Administer and Evaluate Art Therapy and Art-Based Assessments

Question 1

Bridge Drawing

Answer 1

gain insights into perception of connection, transition, and progress in life

• projective assessment that visualizes a transition, communication and/or overcoming an obstacle in one’s life
• help clients make connections, problem-solve, overcome obstacles and aid in communication.

8.5 X 11 blank, white paper
drawing utensils of choice

Procedure:
- Client is asked: Please draw a picture of a bridge going from some place to some place.
- Indicate with an arrow or arrows the direction of travel.
- Place a dot or draw a person to indicate where you are in the picture.
- If you wish, feel free to describe your picture in words.

Question 2

for trauma, what conditions are required for treatment and reduction of fear

Answer 2

1. traumatic memories must be reactivated in order to be modified
2. Corrective information must be provided so that the victim can form a new
   narrative or meaning that places the traumatic memory at the place and time it occurred as opposed to generalizing that experience to everyday life.

Question 3

Trauma interventions

Answer 3

• address the themes of fear, terror, worry, hurt (emotional and physical), anger, revenge, accountability, and victim versus survivor thinking.
• Reexposure, trauma narrative, and cognitive reframing
• Trauma-specific questions must be related to the trauma experience, not necessarily to the incident itself (What do you remember seeing, hearing, or touching? Do you sometimes think about what happened even when you don’t want to? Do certain sounds, sights, smells, etc., suddenly remind you of what happened? What would you like to see happen to the person (or thing) that caused this to happen? Do you ever think it should have been you
  instead?
• slow and progressive detailed reliving, accomplished by presenting structured trauma-specific questions and drawing tasks that address one theme at a time

Question 4

Bridge drawing evaluation

Answer 4

Directionality - Often but not always, the left represents the past and the right represents the future, or something better or good.

Attachment - indicative of how attached a person is to the past or hoped-for future. When more attached to the past - hopelessness, when
more attached to the future- more hope filled.

Elaboration - Where was the focus of the picture, on the communicative element (the bridge), or the past (behind the patient), the future (ahead)?

Matter crossed - What is below the bridge? Sometimes what was crossed represents a fear or temptation.

Viewer vantage point - Is the bridge in the distance (could be distant communication), close (could be secure and honest) or viewed from above (could be controlling) or below (could be insecure)?

Placement of self - Where did the person place themselves? Can show where they are in the journey and this placement can be supported or challenged in order to offer a reality check.

Places the bridge connects - Was the bridge attached to a real entity or a fantasy place? Did the bridge one or both sides in the drawing? Did the patient want others to know where they have been, or were going?

Bridge construction - What construction materials is the bridge made of? Is there a safety rail?

Associations - What associations can you make between the drawing and your life?

Synthesis of the picture - Is there a cohesive and completeness to the picture? A unified statement in the picture?

Question 5

Kinetic-Family-Drawing (KFD)

Answer 5

• all ages
• self concept and interpersonal skills
• evaluates family dynamics
• considers adaptive and defensive levels of functioning
• “draw a picture of everyone in your family, including you, DOING something. Try to draw whole people, not cartoons or stick people. Remember, make everyone DOING something-some kind of action.”
• Examiner leaves the room and checks back periodically
• If the client states “I can’t”, they are encouraged intermittently and left in the room until completion of KFD
• Assessment is terminated once the client verbally indicates or gestures they are done
• No time limit is given and non-compliance is extremely rare

11inch by 8 1⁄2 inch paper
No. 2 pencil

Question 6

KFD evaluation

Answer 6

Actions: movement or energy with self and other characters

Style of drawing: structure, placement, arrangement of drawing
- Example: compartmentalization

Symbols: interpretations of what certain items in drawing may mean
- Example: use of a stop sign

Characteristics of Individual figures: individual traits and appearances
- Example: omission of body parts

Size & Distance of Figures: grid placed overtop of drawing, measured are height, size and distance

Question 7

House-Tree-Person (HTP)/Kinetic House-Tree-Person (K-H-T-P)

Answer 7

• Personality characteristics and interpersonal relationships
• Moving figures yield more info than stagnant ones
• Measures perceptions of self-environment and family

-plain, white 8.5x11-inch paper at an angle to the subject
#2 pencil

• to understand human development: Individual transformation process, reflections of scores included Attachments Present, Figures Other than Self Present, and Additional Figures Present
• house: family ties, physical aspects of the client’s life
• tree: feelings about self, life energy, capabilities, and direction
• person: real life feelings, body image, self concept

