Using Art Therapy to Break Through Treatment Reluctance: An Interview with Naomi Tucker

To understand what makes art therapy so inviting to those who are reluctant to engage in treatment, one must first understand where that reluctance comes from. “A lot of the reasons that people are reluctant to engage in treatment are issues of trust,” Naomi tells me.

Perhaps in the past they have opened up and they have been criticized or judged or hurt when they allowed themselves to be vulnerable. It may also be that they have a history of treatment not working in the past and so they think, ‘Why should I bother to open up and allow myself to engage in this process?’

Although people with any diagnosis may have experiences that damaged their ability to trust, those with histories of trauma are often particularly (and understandably) unwilling to participate.

If someone has one traumatic experience and a wonderful foundation of relationships, it’s going to be much easier to engage in the process—but if he or she didn’t have a good foundation of relationships, and then on top of that have experienced trauma or some other difficulty, it’s going to be much more likely that he or she is reluctant to engage.

Recognizing and honoring the roots of reluctance allows Naomi to approach clients in a welcoming and nonjudgmental way. “This understanding allows a client’s reluctance to become part of the treatment in a safe and supported way, instead of becoming a conflict between client and therapist.”

Naomi believes that the open nature of art therapy makes it uniquely inviting for those clients who struggle with the therapeutic process. Rather than being expected to put thoughts and feelings into words and interact in a highly structured way, art therapy is free-flowing and easily adaptable to different kinds of participation. The level of interaction is determined by each person’s own needs and wants; those who do not wish to share with others are able to use art therapy as an introspective practice in which they can engage in a deeply personal process of creation without having to meet anyone else’s expectations or go beyond their comfort level.

If they come in and they are guarded and not wanting to share, they can simply participate in the process of creating an art piece, and then choose how much or how little to share with the group members and the therapist. What is so special about this is that they can have their own internal and personal process in the group setting, and it’s safe for them to do that—there isn’t an expectation that they have to move beyond that before they are ready to.

As a nonverbal form of healing, art therapy also opens up room for exploring and expressing oneself beyond spoken language. “For someone who is reluctant, art therapy can provide a space to begin to explore and look at his or her challenges, but not have to actually say them out loud,” Naomi tells me. “That is helpful because when people begin to explore or share their pain, they often don’t have words for it yet.” In fact, words themselves may be limiting and unable to truly capture the reality of someone’s experience. “There aren’t always words, and once you choose a word it takes you in a particular direction and understanding, and there may be other aspects of the experience that weren’t included in that word or language.” By operating outside of the boundaries of words, art provides the opportunity to deepen our understanding of ourselves and process our experiences without being confined to the limits of language.

The versatility and flexibility of art therapy allow Naomi to create therapeutic experiences that speak to the needs of each individual within the group. She believes that the therapy should give clients the ability to participate in a way that speaks to them—and that can look different for each person. This begins by framing art therapy directives—the instructions given to guide each art therapy session—as invitations.

I like to call them invitations, because I am inviting them to participate in a particular way, but if they are drawn to do something else in their own personal process, then I welcome that. One of the powerful things about art is that it can be approached and understood in many different ways.The art therapy process can be tailored to the client based on what he or she is needing in that moment; each client can have an individual, personal experience of art-making and then have a chance to process it with the group.

When given the ability to make choices about their own participation, people who are reluctant to engage in treatment often feel an increased sense of agency and control over their own therapeutic process, reducing feelings of trepidation and vulnerability. For those who struggle with trust issues, this can be a powerful experience that allows them to feel safe enough to engage.