40 • Introduction to Art Therapy
not to do so. She was in favor of my consulting to the new Day Hospital, because what they
were doing was “real therapy” (group psychotherapy).
There was much overlap at that time between art and occupational therapy in mate-
rials and approaches, and pioneers like Naumburg feared that the young field might be
engulfed by its more powerful older sibling. Occupational therapy has since become less
psychodynamic, and has moved away from its earlier emphasis on arts and crafts activities.
Nevertheless, many art therapists began their careers under the job title and/or the supervi-
sion of an occupational, activity, or recreation therapist.
All of these fields use art as one of many possible activities, forms of recreation, or ways
of being constructively occupied. All of them also tend to provide art as an activity for
some prescribed purpose, usually specified by the referring physician. Although the social
and emotional well-being of the patient is of interest to other activity-based therapies, art
therapists focus on the psychological aspect of the work. In addition, these other therapies
are always adjunctive, while art therapy often is not.
Art therapists—because of their greater familiarity with media and processes—can
ser ve as resources for these other professions, and can learn from them as well. The woman
who taught crafts to the same hospitalized children I saw for art therapy in 1963 had been
trained in occupational therapy. She taught me task analysis, a method of breaking a task
into its smallest components. This kind of thinking is especially valuable in selecting, offer-
ing, and evaluating art activities for those with neurological impairment and/or develop-
mental disabilities.
The Creative & Expressive Arts Therapy Department (CEAT), which my drama therapy
colleague and I initiated in 1981 at the Western Psychiatric Institute & Clinic (WPIC), actu-
ally replaced Occupational Therapy (C). The group of clinicians I currently work with, who
are under CEAT, includes not only individuals trained in art, dance, drama, music, and
poetry therapy, but also a recreation and an activity therapist as well.
Therapeutic recreation is indeed just that, and is very helpful to people who are in a psy-
chiatric hospital. The activities offered by these professionals greatly relieve tension and are
part of a healthy therapeutic inpatient diet. While they are interested in using art materials
as well as many other kinds of tools in their work, it is clear to me that their goals are as dif-
ferent as the titles of their disciplines would suggest.
Occupational therapy has developed during the time since CEAT replaced the depart-
ment at WPIC into a field whose primary focus is on helping patients to resume activities
of daily living. It has returned to both inpatient and partial hospitalization programs as a
useful resource.
The creative arts therapies are used throughout the continuum of psychiatric care, from
inpatient to partial to outpatient. In addition, CEAT is currently moving into other settings,
including the strictly medical components of the University of Pittsburgh Medical Center,
such as the Cancer Center and the Children’s Hospital.
Art Therapy and Others Using Art in Psychotherapy
Art therapy is more similar to other psychotherapeutic approaches that use art materials
than to its activity therapy relatives. For example, projective drawing tasks were origi-
nally the province of clinical psychologists (Hammer, 1958; Kinget, 1952; Koppitz, 1968;
Machover, 1949). And despite the fact that their validity and reliability has been demon-
strated repeatedly to be uncertain, they have continued to be popular (Burns, 1987, 1990;
Burns & Kaufman, 1970; Hammer, 1997; Klepsch & Logie, 1982; Koppitz, 1984; Gillespie,
1994: Liebowitz, 1999).