Question 8

Person Picking an Apple from a Tree (PPAT)

Answer 8

12x18 piece of white drawing paper - at an angle

• 12 felt tip markers (red, orange, blue, turquoise, green, dark green, hot pink, magenta, purple, brown, yellow and black)
• Mr. Sketch scented markers are suggested
• Subject is directed to “Draw a person picking an apple from a tree.”
• If questions are asked, the therapist reiterates “Draw a persona picking an apple from a tree.”
• No time limit

scored using the Formal Elements Art Therapy Scale (FEATS)

reveal attitudes toward growth, achievement, and fulfillment

Question 9

Formal Elements Art Therapy Scale (FEATS)

Answer 9

1 Prominence of Color

all ages
2 kinds of markers Mr. Sketch
12X18 paper

evaluates formal elements of artwork

cannot say which scores are correlated with specific diagnostic groups

helps understand artistic expression and preferences

Each element is given a value 0-5 (70 points total) Likert scale

• Detailed rating scale featured in the rating manual

#2 Color Fit
#3 Implied Energy
#4 Space
#5 Integration
#6 Logic
#7 Realism
#8 Problem Solving
#9 Developmental Level
#10 Details of Objects and Environment
#11 Line Quality
#12 Person
#13 Rotation
#14 Perseveration

Question 10

Bird’s Nest Drawing (BND)

Answer 10

assess attachment / insights into persons feelings about home, nurturing, and safety

one sheet blank, white 8.5 X 11
10 color pack of fine point markers

rated for the presence or the absence of numerous indicators:
content (eggs or baby birds)
a tree
bottom of the nest able to contain [birds or eggs]
use of most of the page
using more than two colors
line quality
centered image

Question 11

BND secure attach

Answer 11

included birds in their drawings

significantly more often a whimsical, happy quality

composed titles for their drawings that could be described as engaging or gently humorous.

more likely to feature green as the predominant color and include
birds drawn in the nest.

Question 12

BND insecure attachment

Answer 12

nests without bottoms or tilted nests that were unable to
contain their contents.

use fewer colors

themes of danger, lack of protection, and vulnerability.

absence of the mother bird, distortion of the father bird figure, and placing the nest on thin and brittle branches.

Question 13

Draw-A-Person-In-The-Rain (DAP-R, PIR)

Answer 13

1996
reveal emotions, coping mechanisms, and attitudes towards adversity
information about the level of stress a person is experiencing at the time of drawing
determine whether that person has adequate defenses to avoid being overwhelmed to the point of decompensation.

plain, white 8.5x11-inch paper
2, #2 graphite pencils with erasers

paper at an angle to the subject and say:
“I want you to draw a person standing in the rain.”

If they draw a profile, head only, or stick figure, say:
“Wait, I want you to draw a whole person, not just the [head, profile, or stick figure].”

**Alternative instructions:
“I want you to draw a person in the rain with an umbrella. Be sure to draw all three parts: the person, the rain, and the umbrella.”

Evaluation:
examining specific environmental elements (e.g., number of rain drops, lightening bolts) and their relationship to the human figure in the drawing

The theoretical premise is that the size and amount of rain, the type of inclement weather depicted, and the presence or absence of protective factors give an indication of the person’s degree of vulnerability to decompensation

Question 14

Draw-A-Story (DAS)

Answer 14

create story based on given stimulus drawing

Screen for depression (no evidence on this though)

understanding persons cognitive and emotional processes, problem solving abilities

create image. therapist assesses with score card

choose images and create a story with them

Question 15

Diagnostic Drawing Series (DDS)

Answer 15

13 years and older

purpose is DSM diagnosis

12 color pack of chalk flat sided pastels
white drawing paper 18X24

(1) may turn the paper in any direction
(2) up to 15 minutes to work on each drawing, if needed
(3) asked to make three pictures, that there is a separate piece of paper for each drawing, and that the directions for each picture will be given one at a time
(4) the pictures will be discussed when the artist is finished

make a picture using these materials
draw a picture of a tree
make a picture of how you’re feeling, using lines, shapes, and colors

Question 16

Road Drawing

Answer 16

promote insight into the impact of one’s lived experiences as well as current values and goals

sense of direction, goals, and life journey

“draw a road or path”

drawing materials: colored pencils, markers, oil pastels, chalk pastels, or graphite pencils.

