Bringing Into Presence: Client Experiences of SpeakArt, a Group Therapy for Complex Trauma

This qualitative study explored the experiences of women who completed an art therapy group for the treatment of difficulties related to complex trauma. Increasingly, treatments that address problems with self-organization (emotion regulation, self-concept, and relationship difficulties), in addition to classic symptoms of post-traumatic stress disorder, are recommended for individuals with complex trauma histories (e.g., Courtois & Ford, 2016). To date, evidence for the effectiveness of art therapy for complex trauma is limited but promising (e.g., Gantt & Tinnin, 2007; Pifalo, 2006), and process studies are non-existent. No study to date has examined client experiences of art therapy, with the goal of understanding how it is helpful (or not) from the client perspective. The present study aimed to address this gap, through a qualitative investigation of SpeakArt, a 12-week group offered through a hospital-based trauma therapy program. Ten participants completed interviews, conducted after their initial group session, about their goals, expectations, and concerns about the group. A second post-therapy interview invited participants to review a written summary of their initial interview, reflect on their experience of the group overall, and identify personal changes that they attributed to SpeakArt. The post-therapy interviews were analyzed using grounded theory techniques, applied from an interpretive-constructivist stance (Charmaz, 2006; Rennie, 2000). The analysis yielded four conceptual domains, comprising participants experience of art therapy and associated shifts: (1) Negotiating (Un)safeness in the Present; (2) Bringing It Up; (3) Witnessing the Invisible and the Invalidated; and (4) Transferring Transformation. A core category and heuristic model was also developed, describing two participant pathways in the group and a dynamic relationship among the four domains. The core category, Bringing into Presence, refers to processes of integrating old/trauma-related memories and emotions, and creating new meanings and adaptive responses. It is concluded that these integration and creation processes are contingent on experiencing intrapersonal and interpersonal safeness in group, and are mediated by the material, visual, and interactive nature of art-making in a group setting. Bringing into Presence as a concept is discussed and expanded on with reference to literature on integration in trauma recovery, relevant concepts from the psychotherapy process literature, and complex trauma conceptualization.