Senior Project Proposal
Tia Forsman
January 20, 2015
- Title of Project:
Can Art be Medicine: Art Therapy and its Use as Treatment for Recovery.
- Statement of Purpose:
Why have people continued to make art over thousands of years? There must be something that we as humans get out of these forms of creation--painting , drawing, writing. When artists are asked why they make art, the responses vary but all focus on human emotion. Artists, such as photographer Judy Dater, enjoy art because it allows them to express emotions(Smith). But possibly the most interesting reason why artists create is to find what poet Kwame Dawes,Ph.D. calls an “environment of empathy.” Dawes, the Distinguished Poet in Residence at the University of Southern California, explains that he writes “in what is probably a vain effort to somehow control the world in which [he] live[s], recreating it in a manner that satisfies [his] sense of what the world should look like and be like.”
Clearly, these artists gain some sort of personal satisfaction from their work, but can this personal satisfaction become a power tool in medicine and therapy? Catherine Gillespie-Lopes, an art therapist, writer and editor currently living in the Toronto area, attempted to elucidate the idea behind art therapy when she identified the questions that form the “basis for art therapy practice.” “Is it the process itself, the actual act of making art that soothes our nerves and settles our brains? Is it the freedom of expression it allows us? The metaphor and symbolism it can access from our unconscious minds? Or is it the pride and sense of accomplishment we take in the final product; the actual act of creating something that connects us to ourselves and the world on a deeper level? “
Clearly, these artists gain some sort of personal satisfaction from their work, but can this personal satisfaction become a power tool in medicine and therapy? Catherine Gillespie-Lopes, an art therapist, writer and editor currently living in the Toronto area, attempted to elucidate the idea behind art therapy when she identified the questions that form the “basis for art therapy practice.” “Is it the process itself, the actual act of making art that soothes our nerves and settles our brains? Is it the freedom of expression it allows us? The metaphor and symbolism it can access from our unconscious minds? Or is it the pride and sense of accomplishment we take in the final product; the actual act of creating something that connects us to ourselves and the world on a deeper level? “
In my senior research project, I will attempt to answer these overarching questions by studying how art therapy affects patients in hospital settings. Specifically, I will be looking at the treatment of geriatric patients.Many cases of depression and mental disorders go undiagnosed and untreated. And due to the increasingly aging population, it is therefore apparent that methods of treating these mental disorders should be explored. This is where my research will focus. I hope to explore methods of art that will allow geriatric patients to create their own “environments of empathy.”
With my research I will answer the following question: Does art therapy aid in the reduction of stress and depression that exists among a sample of geriatric psychiatric inpatients? The most prominent mental disease I will focus on include Alzheimer's disease, dementia, substance abuse, schizophrenia, bipolar disorder, depression, delirium and psychosis. Depending on circumstances, I will look more specifically at types of mediums, themes, and symbols used within the artwork to determine trends among patients in different situations.
With my research I will answer the following question: Does art therapy aid in the reduction of stress and depression that exists among a sample of geriatric psychiatric inpatients? The most prominent mental disease I will focus on include Alzheimer's disease, dementia, substance abuse, schizophrenia, bipolar disorder, depression, delirium and psychosis. Depending on circumstances, I will look more specifically at types of mediums, themes, and symbols used within the artwork to determine trends among patients in different situations.
- Background:
When I was only one year old, my Grandmother on my father’s side of the family had a liver transplant. As I was too young to remember , my parents told me that everything was supposed to go as planned; she had the best surgeon and doctor and no complications were expected. However, shortly after her operation, her body responded to the new foreign organ and fell into a coma. Months later, she recovered, but not without the help of several methods of therapy. One of the therapy treatments she received was art therapy. Today her liver functions normally and I am convinced that the art therapy she received aided recovery.
As a teaching assistant for 6th grade art history, I found that art allows children to communicate in ways that they usually would not think of. Spending time with these students increased my fascination with the power of art and the importance of having an alternative means of expression. I myself have found art to be a therapeutic activity that lowers my stress levels and increases my mental function. So I hope to continue my study of art in college as I pursue medicine simultaneously.Many medical students are now focusing more on the humanities and the arts . An article titled “Poetry, Painting to Earn an M.D.” explains that many universities require courses in the humanities that “aim to teach students "right-brain" insights and skills they won't learn dissecting cadavers or studying pathology slides. Schools hope the programs help to turn out a new generation of physicians better able to listen attentively to patients, show emotion and provide sensitive personal care.” With my Senior Research Project, I plan to discover a meaningful link between the two fields of art and medicine that these Universities are already quite aware of.
