The Arts in Psychotherapy 57 (2018) 65–71

Contents lists available at ScienceDirect

The Arts in Psychotherapy

Research Article

Itinerant art therapy: An educational model for community outreach

therapeutic service
Lisa Furman a,∗ , Hope Boeve b
a
Albertus Magnus College, 700 Prospect Street, New Haven, CT 06511-1189, United States
b
New Haven, CT

a r t i c l e i n f o a b s t r a c t

Article history: As a practical teaching model, community-based itinerant art therapy provides myriad opportunities
Received 15 November 2016 for direct service delivery to clients and unique service learning for students. This paper will explore a
Received in revised form how cost, creative treatment model affiliated with a graduate program that provides short-term mobile
13 September 2017
art therapy to various populations in and around a large city. This model of community outreach has
Accepted 29 September 2017
three notable benefits: first, strengthening connections between the graduate art therapy program and
Available online 29 September 2017
the community; second, allowing students to have direct contact with a unique client population that
contrasts their practicum experience; and third, providing valuable short-term art therapy, free of charge,
Keywords:
Art therapy
to need-based community programs.
Community outreach © 2017 Elsevier Ltd. All rights reserved.
Itinerant therapy
Art therapy education
Service learning

Community-based, short-term, itinerant art therapy provides tional flooding, and resistance to self-disclosure (Vogel, Wester,
numerous opportunities to connect with a wide variety of popu- & Larson, 2007). Barriers to therapeutic services include lack of
lations by bringing services directly to the client. Itinerant service resources, long wait-lists, complicated intake procedures, and nar-
delivery is similar to the concept of a home visit in that services are row criteria for admissions (Young, Weir, & Rycroft, 2012). Bringing
brought to the clients; itinerant delivery refers to the location of the services into the community can help dispel fears about participat-
services rather than the type of service (Dinnebeil, Pretti-Frontczak, ing in therapy by offering direct experience. In a culture that is
& McInerney, 2009). In many communities, there is a significant increasingly distrustful of institutions, an itinerant model can fos-
gap between the necessity for and availability of treatment ser- ter increased willingness to participate when services are provided
vices (Geller, Beeson, & Rodenhiser, 1997; Bain, 2010), and mobile in a familiar setting in the community (Wadhwani, 2010).
therapy offers one way to address this issue. While this type of ser- Taking services on the road, students and experienced clinicians
vice delivery can be convenient to the receiving program, providing alike have an opportunity to join clients in their individual, cul-
itinerant therapy presents with both benefits and challenges. tural, and historic context outside of a traditional therapy setting
(Moon, 2002; Sezaki & Bloomgarden, 2000). The mobile art ther-
Benefits and challenges of itinerant service delivery apist has a unique skillset to generate a temporary secure space
where participants may to engage in creativity and self-exploration
Itinerant service delivery provides a valuable opportunity to (Kalmanowitz & Lloyd, 2002) through strengths-based group art
provide a high-quality intervention to empower and support interventions that move from the individual experience to make
underserved populations in the context of their own communities connections with the community (Potash & Ho, 2011). Commu-
(Ottemiller & Awais, 2016). Itinerant providers are able to work nity interventions shift focus from the psychology of the individual
with clients who may have less access to therapeutic services, and towards empowerment of the collective identity (Ottemiller &
who may avoid seeking help due to social stigma, fear of emo- Awais, 2016). Furthermore, artwork can act as a bridge between
marginalized people and their greater communities (Gray, 2012).
Community-based itinerant therapy requires that clinicians be
adequately informed, mindful, and adaptive to the client’s cultural
∗ Corresponding author.
context. In addition to clinical training, therapists working in the
E-mail address: [email protected] (L. Furman).

http://dx.doi.org/10.1016/j.aip.2017.09.003
0197-4556/© 2017 Elsevier Ltd. All rights reserved.
66 L. Furman, H. Boeve / The Arts in Psychotherapy 57 (2018) 65–71

