Creativity -- Therapeutic Uses and Therapy -- Alike and Different

Creativity is a good thing on many levels! And, most importantly, creativity belongs to everyone, as do the arts. Where things get complicated is along a continuum of the use of creativity and the arts between and among arts and health, arts education, and arts and social service professionals.
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As 2016 Creative Arts Therapies Week ends, it is important to discuss the meaning and significance of creativity and how it fits into the work of counselors, artists, and creative arts therapists in health, education, and social service settings.

Robert Franken defined creativity as "the tendency to generate or recognize ideas, alternatives, or possibilities that may be useful in solving problems, communicating with others, and entertaining ourselves and others." He believed people's needs for "novel, varied, and complex stimulation"; "to communicate ideas and values"; and "to solve problems" motivate them to be creative (p. 396).

Mihaly Csikszentmihalyi created the "Systems Model of Creativity" articulating the creative domain, the creative field, and the individual creative person who uses symbols of a given domain (e.g., music, engineering, business, math, etc.) and possesses new ideas or sees new patterns (pp 27-28).

Creativity is a desirable trait in our society, and it is among the list of "knowledge, skills, work habits, and character traits commonly associated with 21st century skills." Tony Wagner wrote that today's students must master seven survival skills, one of which is curiosity and imagination, to thrive in the new world of work. He believes these "skills are the same ones that will enable students to become productive citizens who contribute to solving some of the most pressing issues we face in the 21st century." Indeed, creativity is one of my own personal core values and one of the core values identified by my organization.

Creativity is a good thing on many levels! And, most importantly, creativity belongs to everyone, as do the arts. Where things get complicated is along a continuum of the use of creativity and the arts between and among arts and health, arts education, and arts and social service professionals.

In a recent article in Counseling Today, Thelma Duffey, President of the American Counseling Association, said that creativity in counseling refers to "the creative human capacity to effect change," including a "process that involves shifts in thoughts, feelings, behaviors, and perspectives." She added that "our creativity gives us the flexibility to look at things differently and move in a new direction" and that it inspires hope. Based on definitions offered above, these comments make perfect sense. A myriad of creative approaches may be beneficial to clients in counseling.

Also in the Counseling Today article, psychotherapist Elizabeth Hall shared that she often starts therapeutic conversations by asking clients what music, movies or books they like. She has found that clients expressing themselves through discussions about various art forms may make it easier for her clients, particularly teens, to share their feelings. Emily Dennis, holder of master's degrees in counseling and art therapy, said in the same article that she "doesn't think counselors should need specialized training to incorporate creative methods into their practices." In many instances, she is correct, because, as described above, creativity takes many forms.

However, there can be much more to actually creating or performing music, dance, visual art, drama or poetry or prose than meets the eye (or ear-or entire body) with our clients. I will use music therapy to illustrate this point, as that is the profession with which I am most familiar; but the reader may draw parallels to other creative arts therapies.

Angie Snell, a Board Certified Music Therapist in Michigan, explains that music therapists are trained to skillfully observe which musical components an individual responds to and note physical reactions, such as breathing, eye gaze, body rocking, or vocalizations. The music therapist notices whether responses occur if music is heard in a specific key or because of an interesting melodic pattern, certain instrumentation, tempo or rhythmic accents. The music therapist can agilely apply or manipulate various elements of music, to facilitate development of a larger repertoire of responses to music for a student with autism, ultimately helping the child learn more ways to relate to people and objects in a socially acceptable fashion. Snell highlights examples of live music therapy interventions with "prescribed tempo, accents, dynamics, phrasing, harmonic progression and melodic shape" being responsible for supporting "independent sitting, turn-taking, eye contact and performance within a guided music structure tailored to immediate needs." She summarizes, "The cornerstone of music therapy 's success is musical assessment of physical, cognitive and emotional needs, followed by prescriptive music interventions based on the disciplined study of music's relationship to human functioning."

I have experienced this approach in my own practice. When I played familiar children's songs on my flute, all the children in a preschool class I served remained calm and attentive. However, when I switched to playing Yankee Doodle on my piccolo, one young boy with autism started beating his head against his teacher's knees. Quickly assessing the situation, I continued playing, but an octave lower than previously. The child immediately calmed and stopped his head-beating. He apparently was very sensitive to high pitches!

I later worked with two elementary school age boys with autism, both of whom exhibited perfect pitch and possessed quite advanced cognitive and musical skills. When they requested to play Here Comes the Sun in an ensemble using drums, keyboard and guitar, I suggested playing it in the key of G. One boy remarked that on the recording the Beatles played it in the key of E-flat. They were, however, successful in playing in my alternate key, thereby expanding their repertoire of responses and improving their ability to be flexible and adaptable to change.

When working in a very different setting, with a person with a physical disability such as a stroke, a music therapist needs to carefully analyze the patient's gait and determine the musical elements to be focused on. What should the meter of the music be? Does the person walk with a 2-point gait (right-left, with or without a cane) or a 3-point pattern (walker-left-right)? How fast does she walk now and what is the optimum tempo?

There are similarities among counselors, artists and creative arts therapists using the arts in healthcare, education or social service settings. There can be therapeutic aspects to all arts activities or experiences. All these professionals believe in the power of the arts to heal, relieve suffering, elevate presence and awareness and improve people's quality of life.

What sets creative arts therapists apart from their peer counselors or artists in similar settings? Artists might foster participation in and appreciation of the arts by facilitating patients creating visual art, music, dance, drama and poetry; facilitating arts performances; or selecting and exhibiting visual art.

Counselors and Creative Arts Therapists do the above, plus work with patients regarding personal meaning in arts expression and they help facilitate patients' awareness of meaning and what it has to teach them about themselves and achieving optimal health. They do this by consulting with treatment teams, conducting individual and family evaluations/assessments, and providing individual and group therapy sessions in their modalities. They are credentialed and sometimes licensed. All are evidence-based health professions with strong research foundations. Creative Arts Therapists, as noted above, have the additional training and expertise in their arts modalities.

Artists may provide enjoyable, constructive, relaxing and engaging activities, reduce anxiety, enhance and bring beauty to the healthcare or other environment, teach artistic skills to aid with rehabilitation, enhance creativity and feelings of competence, and contribute to someone's overall quality of life. Creative arts therapists may have the same goals as artists, but creative arts therapists may have additional goals: to assess and treat patient health issues, assist patients in developing skills for maintaining optimal health, promote expression of feelings that may be hard to put into words, and help patients gain insight and enhanced self-refection. Counselors may or may not be able to accomplish these goals, again depending on their training and expertise in particular art forms.

Creativity does belong to everyone, as do the arts. But clinical music therapy [and our other sister creative arts therapies] are "the only professional, research-based discipline[s] that actively" apply "supportive science to the creative, emotional and energizing experiences of music" [or the other arts] "for health treatment and educational goals."

To learn more about the creative arts therapies or to find a creative arts therapist, visit individual organizations' websites (i.e., www.musictherapy.org) or that of the National Coalition of the Creative Arts Therapies Associations.

Other References:

Csikszentmihalyi, M. (1996). Creativity: Flow and the psychology of discovery and invention, New York: Harper Perennial, pp. 27-28.

Franken, R. (1993) Human Motivation, 3rd edition. Pacific Grove, CA: Brooks/Cole, p. 396.

Snell, A. M. (2002) "Music Therapy for Learners with Autism in a Public School Setting" in Models of Music Therapy Interventions in School Settings, 2nd ed. (B. L. Wilson, Ed.). Silver Spring, MD: The American Music Therapy Association, 212-275.

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