My work with 6th grade students showed me the individual effect of art on everyone. I now want to study the opposite end of the spectrum with geriatric patients in hopes of discovering similar connections and benefits of art.
As a teaching assistant for 6th grade art history, I found that art allows children to communicate in ways that they usually would not think of. Spending time with these students increased my fascination with the power of art and the importance of having an alternative means of expression. I myself have found art to be a therapeutic activity that lowers my stress levels and increases my mental function. So I hope to continue my study of art in college as I pursue medicine simultaneously.Many medical students are now focusing more on the humanities and the arts . An article titled “Poetry, Painting to Earn an M.D.” explains that many universities require courses in the humanities that “aim to teach students "right-brain" insights and skills they won't learn dissecting cadavers or studying pathology slides. Schools hope the programs help to turn out a new generation of physicians better able to listen attentively to patients, show emotion and provide sensitive personal care.” With my Senior Research Project, I plan to discover a meaningful link between the two fields of art and medicine that these Universities are already quite aware of.
My work with 6th grade students showed me the individual effect of art on everyone. I now want to study the opposite end of the spectrum with geriatric patients in hopes of discovering similar connections and benefits of art.
- Prior Research:
The Foundation for Art and Healing has been working over the past few years “to use its position as a “bridge” to create and expand general awareness about art and healing, to bring forward through research and related explorations critical knowledge about art and healing and the relationship between them, and to help make this knowledge available at the individual and community level.” According to the foundation, “ More than three hundred professional organizations are researching, documenting, and systematizing how engagement with the creative processes impacts the development of disease and the likelihood of recovery.” It is clear that both the medical art worlds are working toward unleashing the potential of art therapy.
Creative processes and other activities have had positive influences on the ability to cope and recover from illness. However, these creative processes and activities are not typically made readily available to patients in clinical settings; instead, patients are usually left to their own devices to recover. This research will focus on the benefits of providing one on one artistic therapy to patients in an organized setting to improve quality of life and mental functioning.
In “The Creativity Gap: When your surgeon has an art-school diploma on the wall”,an article published by The Globe and Mail, Dr. John Semple explains his transition from fine arts to medicine and their correlation. Dr. Semple is the chief surgeon at Toronto’s Women’s College Hospital, where he specializes in post-cancer breast reconstruction. He’s also a professor in the University of Toronto’s Faculty of Medicine and the chair of surgical research at the Canadian Breast Cancer Foundation. However, he also studied painting and sculpture at the Ontario College of Art and Design. He explains: “A training in art is really a training in observation. It teaches you how to be aware and how to see. And that’s certainly something you can use extremely well in medicine.” And “Creativity is really a critical element of how human beings advance in all our disciplines. Where medicine and science need help from art is in looking over the horizon, in looking at something in a completely different way. Thinking as an artist means connecting the dots that aren’t next to each other.” Although this article does not focus on the implications of art therapy, I found it to be an interesting take on how art and medicine can work hand in hand.
Creative processes and other activities have had positive influences on the ability to cope and recover from illness. However, these creative processes and activities are not typically made readily available to patients in clinical settings; instead, patients are usually left to their own devices to recover. This research will focus on the benefits of providing one on one artistic therapy to patients in an organized setting to improve quality of life and mental functioning.
In “The Creativity Gap: When your surgeon has an art-school diploma on the wall”,an article published by The Globe and Mail, Dr. John Semple explains his transition from fine arts to medicine and their correlation. Dr. Semple is the chief surgeon at Toronto’s Women’s College Hospital, where he specializes in post-cancer breast reconstruction. He’s also a professor in the University of Toronto’s Faculty of Medicine and the chair of surgical research at the Canadian Breast Cancer Foundation. However, he also studied painting and sculpture at the Ontario College of Art and Design. He explains: “A training in art is really a training in observation. It teaches you how to be aware and how to see. And that’s certainly something you can use extremely well in medicine.” And “Creativity is really a critical element of how human beings advance in all our disciplines. Where medicine and science need help from art is in looking over the horizon, in looking at something in a completely different way. Thinking as an artist means connecting the dots that aren’t next to each other.” Although this article does not focus on the implications of art therapy, I found it to be an interesting take on how art and medicine can work hand in hand.
