

Results for David

60 48 50 47 41 43 40 30 30 26

0 About Me About Me My Child My Child My Student My Student Pre-test Post-test Pre-test Post-test Pre-test Post-test

David

About Me: "Yes, because I can speak my troubles out to someone that will not tell lots of people."

My Child: "He needs to become more social to learn, which means being out around other peers in a neutral setting that's the gathering focus that they all like."

My Student: "David likes art therapy because he has a chance to express his feelings."

Results for Jane

70 59 58 60 50 42 41 40 35 32 30 20 10 0 About Me About Me My Child My Child My Student My Student Pre-test Post-test Pre-test Post-test Pre-test Post-test

Jane

About Me: "Yes. It has helped me to express my feelings."

My Child: "Jane doesn't share much about her art therapy. I keep asking but I don't press her. I know she enjoys art therapy."

My Student: "Jane's disposition and performance are the same."

Results for Keri

50 46 47 43 45 40 40 35 29 29 30 25 20 15 10 5 0 About Me About Me My Child My Child My Student My Student Pre-test Post-test Pre-test Post-test Pre-test Post-test

Keri

About Me: "They helped me by letting my feelings out in art."

My Child: (none)

My Student: "Self motivation has increased slightly in terms of turning work in, but it is of bare minimum quality."

Results for Lara

70 61 60 55 48 50 44 38 40 32 30 20 10 0 About Me About Me My Child My Child My Student My Student Pre-test Post-test Pre-test Post-test Pre-test Post-test

Lara

About Me: Yes - more comfortable talking to someone that is not a friend or parent. Now, has built more communication with father so she feels she can talk to him more.

My Child: "Yes I do see an improvement needs to work on dependability and decision making."

My Student: "Yes, Lara seems to have acquired the technique of self-motivating.

I have seen her make better choices about who to be around/work with. She cares about her behavior and making good choices."

Results for Michael

60 56 51 49 50 40 40 40

30 26

0 About Me About Me My Child My Child My Student My Student Pre-test Post-test Pre-test Post-test Pre-test Post-test

Michael

About Me: "Yes because most of the time I have problems that I don't want to tell anyone but at art therapy I could tell my problems."

My Child: (none)

My Student: "Michael has made major positive changes since the beginning of this trimester and art therapy. His academic work has greatly improved. He has become an independent reader."

Results for Omar

70 60 60 50 50 50 40 31 30 30 20 10 0 About Me About Me My Child My Child My Student My Student Pre-test Post-test Pre-test Post-test Pre-test Post-test

Omar

About Me: "It has helped me to become a better painter and drawer."

My Child: (unreturned)

My Student: "Omar continues to struggle with many issues at home."

Results for John

60 57 52 50 50 45 42 42 40

0 About Me About Me My Child My Child My Student My Student Pre-test Post-test Pre-test Post-test Pre-test Post-test

John

About Me: Art therapy helped him "feel better."

My Child: "He's always happier on the day he knows he has (art therapy)."

My Student: "John was very eager and excited about participating in art therapy." "It allowed him to express his feelings about his mother's death in a healthy way. The program gave him a sense of stability and something to look forward to each week. He loved the special/extra attention"

Results for Penny

60 49 51 50 43 42 40 29 31 30

0 About Me About Me My Child My Child My Student My Student Pre-test Post-test Pre-test Post-test Pre-test Post-test

Penny

About Me: Yes - she said she has been better with her anger because she talks about her problems.

My Child: (none)

My Student: "Penny has enjoyed art therapy because she likes talking about and sharing her feelings. Her tantrums have diminished since she started art."

Results for Raquel

70 58 60 52 53 50 40 35 30 27 20 10 0 About Me About Me My Child My Child My Student My Student Pre-test Post-test Pre-test Post-test Pre-test Post-test

Raquel

About Me: "Yes. Art therapy has helped me to control my anger. (Like when I get mad I color or draw.) (or punch my cousin.)"

My Child: (unreturned)

My Student: "I have observed little change if any in her actions day to day though I believe she likes art therapy."

Results for Sally

60 54 52 50 42 39 37 40 34 30

0 About Me About Me My Child My Child My Student My Student Pre-test Post-test Pre-test Post-test Pre-test Post-test

Sally

About Me: Yes, fun - look forward to every Wednesday.

My Child: "She's improving"

My Student: "Sally loved and looked forward to art therapy - nice program."

