When we generally think of art therapy, its use with some of the most dangerous people in society does not naturally come to mind. Inmates are a unique cohort living in an unnatural environment. Cognitive or behavioral problems may have contributed to a person's incarceration, and being confined to a single facility for potentially long periods poses rehabilitation challenges. Say no to plagiarism. Get a tailor-made essay on “Why Violent Video Games Should Not Be Banned”? Get an original essay This literature review will examine five studies done over the past 10 years or so in chronological order, ranging from reducing depression in prisoners to the application of art. therapy for difficult cases involving schizophrenia. It will conclude by highlighting some potential gaps arising from the studies; although the overall results are promising with the implementation of the use of art therapy in prison settings. Pearson and Wilson (2009) attest that art therapy provides a mechanism to express and communicate personal experiences from deep within the human soul. Not only does it allow for the expression of nonverbal thought, but the act of creating in a therapeutic space is a time to focus energetic impulses, process personal behaviors, and seek a unified emotional and mental state (pp. 169- 170). Nowhere does this seem more necessary than in a population that is sometimes forgotten by the general public; that of prisoners in prison. The history of the use of art therapy in prisons dates back to the work of Levy (1978) in her work with female prisoners displaying aggressive behavior. Levy discovered the use of art therapy as a nonverbal therapeutic technique that yielded “untapped material” (p. 157) that may have explained the source of the inmate's aggressive behavior. In prison settings, the benefits of art therapy continue thanks to ongoing studies led by David Gussak. Gussak's (2007) study examined the effectiveness of art therapy in reducing depression in prison populations. In an environment where clients may have an inherent distrust of verbal disclosure and rigid defenses for basic survival (p. 444), art therapy has been considered an alternative route to developing feeling essential trust and security necessary for the development of the therapeutic alliance. (Pearson and Wilson, 2009, p. 170). The study was conducted among male inmates at a medium- to maximum-security North Florida prison, selected by the mental health counselor. All participants had an Axis I diagnosis such as depression, despondency, or manic-type bipolar disorder. Gussak used the Formal Elements Art Therapy Scale (FEATS); the Beck Depression Inventory-Short Form (BDI-II) (Beck, Rial and Rickets, 1974, cited in Gussak, 2007, p. 454); and a personally developed 6-point Likert-type survey once before the intervention and once after. Art tasks started with simple individual exercises, such as embellishing a name and a personal symbol activity, to more complex group work, such as collaborating to build a paper bridge and group work on the mandala. These were used in conjunction with an art directive, which involved each inmate drawing a picture of a person picking an apple from a tree (PPAT) using standardized art materials, to check for any changes therapeutic (Gussak, 2007, p. 444-448). ).Gussak (2007) found that PPAT drawingspost-test reflected increased space used, significantly greater detail, and higher compositional integration; thus reflected a greater awareness of their environment. Results also showed that participating inmates showed greater investment in the therapeutic process, greater compliance with guidelines with staff, increased socialization skills, and a significant decrease in depressive symptoms with elevation in mood ( pp. 449-456). The results of this study were promising in a particularly challenging environment. A year later, Michael Hanes took the art-therapeutic modality even further by working with the most at-risk inmates; those on suicide watch. Hanes (2008) applied his art therapy modality in a US county jail where clinicians, with limited availability of resources, were tasked with assessing an inmate's suicide risk based solely on self-assessment of one's internal mental state and behavioral patterns. and the history of life. The use of road drawings was implemented due to their ease of use with limited safe materials to reduce potential safety risks; a 2B pencil (shortened to 3 inches), 8 colored pencils and paper (pp. 78-80). Hanes (2008) theorized that the use of a drawing of a road, which he believed to be a universally understood symbol, can function as a metaphor like the inmate's "path of life" (p. 79); thereby producing vital information that the inmate may be reluctant to disclose in a standard verbal therapeutic setting (p. 83). Hanes found that inmates were able to reflect on their road drawings as a way to self-assess their capacity for change, transform destructive patterns of thought and action, and imbue hope and optimism for their future (p. 83). This “process drawing,” described