In a comprehensive review of art therapy and health outcomes, titled “The Connection Between Art, Healing, and Public Health: A Review of Current Literature,” Heather L . Stuckey and Jeremy Nobel present several examples of cases that display significant benefits of art therapy in clinical settings. They begin by citing the World Health Organization’s definition of “holistic health” as “viewing man in his totality within a wide ecological spectrum, and . . . emphasizing the view that ill health or disease is brought about by an imbalance, or disequilibrium, of man in his total ecological system and not only by the causative agent and pathogenic evolution.” Therefore, health is defined as “a state of complete physical, mental, and social well-being rather than merely the absence of disease or infirmity.” They then went on to describe Guillemin M’s study of “Embodying Heart Disease Through Drawings,” which was one of the first to “use drawings...to understand experiences of health and illness.” Three themes were identified in the drawings of 32 middle-aged women with heart disease. These themes included the heart at the center, the heart in the lived body, and heart disease as a social illness. Overall, Guillemin concluded that the drawings were “ an insightful method with which to explore understanding of illness.” On a more quantitative level, Stuckey and Nobel also referenced cases with results which showed statistically significant decreases in symptoms as well as hospital stay durations. A study by Rockwood-Lane M and Graham-Pole J as well as one by Tusket DO, Cwynar R, and Cosgrove DM both showed that “surgery or critical care patients who participated in guided imagery or had a picture of a landscape on their wall had a decreased need of narcotic pain medication relative to their counterparts and left the hospital earlier.” Additionally, they referenced another study, Monti et al., titled “A randomized, controlled trial of mindfulness-based art therapy (MBAT) for women with cancer. “ This specific study found that “those who engaged in art making demonstrated statistically significant decreases in symptoms of physical and emotional distress during treatment.”
Finally, Stuckey and Nobel referenced a study by Nainis N, Paice JA et al. titled “Relieving Symptoms in Cancer: Innovative Use of Art Therapy.” I found this study particularly fascinating because it focused on the effects of 1-hour art therapy sessions by using the Edmonton Symptom Assessment Scale and Spielberger State-Trait Anxiety Index, tools I may use in my own research. In the study, “50 patients taking part were asked open-ended questions to evaluate their perceptions of the experience. There were statistically significant reductions in 8 of the 9 symptoms measured by the Edmonton scale, including the global distress score, as well as significant improvements in most of the domains measured by the Spielberger State-Trait Anxiety Index. Patients overwhelmingly expressed comfort with the process and a desire to continue with therapy. This study provides initial evidence of the efficacy of art therapy in reducing a broad spectrum of symptoms among cancer inpatients. “
Finally, Stuckey and Nobel referenced a study by Nainis N, Paice JA et al. titled “Relieving Symptoms in Cancer: Innovative Use of Art Therapy.” I found this study particularly fascinating because it focused on the effects of 1-hour art therapy sessions by using the Edmonton Symptom Assessment Scale and Spielberger State-Trait Anxiety Index, tools I may use in my own research. In the study, “50 patients taking part were asked open-ended questions to evaluate their perceptions of the experience. There were statistically significant reductions in 8 of the 9 symptoms measured by the Edmonton scale, including the global distress score, as well as significant improvements in most of the domains measured by the Spielberger State-Trait Anxiety Index. Patients overwhelmingly expressed comfort with the process and a desire to continue with therapy. This study provides initial evidence of the efficacy of art therapy in reducing a broad spectrum of symptoms among cancer inpatients. “
Cathy Malchiodi, an art therapist, visual artist, independent scholar, and author of 13 books on arts therapies, including The Art Therapy Sourcebook reflected on a specific patient in her article titled “Using Art Therapy to Re-Author the Dominant Narrative of Illness.” Malchiodi’s patient, 43 year old Michaela, was diagnosed with ovarian cancer and “ committed herself to do whatever possible to treat not only the disease, but also to explore the “psycho-social-spiritual” effects of the illness on mind and body with everything available including art therapy.” While Michaela’s cancer went into remission, it eventually returned 9 months later. Malchiodi explains in the article that she and her patient “never discussed art therapy as a ‘cure’ for her cancer, but ...often talked about how her creative expression through art and writing were part of her ‘healing’ in the sense of coming to terms with her illness, a divorce and eventually the process of dying.” Michaela did not defeat her disease, but Malchiodi explains that her case showed her that “the creative process of art making within the context of therapy provides an experience that is not clearly categorized as psychosocial, rehabilitative or health-giving. In brief, it is art therapy’s ability to provide patients with the chance to re-author the dominant narrative of their illness or physical disability and provide a way to explore what is referred to as “posttraumatic growth.”
