Authors:

Pantazi Teodora-Angelica

Ilisie Carmen Rozalia

Kiss Cristina Ramona

Gorgan Lavinia

Colesnicov Valeria

Bochis Laura

 

ASOCIAȚIA CES - COLABORĂM EDUCĂM SPRIJINIM, Oradea -Romania

 

 

 

 

 

 

 

 

 

“The European Commission support for the production of this publication does not constitute an endorsement of the contents which reflects the views only of the authors, and the National Agency and Commission cannot be held responsible for any use which may be made of the information contained therein”. 

 

 

 

 

 

 

 

“Alternative approaches for supporting SEN/SLD pupils’ rehabilitation and inclusion

Part 1: EMOTIONAL DEVELOPMENT THROUGH ART THERAPY

 

Project result of KA220-SCH - Cooperation partnerships in school education

“Teach me to help”

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Chapter 1

THEORETICAL KNOWLEDGE

 

What is art therapy?

The field of art therapy has not yet benefited from a complete theorizing, art therapy being, as Judith Aron Rubin, president of the American Art Therapy Association, states, "another technique in search of theories." However, it is considered that:

• in a narrow sense, art therapy involves the use of mainly visual arts (painting, drawing, collage) to fulfill a therapeutic or educational purpose (Houzel, Moggio, Emmanuelli, 2004);
• by extension, including the kinesthetic part (modeling, orientation of perception on one's own body: static or dynamic), it includes all art forms: dance therapy, melotherapy, drama therapy, occupational therapy,

thus, art therapy appeals to the means of fine arts but also to other arts (music, theater), in general to all artistic techniques, each individual or group being encouraged to find their own means of expression. Consequently, the term “art therapy” continues to be applied uncritically to a wide variety of art-related therapeutic activities (Richardson, 2001). So, a definition of art therapy, or a particular way of working, will depend on the personality and theoretical orientation of the therapist, the group of clients and the context in which they work, which may mean an adaptation of the technique (Malchiodi, 2003).

Art therapy is defined by the British Association of Art Therapists (BAAT) as the use of materials for self-expression and reflection in the presence of a properly trained art therapist.

The American Art Therapy Association offers a more comprehensive picture of art therapy, being seen as a mental health profession in which clients, accompanied by an art therapist, using artistic materials, through the creative process and through the final product, explore feelings, reconcile emotional conflicts, develop self-awareness, manages behavior and addictions, develop social skills, finds new perspectives on reality, reduces anxiety and increases self-esteem.

In Romania, according to Preda (2006), art therapy is understood as an activity that uses non-verbal methods, with psychotherapeutic values, highlighted by objectifying imaginative activity in a product of artistic nuance, or by receiving and experiencing the meanings of such products.

 

History of art therapy

Art therapy is a fairly recent therapeutic direction that consists of several related fields of thought: art, art history, anthropology, psychology and psychiatry. There are many ways in which art has been used over time. The art of healing is as old as the drawings on the cave walls, but the profession itself is still young in the family of mental health disciplines (Rubin, 2009). Although new as a discipline, art therapy has its roots in the use of art as a treatment of moral pain in the late eighteenth century, also in the re-evaluation of universal art, the art of the untrained, or the art of people with psychiatric disability (Urmă, 2014).

Art therapy was developed by developing a set of techniques initially used in neuropsychiatric hospitals. Doctors paid special attention to the products of patients' creativity, and the interest in the art of pathologies increased, culminating in the development of diagnoses for patients based on their expressive products.

Most experts agree that art therapy is a profession that has its origins in the 1940s in Europe and North America (Borowsky-Junge, 2010; Hogan, 2001; Vick, 2003; Waller, 1991, 2013), where it is currently being adopted in schools to provide support. for young people with social, emotional and mental health problems. The first to use the term "art therapy" to describe the therapeutic application of image creation is the artist Adrian Hill, from Great Britain. He discovered the therapeutic benefits of drawing and painting during the recovery from tuberculosis. For him, the value of art therapy lies in “completely captivating the mind (as well as the fingers) . . . [and] releasing the creative energy of frequently inhibited patients (Hill, 1948, pp. 101–102). Around the same time, in the 1940s, Margaret Naumberg, a psychologist in the USA, began using the term "art therapy," closely related to psychoanalytic theory, considering that the role of art therapy is to release the unconscious through spontaneous artistic expression. Therefore, the images produced are a form of communication between the patient and the therapist because they contain a symbolic discourse (Naumberg quoted in Ulman, 2001, p. 17). Particular importance is also attached to the patient-therapist transfer relationship and free associations are encouraged.

In essence, Naumberg's position could be described as supporting the use of art in therapy, while Hill supported art as therapy. Even today, there are still contradictory discussions about how to define art therapy. Thus, some therapists see it as a way to help individuals verbalize their ideas, feelings, beliefs, problems, and perceptions of the world. By this definition, therapeutic art is an adjunct to psychotherapy, facilitating the process by creating images and verbal exchange with the therapist. Others see art itself as therapy; that is, the creative process in making art, whether it is drawing, painting, sculpture or some other form of art, is what improves life, having therapeutic valences. In reality, both aspects contribute to the effectiveness of art as a form of therapy and most art therapists relate to both definitions in their work. Thus, Farokhi (2011) describes two perspectives on the approach to art therapy:

• belief in the healing power of the creative process = corresponds to the phrase art as therapy
• emphasizing the product (drawings, paintings, collages, etc.), useful tools for communicating psychological content = corresponds to the phrase art is a method of symbolic communication.

