How suitable is art therapy for autistic people?

In this article, Caroline Hearst, an autistic trainer and consultant with Autism Matters who also qualified as an art psychotherapist, takes a personal look at art therapy for autistic people. Caroline reflects on her own experience as well as others' who have experienced art therapy.  

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How suitable is art therapy for autistic people? 

Many autistic people find it difficult to express feelings in words (or even know what we are feeling at all). Art therapy is often suggested as a way of addressing challenges while circumventing the need to explain in words. However, it doesn’t always work this way because the therapy part can come with unstated assumptions on the part of the therapist that don’t facilitate change for autistic people. I sought the experiences and opinions of autistic adults and parents of autistic children about art therapy and found that while they were positive about the benefits of art there was generally less enthusiasm about art therapy. 

Susan (a mother of three, two of whom are diagnosed with autistic spectrum conditions) was the most positive about art therapy. Having seen her son go through a dip in self-esteem as he grew up she was determined to prevent this happening to her daughter (Rose) by pro-actively supporting her wellbeing. 

Fortuitously, when Rose seemed to experience self-doubt, Susan came across an art therapy studio, liked the art therapist and signed Rose up for 6 sessions. Susan says Rose enjoyed the sessions; she feels they helped Rose with creativity and self-expression and is happy that her daughter would be open to further therapy.

Thomas Clayton, an autistic adult has a different perspective:

I find art a very useful tool for managing emotions and communicating things, but that is when I'm on my own rather than being led by a therapist.”   

He says his experience of art therapy as a child:

“…was pretty useless as a therapy as no one ever explained to me what it was for (other than 'you’re going to see a person and draw for them'), and so I just drew random pictures that the poor art therapist tried her hardest to find hidden meaning in when there was none......things only got better when I went to a specialist college where I was around people who understood.”

Thomas’s experience accords with what my own psychodynamic Art Psychotherapy training at Goldsmiths College led me to expect.  We were encouraged to ascribe meanings to images produced and analyse the relationship between the client and therapist. The training included no information about autism; despite this, I was placed in a school for autistic children and one of the students in the same supervision group was seeing a child diagnosed with Asperger’s syndrome.

To see if the training had changed it was recommended I talk with Dr Robin Tipple who wrote a thesis about the use of art therapy in autism assessment and currently teaches on this course. In conversation he is thoughtful, responsive and empathic, he says his influences are the Tavistock and Meltzer  who have a view of autism that relies on the medical model that defines it as a “triad of impairments” and tend to also lean on psycho-analytic ideas which are not helpful for autistic people. 

In terms of what current students learn about autism, Robin tells me that there is a lecture on autism, where discussion is invited. Most of the teaching is through supervision groups so what students learn depends on the clients being discussed in these groups. He told me that:

Students are also encouraged to explore differences of every kind and on “difference day” we debate the ways in which differences are responded to“. 

Anna, mother to an autistic girl, also believes in the benefit of art:

My daughter (now 12) really enjoys art - both painting and pottery. It is difficult for her to respond to me about the benefits, but I observe that she's eager to take part, will focus for long periods of time, is able to make choices and seems to derive sensory pleasure from the activity (especially from clay) and it helps her relax (in particular her stimming, which is a response to stress, diminishes).”  

She is not convinced about art therapies however:

I am sceptical about the attachment of therapy to disciplines such as art, music and drama, especially in relation to my daughter who is not ill or traumatised and in need of ‘therapy’ to cure or heal her”

She told me that:

The school arranged for some drama therapy. I was told that I couldn't sit in or indeed be told much about the actual sessions as this would breach patient/therapist confidentiality. We were given a handout...full of pretentious piffle. My daughter was 8 or 9 at the time and had little language so I wondered how they'd communicate with her. One of the lads in the class told me that she didn't understand what was going on and spent most of the time trying to climb up the gym apparatus.”

Anna decided to pilot an art group for autistic girls and their parents where the focus was on making and doing and other benefits were allowed to flow from this. The feedback was that:

“The activities in themselves were enjoyable and varied, the experience was relaxing (careful choice of quiet venue, empathy and understanding of sensory issues) and it helped make social interaction and communication easier as it evolved from the activities naturally; the group was small and there was no pressure.”

Larry Arnold, an autistic academic and activist believes:

The problem with art as therapy is that it is predicated on notions that I consider to be wrong and inequitable. Firstly, it is built around the deficit model of disability. Secondly, it exceptionalises need and rations it according to a medical gatekeeping system…Everybody needs to be able to express themselves creatively and what often stands in the way of that in terms of art and craft is poverty, the inability to access the special equipment and materials and knowledge required for one's chosen pursuit. We live in a society where one has to find some medical justification to access things that used to be available through widespread adult education services.  It is all about rationing and denying services, not about giving people what they need at all.”  

What holds many autistic people back in life is not autism, but our own and others' lack of understanding of autism. Help to change this situation is unlikely to come from therapists who do not themselves understand autism. So while engagement in the arts can be very therapeutic, I would urge anyone considering art therapy to first assure themselves that they could establish a positive connection with a therapist who has a good understanding of autism.


Author: Caroline Hearst

Date added: 2 July 2015