community must develop awareness of how their own cultural collective and individual (Elkis-Abuhoff, Gaydos, Rose, & Goldblatt,
identity and prejudices might impact their work and relationships 2010; Feen-Calligan, 2005).
to others (Ottermiller & Awais, 2016). This joining of the commu- Working closely with the community outreach coordinator
nity may help to reduce stigma towards mental health treatment to plan and co-facilitate a focused intervention allows students
(Ottermiller & Awais, 2016), as well as work to strengthen the rela- increased autonomy and a more parallel relationship with the
tionship between institutions and the greater community (Gray, experienced art therapist, both of which can contribute to the
2012). evolution of professional identity. Further, exposure to a diver-
In providing mobile therapy services, communication and sity of clients and therapeutic approaches offer graduate students
advanced preparation are necessary to reduce potential challenges an invaluable opportunity to explore their emerging professional
that may impede a successful experience. Bringing services into identity, while understanding the reciprocal impact on the com-
an established organization, visiting service providers must work munity which they serve. Short-term community outreach therapy
within an existing program structure which may present support provides students the benefit of exposure to an alternative treat-
limitations or potential resistance to collaboration. For example, ment model with a focus on engagement of clients, rather than
there is often a perceived power differential when a professional identification of pathology (Elmendorf, 2010; Lambert, Donahue,
brings outside services to a community organization or group Mitchell, & Strauss, 2001)
(Ottemiller & Awais, 2016). Partnering community organizations
may express resistance to new programming due to common strug-
gles in helping professions: compassion fatigue, secondary trauma,
and other work stressors (Kazmierczak, 2016). For this reason, the Benefits and challenges of short-term group art therapy
itinerant provider must conceptualize a model for collaboration
that encourages engagement and support of both clients and staff For community outreach, short-term art therapy groups can be
at the field site (Joly, Williamson, Bernard, Mittal, & Pratt, 2012; practical and effective, leaving a powerful impression on both the
Kazmierczak, 2016). participating students and the clients. When long-term or indi-
Other challenges include the need to clarify responsibilities vidual treatment is not possible or practical, short-term group
of the itinerant art therapist and the host site prior to the therapy can provide an inexpensive and flexible way to meet the
first visit. Advanced conversations with the community partner varied needs of clients in the community by reducing stress, anx-
should address what materials will be provided, available space, iety, and even depression (Hymmen, Stalker, & Cait, 2013; Lewis,
and who will obtain the appropriate consent forms. Some pro- Dennerstein, & Gibbs, 2008; Paul & van Ommeren, 2013). Specif-
grams, especially those servicing medically fragile populations, ically, short-term art therapy can elicit positive change. Though
may have specific medical requirements such as proof of vacci- research is limited, reviews of recent randomized, controlled out-
nations and/or medical clearance for itinerant providers. Many come studies support the use of brief art therapy interventions,
programs have dress codes, codes of conduct and specific guidelines citing increases in cognitive and psychological effects (Maujean,
about confidentiality, all of which should be discussed in advance. Pepping, & Kendall, 2014; Wood, 2016).
Art therapists face some unique challenges with itinerant work; Several other factors make short-term art therapy an effective
regardless of the venue, art therapists must work to ensure a safe choice in certain situations. As the preparation and facilitation is
space with proper ventilation, access to water and quality materi- brief and intensive, the art therapist can sustain greater investment
als (McElroy, Warren, & Jones, 2006). Additionally, all art materials in planning. Short-term art therapy groups can be creative and flex-
need to be easily transported to and from the site potentially limit- ible, reducing stress for both clients and clinicians (Hughes, 2016;
ing the kind of directives employed. Lack of communication about Northover, 2011; Young et al., 2012). Additionally, with a less of a
these kinds of provisionary responsibilities may lead to tension time commitment, there is often greater investment from clients,
between the provider and the community partner. A written out- as evidenced by higher rates of attendance in short-term therapy
line or proposal of what will be provided by both parties can reduce (Young et al., 2012).
confusion and dashed expectations. In short-term art therapy, several challenges may arise. Since
there is no unifying model for short-term art therapy, designing an
approach requires rigorous preparation (Northover, 2011). In order
Brief itinerant art therapy as a teaching model to be dynamic and impactful, the therapist should have advanced
and thorough knowledge of the population. Short-term or single
With regard to teaching models, brief itinerant therapy ser- session work may also result in the therapist feeling pressured to
vices provide impactful learning experiences for students that are make a difference quickly, which may lead to rushing of the thera-
different from internship experiences. The short duration of the peutic process (Briggs, 2010; Hughes, 2016). Another consideration
experience allows for the student to experience the evolution in rel- is that short-term work is not appropriate for all clients; factors
atively brief period of time. For example, the experienced therapist to consider in selecting clients are: developmental level (Briggs,
may model how to determine criteria for group inclusion, create 2010), severity of symptoms (Paul & van Ommeren, 2013), and
population specific goals and objectives, prepare materials to trans- pre-existing relationships that may inhibit the potential for group
port, communicate with community organizations, and advocate cohesion (Yalom, 2005).
for necessary space and materials, demonstrating in several weeks Additionally, short-term art therapy is not a forum for deep
what might otherwise take a semester or longer in practicum. affective work, delving into the past, or work with clients who
Additionally, careful planning and attentive dialogue between are fragile, acutely psychotic, or struggling with severe psychi-
the community outreach coordinator and program contact can atric symptoms. Short-term therapy is suited for addressing issues
serve as a strong model of professional communication for the and problem solving in the present moment and can be most
participating students (Gussak & Orr, 2005), a skill crucial to main- effective with a strengths-based approach that emphasizes clients’
taining strong relationships with program partners (Klorer & Robb, resiliency (Paul & van Ommeren, 2013). For positive effect, short-
2012) that might not be easily described in a classroom setting. term itinerant art therapy should focus on establishing alliance
Varied exposure to clinical settings coupled with a supportive through creative styles of engagement, rather than defining diag-
supervisory experience in graduate art therapy education can play nosis through assessment (Solomon, 2016; Wood, 2016). Finally,
a pivotal role in the development of the art therapist identity, both as itinerant art therapy is so very brief, in addition to much prepa-
 L. Furman, H. Boeve / The Arts in Psychotherapy 57 (2018) 65–71 67