Results for Terry

70 58 60 56

50 43 44 40 30 30 22 20 10 0 About Me About Me My Child My Child My Student My Student Pre-test Post-test Pre-test Post-test Pre-test Post-test

Terry

About Me: "It's real fun and I'm happier."

My Child: (none)

My Student: "I have not noticed any change in Terry's behavior or work."

Appendix B

Overall Participant Results

Overall Participant Results for About Me Surveys

Penny 51 49

John 57 52

Omar 60 50

Michael 56 51

Lara 61 55

Keri 47 46

Jane 58 59

David 47 48

Gwyneth 44 43

Fran 52 43

Elizabeth 48 55

Dena 39 21

Conner 50 48

Beth 54 51

Ann 63 53

0 10 20 30 40 50 60 70

Posttest Pretest

Overall Participant Results for My Child Surveys

Terry 44 43

Sally 42 39

Penny 42 43

John 42 50

Micael 49 40

Lara 44 48

Keri 43 40

Jane 41 42

David 43 41

Fran 42 41

Elizabeth 48 45

Dena 35 43

Conner 29 33

Beth 39 41

Ann 48 42

0 10 20 30 40 50 60

Posttest Pretest

Overall Participant Results for My Student Surveys

Penny 31 29 John 45 42 Omar 30 31 Michael 40 26 Lara 38 32 Keri 29 29 Jane 32 35 David 30 26 Gwyneth 30 24 Fran 35 32 Elizabeth 33 26 Dena 35 32 Conner 23 30 Beth 43 31 Ann 38 29

0 10 20 30 40 50

Posttest Pretest

Appendix C

Art Release Form

I, ______, hereby agree that my child’s artwork or representations of the artwork may be used in professional or educational training. I understand that my name or my child’s name will not be used in conjunction with the presentation or discussion of the work.

______Signature Date

______Witness Date

Appendix D

Pre-Art Therapy Counseling Survey Cover Letters

Dear Parent or Guardian,

The purpose of the (art therapy counseling program) is to provide your child with an educational and enjoyable therapeutic art experience. The (art therapy counseling program) at (site of study) has created a questionnaire to help us better serve the students in this program. We are asking the parent or guardian of each of the students in the (art therapy counseling program) to complete the attached questionnaire. All the information and answers from this questionnaire are confidential and will only be seen by the Art Therapists working with your child. The information received will be used to help determine the progress and effectiveness of this program. Some or all of the responses may be used anonymously in grant applications and may be included in a master’s thesis. Your name and your child’s name will not be used in connection to the responses given.

Please answer this questionnaire honestly, keeping in mind your child’s behavior in the last three months. Place a mark in the box that most appropriately matches your response to each statement.

Please place the completed questionnaire in the enclosed envelope and return to (school counselor) at (site of study). If you have any questions about this questionnaire or the (art therapy counseling program), please contact (school counselor) at (school phone number).

Thank you for your participation and continued support of the (art therapy counseling program).

Sincerely,

(art therapy counseling program)

100

Dear Teachers,

The purpose of the (art therapy counseling program) is to provide students with an educational and enjoyable therapeutic art experience. The (art therapy counseling program) at (site of study) has created a questionnaire to help us better serve the students in this program. We are asking the teachers of each of the students in the (art therapy counseling program) to complete the attached questionnaire. All the information and answers from this questionnaire are confidential and will only be seen by the Art Therapists working with your student. The information received will be used to help determine the progress and effectiveness of this program. Some or all of the responses may be used anonymously in grant applications and may be included in a master’s thesis. Your name and your student’s name will not be used in connection to the responses given.

Please answer this questionnaire honestly, keeping in mind your student’s behavior in the last three months. Place a mark in the box that most appropriately matches your response to each statement.

Please place the completed questionnaire in the enclosed envelope and return to (school counselor). If you have any questions about this questionnaire or the (art therapy counseling program), please contact (school counselor).

Thank you for your participation and continued support of the (art therapy counseling program).

