Term
|
Definition
includes visual art-making, photography, creative writing, music drama, movement, sand-tray, computer graphics and dance
can be any freely chosen activity that can be self-expressed. |
|
|
Term
|
Definition
can be interchangeably used with creative
Feder and Feder suggest that the term expressive emphasizes communication (of self, ideas or feelings), whereas creativity may be thought to connote problem solving, inventiveness and imagination. |
|
|
Term
| assessments of expressive media |
|
Definition
| very little published work on the subject |
|
|
Term
| some expressive media assessments include: |
|
Definition
COPM-Canadian Occupational Performance Measure
OTTOS-Occupational Therapy Task Observation Scale
COTE-Comprehensive Occupational therapy Evaluation
All have been found useful for assessments in expressive media |
|
|
Term
| debates or controversies of using expressive media assessments |
|
Definition
* controversy over the merits of formal and informal assessments
*Should they be based on single or multiple media?
*should the process or content be assessed? |
|
|
Term
| how therapists use expressive media assessments |
|
Definition
| These are loose assessments with wide ranges of interpretation so the therapists use of them reflects their own theoretical positions |
|
|
Term
| theoretical perspectives used by OTs in assessment and treatment |
|
Definition
Occupational Science
Existentialism
Behavioral
psychodynamic
Object relation's theory
Each will interpret the functions in the assessments differently. |
|
|
Term
| 2 main reasons (or categories) that therapists use expressive media |
|
Definition
1. help patients gain greater competence (and satisfaction) in skills and activities that can be used in everyday life
2. promoting psychotherapeutic change |
|
|
Term
| benefits of expressive media (on a lighter level) |
|
Definition
acquire or rediscover creative and social skills that will reduce occupational deprivation and increasing quality of life
gain self-esteem by making choices and seeing end results
experience mastery, control, achievement and autonomy-strengthen identity and build well-being.
calming effects
reduction in unproductive cognitive ruminations
promoting positive experiences of flow |
|
|
Term
| benefits of expressive media in therapy at a deeper level |
|
Definition
express troubling feelings more openly through nonverbal arts media than through words
patients can control level of engagement and disclosure during expressive activities and this helps to reduce feelings of passivity that are prevalent among those in mental health settings.
helps some interact and relate to other with more confidence
psychodynamic OTs argue that patients use art and other media to project and work through unconscious feelings about themselves and the outer world |
|
|
Term
| psychodynamic view of expressive media |
|
Definition
interpret both the content and process of patients' art and other expressive work, looking for symbolic communications in order to develop a more in-depth understanding of patients' concerns.
includes schools of Freud, Jung and the object relations |
|
|
Term
| basics of psychodynamic perspective |
|
Definition
Patients are unaware of conflicts in the unconscious.
Repression and projection keep such conflicts hidden from the person.
Expressive media enable the patient to express fantasies and troubled feelings symbolically.
Everything has an underlying meaning. |
|
|
Term
|
Definition
emotions, attitudes or perceptions from the past that the patient brings to the relationship
EX: patient may beel negatively judged by the therapist when he or she has had a long family history of criticism or abuse. |
|
|
Term
|
Definition
the total emotional response of the therapist to the patient
carries a risk of over-interpreting patients expressive work. |
|
|
Term
|
Definition
Jung argued that people express their deepest concerns obliquely through art and other forms of expressive media.
In contrast to Freud, Jung was more positive about the processes occurring within the unconscious mind, believing that creative,, healing forces were present.
People make use of collectiveand personal symbolism in their expressive work, such as drawing on archetypes to communicate human experiences like death and fear. |
|
|
Term
| School of Object Relations |
|
Definition
focuses on the role of the therapeutic relationship in helping patients to understand how relationships have functioned in their lives outside of therapy and to find ways of managing appropriate levels of intimacy.
therapist provides a holding environment, increasing the patient's sense of emotional safety and facilitating exploration of feelings.
expressive medium can act as a container for difficult feelings.
artwork as a transitiona object, enabling inner feelings to be externalized, distanced and thereby rendered less powerful. |
|
|
Term
|
Definition
No biomedical or unconscious
therapist focus on describing observable behavior, problematic behavior or adaptive behavior, noting its context, frequency, triggers and consequences.
FEW OTs RELY SOLELY ON BEHAVIORIST THEORY.
usually used only in the observing of patients and their behaviors and not in the treatment. |
|
|
Term
| humanistic or existential perspective |
|
Definition
regards patients as the authors of their own lives and the experts on their own concerns.
the therapists own interpretation of the meaning of the patient's artwork or other expressive product is largely seen as inappropriate.
the therapist encourages the patient to find his or her own meanings in the activity to enhance self-insight, choice and control.
focus is on patient's strengths as well as vulnerabilities.
patients communicate self-insights, aesthetic judgments and other strengths and skills when working in expressive media.
The nonjudgmental acceptance of a patients artwork helps the patient also to feel unconditionally accepted as a person with worth. |
|
|
Term
| what things can be assessed using expressive media? |
|
Definition
cognitive abilities
emotional concerns occupational preferences,
skills
interests
life experiences
may complement traditional interview techniques |
|
|
Term
| expressive medias more distinctive role. specific ways that it gives voice to less consciously available material |
|
Definition
* communicate the inexpressible-traumatic experiences
*containing potentially overwhelming emotions within the art materials or creative encounter, thereby enhancing psychological security and enabling self-expression
*enables oblique or indirect self-expression (eg, the use of metaphors, symbols and archetypes that externalize inner turmoil and hurt, bypassing internal censorship or psychological defenses)
*gives stigmatized people a voice in the world
*reveals patients' strengths and vulnerabilities.
