CHAPTER 8
Olena Helen Darewych
Abstract
Historically, humans across many different cultures have used the arts as healing practices and forms of self-expression. In recent decades, the arts have become suitable creative interventions in clinical practices for improving the physical, psychological, social, and spiritual well-being of individuals. This chapter provides an overview of the creative arts therapies and presents arts-based interventions that have the potential to cultivate psychological well-being in individuals of all ages. Specifically, the following arts-based interventions, grounded in Ryff’s (1989) multidimensional psychological well-being model, are described in detail: Living in the Present, Eco Sculpt, Bridge Drawing with Path (BDP), Island of Connectivity, Sources of Meaning, and Nesting Doll. Case examples illustrate how these arts-based interventions have been integrated within clinical, educational, research, and supervisory contexts. The chapter concludes with some reflections in relation to incorporating these arts-based interventions in research with well-being self-report questionnaires.
Key Words: arts, creative arts therapies, arts-based interventions, positive psychology, psychological well-being
Introduction
Historically, humans across many different cultures have used the arts as healing practices, forms of self-expression, and pathways toward self-discovery and belonging. For example, the Egyptians and Greeks used drama and music to express their daily experiences, while the ancient San people in Africa created rock paintings to protect themselves and their animals from evil spirits (Malchiodi, 2007). In today’s society, the arts continue to play a vital role in contributing to human flourishing. As a result, in recent decades, the arts, including dance, drama, drawing, journaling, music, poetry, and sculpting, have become suitable creative interventions in clinical practices for improving the physical, psychological, social, and spiritual well-being of individuals of all ages. Such clinical arts-based interventions are commonly administered by creative arts therapists (e.g., art therapists, dance/movement therapists, drama therapists, expressive arts therapists, and music therapists) as vehicles by which individuals process grief (Thompson & Neimeyer, 2014), express inner deep conflicts and emotions in a symbolic manner (Puig, Lee, Goodwin, & Sherrard, 2006), gain a sense of accomplishment (Rubin, 2016), and connect with the world around them with all their senses (McNiff, 2009). Creative arts therapists continuously adapt arts-based interventions to suit individuals’ emotional and physical states, preferred art forms, and cultural experiences.
Since the inception of the field of positive psychology, a number of creative arts therapists and psychologists have developed arts-based interventions specifically grounded in positive psychology’s theoretical underpinnings. Positive psychology’s contemporary theoretical framework does not ignore individuals’ deficits and life challenges, but devotes more attention to their positive human attributes, such as growth, resiliency, strengths, and well-being (Seligman & Csikszentmihalyi, 2000). As a result, these recently designed positive-oriented arts-based interventions invite individuals in clinical and nonclinical settings to creatively build upon character strengths (O’Hanlon & Bertolino, 2012), express gratitude (Tomasulo, 2019), elicit positive emotions (Wilkinson & Chilton, 2018), achieve life’s meaning (Steger et al., 2013), explore best possible selves (Owens & Patterson, 2013), and cultivate psychological well-being (Darewych, 2019; Darewych & Riedel Bowers, 2017).
In regard to the concept of psychological well-being, psychologist Ryff (1989) formulated a theoretical model of psychological well-being which delineates six dimensions that contribute to an individual’s mental health and wellness: autonomy, environmental mastery, personal growth, positive relations with others, purpose in life, and self-acceptance. Research has shown that individuals with higher levels of psychological well-being tend to have the capacity to make independent decisions, undergo personal growth, connect with their environment, establish healthy relationships with others within multiple contexts (e.g., education, family, work), gain a sense of life meaning, and acknowledge their multiple self-aspects (Ryff, 1989; Ryff & Keyes, 1995).
This chapter presents action-oriented and reflective arts-based interventions grounded in Ryff’s (1989) multidimensional well-being model that enable individuals to form autonomy, identify personal goals, reconnect with their natural surroundings, establish positive relationships, examine sources that provide them with life meaning, and gain insight into their multiple aspects of self. The following participatory-style arts-based interventions will be described in detail: Living in the Present, Eco Sculpt, Bridge Drawing with Path (BDP), Island of Connectivity, Sources of Meaning, and Nesting Doll. Case examples illustrate the use of these arts-based interventions within clinical, educational, and supervisory contexts.