According to the Romanian Association of Expressive Therapies (www. http://expresive.ro/), three major categories have crystallized in the theory and practice of art therapy:

• The first of these is obtained by the use of expressive artistic tools and means grafted on the already existing psychological and psychotherapeutic theories. Included in this category are most of the current art therapy guidelines: psychodynamic approaches (psychoanalysis, Jungian analysis, Adlerianism, etc.), humanistic approaches (phenomenology, gestalt, person-centered therapy, etc.), educational approaches (cognitivism and behavioralism). Systemic approaches (family systemic therapy, group therapy, etc.). Moreover, the psychoanalytic approach was the first form of art therapy, as a transfer process between therapist and client through which the therapist interprets what the client represents in the work of art and arouses the client to interpret.
• The second category is the integrative approach of art therapy, which uses methods, techniques and theories depending on the client we work with and the specific requirements of the situation. Thus, the integrative, eclectic, creative education, etc. approaches have appeared.
• The third category is given by the theories that emerged from the very use and practice of art therapy. 

 

Artistic means of working in art therapy

The artistic means used in art therapy are multiple (Trace, 2014):

• the painting,
• clay (used for its sectoral properties and due to the possibility of creating shapes and volumes that can become game objects for participants),
• collage,
• drawing (widely used and studied by psychologists, often associated in therapy with other graphic or plastic approaches),
• photography (photographing what you like, inducing personal satisfaction arising from the possibility of exhibiting in galleries),
• photomontage (which consists of the use of pre-selected photo collections according to the target audience, the choice and interpretation of photos by the participants, the explanation of the choice, which leads to the development of group communication),
• writing,
• puppets (making, offering puppets to participants, puppet show for therapeutic purposes, staging a puppet show based on a script or by simple improvisation, psychodrama theater as a means of staging conscious and unconscious conflicts or expressing repressed emotions),
• video (participants create a movie sequence with the help of an animator),
• dance, fabric (used for its sensory aspect, related to dance, body movement, as a way to hide, wrap, etc.),
• theater (as a way to highlight who I am, what I can be, theater can be the support of what cannot be said, the possibility of releasing energies kept in check for a long time, psychodrama being a way to stage emotional experiences painful and unacceptable to society or oneself), mask theater,
• clown (clown therapists, comedians accompanying the patient to his hospital room).
• music (we talk about music therapy or music therapists).

Below, we present some of them in more detail.

Drawing and painting

Painting and drawing are a dialog between the subject and the therapist, a means of communication. Through them, children usually express their personality, emotions, creativity, as they are very close to play. Children use drawing and painting to give a visible shape to ideas, observations, emotions.

Through drawing and painting, the person with disabilities expresses his feelings, feelings, needs, expresses himself and thus discovers his identity.

Collages

Collages requires an effort to compose the space by using cut-out materials to support the chosen theme. It offers the possibility to train the different senses through various sensory stimuli. The role of the collage is to bring an iconographic material in front of the client to transform it into a support of the imaginary; in this case, the client tries to compose the space (Vatavu, 2015).

Modeling

It is a tactile kinesthetic expression method in which the hands come into direct contact with clay, plasticine, or ceramic paste and, through various handling actions, the material used takes on certain shapes. This form of visual-plastic art therapy is a way in which the modeler tells his story, both through the modeled figurines and through the verbal expressions that accompany the modeling activity (Mercea Ilieș, 2013).

Dances and music

Dance therapy starts with the idea that the body is the representation of the self, and how the person uses his body at rest and movement is the expression of his inner world (Mercea Ilieș, 2013). Dance and music release energy, relax, but also energize, charge, motivate, help express a mood, help socialize, understand your own emotions and those of others. Music influences the way we behave and react. The child is discharged at the sound of the sounds, and the dance can be considered the primary response to rhythm and music. Dance and music are forms of releasing emotions, energizing, expressing messages, sometimes stronger than words.

The theater. Puppet Theater. Role play

Theater is a technique for releasing tensions, but also for clarifying the state of the person who gives life to a certain character. The actor actually plays his own experience, with its meanings and feelings (Mercea Ilieș, 2013). This involves structuring on two major levels: the elaboration and structuring of the text/story / game, the staging, and as a result, the child is freed from the tensions and emotions he cannot manifest, he understands the feelings that others experience in different situations. life.

 

Therapeutic metaphors

Metaphor (gr. Metaphors = transport, transfer) is a style figure that consists in giving a word a new meaning, through a implied comparison (example, the expression "sharp mind"). In a broad sense, the therapeutic metaphor is defined as a style figure that presents in a different form the real problem that children face.

The therapeutic metaphor (especially that which functions as a symbol) is a privileged way of access to the psychic unconscious. Imagination involves both the participation of the conscious and the unconscious, it being the psychic process that connects the two psychic instances. Using metaphorical techniques in therapy means working with symbols. And "working with symbols creatively is the key to success in individual development and therapeutic practice" (Stevens, 2001, p. 128). According to Klein (2006), art therapy is a metaphorical itinerary, and metaphor is not conceived as an enigma in rationality, but as a stage of the itinerary.

Metaphor is not an enigma, but the solution to the riddle. One day, the disciple complained to his master: I don't always understand the meaning of your stories, why don't you explain them to me? The master replied, "How would you react if someone chewed a fruit before giving it to you?"