in Pearson and Wilson (2009), supports ventilation and catharsis by using colors, lines, and shapes to express and release internal feelings (pp. 181–182). This is a projective technique that allows you to focus on restorative methods instead of starting with a problem-centered approach. This gives inmates the opportunity to create their story and express their unique perception of reality, rather than focusing on established literal facts (p. 172) that can be presented in their story. Since depression has been found to be the main predictor of suicide among inmates (Suto and Arnaut, 2010, pp. 294-295, 302-304), a study was conducted to further investigate this issue. Gussak (2009b) revisited his 2007 study with the inclusion of female prisoners, in order to advance his previous research base. He simultaneously hypothesized that art therapy would help improve the inmate's mood, socialization skills, problem-solving skills, and locus of control (LOC) (p. 6). As LOC is the degree of control an individual believes they have over their environment, with external LOC indicating a tendency to believe that external influences control one's behavior and internal LOC indicating that one is in control of one's destiny (Bayse, Allgood, and van Wyk, 1992); Gussak (2009b) believes that prisoners may tend to present a greater level of external risk. This correlates with his findings that there is a direct relationship between LOC and depression; the higher the external COL, the greater the risk of experiencing depressive symptoms (p. 6). Gussak (2009b) followed a similar format to therapy sessions in his 2007 study; starting with a simple piece of artindividual that progressed to group-oriented art work, thereby facilitating problem-solving skills. The addition of the Nowicki-Strickland Adult Locus of Control Scale (ANSLOC) was used to assess interpersonal and motivational domains for change in level of control. This was done using a simple yes and no questionnaire (pp. 6-7). The results were a significant change in inmates' ANSLOC scores from external to internal. Gussak (2009b) concluded that through art therapy, inmates learned to manipulate art materials to achieve the desired effect and learned cause and effect through this creative therapeutic process; this knowledge was then internalized (p. 10). Gussak (2009a) re-examined her results and found substantial improvement in mood and internal awareness levels among female prison participants compared to male participants. As it has been shown that female prisoners are potentially more susceptible to depression (Harris, 1993), experience more difficulties with depression (Butterfield, 2003), and display higher levels of external risk (DeWolfe, Jackson, & Winterberger, 1988). );Gussak (2009a) concluded that her results supported the idea that female prisoners who engaged in art therapy had greater room for change (pp. 202-207). Until now, art therapy had demonstrated flexibility in working with both male and female prisoners. The study of its adaptability with another therapeutic modality was carried out. Breiner, Tuomisto, Bouyea, Gussak, and Aufderheide (2012) used art therapy as part of cognitive behavioral therapy (CBT) at Wakulla Correctional Institution in Florida. It targeted anger management at inmates who had a history of anger problems or interpersonal violence. The basic assumptions of CBT are that problematic thinking leads to problematic emotional and behavioral consequences, and that problematic thinking is either learned or results from a lack of learning. The goal of CBT is to identify these thinking errors and help the client correct them by learning the cognitive skills necessary to help eliminate problem behaviors (pp. 1125-1127). Breiner et al's (2012) reasoning for incorporating art therapy was to tailor treatment to the unique characteristics of each inmate which they believed were beyond the scope of standard CBT tools. The flexibility and variability of art therapy allowed them to undertake treatment with clients demonstrating a varied level of verbal and intellectual ability (pp. 1139-1140). This was achieved through an art therapy directive known as the “water contamination exercise.” A 3 part drawing depicting water contaminated by 3 different sources and the effect this has on the water produced at the end of an irrigation system. It was designed to help inmates understand how underlying attitudes can generate the thoughts that may arise in response to a trigger (pp. 1135-1136). For inmates, it was a simple pictorial way to understand cognitive restructuring using the ABCD model of CBT developed by Albert Ellis (Ellis, 2006). Breiner et al (2012) found that art therapy engaged inmates more in the therapeutic process by helping the group. members to access emotions that may be difficult or embarrassing to express. This helped calm inmates who showed signs of nervousness or distress about being in this particular group. They found that the art therapy tasks complemented the CBT material, making it easier to &. 170-171, 190).