Child Art Psychotherapy, (CAP), is a specific method of art psychotherapy, designed in the 1980’s by the Hungarian Art Therapist Vera Vasarhelyi, while working within Child and Adolescent Mental Health Services (CAMHS) in Guy’s Hospital, London. Post Graduate training in CAP (formally Visual Psychotherapy) began in the 1990’s in the UK and Hungary and found a home in the School of Medicine, University College Dublin, in Ireland, in 2001.
The CAP methodology draws its inspiration from Psychodynamic Child and Adolescent Psychotherapy, Psychoanalysis, Analytical Psychology, Developmental Psychology, Attachment Theory, Systemic Psychotherapy, and branches of Philosophy such as Aesthetics. It was developed in order to bring a child centred, creative and relational approach into a predominantly medically focussed CAMH service. The method is based on the principle that visual thinking and expression have a distinctive and direct relationship with the unconscious. Words and verbal communication are viewed as an abstraction of feeling, simplifying often complex processes.
‘the symbolic content of images can facilitate a unique insight into the dynamics of the unconscious, and allow the privilege of seeing hidden processes, which would otherwise remain largely inaccessible to exploration’, (Vasarhelyi 1990)
The use of pictorial language as the primary means of communication within the psychotherapeutic sessions brings an additional dimension to a young person’s experience. Rather than the psychotherapist interpreting the images, as in some other forms of art psychotherapy, the therapist encourages the child to find a way to describe their own stories. This allows for the exploration of the real and imagined, inner and outer versions of experiences and related emotions with support rather than scrutiny.
"No external interpretation should be superimposed onto the patient's own iconography, the patient is the expert, not the therapist." (Vasarhelyi 1990)
Child Art Psychotherapy explores not only the conscious and unconscious processes
within the art work but also what unfolds within the therapeutic relationship. CAP practitioners work relationally and are trained to view both art and the practice of psychotherapy as transitional spaces which exist between individuals, as well as their internal and external worlds (Winnicott 1951).
At the core of the practice of Child Art Psychotherapy is the young person themselves and practitioners work from this ‘child lead’ perspective. It is the overall aim of the therapy to support and empower the young person to build a more integrated sense of ’Self’, leading to an improvement in autonomy and psychic growth.
"To decide when to apply the one or the other method rests with the analyst's skill and experience. Practical medicine is, and has always been an art, and the same is true of practical analysis. True art is creation, and creation is beyond all theories. That is why I say to any beginner: Learn your theories as well as you can, but put them aside when you touch the miracle of the living soul. Not theories, but your own creative individuality alone must decide." (Jung, C. G. 1928)
How long does the therapy last?
The number of sessions varies for each child depending on their unique circumstances and should be discussed at review meetings. As far as is possible a young person should be involved in decisions relating to their ongoing care. When the therapeutic relationship is coming to an end, ideally the therapist is able to prepare the child or adolescent for this transition.
Confidentiality
The images made in the sessions and any information shared with the therapist will be treated with utmost sensitivity and respect. This enables a child or young person to feel they are able to bring any thoughts and feelings whatever the form. The therapist may need to share information in order to help support the child or young person, but does so on a needs basis only and preferably with the young person’s awareness. Please see the ACAP Code of Ethics and Professional Practice and Child Safeguarding Statement for further details.
Benefits
Children and Adolescents for whom this form of therapy may be particularly beneficial are those with: • Anxiety
• Depression
• Attachment Issues
• Communication Difficulties
• Family Crisis
• Psychosomatic Problems
• Loss and Bereavement
• Post-Traumatic Stress
• Difficulties relating to the expression of emotions and self-image
Training
For further information on the Child Art Psychotherapy Professional Masters with The School of Medicine, UCD please go to
https://www.ucd.ie/medicine/studywithus/graduate/childhealthwelfare/professionalmasterschildartpsychotherapy/
References:
Boyle, O. and Mulligan A. (2017). Child Art Psychotherapy Proposed as Adjunctive Therapy for Adolescents with Type 1 Diabetes Mellitus. Diabetes Obes Int J 2017, 2(2): 000153.
Carroll and Coffey, (2016). The Valuable Role of Child Art Psychotherapy. Forum. Journal of the Irish College of General Practitioners, Vol 33 No. 4. p. 50-52.
Case, C. and Dalley, T.(1990). Working with Children in Art Therapy. London. Routledge. P.54-71. Vasarhelyi, V. “The Cat, the Fish, the Man and the Bird: or How to be a Nothing. Illness Behavior in Children: the Case Study of a 10 Year Old Girl”.
Coskunlu, A., Tanıl, E., Coffey, A., Büyüktaskın, D., & Mulligan, A. (2017). The Vasarhelyi method of child art psychotherapy: an adjunctive treatment in childhood depression. Psychoanalytic Psychotherapy 2017. http://www.tandfonline.com/doi/full/10.1080/02668734.2017.1334150
Jung, C. G. (1928) Contributions to Analytical Psychology. Translated by H. G. Baynes and C. F. Baynes. London: Kegan Paul, Trench, Trubner and Co., Ltd. p. 361
McGovern M., Byrne A., McCormack, M., Mulligan A., (2016). The Vasarhelyi Method of Child Art Psychotherapy in Child and Adolescent Mental Health Services: a stakeholder survey of clinical supervisors, https://doi.org/10.1017/ipm.2016.29
Saba L, Byrne A., Mulligan A., (2016). Child art psychotherapy in CAMHS: Which cases are referred and which cases drop out? SpringerPlus 5, 1816 (2016). https://doi.org/10.1186/s40064-016-3509-2
Tanıl E, Coşkunlu A, Mulligan A. (2018) Child Art Psychotherapy in CAMHS in Ireland-a parent satisfaction study. Irish Journal of Medical Science. Nov;187(4):987-992. DOI: 10.1007/s11845-018-1786-1.
Vasarhelyi, V. (1981). What happened on Ben Nevis? Psychotherapy with Pictorial Means and the Time Aspect of Pictorial Thinking. Special Study.27-45. London. Goldsmith’s College.
Vasarhelyi, V. (1991). How Snerp, the snake-dragon and his friends, starlight and the two Bridgets decided to join the United Nations of feelings. Inscape, 18-29.
Vasarhelyi, V. (1992). ‘Visual Psychotherapy, The Hungarian Challenge, The Establishment of the Profession and the First Post Graduate Art Psychotherapy Course in Hungary, Inscape Winter, International Journal of Art Therapy, Taylor and Francis Online
Winnicott, D. W. (1951). Transitional objects and transitional phenomena. London: Tavistock.