 

 

 

Role and importance of art therapy

Over time, art therapy has often used either for understanding (evaluation) or for therapeutic purposes (Rubin, 2009). Art therapy is based on the idea that the creative process of making art heals and improves life, being a form of nonverbal communication of thoughts and feelings (American Art Therapy Association, 1996). Like other forms of psychotherapy and counseling, it is used to encourage personal growth, improve self-understanding, and provide emotional support (Malchiodi, 2003). Thus, art therapy is a method that can help individuals of all ages to make sense and gain perspective, to find relief from overwhelming emotions or traumas, to resolve conflicts and problems, to enrich daily life and to obtain an increased sense of well-being (Malchiodi, 1998, 2003). In art therapy, making images, thinking and expressing through images, develops beyond imagination, emotional growth, self-esteem, psychological and social integration of a person (Edwards, 2004).

The literature highlights several general objectives of art therapy, including:

• channeling the internal resources available to people to overcome the various difficulties of adaptation;
• practicing the abilities of verbal and non-verbal expression, of the tensions, anxieties, feelings, feelings aroused by the proposed themes, stories, songs, movements;
• developing the ability to discover and choose from several alternatives for solving critical situations;
• enriching the thought processes (analysis, construction, comparison) by using symbolism during the creative process;
• the conscious use of creative-imaginary resources has been discovered in everyday life,

therefore, art therapy can be helpful for people with various needs and difficulties.

 

 

Chapter 2:

METHODOLOGY OF IMPLEMENTATION

 

2.1. VISUAL-PLASTIC ART THERAPY

In this section, we will approach art therapy in its narrow sense, according to which art therapy considers only the visual arts and its specific means: drawing, painting, collage.  From this perspective, the question arises "What is the relationship between art, therapy and art therapy?" As a potential answer, Aron Rubin Judith reminds us that art alone could be very therapeutic and therapy alone can be very artistic (Rubin, 1999, 2009). However, NOT every artistic activity has therapeutic values, and art and therapy are NOT mutually exclusive, the terms CANNOT be substituted for each other, but art and therapy comprise two areas of human activity that can remain independent. Art therapy can therefore be the product of the marriage between the two partners, in which neither of them loses their identity.

Perhaps it would be interesting to mention the issues related to "What is NOT art therapy?" So, art therapy should not be confused with art because the following (Vatavu, 2015):

• in art the beneficiary is the work of art
• in art therapy the beneficiary is the man
• art is a means of development made available to people
• artists are not trained in art therapy, no experience, skill, or talent is required
• art is just a way to better understand our own feelings and inner conflicts

While the purpose of art is the painting or sculpture, the purpose of art therapy is personal development, emotional healing, and individual transformation.

 

The objectives of visual-plastic art therapy

As we have already mentioned in this material, art therapy as a professional field of practice, involves the use of both art and healing.​​​​​​​ Uses visual art media, such as paint, paper, clay, collage, and found materials, as the primary means of communication — through which healing and personal transformation can occur. By analyzing the works of art therapy, the therapist tries to obtain from those assisted graphic representations with expressive potential to communicate the most hidden feelings, and then analyzes with them the meaning of the work. This way of working has its basis in psychoanalysis. In this field, Freud and Jung analyzed graphic works to determine hidden aspects in the subconscious and unconscious that were transmitted in the form of symbols. Thus, clients develop a relationship with the art therapist and with the art itself in a safe environment, and this becomes a way to increase self-awareness and greater likelihood of positive change, increased self-awareness, and therapeutic outcomes (Kelly, 2015). Thus, the patient comes to understand himself and to develop communication skills, social insertion, facilitating the development of strategies for resolving conflicts.

Edwards (2004) considers that the goals of art therapy often vary according to the particular needs of the individuals with whom the art therapist works. Thus, these needs may change as the therapeutic relationship develops. For example, for one person, the art therapy process might involve the art therapist encouraging them to share and explore an emotional difficulty by creating images and discussions; while for another it may be directed to allow them to hold a pencil and make a sign, thus developing new ways of shaping previously unexpressed feelings.

 

The target group in visual-plastic art therapy

Although it is often assumed that only people who are technically competent in the visual arts can use art therapy beneficially, this is not true (Edwards, 2004). This is because art therapy will highlight the symbolic expression of human feelings and experience through art and not the quality of the artistic product (Edwards, 2004). Thus, the beneficiaries of art therapy sessions include children, adolescents, adults with various difficulties: autism spectrum disorder, ADHD, behavioral disorders, language disorders, poor school performance, problems adapting to the community, emotional lability, low self-esteem, anxiety, depression, mental and emotional disorders, people who have problems with substance abuse or who face domestic violence.

 

Ways of realization art therapy through visual-plastic means

• In individual therapy - the client-therapist relationship prevails, the client accesses his own resources, confronting expressively the identified difficulties.
• In group therapy - the client has the opportunity to come into contact with issues similar to his.

 

Organizing the space for visual-plastic art therapy and materials

There are various materials in the workshop, to give the participants the opportunity to choose what suits them. Depending on the chosen theme, materials such as paper, colored cardboard, glue, paints of different colors, brushes, canvas, string, modeling clay, sand, stones, shells, etc. can be used at each work session. The therapist guides the client in choosing the materials, depending on his problem, the chosen topic or the therapeutic stage in which he is.