Autonomy
Maslow’s (1970) self-actualization theory and Deci and Ryan’s (2000) self-determination theory have long emphasized the importance of autonomy and self-regulation to individuals’ psychological well-being. Individuals with higher levels of autonomy have the inner capacity to engage in activities with confidence, make independent decisions, and regulate their emotions and behaviors (Ryff & Keyes, 1995).
Living in the Present (Zeller Cooper, 2019) is a sequential arts-based intervention that encourages individuals to actively participate in a creative act that centers on the present rather than on the past or future. When administering the arts-based intervention in clinical settings, an individual is first directed to independently select a color photograph (approximately 8.5 × 11 inches) that most intrigues them from one of the theme-based modules (e.g., animals, nature, travel). Once they have chosen a color photograph, they are invited to read the corresponding short story. After the reading, the individual verbally shares with the mental health practitioner their personal associations related to the color photograph and the reading. The mental health practitioner then administers an outlined template of the color photograph to the individual to color in with their preferred drawing materials (e.g., markers, oil pastels, soft pastels, digital media).
Although the Living in the Present (Zeller Cooper, 2019) arts-based intervention was primarily developed for older adults with early onset dementia who tend to cognitively struggle with recalling past memories and imagining the future, the creative method can also be administered to other clinical adult populations to sustain their cognitive abilities, such as viewing, focusing, reading, speaking, making autonomous decisions, coordinating hand-eye movements, and expressing thoughts and emotions. Regardless of how much or how little assistance the individual requires from the mental health practitioner, the result remains a personal independent accomplishment. The arts-based intervention can be used with individuals and is equally effective in a group setting.
Figure 8.1 depicts the camper color photograph from the Living in the Present (Zeller Cooper, 2019) travel module and the following is its corresponding short story:
Campers on wheels first began their journeys around 1910. People have always been interested in traveling and seeing new places. In order to do this in a vehicle, there needed to be roads to travel on, gas stations, places to purchase supplies and areas to park vehicles for the night. Traveling in a vehicle that included a small fridge and cooking area, as well as a place to sleep, offered independence and freedom. This also made traveling more economical. Now there are many different kinds of camper vehicles that range in size and amenities, such as air-conditioning, heating, electricity, shower, toilet, sitting and sleeping areas. Some have pop-up roofs, or pull-out extensions to offer more space when parked. Some can pull a smaller vehicle for touring, bicycles or even a motorcycle. (para. 1)
Figure 8.2 portrays a camper template colored in by Nathaniel (pseudonym), a man in his late twenties with a developmental disability. The Living in the Present theme-based modules were presented to Nathaniel during a ninety-minute, person-centered (Rogers, 1951), digital art therapy session in Canada wherein he created art using the Fresh Paint art-making application on a password protected touchscreen laptop. First, Nathaniel independently chose the camper color photograph and then read the camper story out loud. After the reading, the art therapist uploaded the camper template in Fresh Paint. Using a stylus, Nathaniel colored in the camper template with blue and yellow simulated paint. When prompted with the guiding question, “If you could take a trip in this camper van today, where would you go?” Nathaniel responded, “To my family’s cottage.” When asked, “What or who would you take with you?” Nathaniel exclaimed, “My mom.” The guiding questions inspired Nathaniel to independently draw an image of his family’s cottage using the Fresh Paint application.
Figure 8.1. Living in the Present: camper.
Figure 8.2. Camper.
Nathaniel, who often finds creating with a blank digital canvas an overwhelming experience, enjoyed coloring in the camper template with his favorite colors. At the end of the session, Nathaniel was proud of his final digital artwork. The arts-based intervention enabled him to use his cognitive working memory, to regulate positive and negative emotions, and to gain a sense of accomplishment in the present moment. Further, the creative sequential process activated his imaginative thinking abilities and inspired him to talk about the significant people and places in his life with the art therapist.
Environmental Mastery
The philosophy of ecopsychology gives emphasis to the idea that humans are organically connected with their senses to the natural world and that continuous engagement with the natural environment enables individuals to maintain their mental health and well-being (Roszak, 1992). Ecotherapy, a form of ecopsychology, is a developing therapeutic practice that occurs outdoors and invites an individual to reconnect with nature, either passively (e.g., viewing, exposure to) or actively (e.g., walking, running) (Jordan & Hinds, 2016). Simply the viewing of natural settings or images can have a positive impact on individuals’ psychological well-being (Wolsko & Lindberg, 2013). Recent studies have shown that ecotherapy can be an effective approach to alleviating individuals’ anxiety (Mackey & Neill, 2010) and attention difficulties (Kuo & Taylor, 2004). A handful of creative arts therapists are now exploring the intersectionality between the arts and nature and have found that both approaches, in combination within clinical practice, have the potential to complement and enrich each other while supporting individuals’ wellness (Kopytin & Rugh, 2017).