ration, attunement to ethical issues are paramount in order to A working model for a community-based itinerant art
generate a positive impact. therapy program

The community based, itinerant art therapy model which will be

Ethical considerations, safety, and liability issues described in this paper demonstrates benefits to the students, the
graduate program, and the community at large. Initially, the con-
Consideration of ethical safety in itinerant treatment entails cept was born out of a need for greater visibility of the graduate art
obtaining appropriate releases and informed consents, as well as therapy program. As the only approved graduate art therapy pro-
abiding by any and all of the safety guidelines indicated by the com- gram in the state, local community institutions seemed unaware of
munity partner organization (Elmendorf, 2010). Informed consents the program’s existence and knew little of art therapy and its pos-
and releases of information should be obtained prior to participa- sible applications. This lack of familiarity of art therapy also limited
tion, in any form of treatment or any exchange of information, as availability of internship placements and job opportunities for local
per guidelines established by the Health Insurance Portability and art therapists. Thus, one hope for instituting this model was to find
Accountability Act of 1996 (HIPAA) and the state of delivery. new ways to strengthen connections between the college and the
Community-based art therapy can be confusing in its scope and community that would have a lasting and far-reaching effect on
therefore creates unique challenges for necessitating clearly artic- local art therapy awareness and growth.
ulated consents and releases. Generally, art experientials that are
provided in public forums, such as career fairs and arts festivals are Role of the community outreach coordinator
more educational, rather than clinical in nature; these art therapy
groups focus on social interaction and engagement, and should be The success of an itinerant therapy model relies heavily on the
described to participants as such, thereby established the bound- responsibilities of the coordinator. Because of the unpredictable
aries of disclosure which differentiate these activities from clinical nature of itinerant service delivery, the coordinator should be a
intervention. Participants in public forum activities are not asked seasoned art therapist, who is flexible in nature and experienced
to reveal personal information that requires privacy insurance. In with itinerant short-term treatment models. The community out-
this case, verbal informed consent that describes the potential ben- reach coordinator (ideally a full-time faculty member) identifies
efits and risks of the inherently therapeutic aspects of art-based and interfaces with local educational, mental health and support
directives should suffice. However, a release to photograph artwork programs demonstrating a need for services.
should still be acquired, and photos should not include identifiable The identified programs may be self-referred or approached by
features or faces of the clients. the coordinator. In either case, one consideration for inclusion is
Some community programs may have consents and releases that there is no duplication of services or similar art therapy pro-
that cover outside services; it is the itinerant art therapist’s respon- gramming currently in place. The coordinator then works directly
sibility to communicate with the program contact in advance to with the identified program staff to develop short-term interven-
determine if additional consent is needed. If needed, a document tions, at no cost, that will best benefit the program needs. The
that includes an informed consent, an agreement to release infor- community outreach coordinator also carefully selects graduate art
mation, and a permission to photograph with usage options should therapy students to actively assist in the planning, organizing and
be provided to all clients at the beginning of the group session. execution of the outreach sessions.
Itinerant art therapy treatment with minors may present with addi-
tional challenges; consents must be procured from the parents or Types of programming, facilities and populations
legal guardians, usually with the help of the program contact, prior
to the start of the itinerant art therapy group. Acquiring client con- Facilities for the community outreach art therapy program
sents and permissions can be a tedious and time consuming yet exampled in this paper have included local elementary, middle, and
necessary part of itinerant art therapy service preparation. high schools, as well as nearby colleges, hospitals, mental health
The itinerant provider should also clarify program policy and programs, cancer support programs, and geriatric residences. Indi-
procedure regarding disclosure of imminent harm, should a client viduals served have included children with medical conditions,
indicate aggressive or suicidal tendencies in a session. A good rule adolescents with emotional and behavioral disorders, adults with
of thumb is to always include a program staff member in an itiner- a history of cancer and their families, seniors with dementia, and
ant group who is qualified to address a disclosure crisis, should one normative populations.
occur. The program staff member can take appropriate measures, as In this model, community outreach art therapy is comprised of
per program/state/federal guidelines should a client disclose abuse, four types of services: clinical, educational, community events, and
self-harm or imminent danger. Moreover, if a client demonstrates consultation (Fig. 1). Clinical programming generally consists of
additional need at the end of short-term itinerant therapy, clini- single-session or short-term highly structured art therapy groups
cians have an ethical responsibility to refer them to further services. that are population specific in theme. Some settings may desire
Having a program staff present during group helps ensure that any a longer intervention; in this case, short-term sessions generally
needing client will have follow-up support once the itinerant group meet for three or six consecutive weekly sessions. Graduate art
ends. therapy student volunteers plan and help execute the groups, as
Because of the moderate elevation in risk of violence in peo- well as receive supervision from the coordinator.
ple dealing with certain mental and emotional disorders, having a Educational events may be in the form of in-service presenta-
qualified staff member from the program present at all times dur- tions or career fairs that educate the community about art therapy
ing art therapy sessions also enhances itinerant therapist safety applications. Student volunteers help plan and participate in the
and reduces potential liability issues. Itinerant therapists should events to gain valuable experience in professional public speaking.
not assume that liability and malpractice is insured by the program Other types of educational events benefit the art therapy commu-
provider; in all cases, both students and clinicians should main- nity more specifically, such as workshops and lectures hosted by
tain the minimum amount of liability insurance required by law. the college that feature prominent art therapists. These events are
Including program staff in the group also has the added benefit of open to the public and create a networking experience for students,
educating program staff about art therapy and how it works, as part alumni, and local professionals. Community events may feature a
of the community outreach mission. group art therapy directive at a local arts festival that invites public
68 L. Furman, H. Boeve / The Arts in Psychotherapy 57 (2018) 65–71

