Lavey-Khan, S., & Reddick, D. (2020). Painting together: A parent-child dyadic art therapy group. The Arts in Psychotherapy, 70, 101687. https://doi.org/10.1016/j.aip.2020.101687
This article was published in 2020, on The Arts in Psychotherapy. This study was conducted in the United-Kingdom, by Shona Lavey-Khan, a psychologist who works in a Child and Adolescent Mental Health Services (CAMHS), and by Dean Reddick, an art therapist, working in a nursery school and children’s centre.
The authors described and assessed an intervention based on an art therapy group, on a parent-child dyad. This intervention is called “Painting Together Group”. The aim of this study is to explore whether group intervention helps parent and child to better communicate. This research is established on some studies that deal with art therapy with parents and children and dyadic group intervention, which aimed at improving parent and children relationship, and most important, meliorating parental mental health and self-esteem. Indeed, research has shown that children, whose parents deal with mental health problems, are at risk to also develop mental health problems.
The “Painting Together Group” (PTG) had three aims, which are the following : “improving parental mental health and emotional well-being” ; “improving parent-child relationships, parental sensitivity, and parenting confidence” ; and “facilitating a child-led play space which allowed for children to express themselves and be heard”.
The intervention lasted 10 months and 7 dyads mother-child participated. Only 6 families’ data are used. One family attended only one session and stopped after because the group therapy provoked too much anxiety. Children are 18 months to 3 years old. 50 % of the mothers reported to live with the father. No fathers were found in the dyads because they worked and can’t come to the PTG. This is commonly found in the litterature by the authors: fathers aren’t really present in these interventions and mothers are highly represented. The intervention is organised as follows : 55 minutes of a child-led art making, then a 10 minutes tidying and get cleaned up, and finally 10 minutes of reflective work on the art produced by children, with the mothers. The two therapists helped parents and children to express their emotions, feelings and to put words to the artwork of children. The clinician psychologist measured the parental mental health (using the Patient Health Questionnaire-9 (PHQ-9)), the generalized anxiety (using the Generalised Anxiety Disorder Assessment-7 (GAD-7)), the parenting stress (using the Parental Stress Index Short Form 4 (PSI), in which scores are measured using 4 scales: the parental distress, the parent-child interaction, the difficult child, and the total stress) and finally, the parent-child relationship, as well as the goals for each dyad. Each goal was rated from 0 to 10 (0 being no progress and 10 being an achievement of the goal). Some goals were as follows : “to communicate feelings more” ; “improving speech of my child to better prepare him/her for school” ; “to communicate better and build the relationship” ; “to become less anxious about paint and messy situations beyond my control”. The authors showed in this study that the art therapy group helped parents and children to improve these goals: the percentage of improvement ranged from 50 % to 300 %.
In order to evaluate the intervention, the authors gathered quantitative and qualitative datas. First, they argued that the mental health of mothers was improved during the group painting intervention. One example can be seen with the family 1, Esther and her daughter, Skye. The “Painting Together Group” provided them a space where they can relax and share a moment together. This was also the opportunity for the mother to talk to others about her post-natal-depression. The group gave them a reflective space for them to think about their experiences.
As for the parent-child relationship, the parental sensitivity and parental confidence, the results suggested that mothers improved their parental confidence. Moreover, the group intervention helped them, because they can discuss their problems with others mothers of the group and guide each other. Another example was Sarah and Peter. This mother had an experience of domestic violence and depression when Peter was a baby (he is 4 years old during the PTG). During the intervention, therapists could see that Peter had limited speech and was overly active. When he talked about his father, his mother froze and didn’t pay him any attention. Therapists and other mothers saw that Peter didn’t stay with his mother but would rather go with other people in the group. Generally, it looked like Sarah and Peter lacked communication and enjoyable time together. The group helped Sarah to imagine what Peter might feel, especially about his father, who he doesn’t have a lot of contact with. By doing this, Peter started to stay with his mother and they made art together. This shows that the group helped them to better interact and talk about their feelings. It was a great support for this dyad in order to help them develop their relationship and Peter had the opportunity to show his fears, desires and problems through the process of art making, which helped him communicate, especially because of his little speech.
Another example was Tom and Joanie: they seemed to have a lack of spontaneity and reciprocity in their relationship. This mother was in a lot of control mode, which slowly reduced as the group therapy went on. This case vignette also focused on how children can, through art making, express their feelings, fears and emotions.
In general, mothers reported an increase of positive changes in a lot of different areas for their children, such as language and speech, confidence, behavior and relationship with others. The art therapy group also helped children to develop their creativity.
The fact that interactions took place in a small group, with other children, helped them to develop prosocial behaviour. They inspired each other, worked together and also played together, which led to the learning of some social rules to live with others.
Authors evaluated the general effectiveness of the intervention. They emphasised that the “Painting Together Group” improved the parental mental health, as well as the children’s well-being. The families who attended the intervention enjoyed the sessions. They stated that the PTG had positive impacts on the goals they had focused on at the start of the therapeutic project. Some families did not show any change in some areas (for example, a mother didn’t show a reduced measure of anxiety score). Two arguments are proposed by the authors: a) the level of problem in this area was initially limited; b) some external events had an impact on this area. One interesting fact is that families with stressful and complex social environment showed less improvement in mental health, but rather had great results in terms of parent-child interaction and improvement of dyadic goals.
The authors collected the families’ opinion towards the “Painting Together Group”. They thought that it was a positive and great experience. One mother had a preconceived idea about art therapy intervention, and told the therapists that it may slow some person to participate in this kind of group. The authors concluded that promoting the intervention through families’ accounts about their experience could be a great way to allow more families to take part in the PTG.
Although a small number of families attending the group and results can not be generalised, this article provides a recent insight of an intervention to improve parent-child relationship, through an art therapy group. Because the intervention was based on the participation of two therapists, a clinical psychologist and an art therapist, it provided a collaborative work, which the authors concluded by saying that different clinical approaches should be used complementary and not separately. For example, this type of intervention gathers some developmental psychology concepts, such as attachment theory, theories of child development, but also systemic theory and neurosciences, which can all be taken together to better understand processes between parent-child interaction. The article also raises a question about the non-attendance of fathers: are the dyads always considered to be mother-child? And why can’t it be father-child dyads? This article puts in light the fact that this program should be replicated with father-child dyads, which can be a really good study theme, especially in the field of attachment theory with fathers.
To conclude, we can state that this article was really interesting. The fact that authors provided both quantitative and qualitative datas helped to better understand the changes in the relationship between parents and their child. The case vignette made the process of reading this article clear and interesting.
→ WORDS I LEARNED:
- CAMHS: un service de santé spécialisé pour les enfants et adolescents
- a child-led play: un jeu mené par les enfants ; les enfants sont libres de choisir les règles du jeu, ce qu’ils veulent faire
- to meliorate: améliorer
- to freeze: se figer
- an account: un témoignage
- non-attendance: absence