In a Huffington Post article titled “Art Helps People Live With Mental Illness,” Michael Friedman describes his visit to an old factory building in the SoHo section of New York City. Here, he finds the HAI Art Studio, where all the artists have mental illnesses. The HAI Art Studio is a program of HAI, a non-profit arts and social service organization, the mission of which is "to inspire healing, growth and learning through engagement in the arts for the culturally underserved in New York City." It provides access to the arts for about 350,000 people each year.He explains how the artists there gain from their experience because “in our society it is not easy for people with mental illness to find opportunities to engage (to immerse themselves) in activities they find meaningful, to experience a sense of accomplishment, and to be part of a community of shared interest and mutual concern. Art can make it possible. “
In her scientific article "Art Therapy and the Brain: An Attempt to Understand the Underlying Processes of Art Expression in Therapy." , Vija Lusebrink discusses the main areas and functions of the brain that are activated in emotional states, the formation of memories, and the processing of visual information. She defines three different levels of expression in art therapy and the implied brain process: Kinesthetic/Sensory, Perceptual/Affective, and Cognitive/Symbolic. She notes that basic sensory/tactile interaction with art media can “serve as a reconstitutive agent in that it can stimulate motor memories including those sequences of motor actions relegated to the basal ganglia.” In conclusion, she found that “art therapy offers the possibility to emphasize selectively different aspects of visual information processing” and “the possibility to deal with basic sensory building blocks in the processing of information and emotions.”
In a study titled “The Effect of Art Therapy on Cognitive Performance of Hispanic/Latino Older Adults “, Amanda Alders and Linda Levine-Madori conducted a twelve week program of art therapy with 24 elderly Hispanic/Latino members of a community center. They used a pretest of drawing a clock and a questionnaire to measure progress. The clock drawing test was used to measure cognitive impairment. Each drawing was given a score based on what is called the Sunderland method, which considers the spacing of the numbers on the clock as well as the hands (Sunderland 1989). Their results show that in the experimental group who attended the art therapy sessions, 77% of the clock test scores improved, 15% stayed the same, and 8% decreased. Alternatively, in the control group, 46% of the scores decreased, 36% improved, and 18% showed no change. Overall,participants who attended art therapy sessions showed an average score increase of 2.20 and those who did not attend sessions only had an average increase of 0.1 points. In conclusion, “the findings suggest that the combination of self-initiated art making with art therapy session attendance may be most beneficial for enhancing a person’s perception of cognitive ability, which in turn may positively affect overall cognitive performance.
In “A Pilot Study to Determine the Psychological Effects of Manipulation of Therapeutic Art Forms Among Patients with Parkinson’s Disease”, Deborah Elkis-Abuhoff et al. tested the hypothesis that “Engagement in a six-week case-control study involving art therapy for patients diagnosed with Parkinson’s disease will decrease symptomology in areas of obsessive compulsive thinking, phobia, depression and stress.” Seven males subjects of the study were asked to manipulate different forms of clay in response to weekly topic discussions. Over the six weeks, the group addressed the following topics: Living with Parkinson’s Disease, Fear and Anxiety, Relationships, Getting Old/Aging, Emotions/Control, and Goal Setting. Assessments were completed pre- and post- on weeks 1, 3 and 6. Their results show “ that verbal discussion and art therapy intervention increased the participant’s ability to explore and enhance their emotions individually and within a group, leading to decrease in symptomology in areas of obsessive compulsive thinking, phobia, depression, and stress. “
In a study titled “The Effect of Art Therapy on Cognitive Performance of Hispanic/Latino Older Adults “, Amanda Alders and Linda Levine-Madori conducted a twelve week program of art therapy with 24 elderly Hispanic/Latino members of a community center. They used a pretest of drawing a clock and a questionnaire to measure progress. The clock drawing test was used to measure cognitive impairment. Each drawing was given a score based on what is called the Sunderland method, which considers the spacing of the numbers on the clock as well as the hands (Sunderland 1989). Their results show that in the experimental group who attended the art therapy sessions, 77% of the clock test scores improved, 15% stayed the same, and 8% decreased. Alternatively, in the control group, 46% of the scores decreased, 36% improved, and 18% showed no change. Overall,participants who attended art therapy sessions showed an average score increase of 2.20 and those who did not attend sessions only had an average increase of 0.1 points. In conclusion, “the findings suggest that the combination of self-initiated art making with art therapy session attendance may be most beneficial for enhancing a person’s perception of cognitive ability, which in turn may positively affect overall cognitive performance.