 

Visual-plastic art therapy methods and techniques

• The thematic drawing method: it is inspired by the projective techniques that use the drawing (TAT, Rorschach, tree test, person test, family test, house test, etc.) consists in presenting a plastic theme to the participant, which he executes.
• The free drawing method: it is a specific art therapy technique, during which the participant execution in the program of regular and supervised activity, free, original thematic works.
• The method for drawing according to the model: it is an occupational therapy art with an occupational therapeutic character, it represents the stage of introducing the participant into the free creative activity.
• Finger painting method: it is a practical variant that uses the pictorial material through direct, sensorimotor contact by the participant as it is done during the modeling and sculpture activity (R. F. Shaw, E.P.Mosse and I. Fleming).
• Family Art Therapy Method (R.Y. Kwiatkowska): is a collective form of art therapy, which occurs in an organized group, represented by the student and possibly his family members.
• Mixed methods: represent the association of some of the above forms, depending on the needs pursued by therapists.
• The method of the unique collective activity: consists in reuniting a small group of 3–5 participants, to execute the same work of great proportions, simultaneously, each executing a fragment of work.
• The method of associating art therapy with other therapeutic procedures, pharmaceutical treatments, other forms of psychotherapy, sociotherapy.

Edith Kramer (1971, p.54) highlighted five distinct categories that illustrate how art media can be used in therapeutic practice. These are as follows:

• Preliminary activities: scribbling, smearing, exploring the physical properties of the material that did not create symbolic configurations, but were experienced as positive and self-syntonic.
• Chaotic discharges: splashing, hitting, destructive behavior that leads to a loss of control.
• Art in the service of defense: stereotyped repetition, copying, tracing, banal conventional production.
• Icons: pictorial communications that replace or supplement words. (Such communications often occur in psychotherapy or other intimate relationships. They usually remain incomprehensible to outsiders.)
• Formed expression or art in the full sense of the word: the production of a symbolic configuration that successfully serves both self-expression and communication.

 

General structure of visual-plastic art therapy session and recommendations

• The moment of capturing the subject's attention, can offer the opportunity to start an insight for the participant on the proposed topic. One can start from a metaphorical story or beloved poetry, a musical sequence, or even established relaxation techniques can create the psychological framework conducive to the creative approach. Their choice depends on the skills of the leader, but also on the objectives of the activities and specifics of the person/group and the problems they face.
• The stage of creation: is dedicated to the actual realization of the artistic product; he is given a longer time.
• Giving meanings, symbols, meanings: once completed, the artistic products can be explained by the participants.
• Sharing/feedback: the exchange of ideas, and interventions of the other participants: can be extremely useful for the one who introduces himself/herself with the paper.

The American Art Therapy Association (1998) provides the following recommendations for the purpose of art therapy, who can apply in specific visual-plastic art therapy activities:

• Each person explains their own work and not the other children or the leader of the activity.
• If the student has difficulty explaining his/her own work, the therapist can support him/her with some suggestions, but the student will decide which explanation is right for his/her work.
• The therapist encourages interpretations of the colors used, and even if the child does not find a suitable explanation at the moment, the therapist's question paves the way for further discoveries.
• When the student interprets the final product, the therapist asks him the first thing that comes to his mind: the person, the situation he remembers in relation to the product.
• He then has to describe each element of his final product and some characteristics of that person.
• The therapist should pay attention to the signals (gestures, breathing, tone of voice, facial expression) given by the participant, while listing the characteristics. After that, the therapist can ask the student to identify the correspondence with his own personality. sometimes the product can be simply interpreted, but sometimes the therapist must capture the substrate.
• The therapist should encourage the students to express their feelings before, during, and after the activity. The therapist must be sure that the student is prepared to approach the topic.
• The therapist must allow the students to do exactly what they are prepared to do. Whether the approach is direct or indirect, the student must feel in control of the whole process and the product.

The therapist may pay attention to the following aspects during an art therapy session (Edwards, 2004):

• The main topics that emerged during the session and how they were answered. If these themes arise spontaneously, they can be of considerable significance to the individual or group. They may indicate, for example, the emergence of new material or the reworking of existing issues.
• Materials used by the customer. Where customers have access to various art materials (including wet and dry media, different types and sizes of paper, clay, and other 3-D media), the choice of materials can be of great significance. The same could change from using clay paint, from making small images to larger ones, or from working in a representative (figurative) to a non-figurative (abstract) way.
• How the client used the art materials. Art therapy clients may have very different ways of working (slow, fast, messy, repetitive, etc.) and which may indicate their current mood. The way the paint was applied (thick or thin, for example), the quality of the marking (heavy or light) or the special use of color, shape and texture can also reveal important aspects.
• Approaching the client in the process of making the image. For some clients seen in art therapy, this can vary greatly over a session or time. Sometimes the client may be prolifically productive, while at other times he may be stuck or unable to work at all.

A therapist must be open, able to create a secure atmosphere, through benevolent neutrality, to be creative himself, able to initiate a rewarding artistic game, to mediate communication and to guide patients in their relationship difficulties, through plastic creativity or some type of artistic language (Fabini, 2006).

