Case Study: Using Art Therapy for a Client with PTSD

Art Therapy can be useful for individuals who have experienced a traumatic event and are experiencing ongoing stress. Activities can facilitate memory reconstruction as well as aid in self-regulating sensory experiences. Art Therapy also provides a relief from verbal communication demands and allows the individual to explore self-expression through visual communication.

Stress-related disorder is a general term, however, the DSM-5 details various subtypes:

TRAUMA & STRESS-RELATED DISORDERS (subtypes)

• Reactive Attachment Disorder
• Disinhibited Social Engagement Disorder
• Posttraumatic Stress Disorder (PTSD)
• Acute Stress Disorder
• Other Specified Trauma/Stress-Related Disorder
• Unspecified Trauma/Stress-Related Disorder

The most common experiences with stress-related disorders are acute stress disorder and Posttraumatic Stress Disorder (PTSD). You can read our previous case study focusing on acute stress disorder here and read this post for more details on PTSD.

PTSD (posttraumatic stress disorder):

PTSD occurs after a stressful event that is threatening in nature. The feelings of distress are pervasive and extend beyond the typical 4 week period that occurs with acute distress. For that reason, a diagnosis of PTSD is typically not given until after a month.

Stress events can include natural disasters, war, serious accidents, situations involving violence and abuse or witnessing these violent situations.

Typical symptoms of PTSD include:

• Flashbacks
• Emotional distress
• Emotional numbness
• Detachment from everyday life
• Hyperarousal and hypervigilance

PTSD is treatable and success has been documented around the benefits of art therapy with combat veterans

Research has found that art therapy can improve the way in which individuals process the trauma through recall and accessing emotions.

You can read an excellent case study of using art therapy with an active duty military service member with symptoms of chronic PTSD and mild TBI (traumatic brain injury) below.

Art therapy for PTSD and TBI: A senior active duty military service member’s therapeutic journey 

HELPFUL CONTACTS:

• Beyond Blue
• Sane Australia
• Phoenix Australia
• PTSD Alliance
• International Society for Traumatic Stress Studies

• Name: Kate
• Age: 22
• Summary of sessions to date: Kate began art therapy a month ago after receiving a diagnosis of PTSD related to sexual abuse she experienced as a younger child by 3 male relatives. Kate has attended 3 sessions to date where the abuse was discussed along with her symptoms of PTSD.

Kate came to therapy today highly anxious and agitated. She explained that she received a promotion in her job where she is required to teach new employees procedures on how to use safety equipment. The thought of addressing her first group of students in 3 weeks has created an enormous amount of stress for Kate and she feels like she won’t be able to do the task. She likes teaching new employees individually, however, the group dynamic is creating stress.

Once Kate starts to think about the task and the stress it is creating she starts feeling powerless and under attack. Kate has felt stress in learning new parts of her job before, however, this task makes her feel overwhelmed and unable to cope. She now wants to ask her boss to assign the group presentation task to someone else.

Kate and her art therapist discussed exploring the parts of the group presentation that represented the most stressful for Kate. Breaking the task down into elements may give Kate an insight into a specific trigger behind her fear.

This art therapy exercise can help your client explore a situation that is triggering a conditioned response of avoidance and arousal.

INSTRUCTIONS:

• Discuss with your client the type of art supplies they may like to work with in this session.
• Ask your client to engage in some deep breathing if necessary to help alleviate any current feelings of anxiety and fear. Your client should feel safe and secure in this environment to explore and discuss their feelings.
• Ask your client to reflect on the situation that is currently triggering a fear response.
• Discuss with your client the individual stages of the situation and the elements of the situation including the location and people involved. These elements may represent a direct threat or memory of a threat to your client. Your client can do this in discussion with you or using art materials to create artwork.
• As your client walks through the situation in stages, ask them to be mindful of their physical reactions to each stage. A strong physical reaction at a certain stage or when thinking of specific elements of the situation may indicate a link to the strong fear response.

Kate discussed with her art therapist the individual elements of the group presentation and noted the following elements:

• Public speaking
• Knowledge of the topic
• Location of giving the presentation at work
• Being interesting
• Having the appropriate resources
• Being in front of people

Kate looked over her list and felt anxious when considering that she was in front of people. She decided to explore that element more in her artwork. Kate felt threatened by the group. Kate also felt this reaction to a group was a common theme in her traumatic experiences.

In her experience of abuse, she was physically assaulted by a group (3 relatives). When she went to court about her abuse, her experience in front of the group of people in the court was traumatic and she felt she received little support from family, friends or professionals.

In Kate’s experience being in the presence of a group was traumatic.

This case study represents a snapshot of the client’s progress in treatment. The exercise in this article could be used as written or as a guide for new and original tasks developed by the Art Therapist. Responsibility for treatment resides with the individual therapist who understands their clients specific needs. The art therapy exercise should not be viewed as a pre-defined directive on how to treat a client that presents with a specific range of problems.This art therapy exercise will help build a database of knowledge to draw upon when helping your client. Art Therapy is associated with psychotherapy techniques, however each therapist often approaches therapy with their own foundation of psychological interventions, whether it be psychotherapy, CBT, DBT or other methods.