Art Therapy a form of psychotherapy? Since the middle of the twentieth century, artistic expression and creation have been seen as valuable assets in the context of therapy and rehabilitation. The impact that art therapy has had on the field of psychology is undeniable, and its influence has contributed to the development of various diagnostic tools and interventions used in psychotherapy. The practice of art therapy involves the process of image making and its resulting products, as well as the relationship dynamic between the client and the therapist in relation to the image and/or each other (Edwards, 2004). Specific definitions of the term 'art therapy' are conflicting and numerous (Edwards, 2004). Currently, the British Association of Art Therapists perceives art therapy as process of practitioners enabling psychological and emotional growth and change in clients through artistic creation, and the relationship between the client and the therapist is viewed as integral to the therapeutic success of art therapy (Karkou & Sanderson, 2006). Several debates exist with the art therapy profession regarding its own identity (Karkou & Sanderson, 2006). In particular there is some disagreement among art therapists in regard to whether art therapy is a form of psychotherapy. The following discussion explores this conflict through an examination of the theoretical contributions of a few prominent figures in the field of art therapy.

There is concern surrounding where art therapy fits in as a therapeutic modality, and whether it could be considered a form of psychotherapy. Misconception exists among many art therapists that the origins of art therapy exist solely in the domain of psychoanalysis. The term 'art therapy' was actually coined in 1942 by Adrian Hill, an artist, who pioneered the use of art as a therapeutic modality (Hogan, 2001). Hill was a landscape and impressionistic painter and taught life and anatomy drawing classes at Westminster School of Art until he became ill with tuberculosis in 1938. While he was in a sanitorium being rehabilitated for tuberculosis, Hill became interested in the use of art as therapy. He observed improved his own psychological, physical, and emotional healing as a result of creating art, and became a proponent for this process, influencing other patients to draw and paint as part of their treatments (Hogan, 2001). Hill purported that art therapy acted as a stimulus that could potentially counteract physical and mental atrophy that was experienced as a result of long-term convalescence (Hogan, 2001).

In regards to his conception of art in the context of rehabilitation, Hill believed strongly in the therapeutic application of art, and promoted the idea of art as therapy rather than art in therapy (Hogan, 2001). Although reluctant, Hill used the word 'therapy' when he created the term art therapy with the intention of gaining support from the medical profession for the use of art as a therapeutic intervention (Hogan, 2001). He felt that the word 'therapy' in this context sounded "quackish," but somewhat necessary for bringing on board the medical profession, whose support would bring increased validity to the emerging field of art therapy (Hogan, 2001).

Hill's beliefs surrounding the therapeutic contributions of art therapy indicate that he considered it to be a form of psychotherapy. Art therapy was considered by Hill to hold more therapeutic value than merely a diversional occupation, and that it held great diagnostic value in determining the source of psychological issues and disorders (Hogan, 2001). The role of the therapist, according to Hill, was to provide the client with the opportunity to illuminate buried mental conflict. This unconscious mental strife is then transmuted through the process of artistic creation resulting in the end product of a drawing or painting, which further resulted in the cathartic release of unconscious negative emotions and thoughts (Hogan, 2001). Hill even suggested that art therapy could make the difference between life and death for some patients, as it had the power to promote an exuberant enthusiasm for life even in some of the most depressed patients (Hogan, 2001).

Overall, Hill was firmly interested in the therapeutic effects that art therapy had on the physical and psychological well-being of patients, and he worked tirelessly towards widespread recognition of art therapy as a psychotherapeutic modality. Hill was in disagreement with attempts to align art therapy with the field of education in the 1960s, as he believed that art therapy yielded benefits that were more rehabilitative and therapeutic in nature (Hogan, 2001). In 1948, The National Association for Prevention of Tuberculosis issued a statement that attested to the validity of Hill's work in art therapy. This report outlined...

Art therapy as practiced by Hill was seen as a way to delve deep into the human subconscious, to places where medicines and x-rays cannot reach (Hogan, 2001). This further gave credit to Hill's promotion of art therapy as an effective therapeutic modality.
Another early proponent of art therapy was Dr., Irene Champernowne, who in 1942 set up an experimental center for psychotherapy through the arts in Devon called the Withymead (Waller, 1991). This therapeutic center had considerable influence on the development of art therapy in Britain, as it was the first reported community where psychotherapy was combined with art therapy (Waller, 1991). Champernowne was heavily influenced by Jung in her early contribution to art therapy (Case & Dalley, 1992). Unlike Hill, Champernowne conceptualized art therapy as a modality separate and different from psychotherapy (Waller, 1991). Champernowne saw a clear distinction between the role of an art therapist and the role of a psychotherapist (Killick & Schaverien, 1997). The role of the art therapist was defined specifically as a facilitator for the creation of artworks by clients, while the psychotherapist would explore the deeper, hidden meanings behind the pictures created by clients (Waller, 1991). According to Champernowne, the role of an art therapist could be defined as a "mid-wife" in the therapeutic process (Waller, 1991). Although she had experience in image-making, Champernowne stood firmly in her role as a psychotherapist, and art therapy was considered as an adjunct to psychotherapy (Waller, 1991; Case & Dalley, 1992). This, however, did not diminish Champernowne's belief in the value of art in the therapeutic process, as she promoted the idea that words alone were not the most optimal medium for the expression of deep life experiences, and that created images may be more effective in many therapeutic situations (Waller, 1991).

Art is a powerful medium since it is a means for expressing and communicating strong emotions (Waller, 1991). Champernowne believed art therapists should be highly skilled at their own art in order to effectively process the expressive communicative and expressive possibilities provided by art created by clients (Waller, 1991). Due to the intense an overwhelming images clients may produce through their art, psychotherapy was considered to be crucial for the support of art therapy (Case & Dalley, 1992). Champernowne summed up this relationship between the work of art therapy and that of psychotherapy as an 'uneasy partnership' (Case & Dalley, 1992).

Hill and Champernowne each held differing views regarding the place art therapy holds in the domain of psychotherapy. Hill saw the process of creating art and its end product as psychotherapy in and of itself, while Champernowne maintained a clear distinction between the therapeutic roles of art therapists and those of psychotherapists. Somewhat of a compromise can be found in the ideas of Schaverien, a Jungian analyst and who suggested different types of art therapy, not all of which could be classified as psychotherapy (Karkou & Sanderson, 2006). Schaverien, who began her career as an artist and later became an art therapist, emphasizes the importance of art, art theory, and art history in the understanding of art therapy in its relationship to psychotherapy (Schaverien, 1993).

According to Schaverien, there are three types of practice in the field of art therapy (Karkou & Sanderson, 2006). The first type of practice is simply termed 'art therapy', and it is characterized by a strong emphasis on the relationship between the client and the image created by them, and the relationship between the therapist and the image created by the client. This approach is primarily art-based, with the relationship between the client and the therapist given less significance. The second type of art therapy suggested by Schaverien is art psychotherapy, in which there is an increased emphasis on the relationship between the client and the therapist rather than the relationships between these two individuals and the image created by the client. This second approach is considered to be primarily based in psychotherapy, as the client-therapist relationship is seen as the most important aspect to the therapeutic process. The third and final type of art therapy suggested by Schaverien is analytical art psychotherapy. This is a more dynamic approach that where all the relationships involved in the therapeutic situation between the client, the therapist, and the created image are…