Fig. 1. Four types of community outreach services.

participation. For example, during one local arts festival, weaving Case example
material was hung in a central location and the public was invited
to add to the piece, as they passed by, throughout the day. The The following case example poignantly illustrates the successes
end result was a beautiful, texturally rich, 50-foot-long communal and challenges of bringing itinerant art therapy to an urban magnet
weaving, reflecting the diversity of the participants. Along with pro- school setting to work with at-risk adolescent girls. This six-week
viding the art materials, information about art therapy was made art therapy group was comprised of girls, ages 12–14 years, of
available to participants in the form of brochures and discussion to Latino, African-American, Haitian and bi-racial decent. All had a
increase awareness of the field through community art. history of loss and/or trauma with some behavioral issues and/or
Other types of community-based events to encourage public sexual acting out, and all had a positive, pre-existing relationship
awareness include facilitating art therapy exhibitions. For example, with the on-site program contact. Prior to the group, the girls had
one successful event involved local printmakers teaching printing varying levels of superficial social relationships with each other;
techniques to art therapy students. The students then adapted the the hope was that the pre-existing relationships might help pro-
techniques to provide art therapy for children in a pediatric unit mote group cohesion in the short time frame. The school did not
at a local hospital. The children printed on hospital gowns, surgi- offer art therapy programming and, as often the case in urban
cal gloves and other medical equipment as a means of expressing school settings, only minimal verbal therapy services were avail-
some of the stressors of medical treatment. The experience culmi- able to students. The program contact was a highly invested social
nated in a moving public exhibit which featured the work of the worker who enthusiastically attended all six of the art therapy
professional printmakers, the art therapy students, and the pedi- group sessions. Her inclusion was welcomed since she had inti-
atric clients. This type of community-based exhibit can also reduce mate knowledge of the girls’ histories and could provide support
perceived power differentials and acknowledge all levels of artistic for any potential behavioral issues that might occur in session.
expression, by including clients, professionals and students in one
unified exhibit. Group format, content and structure
Finally, consultation services as community outreach include
assisting programs in posting art therapy jobs, screening volun- The content and format of art therapy group was considerably
teers, and guiding media blasts. Oftentimes, a request for assistance structured with weekly themes and related art directives. Each
in posting a job opportunity follows a community outreach event, group lasted approximately 50 min. The group began with a review
as the program is able to see how art therapy can be permanently of the parameters of confidentiality and a brief check-in to establish
integrated into their services. While most of the consultation work the current emotional state of each participant. This introduction
is facilitated by the coordinator, students may participate in some was followed by two minutes of silent journal writing. Sometimes
aspects of creating guided media, which can be a valuable lesson in the journal writing was unstructured in content and other times
how to accurately portray the profession of art therapy. the participants were asked to respond to a prompt related to the
current week’s theme.
 L. Furman, H. Boeve / The Arts in Psychotherapy 57 (2018) 65–71 69

