skip to Main Content
Pioneer House, 46 Britannia St, London WC1X 9JH | +44 20 3489-9192

Clinical Meeting: To theme or not to theme…

For January’s clinical meeting, the London Art Therapy Centre’s director and long-standing art therapist Hephzibah Kaplan led a discussion about an aspect of art therapy which can be somewhat controversial: theme-directed art therapy. While the psychodynamic orientation of some art therapy training programmes is focused on non-directive work, it can certainly be beneficial to use a theme in order to bring a group together, or as a focal point to engage clients who might find non-directive work too anxiety provoking. At the start of the meeting, Hephzibah read out two quotes that highlight this tension between the approaches, both by esteemed therapists:

“A spontaneous image can contain diverse aspects of the self expressed symbolically, come to us from the unconscious, to be known, to be interpreted.” Liesl Silverstone

“Art therapy groups address the tension between the diverging drives for closeness and self-sufficiency by being functionally structured to mediate between privacy and interaction.” Anthony Storr

Hephzibah then invited the clinical team to make some art and presented us with a group exercise: folded up pieces of papers were given to each participant. We were told that half of them had a theme written inside and the other half said “no theme”. We did not know what instructions others had; neither did we know if those who were given themes had the same theme or several different ones.

I have always been curious about theme-based work. I have only occasionally used it in my own practice, yet I feel it can have a great deal of potential and would like to know more about it. At the same time, perhaps as a product of a ‘non-directive’ art therapy training programme, I had reservations about this way of working, worrying it would somehow lead to overly similar images, or impose an idea on a client who might have his/her own specific issues they would like to explore.

When I opened my folded paper, I found the sentence “The well trodden path” written on it. This, it emerged, was the theme given to half of us – yet one would not be able to guess this by looking at the images; each one looked very different. In discussing the work it was important to reflect how different people felt when handed the theme or “no theme” piece of paper. We all shared our various views and this helped us get inside the potential mind of the client when offered a theme.  The specific theme resonated differently for different practitioners, with the notion of a trodden path seeming ‘conformist’ to some while offering comfort to others and, as with most art therapy experiences, showing us something about ourselves in the process. Some of the participants who were given no theme confessed to feeling left out, demonstrating that having a theme can create a sense of belonging and group cohesion.

Looking at the idea and purpose of theme-directed art therapy, Hephzibah explained that she uses theme-directed work in four different contexts. Firstly, with individual clients, she may occasionally suggest a theme if the client has reached a point of ‘stuckness’ or is struggling to think symbolically. This has to be presented to the client not in order to rescue them but to offer a bridge, or transition to a creative space. She explained that the theme can represent a ‘transitional object’ in that it can enable the client to develop their own creative resources once they have a starting point.  An example of a theme may be “make an image of a door” for a client who is in the process of life changes and perhaps needs to identify what may be gained and what may be lost, what may be feared, and what is desired in making active changes.

The second clinical context in which Hephzibah may use themes is with the Well-being and Support Group. The clients who attend this group come from diverse settings and share some history of mental health difficulties. Hence the theme serves to bring the clients together and to have a shared experience. This can lessen their sense of social isolation as everyone, including the facilitators, will use the theme for their image-making. At the beginning of the session there is a general ‘check-in’ conversation and the group members share what may have been most pressing or on their minds during the past week. Rather than deciding on a theme in advance, Hephzibah invites the group members to propose a theme which has commonality and the group members set about exploring this theme in their creative work. An example of a theme may be “connections”, and while the group members make images of connections, the facilitators share via their artwork some of the routes as well as obstacles that may be around in this theme.

With non-client art therapy groups, such as Art for the Heart, Hephzibah has been using theme-directed work since 1997. Hephzibah has over 250 themes she uses, and sees her work as a way of using metaphor to mirror something to the individual and bring the group together. As Art for the Heart is run as a slow-open group there can be the same group members as well as newer members each session. Thus the theme serves to bring the group together with a shared focus. The different themes cover different aspects of the psyche and in each workshop a different theme is explored. For example, she might offer a word such as “ladders”, and invite people to include ladders in their images, or she may even bring in some feathers so that specific materials become the theme or the shared experience. In this way, clients can compare the creative interpretations of other group members and learn additionally about themselves. As the art therapist Bruce Moon says: “art therapists are by their very nature metaphoreticians”.

The final way in which Hephzibah may use themes is when she is running one-off or short-term art therapy ‘taster’ experience and teaching workshops. The theme is chosen specifically to meet the brief of the workshop and to take into consideration the client or organisation. Things are slightly different when running workshops about art therapy for professionals, or experiential art therapy sessions; in these scenarios, the art therapist needs to fit the artmaking exercise into a set amount of time while keeping the work informative and contained. In these cases, a theme can help participants make the most of the experience without becoming overwhelmed by personal material. For example, on a recent trip to Japan, Hephzibah invited a group of health professionals to “make an image of yourself as a tree”. This was a useful theme as it allowed the somatic to be expressed via the tree symbolism. Thanks to this use of a theme, the workshop overcame cultural barriers and inhibitions by providing a safe, common framework and a manageable level of personal exposure.

Ultimately, it appears, the way we work reflects the personality and individual style of the therapist. It seems to me that all therapists can be directive in their own way: some of us might suggest to clients that they try certain art materials, especially if we sense they are stuck or have a need to express something differently; others might use interpretations, challenging questions or mirroring to gently lead the client towards certain insights. Certain art therapists might arrange the therapy space in a certain way, place the materials in specific order or use the body, movement and sensation in their work. Others offer a particular branch of art therapy for certain issues, such as guided visualisation or mindfulness. Ultimately, we can only be authentic by working in a way which fits in with who we are – although it is always useful to add to our tool kit by learning new skills.

Hephzibah finished the talk by showing us a selection of images from themed art therapy sessions which included bridges, body parts, trees, symbolic family images and mythological creatures; they were all unique and expressive, demonstrating that the use of a theme can harness, rather than stifle, creativity.

Posted by Nili Sigal, art therapist &
clinical meetings coordinator

Back To Top