The Basics • 75Knowing Pathology and Potential
Like other clinicians, art therapists are familiar with the major theories of personality
and psychological functioning. All therapists need to have some coherent way of think-
ing about what is wrong (pathology) and what is right (strengths) so they can figure out
how best to help (therapy). Eventually, most practicing clinicians choose to deepen their
understanding of one preferred frame of reference, so that theory becomes well integrated
with technique.
Because psychopathology has been defined descriptively as well as etiologically, art ther-
apists are trained to understand the meaning of the current diagnostic classifications. The
specific languages individual art therapists utilize depend mainly on where they work. For
example, those who are in psychiatric settings understand the thinking behind systems like
ICD-10 (World Health Organization [WHO], 1992) and DSM-IV TR (American Psychiatric
Association [APA], 2000), the most widely used forms of classification. Similarly, those in
special education and rehabilitation are familiar with current categories in the classification
of disabilities.
Knowing Treatment Planning
In addition to knowing the terms used to define different diagnostic groups in human ser-
vice settings, art therapists are also familiar with the various languages used to describe
the process of helping. Whether writing a treatment plan in a psychiatric hospital or an IEP
(individualized educational plan) in a school, art therapists are multilingual, though flu-
ency in any one language develops through usage. Regardless of the setting, competent art
therapists understand ways of describing what is wrong, planning to help, and evaluating
the effectiveness of their intervention (cf. Frostig & Essex, 1998).
Knowing the Therapeutic Dyad (DVD 4.2)
Another core area of understanding about therapy has to do with the importance and mean-
ing of the relationship with those who are served. Whether or not an art therapist fosters
or utilizes the symbolic aspects known as transference, all schools of thought about helping
people to change recognize the significance of the climate between clinician and client. Art
therapists are usually encouraged—and sometimes required—to get to know themselves
better through their own psychotherapy. This is essential, so that their own issues do not
interfere with their ability to use themselves in their work with other people.
Many outcome studies, involving a wide range of theories and techniques, have found
the most critical variable in the therapeutic equation to be the fit between patient and cli-
nician. Art therapists of all theoretical stripes agree on the importance of the therapeutic
alliance. Freud once suggested that this critical relationship provides the “anesthetic” that
makes possible the sometimes-painful “surgery” of an interpretation. Alliance in psycho-
therapy means trust and commitment, not social or physical intimacy. Ethics committees in
service disciplines report that most patient complaints involve what are known as boundary
violations, the dark side of the immense power in the relationship itself.
Although some argue that art therapy dilutes the intensity of the transference—because
of the more active teaching component in the therapist’s role and the existence of the art
object as an intermediary—I do not agree. In fact, it appears to me that art therapists,
because we draw on and expose the innermost private parts of the human soul, often have
an even more “intimate” relationship with our clients than talk therapists. And, since a
great deal of physical activity (with materials, tools, products) is a necessary component of