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Children's Voice Article, July/August, 2005

Creative Solutions

Art, drama, and music can open the door to healing and new directions for children and teens.

By Jennifer Michael

In a Washington, DC, hotel conference room, far from Balboa High School in San Francisco, 17-year-old Monique stood before more than 100 strangers. Remembering the performance techniques she had rehearsed countless times, she began to speak about her father, reciting in a clear, steady voice the personal stories and memories she first crafted on paper and was now sharing with an attentive audience.

She recalled riding the bus with her father when she was a little girl and the advice he'd give her about growing up, and how he would cook her dinner and shape his meatloaf into a heart. She also remembered a Monday afternoon when police forcefully entered her house, handcuffed her father, and took him to jail. The card game Monique had been playing was left strewn across the room. She was 11 years old.

In the care of a family friend during her father's incarceration, Monique recalled, "I missed my bed and my room, and I missed the smell of the house. I was saying my prayers that he would get out soon, that he would be safe."

Monique's story was one of many that 15 students from Balboa High School shared during CWLA's National Conference in March. Through dramatic recitation, poetry, rap, and song, the teens told of separation and loss of loved ones to incarceration, immigration, or death. The audience, a cross section of professionals from the child welfare industry, gave a standing ovation and, in a discussion that followed, praised the students' creativity and courage.

Many of the students expressed new outlooks on their future, thanks to the nonprofit Community Works, California. Their performance was the result of their participation in Roots, an expressive arts class at Balboa High, funded by Community Works. The high school is located in a neighborhood where a disproportionate number of residents are incarcerated. In the class, the students use creative writing, drama, and music to explore their feelings and better understand this separation and other types of loss in their young lives.

Child welfare agencies and other organizations have long used the creative arts to help children and teens cope with myriad issues. Art therapists, teachers, and others who work with vulnerable young people say that, for kids who have been physically or sexually abused, shuffled about the foster care system, incarcerated in the juvenile justice system, forced to live in homeless shelters, or exposed to violence or tragedy in their communities, making something out of nothing can do wonders for their behavior and boost their self-esteem and verbal capabilities.

But even as creative arts organizations like Community Works have blossomed and seen increased demand in recent years, some child welfare agencies have struggled to fund such programs when their resources are already stretched thin. And, from a research perspective, the results of creative arts programs can be difficult to measure. Nevertheless, demand for art therapists has grown, according to one college professor, and those working with children and teens in arts programs often express a desire to expand their scope.

Balboa High School Administrator Thomas Graven attests to the success of the Roots program in turning around some of the students' difficult behaviors, and he hopes the program will continue. "It's been very powerful for the teachers. They see these kids disciplined and doing incredibly creative things, and it opens up a whole place for them to again approach the kids and help them be successful in school."

Uncorking Talent

Pencils and paper, paint, clay, a Polaroid camera, weaving materials, papier-mâché, a musical instrument--these are just some of the tools art therapists use to help children lift their heads off the table, to verbalize or to relax, to build up fragile self-esteem, and to discover their strengths.

"Everybody is artistic, it's just a matter of uncorking it," says Ellen Horovitz, Director of the graduate art therapy program at Nazareth College of Rochester in New York, Horovitz has worked in the art therapy field for 30 years. Before heading Nazareth's art therapy program, she worked for 16 years at Hillside Children's Center in Rochester. Most of the children under her care at Hillside had very serious problems. They also had wide-reaching talent, she says. By "uncorking" this talent, Horovitz was able to change the direction many of the children were headed.

Horovitz recalls bumping into a former student several years ago and discovering he had successfully overcome great obstacles as a child to eventually pursue a career as an art teacher. She remembers when the boy, Michael,* first arrived at Hillside at age 11. "This was a kid who, at age 7, witnessed his father bludgeoned to death and was completely nonverbal for two years," she says.

Horovitz introduced Michael to watercolor and acrylic paint, and it wasn't long before he opened up. "Within three weeks, he was doing art work and was talking up a storm," Horovitz recalls. Eventually, she was able to work with Michael on the issues surrounding his father's death.

Another student, Tom,* who was deaf, arrived at Hillside after having tried to stab his grandmother. Filled with anger and aggression, he would repeatedly spit in Horovitz's coffee cup and pull the fire alarm. But Horovitz discovered Tom enjoyed working with metals and, together, they soldered sterling silver and gold to make his mother a ring.

After building his trust, Horovitz worked with Tom on his anger and conducted art therapy with his family, to whom he eventually returned. Today, Tom works as a locksmith, Horovitz says. "With these kinds of cases, you really realize the power of art," she says.

Much of that power comes not only from children discovering a unique, safe means of expressing their feelings and telling their stories, but also in the recognition they receive that what they have created has worth and value.