encouraged to consider aspects of the road……
type of road it is (windy, straight, narrow, wide, curved, multi-directional),

material that the road is made out of (asphalt, dirt, stones, grass)

condition of the road (potholes, cracks, newly paved and painted, faded lines/unclear boundaries)

location of the road (city, countryside, near the coast, near mountains)

accessories that may or may not be present on the road (road signs, construction blockades, speed bumps, fences, bridges)

foreseeable destination- where is this road headed toward or leading to

Question 17

Administer a formal art therapy assessment

Answer 17

allow art therapists to understand their clients, based on their assessment scores, as similar to or varying from others who have executed the same assessment

one to three drawings

standardized art materials

standardized and consistent procedures or directives

a rating or scoring system

Question 18

analysis and interpretation of process, form, and content

Answer 18

conscious and unconscious content
conflicted material apparent in artwork
art as object of transference
aware of physical/perceptual-motor, social, cultural, cognitive, emotional, and dev influences
multiple levels of symbolism
importance of clients analysis of art
technique of dialoguing with image

Question 19

mental status exam

Answer 19

reality testing
orientation to person, place, and time
identify hallucinations, delusions
level of agitation
assess mood and affect
thought content
suicidal and homicidal ideation
clients ability and willingness

Question 20

Belief Art Therapy Assessment

Answer 20

• Assessing clients spiritual dimension, sensibilities, particulars
• Explore meaning and purpose of life
• Explore relationship, struggle, belief/non-belief, with God

History Taking
- 10 questions of religious affiliation

First Directive
- Have you thought about how, who, what was responsible for creating the universe?
- if you have a belief in God, would you draw, paint or sculpt what God means to you?

Post-Assessment Interrogation
- can you explain art, what it means to you
- how you feel about it
- have you seen God in this form?-skip (c) if atheist. Let client talk freely.

Second Directive
- If you believe there is an opposite of-God, force-draw, paint or sculpt it.

Materials
- 2-dimentional drafting media
- 2-dimentional painting media
- 3-dimentional media
Assorted paper sizes, color-construction

Evaluation
FEATS scoring

Question 21

Cognitive Art Therapy Assessment (CATA)

Question 22

Face Stimulus Assessment (FSA)

Answer 22

Participants are asked to draw a face
drawing is analyzed for facial features, expressions, and other elements to gain insights into emotional and social aspects

three pieces of white 8.5” x 11” paper
standard packet of 8 Crayola markers
packet of 8 Crayola Multicultural markers

Picture 1: standardized image of a human face
Picture 2: outline of the face only
Picture 3: blank page

Question 23

Kinetic-School-Drawing (KSD)

Answer 23

plain white paper
#2 pencil

insights into person perception of relationships, environment, and personal dynamics

Question 24

Family Art Evaluation

Answer 24

Hana Kwiatkowska

• family members creating art together to draw
• free picture
• pic of family
• abstract family portrait
• pic started with help of a scribble
• joint family scribble

explore family dynamics
communication patterns
relationships

Question 25

**Levick Emotional and Cognitive Evaluation and Assessment Method (LECATA) **

Answer 25

3-11 years 16 crayons pencil purpose to measure emotion and cognition defense mechanisms and development assesses emotional expression, coping strategies, and cognitive functioning

Question 26

**Mandala Assessment Research Instrument (MARI)**

Answer 26

Joan Kellogg newer assessment, still undergoing research ideal for pre/post assessment analyzed from symbolic content examines 12 lifeforces insights into individuals' unconscious thoughts, emotions, and inner conflicts Jungian perspective box of Holbein oil pastels piece of 12″× 18″ white drawing paper with a 10½″ circle in the center, predrawn in pencil. use the space in any way you wish, allowing images or shapes to spontaneously evolve, starting in the center if it feels right to do so, and using the boundary of the circle as a guide, not a barrier - lower half of circle: unconscious - upper half: conscious realms. - Stage 0 (Clear Light), at the center of the circle: transpersonal space that is considered the source of all existence. - lower left quadrant: prenatal and/or deeply unconscious material. - Stage 1 (The Void): attachment, trust, and safety issues - Stage 2 (Bliss) : passive, receptive, generative state - Stage 3 (Labyrinth, Spiral): movement of energy. - The upper left quadrant: birth to adolescence - Stage 4 (Beginning): oral dynamics and nurturance needs - Stage 5 (The Target), anal dynamics and boundary setting - Stage 6 (The Dragon Fight), Oedipal dynamics and dealing with the shadow. - The upper right quadrant: adulthood and its many challenges. - Stage 7 (Squaring the Circle): integration, readiness, and commitment - Stage 8 (The Functioning Ego): self-identity and autonomy - Stage 9 (Crystallization): completion of goals and relationship to others. - lower right: return to the unconscious resulting in a change of consciousness. - Stage 10 (Gates of Death) marks endings and loss - Stage 11 (Fragmentation): disintegration and chaos - Stage 12 (Transcendent Ecstasy): transformation