Eco Sculpt is a multi-sensory arts-based intervention that invites individuals or groups to creatively explore their natural environment and shape a sculpture using nature-based objects. Figure 8.3 illustrates an Eco Sculpt created by youth orphans (aged 12–18) in Ukraine during a one-hour strengths-based group art therapy session which occurred outdoors in a natural beach setting. The group was prompted to create a sand sculpture using found objects from the natural beach setting symbolically representing humor, one of the Values in Action (VIA) 24 character strengths (Peterson & Seligman, 2004). This particular group collectively chose to create a sand sculpture using beach sand, shells, seaweed, and sandstones to create a portrait of American musician Elvis Presley. During the post-intervention group dialogue, group members reflected on how listening to some of Elvis Presley’s songs uplifts their spirits, kindles laughter, and evokes positive emotions such as joy in them. Near the end of the session, two of the group members sang one of Elvis Presley’s songs in English.
Figure 8.3. Eco Sculpt.
The group art therapy session, which occurred outdoors in a natural beach setting, permitted the youth orphans (who predominately reside in orphanages located in or near an industrial city with minimal green space) the opportunity to gain a sense of appreciation of nature and to reconnect with the natural beach setting with their senses. More specifically, the Eco Sculpt arts-based intervention encouraged the youth orphans during the group process to utilize their character strengths of creativity, curiosity, social intelligence, and teamwork, and express the character strength of humor verbally and nonverbally through creative means.
Personal Growth
Positive psychological functioning requires an individual to continuously undergo personal growth along their developmental life span (Ryff & Singer, 1996). Establishing concrete short-term and long-term goals inspires individuals to grow, overcome life challenges, and envision their future (Emmons, 2003). The inability to establish a growth or goal mindset may lead one to struggle with “developmental paralysis” (Damon, 2009)—a period in their lives when they are overwhelmed by feelings of emptiness, boredom, or being stuck.
Bridge Drawing with Path (BDP; Darewych, 2013) is a goal-oriented arts-based intervention that directs an individual to draw a bridge that is connected to a path and then prompts them to write or verbally state where the path is leading them to. It is theorized that the path depicted in the drawing symbolically represents their life pathway, which is leading them to a goal they are hoping to achieve. In clinical settings, the BDP is well-suited for youth or adults who are psychologically preparing to undergo transition (i.e., career, educational, environment, relationship) and are open to exploring their present and future goals in a creative way (Darewych & Campbell Brown, 2016). Upon completion of the BDP, the following guiding questions could be presented to the individual: Why do you want to achieve this goal? Is your goal realistic and attainable? What do you hope your goal will provide you or allow you to do? Do any obstacles stand in your way from achieving this goal? If yes, what are the internal (e.g., character strengths) and external (e.g., peers) resources that will assist you with overcoming the obstacles?
To date, in the research arena, the BDP has been administered to youth orphans in Ukraine (Darewych, 2013), adults with autism spectrum disorders in Canada (Darewych, Newton, & Farrugie, 2018), and higher education students in Britain and Canada (Darewych, 2014).
Figure 8.4 illustrates a BDP created by Sophia (pseudonym), a female undergraduate art student in her early twenties studying in Britain. Sophia completed her BDP drawing during a single thirty-minute research session. On a sheet of 8.5 × 11-inch white paper with a pencil, she sketched a bridge connected to a path leading to “autonomy and complete self-reliance … a path home.” The BDP provided Sophia for a brief moment during her academic journey to pause and reflect on her future possible self and future journey back home upon graduation.
Positive Relationships with Others
Ryff (1989) identified interpersonal connections as an essential element of psychological well-being. Therefore, it is important for individuals throughout their life journey to establish healthy relationships in multiple contexts (i.e., community, family, work) in order to maintain their overall wellness.