Colors can say a lot about a drawing but also about the personality of the little artist:

• Red - its exclusive use indicates a tendency towards aggression, a lack of emotional control.
• Blue - used in excess, may indicate too much self-control.
• Green - control of social relations.  
• Yellow - used alone, denotes an adult child addiction.  
• Brown - can translate into poor family and social adjustment, various child conflicts, regression.  
• Violet is a sign of restlessness, anxiety, especially when associated with blue.
• Black betrays anxiety

An analogy would exist between the spatio-temporal framework in which the child is situated and the graphic space - a parallelism between his impulses and graphic movements:

• systematic filling of the entire sheet: ambitious child, who seeks to assert his presence, but also a sign of immaturity
• use of an exaggeratedly small space: it may be a sign of imbalance

 

Visual-plastic art therapy in the clinical environment

Various mental and psychological disorders can be diagnosed and treated through visual-plastic art therapy. For example, the analysis of more than 300 drawings of children with epilepsy allowed the correlation of certain artistic patterns with the epileptic seizures and laterality problems. In the post-crisis period, the drawings of children with epilepsy had areas with errors that showed transient motor or cognitive disabilities. For patients, the main benefit of producing artistic objects is separation, at least for the time being, from the emotional effects of the disease. Patients diagnosed with cancer could build a healthier identity from the work created, significantly reducing the level of stress caused by the fight against the disease. Research has shown that patients included in therapy groups have better vital signs and more peaceful sleep (Farokhi, 2011).

 

Visual-plastic art therapy in children with intellectual disability

The visual-plastic art therapy session for this category is first a pleasant sensory experience, and then its sensory, to give way to experiment space, time, life situations, the identification of solutions to the difficulties encountered. The visual-plastic art therapy sessions reside in the alternation of the free instinctual expression and of the directed activity. Sessions can be very short, especially if there is difficulty concentrating, emotional instability; the art therapist will consider the importance of ritualizing activities. People with intellectual disabilities often show greater spontaneity than people with typical development.

 

Visual-plastic art therapy in children with autism spectrum disorder

Visual-plastic art therapy can be beneficial in children with autism spectrum disorder because painting can be considered a combination of spots, lines, graphic signs that make up a rhythm. … „The painting itself can be seen from the perspective of rhythm. visual patterns, repetitions, ascending and descending lines, and other aspects are related to elements of music” (McNiff, 2009). Translating the attraction of rhythm into painting makes this environment a favorite of children with autism spectrum disorder (Grandin, Barron, 2005)

According to N. Vatavu (2015), visual-plastic art therapy can be a good way to teach children with ASD to socialize, primarily due to voluntary involvement in activities. A very common therapeutic technique is to learn social skills using anecdotal picture cards. The images are drawn by the therapist alone or with the help of the child for later analysis. Another benefit of visual-plastic art therapy is the development of the ability to solve problems visually. By using symbols, images, or social stories, the child can recall the information learned in therapy. According to C Gray, when the child collaborates with the therapist to create their own symbols, images, or social stories, they are incorporated more effectively by the child, who integrates them into his inner experience.

The visual and concrete nature of art helps children with autism spectrum disorder who often experience anxiety in social situations to relax and enjoy the experience while learning social skills in the controlled environment of group therapy. Training imaginative availability within the therapeutic art activities is one of the main goals of the visual-plastic art therapy of the child with autism spectrum disorder; by creating challenging situations the child can exercise their skills of flexible adaptation to the environment or can learn new behavioral strategies (Vatavu, 2015, p. 78).

Objectives in visual-plastic art therapy program for children with autism spectrum disorder:

• Decreasing the degree of frustration with dirt;
• Training in writing/drawing / painting objects;
• Integration of the body scheme:
• Increasing communication and social skills;
• Exercising perceptual skills;
• Increasing flexibility with the rules.

The proposed topics focus on developing compensatory availability, correcting deficient behavioral or sensory patterns, or learning new concepts or skills. For example, to ensure the integration of the body scheme, it is recommended to approach the different body segments and relate to them from several perspectives: rendering one's own hand, rendering one's hand to the participants, self-portrait, portrait of another child, full figure,

 

2.2. DANCE THERAPY

Dance as a therapeutic activity offers a special way of relating to the environment and to others, offering the child various possibilities to develop acquisitions that allow him to understand and adapt to the environment starting from the fundamental principle that dance is a universal language.

 

Primitive expression

The primitive expression is a simple dance, accessible to anyone in which the most important are personal experience and experience of the environment. It is a dynamic, cheerful, playful dance with a poetic and musical character. The term "primitive" brings to mind the basic, ancestral, and specific elements of fetal development in the womb, and "expression" refers to the way in which thoughts and feelings are brought to the surface.

The principles of primitive expression refer to experiences that everyone has had since the womb: movement, rhythm, voice, to which the group is added.

Examples: Rhythm: walking, running, heartbeat ... mother

   Voice: mother's speech, singing, shouting, laughing

   Whole body movements

Primitive expression: Basic music is live percussion (djembee), which stimulates dance, song, movement, play. The rhythms are easy to follow, they have a repetitive character. The rhythm gives on the one hand the necessary stimulation and on the other hand the feeling of security.

 

Wave - The 5 Rhythms

American dancer Gabrielle Roth developed the WAVE concept - the five rhythms that make up a cycle of movement. Through dance and movement, experiencing, improvising, the human being communicates with himself, he can express his own feelings. The body can say what words cannot. The expression of emotions through dance determines a release and a healing. Through dancing, exploring the nature of every natural movement of the body, the child learns to feel safe, a process that helps the child to regain his own body, to know it better and to feel comfortable in it.

In dance therapy, the body is the representation of the self. The feelings that person has towards his body and the way he uses his body at rest or in motion, are an expression of his inner world. Absorbed in the dance, the child may express all feelings and may express resentment

The practice of the 5 Rhythms is a form of meditation movement without fixed steps or choreography, whose central idea is: "if you put the psyche in motion it will heal on its own" (Gabrielle Roth).