Following the journal writing, the art therapy student led a In the time between sessions, the group leaders watched the
review of what was discussed the previous week. Each week, she video; student supervision focused on how the content of the video
passed out a printed summary of what had been discussed that reflected the group’s needs. The viral video was a powerful example
could be pasted in the participant’s journal. This review served two of a young woman’s use of physical strength as a form of domina-
purposes: first, the review provided an opportunity to ascertain if tion and control, with the passivity of the observers reinforcing the
learning had taken place for the group members outside of therapy aggressive acts as a behavioral norm. The art therapy group partic-
in the time between sessions; secondly, this provided an opportu- ipants seemed to be questioning the appropriateness of the girl’s
nity for the student to synthesize the art and verbal content of the behavior in the video, so the following week’s discussion shifted
session as part of the supervisory experience. Reviewing therapeu- from the scheduled topic to the subject of how young women might
tic content serves to amplify and reinforce important insights for emulate characteristics of physical and emotional strength in a
both group participants and leaders (Yalom, 2005). socially acceptable manner, in other words, how to be a girl and
Following the review, the art therapist introduced the weekly be strong. The art therapy group participants engaged enthusiasti-
topic in a psychoeducational context, followed by the related art cally in the discussion. The girls also had many questions about the
therapy directive. Weekly topics were pre-selected, based on dis- passive observers in the viral video, sharing their own similar sto-
cussions with the program contact, and were deemed relevant to ries, including fear of retaliation if they chose to protect someone
this particular group of girls. The weekly themes were as follows: who was being bullied or abused.
self-identity, how emotions affect the body, self-care, managing The shift in the focus of the group content had far reaching
anger, sexuality, and dealing with loss. effects in terms of intensifying group cohesion and trust in the
After about 20 min of art-making, both the art therapist and group leaders. Additionally, the change in topic, while different
graduate student led a sharing discussion and verbal processing from what from the what the leaders had hoped to discuss, was
of the art. The group ended with a brief check-out as a means of clearly of great importance to the group members; strength in
determining emotional states and facilitating closure and transition character and supporting peers in a safe, healthy manner without
from the cloistered therapeutic environment to the school setting. inciting harm to themselves, is, for adolescents, an important form
Between sessions, the art therapist and the graduate student would of self-care. The willingness of the group leaders to respond to the
meet to reflect on the previous week and make responsive changes client needs in such a short-term format had benefits for both the
to the goals going. group and the student art therapist. In addition to the observably
more open and cohesive quality to the group in following sessions,
Flexibility within the structure the graduate student described the event as modeling an important
therapeutic technique that would have otherwise been difficult to
During week three, a significant group event occurred that communicate in a traditional classroom setting.
demonstrated the importance of flexibility with this highly struc-
tured format to best meet the therapeutic needs of the participants.
This flexibility, both in therapeutic process and practice, seemed to Student benefits to the itinerant art therapy experience
be the hallmark of all of the most successful itinerant short-term
art therapy groups and is exampled here as a key element of the An important aspect of this itinerant art therapy model is pred-
model. icated on a supportive supervisory relationship that helps students
During a doll-making art therapy directive, 13-year-old Sonia of art therapy develop a stronger awareness of self and an emerging
(pseudonym) began creating a doll that looked markedly differ- professional identity, as described by Elkis-Abuhoff et al. (2010).
ent from the other participants work. While the other girl’s dolls In the same way short-term therapy can have positive effects on
were bright in color with a variety of textures and details, Sonia’s clients; short-term clinical involvement can also greatly enhance
doll was dressed in a simple, dark colored top with pants and a a student’s learning experience under the right conditions. With
wide belt at the waist. Resembling a martial arts outfit, the doll’s a supervised itinerant art therapy experience, students have the
attire seemed to reflect Sonia’s rather guarded and defended pos- opportunity to adapt the art therapy process to meet the needs
ture in group. Not surprisingly, according to the program contact, of individuals within a socio-political and cultural context. Partici-
Sonia had recently experienced the death of a family member. This pating in community outreach art therapy can also better prepare
recent loss, along with her tendency towards acting out negative students for professional roles, allowing the student to transform
behaviors in school, suggested that Sonia’s doll character may have theories into practice and to negotiate with other professionals
symbolized the current acute stage of her grieving process and her (Gussak & Orr, 2005). Short-term service learning opportunities dif-
need to defend against deep feelings of sadness. fer from internship or practicum, as the student is able to focus
Based on suggestions from the program contact, the scheduled more intensively on assessing and addressing the needs of the
weekly topic for this particular group was to be on the subject community, rather than the additional focus on expectations of an
of sexuality; the session would serve as an opportunity to ask ongoing practicum role (Feen-Calligan, 2005). In these brief inter-
questions or express concerns about the challenges of adolescent ventions, the student is able to see the entirety of the therapeutic
sexuality. Rather than a structured discussion, the group leaders process, from planning, to implementing, to termination. Finally,
had hoped to facilitate a more open dialogue during the art pro- the close mentoring and modeling of the experienced art therapist
cess, as past experience had shown that the structured activity of provide dynamic and immediate feedback. In some cases, graduate
doll-making often helped decrease anxiety around difficult topics. art therapy students have not seen an art therapist in action leading
Instead of discussing the chosen topic, Sonia began to talk about a a session, so this kind of first-hand observation can be a powerful
recent viral social media video which documented a group of ado- form of learning (Elkis-Abuhoff et al., 2010).
lescent girls who stood by, passively watching a peer physically Equally, feedback from students about the itinerant art therapy
attack another girl. The rest of the group members responded with experience is also an important part of the evaluative learning pro-
excitement about the video, as well as the topic of peer pressure and cess. In the model presented in this paper, the supervision process
aggression, curious and eager to know the group leader’s response. involved asking students to identify what they learned during the
As neither group leader had seen the video and felt unprepared experience and how this may inform their future practice. As an
to respond, they told the group as much and postponed further illustration, the co-author of this paper specifically identified some
discussion until the following week. valuable incidental lessons learned in her role as the graduate art
70 L. Furman, H. Boeve / The Arts in Psychotherapy 57 (2018) 65–71