Island of Connectivity is an arts-based intervention that encourages individuals in a group setting to contribute jointly to one creative finished product. When administering the arts-based intervention, group members are first presented with the following solution-focused “stranded on an island” scenario:
You are all on a boat that has struck an obstacle in the water that has caused some damage to the boat. There is an island nearby that everyone can swim to with their life jackets on. As a group, you are able to take five items and a sack of food to the island with you for survival purposes until the rescue team arrives. On the island, there is a waterfall and a cluster of fruit trees. As a group, determine who will build temporary shelter from the sun and wind, and which individuals will prepare food. Additionally, determine actions to quicken your rescue. Finally, name your island.
Figure 8.4. Bridge Drawing with Path.
The group is then invited to draw or build their island. Figure 8.5 depicts an Island of Connectivity drawing created by youth orphans (aged 12–18) during a group art therapy session in Ukraine. This particular group of eight chose to draw their island on a large 22 × 24-inch white poster board using colored markers. The bottom half of the circular drawing depicts the five items (i.e., rope, matches, first aid kit, compass, and knife) and food (i.e., bread, salt, spaghetti, sugar, potatoes) that they selected to take with them to the island for survival purposes. In order to quicken their rescue, the group decided to build a wooden raft with a sail that would accommodate everyone and build an “SOS” fire. At the end of the creative process, group members named their island “Chance.”
The Island of Connectivity arts-based intervention instilled hope and feelings of connectedness in the youth orphans. Further, the creative group process encouraged them to use their interpersonal and problem-solving skills, and to build positive relationships with one another.
Figure 8.5. Island of Connectivity.
Purpose in Life
Individuals throughout their life journey search for life purpose or meaning. Finding meaning in one’s life can be viewed as a significant existential task. Psychologist Steger (2012) described meaning as “the web of connections, understandings, and interpretations that help us comprehend our experience and formulate plans directing energies to the achievement of our desired future” (p. 165). Studies investigating the concept of meaning have found a positive association between meaning in life and psychological well-being (Zika & Chamberlain, 1992). Individuals who struggle to achieve a personal sense of a meaningful life may succumb to feelings of emptiness (Frankl, 2006 [1946]). Over decades now, several mental health practitioners have emphasized that the creative process in and of itself can reduce individuals’ feelings of emptiness and illuminate sources that provide them with life meanings (Allen, 2005; Lantz, 1993). Moreover, psychologist Csikszentmihalyi (1996) proclaimed that “creativity is a central source of meaning in our lives” (p. 1). Studies have identified the following as primary sources that provide individuals with a sense of life meaning: significant relationships, career and academic achievements, belonging to community organizations, spirituality, and self-development (Damon, 2009; Darewych, 2014; Steger et al., 2013).
Sources of Meaning (Darewych & Riedel Bowers, 2017) is an arts-based intervention that prompts an individual to take a few minutes to visually explore pre-cut magazine images of colors, objects, symbols, and people that are laid out in front of them on a table. After viewing the images, they are directed to select one image and then, on a sheet of paper or in their journal, to freely write about how the element depicted in the image (i.e., person, place, or object) fills their mind, body, and soul with life meaning.
Figure 8.6 portrays a magazine image chosen by Chloe (pseudonym), a female psychotherapy student in her thirties who engaged in the Sources of Meaning arts-based intervention during a one-hour clinical supervision session. Chloe selected a magazine image depicting renaissance artist Leonardo da Vinci walking down a cobblestone alley lane. The following presents her free writing associated with the Leonardo image:
Leonardo, it was his imagination that has fascinated me for a very long time. He would dream, create and think his way around things—he didn’t have all the answers, but that didn’t stop him. He makes me wonder about so much—like he’s walking through the streets while the world goes by, everyone unaware that he’s making change in this moment. I think Imagination creates meaning. Both are unique human qualities. This image of Leonardo reminds me to live with my imagination, so I may bring meaning to my life.
Figure 8.6. Sources of Meaning.
The arts-based intervention provided Chloe, near the end of her academic and clinical internship journey, a micro-moment to reflect on an artist from the past who continuously sparks her personal creativity and imagination, and provides meaning to her life.
Self-acceptance
The post-modern theories of multiple selves (Markus & Nurius, 1986) and self-aspects (McConnell, 2011) contest the viewpoint that humans possess one single unified self. These theories stress that individuals are made of multiple self-aspects which develop out of their life experiences, and collectively form who they are. Individuals who accept themselves for who they are and acknowledge their multiple aspects of self, including strong and weak attributes, generally possess a more positive attitude toward the self (Ryff & Keyes, 1995).