For three decades, Janice Gould has taught art classes to students in the residential program at Lawrence Hall Youth Services in Chicago. "Many children who come to us have very low self-esteem," she says. "For whatever reason, they don't fit into the mainstream school, and they've withdrawn."

Students at Lawrence Hall are required to complete a year of art. By tapping into their creativity through art classes, Gould says the students can begin to build skill and trust.

"In art, it doesn't matter if you can't do your math at level, or your reading at level," she says. "If they become comfortable in one subject, hopefully the students will be successful elsewhere in school and in their lives."

Unfortunately, many of Gould's students don't have anyone to applaud their accomplishments, so she has come up with her own "refrigerator door" on which to display her students' talents--Lawrence Hall's holiday cards, notepads, and wall calendars, featuring student artwork, are sold each year to raise funds. Students also enter their artwork in local, state, national, and international competitions.

Barbara Horowitz, Founder and President of Community Works, New York--the sister organization of Community Works, California--says the creative arts are also a way for young people to celebrate their culture and diversity and develop role models. One of the primary programs sponsored by Community Works, New York, is Theater Connections, which taps city school children--many of them low-income--into the vast diverse multicultural theater experiences the city offers. Community Works exposes 65,000 students and community groups to city theater productions each year.

"The arts inform young people of the multicultural world in which we live and broaden their tolerance and respect for diversity," she explains.

Growing Interest, Funding Challenges

Horowitz describes Community Works' growth as "organic." Today, Community Works programs serve 150,000 children a year. "When I started the organization in my kitchen in 1990, I did not imagine that in a short period of 15 years, it would transform from a grassroots entity to a leading arts education provider for youth in New York City."

In addition to the theater programming, Community Works has expanded beyond New York City through its public art exhibition and education program, The Long Walk to Freedom, which honors civil rights activists and has toured Atlanta, New York, San Francisco, and Washington, DC.

The sister program in California initiated its youth arts education program in 1997. Ruth Morgan, Executive Director of Community Works, California, says several San Francisco Bay area schools have asked the organization to replicate its Roots program.

In recent years, similar arts programs geared toward youth, particularly disadvantaged youth, have come to life. Art Start, also based in New York City, began in 1991 when a handful of artists came together to engage homeless children in art activities in shelters citywide. Today, the organization operates a full-time staff and has worked with at least 5,000 kids from seven different homeless shelters, more than a dozen alternative high schools, and several programs for teenagers leaving prison.

The art therapy field is also growing, adds Nazareth College's Horovitz. "We can't keep up with the number of people who want [Nazareth] interns," she says.

At Lutheran Child and Family Service (LCFS) of Michigan, Development Services Director Lisa Bonney says she always tries to have an art therapist on staff. "Art therapy has always been a good addition to all the other therapies we do here."

LCFS recently obtained a four-year grant to fund a part-time art therapist and a program called Children Are a Work of Art. The program has brought professional artists, including a visual artist, a photographer, and a musician, to work with children at four facilities operated by LCFS. All of the children at the agency can benefit from participating in regular arts programming, says art therapist Debra Slavin-Glazer, but she can only serve about half the children on her part-time schedule. "We have our fingers crossed for another grant."

Bonney is quick to point out the reality for creative arts programs in today's economic climate. "It's one of those positions that's the first to get cut if times get tough," she says.

Andrea Shorter, Deputy Director for the Center on Juvenile and Criminal Justice in San Francisco, agrees that among the services required for children in need, arts programming is often "inconsistent" due to reliance on grant funding or volunteer assistance. "In most cases," she says, "therapeutic arts is a kind of boutique feature."

Although the use of creative arts in therapeutic settings resonates with many people, Margaret Blaustein, Director of Training at the Trauma Center in Massachusetts, sees the creative arts coming and going in everyday practice for various reasons, from a lack of funding or insurance coverage to a shortage of research showing the positive results of creative arts programs.

"It's harder to measure and quantify and implement exactly with every kid," she points out.

Due to the dearth of research, Blaustein and her colleagues at the Trauma Center have conducted their own studies. Currently, they are analyzing behavioral changes from participation in a Massachusetts-based theater project called Urban Improve. So far, the program, which uses theater techniques to teach children problem-solving skills, has had a positive effect on fourth-grade participants. "Urban Improve held the level of aggressive behavior steady, and a number of children showed prosocial behaviors," Blaustein explains.

Music therapist Amy Donnenwerth assesses youth extensively before they begin participating in her music programs at Optimist Youth Homes and Family Services, in Los Angeles, and then conducts her own final evaluations to assess the validity of the programs when the youth complete them. Her music therapy programs include a rapping group, a choir, and a music therapy/lyric discussion group.

Donnenwerth says she has enough success stories from working with youth--most of whom are serving juvenile court probation--to fill a book. One young man who had talked little in his therapy sessions with his social worker came to Donnenwerth's music therapy/lyric discussion group with his head down and no enthusiasm to participate.