therapy student volunteer for the six-week itinerant art therapy follow, always allowing for time between groups to evaluate how
group described earlier in the case example: the goals might be adjusted to meet rising needs.
In short-term art therapy, always create goals and objectives and
know the difference. In order to measure the impact of an interven-
tion, clinicians should articulate how they will measure progress Summary
and whether adjustments are needed as the group progresses.
Do not reveal all art materials at once. Lay them out as needed. In conclusion, this paper describes a successful model for com-
Sequential presentation of art materials creates a sense of antici- munity art therapy outreach with multi-tiered benefits. First, the
pation and prevents overstimulation of clients. model strengthens connections between a graduate art therapy
When emotions arise with intensity, diffuse them to prevent escala- program and the community. Second, the short-term nature of the
tion. In the first session of the itinerant art therapy group exampled work allows art therapy students to have a direct experience with a
in this paper, a member was moved to tears as she shared her specific client population, different from practicum, while working
artwork, poignantly expressing her feelings of loss and grief. To with a skilled mentor. The combination of working closely with an
address the situation, the art therapist acknowledged the girl’s experienced art therapist while providing an intensive interven-
feelings, and then opened the topic up to the group, asking if any- tion, allows the student to increase self-awareness and confidence,
one had experienced similar feelings. This intervention served two as direct experience with clients redefines the student’s concept of
purposes, to validate her feelings, and also to diffuse them by bring- the role of art therapist (Elkis-Abuhoff et al., 2010). From the com-
ing the focus back to the group process. While this could easily munity outreach experience, students learn flexibility and meeting
be described in a classroom setting, firsthand observation of the needs of clients in context (Feen-Calligan, 2005). Finally, the itin-
technique created a more profound learning experience. erant approach can provide much needed clinical, educational,
Never alienate personnel who work with the partner organization; and engagement services for a variety of programs, populations,
the best way to represent the efficacy of art therapy is by making and institutions in the community that might not otherwise have
staff feel and become an integral part of the experience. In this case access.
example, the school social worker attended every session. The art
therapist repeatedly let her know that her presence was both wel-
References
comed and needed for a successful group experience. At the start,
though she was unfamiliar with the approach of art therapy, she Bain, S. F. (2010). Itinerant counseling services for rural communities: A win/win
appeared motivated by her perceived value in the group, quickly opportunity. Journal of Rural Community Psychology, 13(1) [Retrieved from].
http://www.aabri.com/OC2010Manuscripts/OC10046.pdf
adapting to the process and supporting the group routines and
Briggs, S. (2010). Time-limited psychodynamic psychotherapy for adolescents and
rituals wholeheartedly. young adults. Journal of Social Work Practice, 24(2), 181–195. http://dx.doi.org/
See strengths in clients. As previously stated, a short-term ther- 10.1080/02650531003741660
apy model must emphasize the available skills and resilience of Dinnebeil, L., Pretti-Frontczak, K., & McInerney, W. (2009). A consultative itinerant
approach to service delivery; considerations for the early childhood
clients. Identifying these strengths can help clients make use of community. Language, Speech and Hearing Services in Schools, 40, 435–445.
these skills once they leave the therapeutic environment. Merely http://dx.doi.org/10.1044/0161-1461(2008/08-0028)
acknowledging these strengths, however, is not enough; praise Elkis-Abuhoff, D., Gaydos, M., Rose, S., & Goldblatt, R. (2010). The impact of
education and exposure on art therapist identity and perception. Art Therapy:
must be authentic to be effective, for false sentiment can under- Journal of the American Art Therapy Association, 27(3), 119–126. http://dx.doi.
mine the therapeutic value of the intervention. For example, simply org/10.1080/07421656.2005.10129490