Nesting Doll (Darewych, 2019) is an arts-based intervention that prompts an individual to playfully discover their inside and outside self-aspects (specifically, past, present, and possible future selves), and obtain a better understanding of how their self-aspects behave, view the world around them, and function with others. The arts-based intervention is well-suited for youth and adults in individual and group settings. When administering the Nesting Doll in clinical settings, the mental health practitioner first presents a colorful decorated wooden Matryoshka doll, also known as a nesting doll, a type that was first crafted in Russia. When viewed with a psychological lens, the doll’s one-inside-another figure symbolically exemplifies one’s repertoire of self-aspects which are interrelated and continuously transforming in size and shape. There are moments when certain self-aspects are in alliance with one another, and then there are moments when certain self-aspects are engaged in an internal dragon fight. The individual is then prompted to define five of their self-aspects with “I am” statements (e.g., I am a friend, a sibling, a parent, a volunteer). Once they identify their five self-aspects, they are given decorative paper, colored markers, scissors, glue, and a multi-size nesting doll paper template, and are directed to create their personal nesting doll ranking their self-aspects from the most prominent (the largest) to the least prominent (the smallest). The most prominent doll may represent their self-aspect that is growing and undergoing self-transformation, whereas the least prominent doll may characterize their vulnerable self or their self-aspect that is becoming less relevant in their inner or outer world. Upon completion of their nesting doll art piece, the individual is prompted to look at each self-aspect individually and to reflect on each self-aspect’s character strengths and values (Peterson & Seligman, 2004). The Nesting Doll arts-based intervention has been adapted for educational settings as well, particularly for high school and higher education students (see Darewych, 2019).
Figure 8.7 depicts a five-size Nesting Doll created by Laryssa (pseudonym), who attended an intensive four-day group psycho-education workshop for youth orphans (aged 17–22) in Ukraine. At the time of the workshop, Laryssa was a fourth-year university student who was approaching the end of her academic journey and was psychologically preparing for her transition to the workforce. During the second day of the workshop, the Nesting Doll arts-based intervention was administered to all group members. Laryssa created her five-size nesting doll using the template and floral-patterned scrapbook paper. Her nesting doll presents her five self-aspects of (from most prominent to least prominent): “journalist, leader, translator, student, and photographer.” After identifying each self-aspect, she wrote on the back of her nesting doll two strengths and one value for each self-aspect. During the post-intervention group dialogue, Laryssa verbally described her “student” self-aspect’s character strength of perseverance and how her budding “journalist” self-aspect who values “optimism” was growing and hoping to acquire employment in the near future that would sustain her whole self emotionally and financially.
Figure 8.7. Nesting Doll.
The Nesting Doll arts-based intervention offered Laryssa and the other youth orphans, in a group setting, the opportunity to create a concrete artwork depicting their inside and outside self-aspects. Moreover, the creative method encouraged them to envision their future professional self-aspects, and to explore resources (i.e., people, places, and things) that will support their future professional self-aspects.
Conclusion
Due to the continuous contribution of the arts to human flourishing, the arts—such as dance, drama, drawing, journaling, and music—have become suitable creative interventions in clinical practices for improving the physical, psychological, social, and spiritual well-being of individuals of all ages. This chapter has presented action-oriented and reflective arts-based interventions that have the potential to cultivate psychological well-being in individuals from different cultural backgrounds within clinical, educational, and supervisory settings. The arts-based interventions presented in this chapter are cutting-edge creative methods, and hence are theoretical and practical in nature. Only in the last few years have studies examined the outcomes of the Bridge Drawing with Path (BDP) arts-based intervention as a creative vehicle for individuals to explore goals and sources of meaning (Darewych, 2013, 2014; Darewych, Newton, & Farrugie, 2018). Consequently, more empirical cross-sectional and longitudinal research is required to better understand the unique effects and benefits of these arts-based interventions on individuals’ psychological well-being in clinical, community, educational, and organizational contexts. Future studies, with clinical and nonclinical samples around the world, could administer these arts-based interventions in parallel with valid and reliable well-being self-report questionnaires, such as Ryff’s (1989) Scale of Psychological Well-Being and Diener et al.’s (2009) Flourishing Scale.
Acknowledgments
The author would like to thank the individuals who consented to include their artwork for publication.
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