"Over the next 12 weeks, he began to sit up, talk about his family problems, talk about his future, and to express his sadness," she recalls. "By the end of the 12 weeks, he reported in his evaluation: 'This group helped me realize that I can get help and that there are people that care about me because before I came to this group, I hated everybody.'"

New Directions

At the end of their performance during CWLA's National Conference, the Balboa High students sat back in their chairs, positioned in a semicircle, and took questions and comments from the audience. Balboa Administrator Graven asked if any of the students felt changed by participating in the arts program and preparing for the Washington performance.

Graven knew how, during the school year, most of the students had improved their attendance and behavior and demonstrated a concerted effort to raise funds for their cross-country trip and rehearse for the performance. Now he wanted to hear about it from the students themselves. Their hands quickly shot up.

"Before this class, I didn't know how to deal with the stress of my mom being gone," said one girl whose mother is incarcerated. "This class has helped me to be a better person."

"I didn't care about nothing until this class," said a boy who admitted to once cutting school on a regular basis and clowning around when he did attend class. "I've realized there is a whole bigger world out there."

Another boy admitted he served time in a boot camp and when he was released, his family gave him little support. The Roots program, on the other hand, "opened the door for me to express myself," he explained. "It's a doorway to more doors."

Monique said Roots has changed the direction her life was headed. "I was to the point where [I told myself], 'Society doesn't like me for who I am, so why try to treat it with respect.'" In Roots class, she felt she was finally taken seriously as a teenager.

"We should have Roots class all around the world, not just in San Francisco," she said.

Jennifer Michael is Managing Editor of Children's Voice.

* Not their real names.

Art as Trama Therapy

Tsunami victims heal wounds with the arts.

Few natural disasters have affected as many people and cultures as the December 2004 tsunami. The direct impact of the tsunami was felt in countries across South Asia, in villages large and small, and by the young and the old.

The United Nations reports the tsunami directly affected 1.5 million children. Many lost one or both parents. Aid workers worldwide responded immediately by providing food, clothing, medical care, and reunification assistance to the child victims. They also dispatched boxes of art supplies, books, and musical instruments.

Creative expression has proven to be an important way for children to cope with anxiety, posttraumatic stress disorder, childhood traumatic grief, and other traumatic reactions following natural or manmade disasters, according to the International Child Art Foundation (ICAF) in Washington, DC. By drawing, painting, writing, and making music, thousands of children have expressed themselves in ways their words cannot following traumatic events such as September 11, the war in Iraq, and the 2003 earthquake in Bam, Iran, that killed 46,000 people.

In January 2005, ICAF launched a healing arts program for young tsunami survivors. The organization sent a team of experts to the region and collected donated art supplies. In Sri Lanka, ICAF worked with its partner, the Colombo Book Society, to launch a "happy camp." Hundreds of children affected by the tsunami participated in the camp's art workshops, including an art contest.

Dhammadesha Ambalampitiya, founder and president of the Colombo Book Society, says many of the schools damaged by the tsunami are being repaired, and children have been relocated to other schools, but they lack extracurricular activities. The art camps have made up for this. The children "temporarily forget" the tsunami disaster while attending the camps, Ambalampitiya says, and "their faces brighten with smiles and happiness."

"Most of the children depict the tsunami in what they draw and paint," he says. "However, some of them choose very different subjects, such as a flower garden and landscapes. We are seeing the healing impact of the arts on the Sri Lankan children."

This summer, ICAF is sending about 40 volunteer professional art therapists to continue working with child tsunami victims in South Asia.

ICAF has also distributed art therapy training workshop guidelines to professionals and teachers throughout the tsunami-affected areas. The guidelines suggest how volunteers and professionals can support trauma recovery in children, and they provide ideas for healing arts activities:
  • Nonstructured activities
    Many children already have ideas about what they would like to make in art and if they do, allow them to experiment freely with materials in a safe and structured environment . . .Try not to be tempted to draw or paint for them, but be attentive and supportive . . .

  • Structured activities
    Ask the child to draw a picture of a "worry." Many children who have been traumatized have worries and fears since the tragedy happened. Making a picture of the worry or showing how big, what color, or what shape a worry is helps children to begin to identify fears and gives us a tangible image of what worries children find difficult to tell about with words…Help children to create a painting or drawing of a real or imaginary "safe place" . . .

  • Other activities
    A "safe box," a simple paper envelope or paper box. . .can be painted and decorated with images of the child's choice; drawings, pictures, or objects that the child enjoys or finds comforting can be placed in the box. In the case of grieving children, creating a container for positive mementos of loved ones lost can be an important and healing experience.
Source: International Child Art Foundation. (2005). Healing Arts for Tsunami Survivors: Using Art Activities to Support Trauma Recovery in Children. Available online.