Question 27

**Silver Drawing Test (SDT)**

Answer 27

assess cognitive skills and emotional strengths access to fantasies and concepts of self and others personal growth emotional stability interpersonal relationships two sets of 15 stimulus drawings administered individually or in group settings to adults and children over age 5 Responses to drawing tasks are scored on rating scales that range from 1 to 5 points, with 5 the highest score. Predictive drawing—assesses the ability to sequence. rational thought depends on this ability, which begins to develop around the age of 7 - predict changes in appearance of objects by adding lines to outline drawings Drawing from observation—assesses the ability to represent spatial relation- ships of height, width, and depth. Drawing from imagination—assesses the ability to deal with abstract concepts, use personal creativity, and project feelings. - choose two or more stimulus drawings / imagine something happening between them / draw what they imagine / add titles or stories / discuss responses to clarify meanings

Question 28

**Determine the need for, select, and administer the appropriate art therapy and art-based assessment**

Answer 28

linked to client goals

Question 29

**Write and evaluate art therapy and art-based assessment reports**

Question 30

Interpreting Color

Answer 30

unique responses to color relationship between color and emotion

Question 31

Drawings as measures of cognitive maturation

Answer 31

line quality integration of body parts proportions and shading features not normally seen in human figures omission of features one would expect to see in human figures

Question 32

Observations of Behavior

Answer 32

motor dexterity dependency needs anxiety impulsivity changes in tempo affect tone of voice body posture erasures focus on specific details of drawing

Question 33

Schizophrenia art features

Answer 33

hallucinations distorted body parts bizarre facial expressions transparencies geometric patterns unusual coloring fragmentation disturbed spatial orientation lack of figure/ground over elaboration regression labelling writing on artwork depersonalization alienation religlosity

Question 34

Depression art features

Answer 34

somber or dark colors lack of color lack of detail poverty of ideas evidence of low energy immobile figures obstacles concentric circles starless nights suicidal themes signs of death

Question 35

Bipolar disorder art features

Answer 35

Manic: vivid colors, deterioration in composition, body distortion, carelessness, scant detail, expansion

Question 36

obsessive-compulsive disorder art features

Answer 36

little use of color rigid controlled isolation of affect attention to detail

Question 37

paranoia art features

Answer 37

rigid geometric symmetrical idiosyncratic images of eyes

Question 38

hallucinogen abuse art features

Answer 38

bright colors psychedelic fantasy images drug paraphenalia

Question 39

borderline art features

Answer 39

lack of organization themes of splitting emptiness intense emotion neg self images black and red may be prominent

Question 40

antisocial art features

Answer 40

aggressive or hostile symbols i.e. snakes, daggers, guns

Question 41

organic mental disorders art features

Answer 41

flat size distortions broken line quality one side blank inability to close forms perseveration bizarre human figures

Question 42

anorexia art features

Answer 42

hesitant to reveal self sketchy lines controlled reluctant to use color / make mess restricted affect poison food

Question 43

bulimia art features

Answer 43

impulsive taking more than needed more apt to make a mess metaphores of bingeing / purging

Question 44

dissociative identity disorders art features

Answer 44

fragmentation of self chaos and confusion trance like imagery internalized abusive aspect of self

Question 45

Things to take into consideration when interpreting artwork

Answer 45

developmental stage creativity situation in which art was made personal associations cultural context inaccuracies in our knowledge of art assessments mysterious nature of art and creative process

Question 46

PTDS art features

Answer 46

eye appears disembodied fragmentation heavy use of red and black floating or detached jail bars / caged in absence of future orientation unusual emphasis on genitals or sexual themes protective walls and barriers vaginal or phallic forms stick figures difficulty drawing or imagining feeling of safety marks on figures (scars or self-mutilation)