The 5 rhythms, successively, make a cycle of movement known at the Wave.

When we dance the 5 rhythms,we enter in turn into five distinct fields of energy. Dance you can relax or relieve worries and thoughts, rhythm or energy can bring you peace. Rhythms gives you the opportunity to dance cheerful and passionate, but sober and modest, whoever you are.

When we practice embodying these different rhythms, we often begin to notice such benefits as  improves mental, emotional and mental,  gives greater vitality, increase concentration, sharpen instincts and gives a good general condition.

Before starting the five rhythms dance is performed to heat the body parts. This is an active meditation, attention is paid by slight movements, each part of the body: head, shoulders, body, hands, waist, legs, knees, etc.

 

The 5 Rhythms and their simbolism

1. Flowing

Symbol: earth

The beat: maternal rhythm, feminine, sensitive, allows entry into contact with intuition

Movements: endless circles, breath in, breath out; every movement is linked to the first round; feet remain motionless

Feels like: wave, openness, swaying and turning, moving seamlessly continuous circles, floating light

Music: melodious, waltz, jazz 

 

 

 

2. Staccato

Symbol: fire

The beat: paternal rhythm, male, strong, expresses energy

Movements: sharp and limited movements, clear beginning and ending, angular, with focus and direction, pushing, pulling, hand flapping, pinching.

Feels like: passion and energy

Music: rhythm is short, strong, similar to the African.

 

3. Chaos

Symbol: water

The beat: rhythm in crescendo, music stimulates, lead, we lose control, we give free rein emotions

Movements: float around, you shake and shiver, eventually surrender

Feels like: reliever thoughts and feelings

Music: rhythm is stimulating accelerated Irish music, gypsy

 

4. Lyric

Symbol: air

The beat: cheerful rhythm, optimistic, it charges us with energy, make room for the new

Movements: open, energetic arms, hands, face upward is in contact with others

Feeling: elegance, exuberance

Music: lively, radiant and easy, Brazilian music, salsa, folk.

 

5. Stillness

Symbol: loneliness

The beat: slowed down, stopped, allows return to own person, finding inner peace

body awareness

Movements: soft movements, almost meditation, massaging and touching, lying down or sitting on the ground without moving

Feels like: rest, coming home, peace

Music: conciliatory, harmonious, soft, classical music, a musical.

 

2.3. MUSIC THERAPY

The therm of meloterapia  was introduced by dr. Mousson Launage in 1924 (Voight, 1999) describing the effect of the music over disease healing or improving. The word, not found on general or medical dictionaries, can be accepted as an ethimological creation, from melos and terapia.  Melos, according to Platon, has 3 parts: words, harmony and rhime. Terapia, after teh definition of Liddell and Scott, means a service to the sick people, a cure. So, meloterapia is a new therm for an old therapy, supposing treating sickness through music (Cooke, 1969). Music as Therapy can be defined as the use of music and sound in a structured setting to promote the mental, physical, emotional and social well-being of an individual (Aldridge, Gustoff, Neugebauer, 1995, Gold, Wigram, Elefant, 2006, Pantazi, 2009)

According to Pantazi (2010) and Werbner, (1966) Music Therapy is not music education and while children/adults may pick up basic musical skills, such as how to play a certain instrument, music education is not the aim of the work. When using music therapy, the music is used initially to establish a point of contact with the child or adult and then as a means of addressing, within a safe, secure environment, whatever difficulties the child/adult is experiencing:

• children who are withdrawn and unresponsive to draw them into shared musical activity.
• to channel – in a positive and constructive way – the energies of very active individuals

Group work can be used to develop and practice social skills, such as: awareness and appreciation of other group members, listening, turn-taking and leadership skills (Pantazi, 2009, Pantazi 2010).

 

 

Basic principles of Music Therapy in practice

Music therapy is client-centred (which does not mean client-led, but playing mostly improvised according to client needs and potential) and based on trust, confidentiality and unconditional positive regard (Pantazi 2010).

Music therapist llistens to, acknowledges and values the client’s authentic expression:

• Instrumental - music therapy involves a largely non-verbal medium of music, usually on the instruments.
• Vocal - vocalisation, babble, melodic, exclamatory, primal expression, spoken word, songs
• Through movement and gesture - dance, spontaneous or involuntary movement
• Through eye-contact and facial expression
• Through silence

During the music therapy sessions, the practitioner observes the client, wait for the client,  listen to the client’s sounds and after that responds to the client.

Objectives and activities of music therapy sessions are chosen according to client needs and potential:

Time and space organisation

• frecquency : (1-2/times on week)
• duration: 25-30 minutes (individual), 45-60 minutes (group)
• time: same day and hour
• space: same room

Human resources involved:

Music therapy can be individual and group work

• Individual work: 1 client-1 therapist
• Group work: 1-2 therapists – maximum 8 clients, group and session structure are stable

Beggining and end of the session – clearly marked through Wellcome and Goodbye songs (Pantazi 2009)

 

Session planing process

The questions the therapist/teacher shoul ask when plan a music therapy session are:

WHO is the target group? (group/individual needs and potential)

WHAT kind of activities we propose?  (group, individuals voice, instrumental, etc )

WHY  we propose each activity?  (aims and objectives)

WITH WHAT? (materials/instruments we need?)