The Hidden World Behind Childrens Art

Children's art may seem insignificant to the untrained eye, but the images have more meaning than most realize. A whole world of hidden information is waiting to be explored. Ask a 4-year-old what his scribbles mean, and a story will surface. Art therapy is a portal to understanding how children experience the world around them. It also helps children convey what they normally would not feel safe or comfortable revealing. Knowing how to express feelings, and feel-ing secure enough to do so, can be challenging for a child. Young children lack the ability to "language" their internal world as eloquently as adults. Art therapy can help children express complex feelings that would otherwise be difficult for them to verbalize.

Research indicates art therapy stimulates the preverbal area of the right hemisphere of the brain. The right side of the brain works by quickly scanning, sensing, and taking in sensory information "as it is," while the left hemisphere changes the incoming information by analyzing, censoring, and pulling up language to describe the information. Making art is a right-brained activity that bypasses the censoring left side and enables access to initial impressions where emotions lie in their original undiluted state. Art cuts to the core and consequently requires the utmost sensitivity and skill.

Art is powerful. It can bring up very deep feelings and possible crisis. Working with a registered art therapist is highly recommended. Registered art therapists are trained in both therapy and art and are ethically and legally bound to the standards set by the American Art Therapy Association (www.arttherapy.org). When I use art therapeutically, I use a consent form that describes what art therapy is and what effect it has, and that permits the sharing of pertinent information to other child care personnel or agencies that serve the child.

Once a child has drawn a picture, knowing how to discuss the art is important. Critiquing, judging, making additions, or suggesting changes sends a negative message that the child's creation is not acceptable. It is best to be curious. The artist--the child--knows best what her drawing means. Speak to her in a way that makes her the expert. If she has drawn a butterfly in a jungle, with the sun shining, a way to begin to discuss the drawing is to say, "Tell me about your picture," or "I see a butterfly in the jungle. I wonder what it must be thinking." Ask the child about the feelings of the other images in the drawing. Have her explain what the images would be saying to one another. Avoid questions like, "Why did you draw the butterfly?"

Just as a person experiences predictable psychological stages in life, so too are there predictable stages in art development--and with a working knowledge of the developmental stages of art, one can begin to comprehend and realistically assess children's art.

Normally, a child's scribbles become radials and triangles by age 3, squares at age 4, and representational "tadpoles" (encephalopods) by 5. A kindergartener will most often draw no torso, with limbs extended from the head. From 7 to 9 (the schematic stage), a ground line and skyline appear, with families often lined up in a row. From 9 to 12, children show more interest in detail, and from 12 to 14, more naturalistic features are noted. Most people do not develop art abilities beyond the schematic stage.

Following are examples of how I have used art therapeutically to benefit three different students I encountered during my internship in the Los Angeles county schools.

"Maria," was a 5-year-old referred to me because of her persistent refusal to go to class, fighting with students, and outbursts of anger. I asked her to draw a picture of anything she wanted. She drew two "tadpole" images (encephalopods), one very large and the other very small. When I asked her to describe the two seemingly harmless figures, Maria explained that the big figure was hitting the little figure with an object. After further sensitive questioning, she disclosed that she had been hit with an object and was quite angry about it. I immediately took her to the school nurse, who found bruises and consequently filed a report of child abuse.

"Joe," 7, was referred to me because he was fighting with others on the schoolyard. He had above average grades and was hearing impaired with an expressive language disorder. Joe drew several pictures with ground lines-one showed a monster he titled "The Hulk." When asked to describe the picture, he said, "The Hulk got shot in the mouth, had no tongue, and people laughed at him." We explored how the monster felt and whether Joe felt the same as the monster. We also discussed how Joe felt having an expressive language disorder, what to do when others teased him, ways to handle conflict, and ways to self-regulate.

"Darius" was an 11-year-old African American youth referred to me because of possible retention. During one session, he boasted, "I'm becoming a man. I can now fit into adult-sized shoes!" Noticing his enthusiasm, I asked him to draw a picture of the "ideal" man. Darius drew a picture of a blue-eyed European American. When asked to describe the image, he said, "Blue-eyed people are nicer than African Americans because they keep their jobs, they're never late, and they aren't dirty."

In our work together, we explored the negative messages of the media regarding African Americans and its contributing influences, positive contributions of African Americans, and the need for positive self-talk. The principal of the school was African American and became a frequent visitor during our sessions, with the permission of Darius and his mother. The principal later decided a series of classes was needed to empower African American students.

Using art as an adjunct while counseling children can provide caseworkers, welfare staff, and parents with valuable tools to understand concerns, strengthen empathetic attunement, and facilitate the child's expression of feelings.

Diane Alvy, MA, ATR-BC, is a board-certified registered art therapist in Los Angeles.


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