saying a client’s artwork is “really nice” is not enough. The art ther- Elmendorf, D. (2010). Minding our P’s through Q’s: Addressing possibilities and
precautions of community work through new questions. Art Therapy: Journal of
apist should find something genuinely appealing about the work, the American Art Therapy Association, 27(1) http://dx.doi.org/10.1080/
whether it is form, content, color or line, and tell the client why it is 07421656.2010.10129564
interesting. In this way, identified strengths in the art process serve Feen-Calligan, H. (2005). Constructing professional identity in art therapy through
service-learning and practica. Art Therapy: Journal of the American Art Therapy
as a metaphor for the client’s strengths.
Association, 22(3), 122–131. http://dx.doi.org/10.1080/07421656.2005.
Clients bring up things that matter; the therapist can listen for these 10129490
opportunities. In brief therapy, flexibility and a willingness to re- Geller, J., Beeson, P., & Rodenhiser, R. (1997). Frontier mental health strategies:
integrating, reaching out, building up, and connecting. In Letter to the Field No.
evaluate the group content or goals can better address the needs of
6. DHHS: Frontier Mental Health Services Resource Network. [Retrieved from:
the client. As demonstrated in the case example, if clients bring an http://www.wiche.edu/MentalHealth/Frontier/letter6.asp].
issue to the table, the therapist has a choice to respond in a dynamic Gray, L. B. (2012). The babushka project: Mediating between the margins and
way and may need to be open to a shift the direction of previously wider community through public art creation. Art Therapy: Journal of the
American Art Therapy Association, 29(3), 113–119. http://dx.doi.org/10.1080/
established goals. This approach values the autonomy of the client, 07421656.2012.701600
while addressing the presenting needs. Gussak, D., & Orr, P. (2005). Ethical responsibilities: Preparing students for the real
It can be challenging to protect the therapeutic space when you are art therapy world. Art Therapy: Journal of the American Art Therapy Association,
22(2), 101–104. http://dx.doi.org/10.1080/07421656.2005.10129445
a visitor. To better create a safe space, viewing the therapy room Hughes, R. (2016). Time-limited art psychotherapy. Developments in theory and
prior to the first group is critical. In the case example, the room practice. New York, NY: Routledge.
provided also served as a convenient passageway connecting two Hymmen, P., Stalker, C. A., & Cait, C. (2013). The case for single-session therapy:
Does the empirical evidence support the increased prevalence of this service
hallways of the school. During the first session, school staff walked delivery model? Journal of Mental Health, 22(1), 60–71. http://dx.doi.org/10.
right through the closed doors of the group in progress. Because of 3109/0963.2012.670880
the strong relationship with the community program, the program Joly, B., Williamson, M., Bernard, K., Mittal, P., & Pratt, J. (2012). Evaluating
community outreach efforts: A framework and approach based on a national
contact quickly took steps to ensure that no staff entered the group
mental health demonstration project. Journal of MultiDisciplinary Evaluation,
during the subsequent weeks. 8(17), 46–56. http://dx.doi.org/10.1108/17465721211289374
Prepare, prepare, prepare! For a brief and dynamic intervention, Kalmanowitz, D., & Lloyd, B. (2002). Inside the portable studio: Art therapy in the
former Yugoslavia: 1994–2002. In D. Kalmanowitz, & B. Lloyd (Eds.), Art
preparation is time consuming, extensive, and must be thorough.
therapy and political violence (pp. 106–125). New York, NY: Routledge.
The process begins by connecting with the community partner to Kazmierczak, E. T. (2016). Engaging communities through an art program at a
survey the needs of the population and discussing how the group domestic violence shelter. In L. N. Hersey, & B. Bobick (Eds.), Handbook of
will be selected. The goals, objectives, and art material preparation research on the facilitation of civic engagement through community art (pp.
339–366). Hershey, PA: IGI Global.
Klorer, G. P., & Robb, M. (2012). Art enrichment: Evaluating a collaboration
between Head Start and a graduate art therapy program. Art Therapy: Journal of
 L. Furman, H. Boeve / The Arts in Psychotherapy 57 (2018) 65–71 71

