By CATHERINE SAINT LOUIS
February 10, 2017
WASHINGTON — For much of her childhood, RyAnn Watson has been hospitalized for excruciating flare-ups of sickle cell disease. Now 16, she takes refuge from her pain in an art studio at MedStar Georgetown University Hospital. On a recent Friday, she was sketching the sandstone towers of the Smithsonian castle with a burnt-red coloring pen, under the watch of her therapist, Tracy Councill.
“It’s more about putting my emotions into the artwork than telling someone about it and making myself upset,” RyAnn said. Without any “pressure to spill the beans,” she said, “I end up talking to Tracy about everything, once I’m drawing.”
Although art therapy is offered by a number of established medical centers, many Americans don’t know much about it. Art therapy is a form of psychotherapy where mental health professionals use art materials to help patients explore feelings that may not be easy to express in words.
Almost overnight, the field has attracted new attention because of a connection with the Trump administration. On Inauguration Day, Karen Pence, the second lady, announced on the newly revamped White House website that she wants to shine a “spotlight on the mental health profession of art therapy.” Mrs. Pence, a watercolorist herself, has been a board member of the art therapy program Tracy’s Kids since 2011, and helped raise funds to hire two full-time art therapists for patients at Riley Hospital for Children in her native Indiana.
“I want to get more people aware of art therapy, not only for children who are going through an illness, but adults as well who have gone through trauma,” Mrs. Pence said in a phone interview.
Such attention from the second lady of the United States normally would be a boon to any profession, but these are not normal times. Some art therapists were thrilled that Mrs. Pence chose their underappreciated occupation as her signature cause. The American Art Therapy Association announced in its newsletter that it was “enthusiastic about Mrs. Pence’s commitment” and eager to support her efforts.
“It’s a breath of fresh air that someone in such a position can highlight our profession and can bring attention that’s needed and well deserved,” said Irene David, a pioneer of the field and the longtime director of therapeutic arts at NYC Health and Hospitals/Bellevue in Manhattan.
But many art therapists held a different view. On social media, some art therapists argued that the policies supported by President Trump and Vice President Mike Pence, Mrs. Pence’s husband, are largely at odds with the group’s principles and hurt the very people the profession treats, such as immigrants and trauma survivors.
Kate Broitman, an art therapist in Chicago, started a Facebook page called Art Therapists for Human Rights to organize with other art therapists who “felt that great harm might come to our field, our clients and our work, if the association were to enter into a dialogue with Karen Pence.”
The group now has about 325 members.
“There is a real divisiveness right now between art therapists,” said Savneet Talwar, an associate professor of art therapy at the School of the Art Institute of Chicago, who also works with Bosnian refugees. One side is “for utilizing this opportunity to bring more visibility to art therapy,” she said. On the other side, Dr. Talwar said, people say “aligning yourself with her means you’re not being true to our ethical principles.”
Ms. Broitman said her clients in Chicago are worried they may lose their health insurance or be deported as a result of the policies supported by the vice president. “You can’t shine a spotlight on art therapy without being accountable to the real danger our clients currently face,” she said.
Asked to comment on the schism, Kara Brooks, the communications director for Mrs. Pence, said in an email that the second lady “has been a champion for art therapy for many years.”
“She has a true appreciation for all those who work in this mental health profession,” Ms. Brooks said. “Mrs. Pence’s efforts to bring awareness to art therapy over the years show that she really wants to make a positive difference.”
Some might argue that art therapy should welcome any national recognition. There are an estimated 5,500 registered art therapists nationwide compared to 106,000 psychologists. And 20 percent of art therapists are clustered in New York and New Jersey, meaning many patients around the country don’t have access to the treatment, according to the Art Therapy Credentials Board.
Most states don’t offer licenses to art therapists, meaning they can’t bill insurance. Often, private donors fund art therapists in states without licensure so they can work in schools, mental health clinics or hospitals.
The profession also receives support from the National Endowment for the Arts, an organization that may face additional cuts under the Trump administration. Funds from the NEA and the Department of Defense pay for a prominent program called Creative Forces, which offers art therapy to soldiers and veterans coping with post-traumatic stress disorder or traumatic brain injuries.
“We know how valuable it is, now it’s a matter of carrying out the studies to further the evidence of value,” said Dr. Sara Kass, a retired Navy captain who is trained as a family physician, who had planned to have the program at a dozen military sites by year’s end.
That said, Dr. Kass is concerned their funding will dry up. “I think we stand to lose a valuable tool,” she said.
Despite threats that members will quit, the leaders of the art therapy association still are open to working with the second lady. “If Mrs. Pence asks for and wants our support — which she hasn’t yet — of course, we are going to offer support and resources,” said Cynthia Woodruff, the executive director.
One of the biggest boons from Mrs. Pence’s support could be additional public and private funding for research. In a 2015 systematic review, the research arm of Britain’s National Health Service gave art therapy mixed results. It found that 10 out of 15 randomized trials show benefit to patients, but that overall, the quality of the research was low. The studies reviewed included adults and children with depression, cancer, sickle cell disease and post-traumatic stress disorder.
Dr. Anjan Chatterjee, the chairman of neurology at Pennsylvania Hospital, said he believes that art therapy may capitalize on what Alzheimer’s patients can still do, like drawing, so it can improve the sense of well-being. A few small trials suggest art therapy engages attention and improves neuropsychiatric symptoms, social behavior and self-esteem for Alzheimer’s patients, Dr. Chatterjee concluded in a 2014 review of existing evidence.
“The big problem with all of this is there’s no real, well-designed studies to show art therapy helps with people’s cognition or general well-being,” he said.
After Sonali Agrawal, of Washington, D.C., was given a diagnosis of leukemia at age 4 in 2012, she regularly went to Ms. Councill’s studio for years. As she had some of her chemotherapy infusions, she made a clay colander and a bird’s nest.
“Sonali made a lot of pieces of art in which she was caring for an animal and keeping an animal safe,” said Ms. Councill, founder of Tracy’s Kids, which has outposts in Washington, San Antonio, Baltimore and New York. “That had a lot to do with her wanting to feel safe.”
Sonali’s father, Dr. Manish Agrawal, an oncologist himself, thought it was “crazy to think she looked forward to coming to the hospital to get chemo.”
But she did. After watching his daughter’s treatment with art therapy, Dr. Agrawal said he felt the need to change how he practiced medicine. “We are so cut and dry,” he said of doctors, but “there’s a huge emotional toll. There’s real suffering.”
Dr. Agrawal conceded that he is not a Trump supporter, but Mrs. Pence’s support for art therapy, he said, “may be the silver lining.”