Sincerely,

(art therapy counseling program)

101

Appendix E

Pre-Art Therapy Counseling Surveys

Name______

About Me Yes/Agree/ Maybe / No/Disagree/ Always Sometimes Never 1. Other kids think I am fun to be with. 2. I do not have as many friends as other kids my age. 3. I am usually proud of the school work I do. 4. I often get picked on or bullied. 5. People ask me for help when they are having trouble. 6. No one pays much attention to me at home. 7. I am a very important person in my family. 8. My parents feel they can depend on me. 9. My parents expect too much of me. 10. I am an important person in my class. 11. Schoolwork is harder for me than most kids. 12. My teacher is usually happy with the work I do. 13. I do not get along with the other kids living in my home. 14. I get in trouble at school. 15. I make good choices. 16. When I have a problem, I can usually figure it out. 17. I get mad easily. 18. I turn in my schoolwork on time. 19. My parents are proud of me. 20. I spend a lot of time alone in my room. 21. My parents try to understand me. 22. I like myself.

102

My Child

Name ______Yes/Agree/ Maybe / No/Disagree/ Always Sometimes Never 1. My child usually shares ideas and feelings openly. 2. My child is picked on or bullied by other children. 3. My child usually follows directions without being reminded. 4. My child says nice things about him/herself. 5. My child struggles to finish tasks or projects on time. 6. My child says nice things about others. 7. My child's school reports have stayed the same or improved. 8. My child expresses anger in appropriate ways. 9. My child is not dependable. 10. My child gets along well with other children living in our home. 11. My child does not like him/herself. 12. My child usually handles difficult situations well. 13. My child does not make friends easily. 14. My child is good at finding solutions to problems. 15. My child spends a lot of time alone in his/her room. 16. My child turns in schoolwork on time. 17. My child gets frustrated easily. 18. My child makes good choices. 19. I am proud of my child.

Name of Parent or Guardian ______

103

My Student

Name______Yes/Agree/ Maybe / No/Disagree/ Always Sometimes Never 1. Shares ideas and feelings openly 2. Makes positive choices 3. Follows directions independently 4. Picks on or bullies other students 5. Academic performance has declined 6. Completes tasks in the expected time frame 7. Makes positive statements about others 8. Expresses negative feelings Inappropriately 9. Is disruptive in class 10. Interacts inappropriately with peers 11. Is liked by other students 12.Has good problem solving skills 13. Uses inappropriate language 14. Makes positive statements about him/herself 15. Quality of schoolwork usually meets or exceeds expectations

Your Name ______

Date ______

104

Appendix F

Post-Art Therapy Counseling Survey Cover Letters

Dear Parent or Guardian,

The purpose of the (art therapy counseling program) is to provide your child with an educational and enjoyable therapeutic art experience. The (art therapy counseling program) at (site of study) has created this questionnaire to help us better serve the students in this program. We are asking the parent or guardian of each of the students in the (art therapy counseling program) to complete the attached questionnaire. All the information and answers from this final questionnaire are confidential and will only be seen by the Art Therapists working with your child. The information received will be used to help determine the progress and effectiveness of this program. Some or all of the responses may be used anonymously in grant applications and may be included in a master’s thesis. Your name and your child’s name will not be used in connection to the responses given.

Please answer this questionnaire honestly, keeping in mind your child’s behavior in the last three months. Place a mark in the box that most appropriately matches your response to each statement. Also, we welcome any comments you may have regarding your child’s participation in this program and have included space on this questionnaire for your feedback.

Please return the completed questionnaire to (school counselor) at (site of study). If you have any questions about this questionnaire or the (art therapy counseling program), please contact (school counselor) at (school phone number).

Thank you for your participation and continued support of the (art therapy counseling program).

Sincerely,

(art therapy counseling program)

105

Dear Teachers,

The purpose of the (art therapy counseling program) is to provide students with an educational and enjoyable therapeutic art experience. The (art therapy counseling program) at (site of study) has created this questionnaire to help us better serve the students in this program. We are asking the teachers of each of the students in the (art therapy counseling program) to complete the attached questionnaire. All the information and answers from this questionnaire are confidential and will only be seen by the Art Therapists working with your student. The information received will be used to help determine the progress and effectiveness of this program. Some or all of the responses may be used anonymously in grant applications and may be included in a master’s thesis. Your name and your student’s name will not be used in connection to the responses given.

Please answer this questionnaire honestly, keeping in mind your student’s behavior in the last three months. Place a mark in the box that most appropriately matches your response to each statement. Please respond to every statement.

Please return the completed questionnaire to (school counselor). If you have any questions about this questionnaire or the (art therapy counseling program), please contact (school counselor).

Thank you for your participation and continued support of the (art therapy counseling program).