the American Art Therapy Association, 29(4), 180–187. http://dx.doi.org/10. Paul, K. E., & van Ommeren, M. (2013). A primer on single session therapy and its
1080/07421656.2012.730920 potential applications in humanitarian situations. Intervention, 11(1), 8–23.
Lambert, D., Donahue, A., Mitchell, M., & Strauss, R. (2001). Mental health outreach: http://dx.doi.org/10.1097/WTF.0b013e32835f7d1a
Promising practices in rural areas. National Association for Rural Mental Health, Potash, J., & Ho, R. H. (2011). Drawing involves caring: Fostering relationship
Center for Mental Health Services, Substance Abuse and Mental Health building through art therapy for social change. Art Therapy: Journal of the
Services Administration, U.S. Department of Health and Human Services. American Art Therapy Association, 28(2), 74–81. http://dx.doi.org/10.1080/
Retrieved from:. http://www.narmh.org/publications/archives/REVISED 07421656.2011.578040
OUTREACH PAPER.pdf Sezaki, S., & Bloomgarden, J. (2000). Home-based art therapy for older adults. Art
Lewis, A., Dennerstein, M., & Gibbs, P. M. (2008). Short-term psychodynamic Therapy: Journal of the American Art Therapy Association, 17(4), 283–290. http://
psychotherapy: Review of recent process and outcome studies. Australian and dx.doi.org/10.1080/07421656.2000.10129756
New Zealand Journal of Psychiatry, 42, 445–455. http://dx.doi.org/10.1080/ Solomon, G. (2016). Evidence for the use of imagery in time-limited art
00048670802050520 psychotherapy, emotional change and cognitive restructuring. In R. Hughes
Maujean, A., Pepping, C. A., & Kendall, E. (2014). A systematic review of (Ed.), Time-limited art psychotherapy (pp. 152–179). New York, NY: Routlege.
randomized controlled studies of art therapy. Art Therapy: Journal of the Vogel, D. L., Wester, S. R., & Larson, L. M. (2007). Avoidance of counseling:
American Art Therapy Association, 31(1), 37–44. http://dx.doi.org/10.1080/ Psychological factors that inhibit seeking help. Journal of Counseling and
07421656.2014.873696 Development, 85, 410–422. http://dx.doi.org/10.1002/j.1556-6678.2007.
McElroy, S., Warren, A., & Jones, F. (2006). Home-based art therapy for older adults tb00609.x
with mental health needs: Views of clients and caregivers. Art Therapy: Journal Wadhwani, S. (2010). Taking the couch on the road: Reaching diverse students
of the American Art Therapy Association, 23(2), 52–58. http://dx.doi.org/10. with critical mental health services requires innovative, culturally competent
1080/07421656.2006.10129640 outreach. Diverse Issues in Higher Education, 27(22), 27.
Moon, C. H. (2002). Studio art therapy: Cultivating the artist identity in the art Wood, C. (2016). Quick sketches and snapshots for brief art therapy: As a
therapist. Philadelphia, PA: Jessica Kingsley. time-limited approach. In R. Hughes (Ed.), Time-limited art psychotherapy (pp.
Northover, D. (2011). Brief dynamic art psychotherapy. In C. Wood (Ed.), 27–43). New York, NY: Routlege.
Navigating art therapy: A therapist’s companion. London: Routledge [pp. 40]. Yalom, I. D. (2005). The theory and practice of group psychotherapy (5th ed.). New
Ottemiller, D. D., & Awais, Y. J. (2016). A model for art therapists in York, NY: Basic Books.
community-based practice. Art Therapy: Journal of the American Art Therapy Young, J., Weir, S., & Rycroft, P. (2012). Implementing single session therapy. The
Association, 33(3), 144–150. http://dx.doi.org/10.1080/07421656.2016. Australian and New Zealand Journal of Family Therapy, 33(1), 84–97. http://dx.
1199245 doi.org/10.1017/aft.2012.8