WHEN do we use a certain activity (worm up, main or closure)

WHERE  organise activities? (adequate space for proposed activity)

HOW do we structure sessions? (some needs more flexibility then others)

 

Way of responding to the client in music therapy

The ways of responding to the client in music therapy are:

Imitation -  a response which closely resembles the client’s sounds. When you are imitating a child you are getting closer to him, you go away,  you imitate  the child, according to his reactions

Matching - a response which resembles the client’s sounds in that it closely matches its emotional quality. When you are matching with the child, you can try to bring the more instruments closer to him and to increase the intensity of interaction/communication.

Varying - a response which while being based on the client’s sounds, adds significant variation to it. When you are varying the child, starting from its reactions you try to modify them.

This ways of responding:

• can alternate during session, according to objectives and child mood
• can be used differently to reach the proposed objectives and managing change
• can be use for responding in individual and group work

 

Types of music therapy

Sessions of music therapy can be organized  individual or in group work.

Individual work structure is more flexible, beeing proper for children more difficult to adapt to the group

Aims:

• to development of important communication skills
• to offer the posibility of expressing in a calm environment

Instruments: the one children likes (known) or for the first meeting, tunable percussion instruments, xylophone, small instruments

Group work offers the child the oportunity to develop comunication and interaction skills.

Gathering the group: Choosing the proper children, according to specific issue they are facing with. It is recommended a balance between developmental level, abilities and skills and their different personalities.

Aims:

• creating oportunities to express free in the relationship with others
• increasing interaction inside the peer group
• developing children listening and focusing abilities

Lesson structure: 2-5 activities during a session, according to objectives

 

Specific  objectives of music therapy

The objectives set through music therapy sessions are multiple, and have to be chosen according to child or group need and potential. We will mention some of them as follows, but you can find more:

• to develop the capacity of imitation a rithm
• to develop the capacity of taking turn
• to increase frustration tolerannce level
• to diminush the agresivity; using in a positive way impulsive and agresive drives
• to assume lider role and its resonsability
• to respect the rules of the group
• to develop atention and observation
• to develop the capacity of expressing pozitive an negatuive emotions through musical instrument
• to reduce anxiety
• to develop imagination and creativity
• to develop selfesteem and trust in ...
• to develop sociability, through participation to group activities;
• to develop the sence of belonging to a group
• to educate facial expression
• to improve space and time orientation and motrical coordination;
• to create general welbeeing, harmony

 

Suggestions for session structure

This are a few suggestion coming from authors practice:

• to have 2 coordinating teachers for group work: 1 therapist who lead the activity and 1 co-therapist, who support group members during activity;
• therapist role is to encourage the child to participate as much as possible and not to lead them to sing in a specific way;
• to choose the optimus number of participants and structure for the group;
• each child to have a good reason for beeing part of the group – 3 realistic and achievable purposes for each child;
• to archieve the goals/aims – proper activities; 2-5 activities between wellcome and good bye songs;
• to have the same activities in order to be familiar and allow children to improve self esteem. Still, changing instruments – wake up child interest from one week to another
• the session structure may be different from one group to another
• the activity of leading will increase self esteem
• using voice is important in music therapy, but once music starts – no more verbal indications
• to set clear rules from one week to another:
• to have respect for instruments and for other participants;
• time, duration, place to be the same, each week; 
• group members: children, thearpist, co-thearpist to be the same, each week;
• session duration can be different from one group to another
• reviewing goals every 6-8 weeks will lead to changes in the activities and instruments
• the progress can be different from one group to another and from one child to another
• choose the proper instruments and puting them in the specific order they will be use, when preparing the activity;
• choose instruments that reflects the goals for each child;
• the instrument choosed for a child should be also according to its mood;
• child should not be forced to sing to one instrument but might need help;
• percution instruments are accesible to all – no special training is required to create percussion sounds
• exemples of using percusion in music therapy: anger and frustration - drum, rhythmic pulse - maracas, harmony and reflection of a mood - metalofon, calm – chimes
• be realistic when you design your activities!
• use imagination to create can not be good or bad!
• build activities upon your personal experiences!
• adapt games and exercises. remember all the time how flexible music is!
• be very clear & specific when you introduce a new activity.
• use spontaneity to your benefit.
• invite kids to come with new ideeas for activities.
• trust your Each has its own individual stile that has to be found;
• do each activity with entuziazm!
• the main goal of each music therapy session is to reach wellbeing. If you feel good there are big chances group members to feel the same! (Pantazi 2009, Pantazi 2010).

 

2.4. CHALLENGES AND LIMITS OF ART THERAPIES

What is a limit?

A limit is something that indicates boundaries or fences. They are established according to the client's needs, but also according to their own level of skills.

 

The role of limits:

• allow the development of a healthy therapeutic relationship
• provides a space where one can respond with consideration to reactions and behaviors, and where difficult emotions can be expressed
• provides physical security (session leader, client / clients, tools

 

Type of limits:

Practical limits

• Space - same room or other locations?
• Time - recognized start / end time of the session, session duration
• Instruments/art technicues - are there any limits on their use?
• Therapeutic relationship - is there a connection with the client outside the session?
• Physical contact- whether or not appropriate
• Privacy - which will be kept in the room, which can be shared with other customers

Behavioral limits

• imposed on the language of the clients towards the leader / other clients
• imposed on aggressive behavior (screaming, hitting)

 

Ways to set effective limits:

• Through words: clear, simple vocabulary, calm expression
• Through your actions and body language: supporting, confirming words through appropriate gestures
• Through music/colour: familiar, predictive structures/flexible, unpredictable structures

 

Chapter 3

PRACTICAL IDEAS AND ACTIVITIES EXAMPLES

3.1. VISUAL-PLASTIC ART THERAPY

……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………….