Sincerely,

(art therapy counseling program)

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Appendix G

Post-Art Therapy Counseling Surveys

Name ______Date ______

Has art therapy helped you? How? ______

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My Child

Has art therapy helped your child? Please explain.______

______Name of Parent or Guardian (printed) Parent or Guardian Signature ______Date

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My Student Name______Yes/Agree/ Maybe / No/Disagree/ Always Sometimes Never 1. Shares ideas and feelings openly 2. Makes positive choices 3. Follows directions independently 4. Picks on or bullies other students 5. Academic performance has declined 6. Completes tasks in the expected time frame 7. Makes positive statements about others 8. Expresses negative feelings Inappropriately 9. Is disruptive in class 10. Interacts inappropriately with peers 11. Is liked by other students 12.Has good problem solving skills 13. Uses inappropriate language 14. Makes positive statements about him/herself 15. Quality of schoolwork usually meets or exceeds expectations

Have you noticed any changes in your student since he/she started art therapy? Please explain. ______

Additional Comments______

Your Name______Date______

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Appendix H

Survey Scoring Forms

About Me Yes/Agree/ Maybe / No/Disagree/ Always Sometimes Never 1. Other kids think I am fun to be with. 3 2 1 2. I do not have as many friends as other kids my age. 1 2 3 3. I am usually proud of the school work I do. 3 2 1 4. I often get picked on or bullied. 1 2 3 5. People ask me for help when they are having trouble. 3 2 1 6. No one pays much attention to me at home. 1 2 3 7. I am a very important person in my family. 3 2 1 8. My parents feel they can depend on me. 3 2 1 9. My parents expect too much of me. 1 2 3 10. I am an important person in my class. 3 2 1 11. Schoolwork is harder for me than most kids. 1 2 3 12. My teacher is usually happy with the work I do. 3 2 1 13. I do not get along with the other kids living 1 2 3 in my home. 14. I get in trouble at school. 1 2 3 15. I make good choices. 3 2 1 16. When I have a problem, I can usually figure it out. 3 2 1 17. I get mad easily. 1 2 3 18. I turn in my schoolwork on time. 3 2 1 19. My parents are proud of me. 3 2 1 20. I spend a lot of time alone in my room. 1 2 3 21. My parents try to understand me. 3 2 1 22. I like myself. 3 2 1

Name ______

Date ______

Total Score ______

110

My Child

Yes/Agree/ Maybe / No/Disagree/ Always Sometimes Never 1. My child usually shares ideas and feelings openly. 3 2 1 2. My child is picked on or bullied by other children. 1 2 3 3. My child usually follows directions without 3 2 1 being reminded. 4. My child says nice things about him/herself. 3 2 1 5. My child struggles to finish tasks or projects on time. 1 2 3 6. My child says nice things about others. 3 2 1 7. My child's school reports have 3 2 1 stayed the same or improved. 8. My child expresses anger in appropriate ways. 3 2 1 9. My child is not dependable. 1 2 3 10. My child gets along well with other children 3 2 1 living in our home. 11. My child does not like him/herself. 1 2 3 12. My child usually handles difficult situations well. 3 2 1 13. My child does not make friends easily. 1 2 3 14. My child is good at finding solutions to problems. 3 2 1 15. My child spends a lot of time alone in his/her room. 1 2 3 16. My child turns in schoolwork on time. 3 2 1 17. My child gets frustrated easily. 1 2 3 18. My child makes good choices. 3 2 1 19. I am proud of my child. 3 2 1

Child's Name ______

Parent or Guardian's Name ______

Date ______

Total Score ______

111

My Student

Yes/Agree/ Maybe / No/Disagree/ Always Sometimes Never 1. Shares ideas and feelings openly 3 2 1 2. Makes positive choices 3 2 1 3. Follows directions independently 3 2 1 4. Picks on or bullies other students 1 2 3 5. Academic performance has declined 1 2 3 6. Completes tasks in the expected 3 2 1 time frame 7. Makes positive statements 3 2 1 about others 8. Expresses negative feelings 1 2 3 Inappropriately 9. Is disruptive in class 1 2 3 10. Interacts inappropriately with peers 1 2 3 11. Is liked by other students 3 2 1 12.Has good problem solving skills 3 2 1 13. Uses inappropriate language 1 2 3 14. Makes positive statements about 3 2 1 him/herself 15. Quality of schoolwork usually meets or exceeds expectations 3 2 1

Student's Name ______

Teacher's Name ______

Date ______

Total Score ______

112