*works at the patient's comfort level |
|
|
Term
|
Definition
| demands a tolerance for spontaneity-can be anxiety-provoking for pt with shaky boundaries, a need for containment or obsessionsal neatness |
|
|
Term
|
Definition
| creates social challenges for patients |
|
|
Term
| reasons to use multiple media's |
|
Definition
the expressive products do not just reflect the maker but the relationships of the therapist and other patients and such.
should be very cautious in inferring from a single medium used. |
|
|
Term
| good reason to use EM assessment |
|
Definition
patients may feel emotionally safer when engaged in creative work rather than in face to face verbal interaction
more likely to reveal personal concerns and experiences
may demonstrate more optimal functioning.
can gain info on strengths and vulnerabilities |
|
|
Term
|
Definition
most use visual arts (painting and drawing)
some considered projective and are less structured
therapist attempts to gain insight into deep seated concerns by interpreting the meanins of the images or stories created.
low validity possibly |
|
|
Term
|
Definition
include:
house-tree-person
draw-a-person
Kinetic family drawing
draw-a-person-picking-an-apple-from-a-tree
those developed by OT include
the Azima Battery and Goodman Battery
Lerner and Ross Magazine picture collage
Ehrenberg Comprehensive Assessment Process
Little has been published in recent years about these assessments and their validity and reliability are uncertain
Time-Consuming too |
|
|
Term
| theories that influence projective tests |
|
Definition
| Jungian and Object Relations theories |
|
|
Term
| Diagnostic drawing series |
|
Definition
| used as diagnostic tool to detect signs of schizophrenia, dissociative disorders and ADHD. |
|
|
Term
|
Definition
developed by Machover-projective test
assumes patient expresses in metaphorical or symbolic terms, aspects of his or her self-image or conceptualization of relationships through the image created. |
|
|
Term
| possible differences seen in projective tests with schizophrenic patients |
|
Definition
| they had figure drawings with distinctive head shapes and unusual sizes and exaggerated (or omitted) eyes and ears. |
|
|
Term
| OTs unlikely to use projective techniques |
|
Definition
those that prefer to focus on a patient's unique constellation of occupational goals, vulnerabilities and competencies.
some projective ests undermine patients' performances through being time-consuming and exhausting therby raising evaluation anxiety |
|
|
Term
| therapists who make use of informal expressive media |
|
Definition
| are more likely to integrate their own observations with patients views and narratives, rather than relying on their own "expert" opinion alone. |
|
|
Term
|
Definition
| supposed to express life role and life satisfaction |
|
|
Term
| silver drawing test (SDT) |
|
Definition
has undergone lengthier process of validation than many other expressive media assessment tests.
Originally developed to assess the cognitive skills of children with hearing impairments but have been subsequently used to assess depression and other emotional problems.
presents to patients an array of ready-made stimulus drawings such as a parachute, tree or dinosaur. This is to help those that woule feel anxious with unstructured expressive or reative tasks
patient chooses two pictures from the series of images and then draws a picture combining both of these choices. Other elements added if the patient so wishes.
Then patient gives a narrative about the picture as well as a title.
Has been found useful in in identifying depressive and aggressive tendencies in patients. |
|
|
Term
| what can enhance the patient-centered assessment process with projective material |
|
Definition
| If the therapist is comfortagle with metaphor and uncertainty and brings hypotheses rather than certainties to the patient's expressive communications. |
|
|
Term
| Formal Elements Art Therapy Scale (FEATS) |
|
Definition
Gantt
detailed scoring system for analyzing series, both of freely made pictures and also images created in response to instructions to draw a person picking an apple from a tree (PPAT).
fourteen 5 point scales are used by therapists to assess aspects of expression -prominence of color, amount of energy depicted, integration of elements, logic and realism. |
|
|
Term
|
Definition
there may be a graphic equivalent of symptoms. EX: depresses mood may reveal itself in the absence or presence of prominent color.
clusters of graphic features may suggest mental states.
arguement is that there is no 1 to 1 relationship between imagery used and clinical features EX: no specific imagery associated with suicidal thoughts or sexual abuse. |
|
|
Term
| Diagnostice Drawing Series |
|
Definition
Cohen and colleagues
says patients should have a high quality art experience to facilitate a greater range of artistic exploration.
patient creates a series of pictures consisting of a free choice image, a tree, and a representation of their current feelings. Patient is thought to have more opportunity to reflect and thereby to control the artwork. Patient comments on the art verbally.
high inter-rater agreement has been found on many of these dimensions (36) |
|
|
Term
| formal assessments validity and reliability of scoring |
|
Definition
| difficult using expressive media other than ART |
|
|
Term
| Diagnostic role-playing test |
|
Definition
Rad-Johnson
requires patients to act out five roles using props.
proposed that this formal assessment is unstructured enough so that patients can project their concerns and problems into their role play. |
|
|
Term
|
Definition
creative activity in which group members put together rods, wheels and other construction materials to their own design.
Clark-Schock and colleagues describe assessment by a multidisciplinary team, including an OT which focuses more on the creative process.
Scoring focuses on patients' demonstrated self-esteem and self-confidence during the task, level of cooperation with peers and therapist, reality orientation, concentration, frustration tolerance, attention to detail, planning and motivation. |
|
|
Term
|
Definition
Rosner Kelly
Multiple media, such as art, music, drama and movement are needed for a holistic assessment. The patients' preferences for some media over others may reflect his or her comfort in using verbalization, action or fantasy.
This in itself can suggest treatment goals and meaningful activities. |
|
|