 

3.2. DANCE THERAPY

Potential stories to use in dance therapy

The story of the fairies

Our story begins in a wonderful country where everything ends well.

It was an autumn with golden leaves. Fairies from all over the world have heard that they must meet to help children find a magical treasure, a treasure that will help them grow as in fairy tales, wise and diligent.

The preparations for leaving for the wonderful country began, gathering all the children to give them strength through their game of life. Their strength increased with every good deed, every handshake and every smile they gave. The branches swayed in the wind and the power of the fairies increased, the sun's rays or the raindrops all helped the fairies to be ready to go.

And they set out for the wonderful land. They had a long way to go and a lot of work to do. They needed a plan to succeed. The road was difficult. Full of logs that had to be removed, of fierce animals that he had to drive away in order to escape with his life, of the precipices that he had to cross. Our fairies were so determined that they managed to arrive safely ...

They met in the beautiful country, but a fierce witch threw them into a spell so that they no longer recognized each other. Everyone thought that one of them was a witch, and about the witch they thought she was a real fairy ... It was very hard for them to get rid of the bad spell ... luckily the powers of the real fairies increased with every good deed done by the children on who had left them at home.

When the fairies escaped the evil spell, they sat face to face and released their powers. They knew they had worked hard to get together, and now they could learn everything the others knew! And they could teach the children at home. Gathering their strength, they discovered the treasure: it was all the children's games at home, the games through which they built a better world!

They clasped their hands and the treasure shed its power: the world shone with warm rays of the sun, rainbows shone from light raindrops, and the bells poured sounds of peace and tranquility over the world.

 

 

The story of the clouds

Once upon a time, but not like never before, because it is still a kingdom of heaven. Who was the king and who was the queen? This is not so important now, because I want to tell you more about the people of this country. None other than the stars, the clouds and the wind. Well, among those who do you think gave the biggest headaches to the "law enforcement" in the kingdom? Certainly not the stars who, well, knew their place in the sky well and illuminated the blue darkness every night. The tumultuous clouds, however, in company with the mad wind did not stand still for a moment. They ran and played all day long. The old Sun looked at them with sufficient indulgence, remembering fondly the years of his own childhood. Sometimes he only touched them with a warmer ray, calming them gently. He loved them all equally, considering them his own children.

That's why, one day, the Sun had a big party, inviting all sorts of clouds to get to know each other.

-Some clouds were white, fluffy and soft. They floated and spun easily in wide circles, whispering the songs known only to them, and it was so pleasant to let them be driven by the currents of air ...

-Other clouds, black, were not friendly at all, and made some deafening noises. It was as if every move made steel plates rattle. They moved so fast, as if they were arrows of fire, thrown by the power of a giant. It was really thunder.

- The last clouds will reach us! cried a frightened white cloud. And so it happened, in a few moments our clouds were so white, they were unrecognizable: together with other clouds, coming from behind, they mingled, scattered, if you did not know which is white and which. and black, where you can hear the whispered songs or deafening thunder ... Now a fast cloud was passing, now you were caressed by the breeze of a velvety cloud ...

So far, so good! Good dear friends! voices were heard everywhere ...

- We will turn into raindrops, we will reach the ground and who knows what will happen to us!

Of course, this is what happened: we, the clouds of all kinds - white, black or gray, fluffy or sharp, calm or stormy, we mingled so much, we pushed, we gathered, we shook so much so dizzying that we turned into raindrops and detached one by one ...

"Maybe we'll see each other again on earth!" we could hear all around us, and we could see them all coming down quickly. Thrilling ... The view was wonderful ... I could see drops dripping on a stray bird, rolling on the roofs of houses or slipping through the branches of trees. Some strayed from the highway, carried by a gust of wind, others were caught together, eager to rush on the road to earth. To the ground ... but what will happen on earth? ... Nobody told us what would happen to us and we were already so close to the ground. Where will we fall? Looking around, we saw a violin signaling us to reach it. It was not easy to reach her among other drops, but we succeeded.

 - Thank you! We've been waiting for you for a long time, the violin told us. I need splashes to grow!

It was so nice to hear one like this! I don't think we've ever felt better. It was great! Hundreds of drops fell around us so that together, next to the violin, we formed a small puddle of water. Every drop that fell began to tell the story of his journey to earth. We also told them our story and they listened to it with great patience. And that's how we made a lot of friends among the other drops. And together we will make the violin the most beautiful flower on earth.

Now that you've heard the story of clouds of all kinds, we're curious to know, "What's your story?" What are your stories? ”

 

3.3. MUSIC THERAPY

Examples of musical instruments

Drum	Ocean drum	African drums
Tamburine	Chimes	Beed cabasse
Wooden cabasse	Cymbal	Cymbal
Triangle	Acoustic stiks on stand	Xilophone
Wooden stiks	Castanet	Metalic shaker
Rain drops	Maracas	Wooden tulip

 

Examples of exercises used in music therapy

The beginning and end of a session

"Hello" and "Goodbye" Song

Each individual or group session opens / closes with the song "Hello" and conclude with "Goodbye" song.

The session begins with the first beat of the drum (or sound of the instrument chosen) and ends with the last beat of the drum (or sound of the instrument chosen).

This helps&