In “A Pilot Study to Determine the Psychological Effects of Manipulation of Therapeutic Art Forms Among Patients with Parkinson’s Disease”, Deborah Elkis-Abuhoff et al. tested the hypothesis that “Engagement in a six-week case-control study involving art therapy for patients diagnosed with Parkinson’s disease will decrease symptomology in areas of obsessive compulsive thinking, phobia, depression and stress.” Seven males subjects of the study were asked to manipulate different forms of clay in response to weekly topic discussions. Over the six weeks, the group addressed the following topics: Living with Parkinson’s Disease, Fear and Anxiety, Relationships, Getting Old/Aging, Emotions/Control, and Goal Setting. Assessments were completed pre- and post- on weeks 1, 3 and 6. Their results show “ that verbal discussion and art therapy intervention increased the participant’s ability to explore and enhance their emotions individually and within a group, leading to decrease in symptomology in areas of obsessive compulsive thinking, phobia, depression, and stress. “
In a study titled “A Short-Term Intervention to Enhance Cognitive and Affective Functioning in Older Adults” conducted by Helga Noice of Elmhurst College, Tony Noice of Indiana State University, and Graham Staines of the National Development and Research Institutes, one hundred twenty-four community-dwelling participants (aged 60 to 86) took part in one of three study conditions: theater arts (primary intervention), visual arts (non-content-specific comparison group), and no-treatment controls. The results show that theatre and arts made significant gains in both cognitive and psychological well-being measures compared to the no-treatment controls.
In an article titled “Jewish Art Therapy Group Helps Seniors With Self-Expression” by Cathy Malchiodi, the benefits of art therapy for seniors are explored more. Art therapist, Sherri Jacobs, explains her use of Jewish themes and her work with Holocaust survivors. She elucidates that art therapy allowed the seniors to talk about issues such as loneliness and depression. Her work with the Holocaust survivors also showed that each individual included a symbol of a key; she explains that “the one thing every survivor had was a key to their house, because they thought they would be able to go back home when the Holocaust was all over.”
In an article titled “Jewish Art Therapy Group Helps Seniors With Self-Expression” by Cathy Malchiodi, the benefits of art therapy for seniors are explored more. Art therapist, Sherri Jacobs, explains her use of Jewish themes and her work with Holocaust survivors. She elucidates that art therapy allowed the seniors to talk about issues such as loneliness and depression. Her work with the Holocaust survivors also showed that each individual included a symbol of a key; she explains that “the one thing every survivor had was a key to their house, because they thought they would be able to go back home when the Holocaust was all over.”
- Significance:
Due to the world’s rapidly aging population, demand for medical treatment of adults over the age of 60 is undoubtedly increasing. The growth of an aging population also puts a burden on families, businesses, and policymakers. According to the U.S. Census Bureau, the population age of 85 or older is projected to increase from 5.5 million in 2010 to about 19 million in 2050. While modern medicine effectiveness increases, life expectancy increases, yet treatment and care of the elderly will still remain a major concern. As mentioned before, according to the National Institute of Mental Health, older adults have the nation’s highest suicide rate, and as many as 20 percent suffer from depression and other mental disorders. Many cases go undiagnosed and untreated. Due to the increasingly aging population, it is therefore apparent that new methods of treating these mental disorders must be explored.
I hope to explore a potential solution to the treatment of geriatric patients in my research. Art therapy could not only treat other groups of patients such as children or the terminally ill, but it would be a simple, feasible approach to caring for these individuals. Through my research, I hope to understand what specific methods of art therapy are the most effective in treating emotional depression so that these methods may possibly be used in future programs in clinical settings around the world. My research will focus on a broad idea of giving meaning to individuals and will therefore be able to be applied to a wide range of patients in a wide range of settings.
- Description:
To answer my research question of which art therapy implementations elicit the greatest sense of meaning among geriatric patients, I will observe patients with various disorders and their responses to various art therapy methods. In a clinical setting, I will evaluate the medium used during therapy, the level of involvement from both the patient and therapist, the appearance of symbolism in the art, the length of time spent on art during each session, etc. I hope to be able to analyze responses from both the participating therapist and the patients themselves to further elucidate the effectiveness of the art therapy experience. While I hope to conduct much of my research during live therapy sessions, I also plan on researching the psychological implications of artistic expression by studying previous research as well as published texts.
