The Couples' Closeness-Distance Scale- Observation through joint-drawing: A pilot dyadic validation study.

The study aimed to evaluate the Couples' Closeness-Distance Scale (CCDS), an observational assessment reflecting couples' relational dynamics; based on joint-drawing, it offers measurable dimensions. Forty cohabiting Israeli couples participated in the joint-drawing task and answered self-report questionnaires for attachment, differentiation of self, and relationship satisfaction. The paintings were assessed by trained observers on the CCDS scales (too distant, too close, autonomy, engagement) for both the women's and men's experiences. A two-level-dyadic model showed that differentiation and relationship satisfaction predicted the CCDS and revealed a "pursue-withdraw cycle": Women sensed the men as too distant, while men sensed the women as too close. Participants' sense of discomfort from their partners' distance related to less autonomy and engagement during the painting, with a greater effect on the women. The pilot implies that the CCDS enables observing dyadic-systemic aspects of couple dynamics and may enrich clinical evaluation.

Couple relationship experiences of siblings and siblings-in-law of persons with intellectual disabilities.

BACKGROUND: This study examined how siblings and siblings-in-law of persons with intellectual disabilities experience the establishment of and processes within the couple relationship. METHOD: In-depth semi-structured interviews with 12 siblings and 12 siblings-in-law of persons with intellectual disabilities were analysed using thematic analysis. RESULTS: The participants did not perceive their special siblinghood as detrimental to their couple relationships. Siblings-in-law's prior acquaintance with persons with disabilities and professional support provided to the family of origin emerged as contributing factors. The effect of the siblinghood on the couple relationship was both positive and negative. CONCLUSIONS: The findings support the importance of the acceptance of others who are different, including in couple relationships when a sibling or sibling-in-law has intellectual disabilities, and underscore the role of professional therapists.

The Meaning of a Group Facilitation Training to Creative Arts Therapists Working in the Public Education System.

Many creative arts therapists who provide group therapy to children and adolescents in the Israeli education system do not feel they were sufficiently trained as group facilitators. Group facilitation training was provided over the course of two consecutive years by a regional support center to over 40 creative arts therapists and their clinical supervisors working in the Israel Ministry of Education. A two-stage qualitative research project examined the participants' experiences during this training. Interviews were conducted regarding the therapists' first-year experiences. A questionnaire was administered at the end of the second year. Both were analyzed according to the Consensual Qualitative Research method. The research findings pertain to the participants' perceptions of group arts therapy in the Israeli education system and included the development of unique group models, the advantages and power of group therapy at school, and the intimidating and disruptive experiences of school settings. The participants also provided their impressions of the training course: their growing confidence and skills, and the many changes required in group arts therapy at public schools to provide more professional and efficient service. The discussion centers on the value of group arts therapy in the education system and the steps needed to enhance therapists' confidence and efficiency in this field.

Ultra-Orthodox Parents' Perceptions of Arts Therapies for Their Children.

Studies have underscored the complexity of psychotherapy for Ultra-Orthodox Jews, and cross-cultural therapy in particular, which evokes fear of disruption of basic values. Parents' sense of responsibility for their child's religious education exacerbates these problems in child therapy. However, there is scant research on child therapy for the Ultra-Orthodox, especially in the field of arts therapies. The present study examined the perceptions of 17 Ultra-Orthodox parents whose children were receiving arts therapies (including art therapy, dance/movement therapy, music therapy, psychodrama and bibliotherapy). Semi-structured interviews were conducted with the parents and analyzed based on the principles of Consensual Qualitative Research. The study covered five domains: (1) The parents' experiences in therapy; (2) The parents' perceptions of the child's experiences in therapy; (3) Implications of environmental-social factors on the parents' perceptions and experiences of therapy; (4) Effects of intercultural aspects on therapy; (5) Perceptions of the use of the arts in therapy. The findings show that the experiences of ultra-Orthodox parents in the arts therapies of their children is complex due to the influence of the socio-cultural context, which involves dealing with stigma and tensions in their relationship with the education system. This context also shapes their perceptions of therapy, which can be characterized as purpose-oriented. The findings also highlight the parents' challenges in coping with the intercultural therapeutic relationship, and emphasizes the parents' preference for a therapist from a similar religious/cultural background and for cultural supervision of therapy. However, the results also suggest that there are benefits inherent to intercultural therapy in general and arts therapies in particular, including a sense of security, openness and acceptance of the parents and children.

