'It's about the process': Art therapy provides creative outlet as mental health care

This article is part of the Mental Health Collaborative, a project completed by nine North Carolina college newsrooms to cover mental health issues in their communities. To read more stories about mental health, explore the interactive project developed specifically for this collaborative.

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When hospice employee and registered art therapist Anna Hicken asks her patients to paint something that represents their grief, she sees a variety of different images — a flower, a house, a landscape and even the weather. 

Hicken's work focuses on how trauma, specifically grief and loss, can be accessed through these metaphors.

Art therapy encourages self-expression through a variety of forms including painting, poetry, dancing and acting. Hicken said these activities allow her clients to slow down and connect with their senses in the moment.

“Doing something that's very present-oriented and grounding is soothing to the nervous system,” she said. 

Hicken said art therapy is often dismissed because people think they must be artists in order to benefit from it.

In contrast, it is not about the art created, she said, but about using creation to gain insight about experiences. 

“It's not about it looking beautiful or having something that you want to display on the wall or something that you're feeling like 'Oh, I need to frame this,'” Hicken said.  "It's about the process."

Co-founder of Triangle Art Therapy and UNC alumna Eva Miller said that art therapy is not about skill or judgment.

“The focus is different than an art class because we're really interested in the process and what's coming up while creating,” Miller said. “I don't interpret my client's artwork — they get to make meaning of what they're creating.”

People of all ages and in all settings — such as prisons, schools and hospitals — can benefit from art therapy, she said. 

Hicken has seen art therapy be particularly successful for those who have a hard time expressing themselves verbally.

“I feel like art is for everyone," she said.  "And it's so healing and it's such a healthy way to express yourself, to calm yourself down. It’s such a healthy distraction when we have so many distractions that are not healthy."

Anji K. has been a part of the Arts and Peer Support Group — currently facilitated by UNC School of Social Work professor Laurie Selz-Campbell — since 2014. The group meets virtually each week and members check in with one another to discuss or share their art. 

Anji K. said the check-ins are the most important part for her.

“It just helps because it can be hard to have that kind of support, or being in a group of people that really understand that level of psychiatric care,” she said. 

Her artistic contributions are through written and spoken word, like fictional short stories and speeches. She wrote an essay for the group’s self-published book “Out of Line: Fearless Reflection, Fearless Expression” using a butterfly as a metaphor for change.

Music therapy also offers alternative solutions for people with difficulty communicating emotions verbally. It is an applied health care profession that uses music for clinical goals, board-certified music therapist Hailey McCulloch said. 

The Certification Board for Music Therapists, which certified McCulloch, provides a list of board-certified music therapists on its website.

Before establishing her private practice located in north Raleigh, Fiddlehead Music, McCulloch was the music therapist at Triangle Disability & Autism Services and also has experience with contracting at medical facilities. The nonprofit organization serves children, teenagers and adults with intellectual or developmental disabilities and autism.

Her sessions aimed to meet the clients’ goals, such as improving emotional regulation or sustained attention, through songwriting and other musical applications using their preferred music.

In the past, she said she helped coordinate a child's fine motor skills by moving their hand across a guitar or increasing sensory awareness when they hear their name in a song. 

Her adult sessions at Triangle Disability & Autism Services focused on emotional expression, communication and speech. Clients performed exercises such as singing song lyrics that included a consonant sound they struggled to vocalize — which helps coordinate the muscles needed for speech.

McCulloch said music therapy is for anyone who wants to improve their health and well-being.  

“I just definitely want people to know that it is a great treatment option out there,” she said. “It is evidence-based; there is more and more research being done all the time.” 

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