- Methodology:
My research will be conducted at St. Mary’s Hospital in Tucson, Arizona in the “Bridges” Program, which focuses on the treatment of geriatric patients. I plan to shadow Mrs. Emily Endreson, an established art therapist with a Masters in Art Therapy from New York University and a Bachelors in Art Education from the University of Iowa. While shadowing Mrs. Endreson, I will be able to observe her one on one and group sessions with patients and participate in the therapy sessions. I will not only gain an understanding of how a clinical setting make a patient feel, but also how art therapy can help alleviate the patients’ levels of stress and depression.
- Problems:
Some potential problems I may encounter with this project include travel, data collection, and time restraints. As far as travel is concerned, depending on my schedule, I may end up working with Mrs. Endreson for an extended period of time over a couple days and then having to drive back to Scottsdale. However, these details should be worked out shortly .
Data collection in this type of project will not be as straight forward as other projects. I hope to be able to interview patients and doctors, but much of in the information I receive may be unreliable or biased. Additionally, depending on the mental and physical state of many of the geriatric patients, it may or may not be convenient to speak with them about their feelings and their disorders.
Finally, time restraints may play a role in this project because of the lengthy amount of time it takes to fully recover (or even partially recover) from depression or other mental disorders. Because I only have a few months to conduct research, it seems I will only see a small amount of change in patients and will not be able to take into account the long term effects of art therapy.
Data collection in this type of project will not be as straight forward as other projects. I hope to be able to interview patients and doctors, but much of in the information I receive may be unreliable or biased. Additionally, depending on the mental and physical state of many of the geriatric patients, it may or may not be convenient to speak with them about their feelings and their disorders.
Finally, time restraints may play a role in this project because of the lengthy amount of time it takes to fully recover (or even partially recover) from depression or other mental disorders. Because I only have a few months to conduct research, it seems I will only see a small amount of change in patients and will not be able to take into account the long term effects of art therapy.
- Bibliography:
Alders, Amanda, and Linda Levine-Madori. "The Effect of Art Therapy on Cognitive Performance of Hispanic/Latino Older Adults." Art Therapy 27.3 (2010): 127-35. American Art Therapy Association. Web. 09 Oct. 2014.
Elkis-Abuhoff, Deborah. “A Pilot Study to Determine the Psychological Effects of Manipulation of Therapeutic Art Forms Among Patients with Parkinson’s Disease” 18.3 (2013): n. pag. Taylor and Francis. International Journal of Art Therapy: Formerly Inscape, 29 May 2013. Web. 10 Oct. 2014.
Friedman, Michael. "Art Helps People Live With Mental Illness." The Huffington Post, 23 May 2012. Web. 20 Nov. 2014.
Gillespie-Lopes, Catherine. "ART THERAPY: The Healing Power of Art | The Mindful Word." The Mindful Word. N.p., 20 July 2012. Web. 08 Dec. 2014.
Landro, Laura. "Poetry, Painting to Earn an M.D." The Wall Street Journal. Dow Jones & Company, 1 Feb. 2011. Web. 21 Nov. 2014.
Lusebrink, Vija B. "Art Therapy and the Brain: An Attempt to Understand the Underlying Processes of Art Expression in Therapy." Taylor & Francis. American Arts Therapy Association, 22 Apr. 2011. Web. 09 Oct. 2014.
Noice, H., Noice, T., & Staines, G. (2004). “A short-term intervention to enhance cognitive and effective functioning in older adults.” Journal of Aging and Health. 16 (4), 562-585.
Malchiodi, Cathy, PhD. "Using Art Therapy to Re-Author the Dominant Narrative of Illness." Psychology Today: Health, Help, Happiness + Find a Therapist. Sussex Publishers, 5 June 2012. Web. 20 Nov. 2014.
Martin, James. "When Your Surgeon Has an Art-school Diploma on the Wall."The Globe and Mail. Phillip Crawley, 11 June 2012. Web. 09 Oct. 2014.
Malchiod, Cathy. "Jewish Art Therapy Group Helps Seniors With Self-Expression." Art Therapy. American Art Therapy Association, n.d. Web. 09 Oct. 2014.
Smith, Jeremy A., and Jason Marsh. "Why We Make Art." Greater Good. University of California, Berkeley, 1 Dec. 2008. Web. 21 Nov. 2014.
Stuckey, Heather L ., and Jeremy Nobel. “The Connection Between Art, Healing, and Public Health: A Review of Current Literature.” Framing Health Matters. American Public Health Association. Feb. 2010. Web. 8 Dec. 2014.
Sunderland, T. (1989). Clock drawing in Alzheimer’s disease: A novel measure of dementia severity. Journal of the American Geriatric Society, 37, 725–729.
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