Artmaking in Elementary School Art Therapy: Associations with Pre-Treatment Behavioral Problems and Therapy Outcomes.

Engaging in artmaking is one of the key components of art therapy. Theoretical conceptualizations posit that artmaking is not only influenced by the mental state of the artmaker, but can also modify it. The quantitative longitudinal study reported here examined these assumptions in the context of school art therapy. Seventy-seven elementary school students in art therapy in Israel completed the Art Based Intervention Questionnaire (ABI) three times during the therapy year. Their parents and homeroom teachers reported on the students' behavioral and emotional problems on the Child Behavior Checklist (CBCL for parents, and TRF version for teachers). The results indicated an inverse correlation between the students' externalizing and mixed problems before starting treatment and these clients' experiences of artmaking during the first month of therapy. A regression model for predicting gain scores on the TRF internalizing problem indices was significant, whereas the significant regression predictor was the students' experience of artmaking at T1. These findings provide initial support for an association between the experience of artmaking and mental state, and an improvement in mental state, and are discussed in relation to the context of school art therapy.

Relationships Between the Therapeutic Alliance and Reactions to Artistic Experience With Art Materials in an Art Therapy Simulation.

In art therapy, art-making plays an important role in the therapeutic relationship. To better understand the triangular relationship between the art therapist, the client and the artwork, this study investigated the association between the therapeutic alliance and reactions to artistic experiences with art materials in an art therapy simulation. The simulation consisted of a series of 6-8 sessions in which art therapy students were divided into teams composed of a permanent observer (art therapist) and creator (client). The client's role was to self-explore through art- making, and the art therapist's role was to accompany the client. Thirty-four students, all women, who played the art therapist role, and 37 students (one male) who played the client participated in the study. Of these participants, there were 24 pairs where both participants filled out all the questionnaires. A short version of the Working Alliance Inventory (WAI) was completed by the clients and the art therapists on the second session (T1) and on the penultimate session (T2). The clients also completed the Art-Based Intervention Questionnaire (ABI) at T2. Significant positive correlations were found between indices of the WAI for the art therapist and the client and the clients' reactions to the artistic experience with art materials on the ABI. The evaluation of the emotional bond between the art therapist and the client at the start of the simulation significantly predicted the client's reactions to the artistic experience with art materials at the end of the simulation and explained 45.4% of the variance for this variable. These findings highlight factors related to the development and influence of the therapeutic alliance, as well as the role of the artistic experience in art therapy and lay the groundwork for further research.

Non-Haredi Arts Therapists' Perceptions of Therapy With Ultra-Orthodox Children.

Studies have underscored the complexity of the encounter between ultra-Orthodox (Haredi) society and psychotherapy, as well as the challenges involved in developing a therapeutic relationship in cross-cultural therapy. However, there is scant research on therapy for ultra-Orthodox children, especially when it comes to arts therapies that take place in a cross-cultural setting. The current study examined the perceptions of 17 arts therapists (including visual art therapists, dance/movement therapists, psychodramatists, music therapists and bibliotherapists) who are not ultra-Orthodox, and who currently work or have previously worked with ultra-Orthodox children. Semi-structured interviews were conducted with the therapists and analyzed using the principles of Consensual Qualitative Research. The study covered four domains: (1) perceptions of the significance and objectives of arts therapy with ultra-Orthodox children; (2) the influence of the cultural difference between therapist and client on the emotional experience and the therapeutic relationship; (3) the use of arts in therapy; (4) systemic aspects. The findings indicate significant perceptual and value-based disparities between therapists and clients, which pose difficulties and challenges to all participating parties and require therapists to be highly sensitive. Aside from the difficulties, the findings suggest that this cultural difference may also have certain advantages for clients as well as therapists. The findings likewise attest to the multifaceted process of change that is taking place within Haredi society in its attitude toward psychotherapy in general and arts therapy in particular.

Friends' Closeness and Intimacy From Adolescence to Adulthood: Art Captures Implicit Relational Representations in Joint Drawing: A Longitudinal Study.

This longitudinal study, employing a mixed-methods explanatory design, explored the power of art to express aspects of one's inner world using the joint drawing technique, which allows for observation and treatment of implicit representations of relationships. At Time 1 (T1, 1977-1978), 200 adolescents created a joint drawing with either a good friend or with a classmate who was not a friend and filled out the Intimate Friendship Scale (IFS) in relation to their best friend. In 2014 (T2), 36 women and 21 men from the original cohort completed the IFS with regard to a good friend and with regard to their spouse. The drawings were analyzed qualitatively to define pictorial phenomena that may be indicative of closeness. The analysis was conducted in accordance with the phenomenological approach to art therapy and with the principles of thematic analysis. Fourteen pictorial phenomena were defined, and a scale was constructed to quantitatively evaluate the extent to which each phenomenon was present in the joint drawing. This yielded a closeness score for each drawing. Quantitatively, no correlations were found between intimacy as measured by IFS at T1 and at T2. In contrast, there was a correlation between the degree of closeness in the joint drawing at T1, and the IFS score with the partner in T2, suggesting continuity over the 36-year time span. This correlation was likewise found when examined separately among participants who drew with a friend. The multivariate ANOVA (MANOVA) results showed a marginally significant effect for the interaction between closeness in drawing and drawing with a friend/non-friend - on IFS. An ANOVA showed that the IFS regarding the participant's best friend and their romantic partner at T2 was higher when the closeness in the drawing at T1 was higher. There was also a significant interaction between closeness in the drawings and the participant's IFS score regarding their best friend at T1. The differences between the joint drawing with the close friend and the non-friend are discussed. These findings, from a span of over 36 years, thus contribute to the validity of the IFS and the joint drawing technique when assessing closeness and intimacy.

Perceptions of Art Therapy in Adolescent Clients Treated Within the School System.

Research in School-Based Art Therapy has been widely discussed in recent years, and the number of studies that examine staff perceptions and the special characteristics of art therapy within the education system has risen considerably. The current study explored the critical issue of adolescent clients' perceptions of art therapy in school, from their point of view as clients. The methodology and data analysis were conducted according to the principles of Consensual Qualitative Research (CQR). The sample was composed of 12 adolescent clients, aged 14-18 (M = 16), who took part in in-depth semi-structured interviews. The findings were organized into five domains that emerged from the interviews: referrals and initial engagement with therapy, the setting within school, the nature of art therapy at school, the relationship with the art therapist, and the impact of art therapy on these clients. The analysis revealed that although some participants initially agreed to art therapy because it got them out of class and let them have fun instead, they realized after a period of time of art therapy that they were engaged in a personal and emotional process focusing on them which allowed them to express their feelings without the fear of judgment. Participants at times used the word "mother" to describe their relationship with the art therapist, and stated that the presence of the art therapist at school made them feel safer and helped them deal with day-to-day problems. School-based art therapy was seen as having specific advantages according to the participants. Having a therapeutic hour during a stressful school day was considered to give these students an opportunity to relax, and the art therapy room was perceived as a shelter. In addition, when the therapist was perceived as a supportive figure, the whole school experience tended to be perceived as supportive or enabling greater acceptance.

In-session behaviours and adolescents' self-concept and loneliness: A psychodrama process-outcome study.

As adolescents spend many hours a day in school, it is crucial to examine the ways in which therapeutic practices in schools promote their well-being. This longitudinal pilot study examined the contribution of school-based psychodrama group therapy to the self-concept dimensions and perceived loneliness of 40 Israeli adolescents (aged 13-16, 60% boys) in public middle schools. From a process-outcome perspective, we also examined the understudied trajectory of adolescents' in-session behaviours (process variables) and its associations with changes in their self-concepts and loneliness (outcome variables). Psychodrama participants reported increases in global, social, and behavioural self-concepts and a decrease in loneliness compared to the control group. In-session productive behaviours increased and resistance decreased throughout the therapy, but varied process-outcome relationships were found. The study suggests that conducting further research into the process-outcome relationships in psychodrama group therapy is warranted to pinpoint specific mechanisms of change. Suggestions for future studies are provided.