Recently a veteran referred to our studio as a “second home.” He was referring to an art therapy program I had an opportunity to develop 4 years ago at a community-based organization for veterans in Rochester, NY, Veterans Outreach Center, Inc. During its first year the program more than doubled in size; veterans were hearing about it from friends and came requesting art therapy services specifically. Since its inception, the program has grown to include a fully functioning art studio, three full-time art therapists and a storefront gallery space where veterans can showcase their artwork.
“Home” can be a loaded term for veterans returning from service and reintegrating into civilian life. As treatment providers we need more knowledge to promote and advocate for veterans with community practices that encourage healing and reintegration. Building resilience and promoting successful reintegration is a task that reaches beyond the usual scope of mental health providers (Wheeler & Bragin, 2007). It is a calling for mental health providers to involve family, friends, and the entire civilian community. When art therapy incorporates studio engagement and gallery exhibition, veterans receive unique benefits that can address the multiple levels of need starting with the veteran and reaching out into the context of the community or “home” where the veteran returns.
In July 2013 Veterans Outreach Center received national recognition from the White House with an invitation to present a case study of our program at the Veterans and Military Family Mental Health Conference in Washington, DC. The conference highlighted the work of community-based organizations and their vital role in offering complimentary treatments and alternative options to treatment seeking veterans. In our community art therapy has become a sought-after treatment option by veterans working through issues related to readjustment and PTSD. The conference set the stage for President Obama’s national initiative that directed all VA medical centers nationwide host annual mental health summits. The summits brought together community providers and VA representatives to identify ways to improve collaboration and collectively meet veteran needs.
Readjustment
Veterans experience cognitive, spiritual, emotional, and social challenges that may impact supportive relationships and complicate their reintegration into post-conflict or civilian life (Bruner & Woll, 2011). The impact of these challenges may take many forms including difficulties with finding and sustaining gainful employment; reconnecting intimately with spouses, children, and close civilian friends; and attending to daily responsibilities (Caplin & Lewis, 2011). There also are certain risk factors associated with the failure to adjust. I have found such veterans to be at greater risk for the development of mental health conditions like depression or substance abuse. Veterans with a diagnosable mental health condition at the time of separation from service often struggle with the tasks of reintegration into routine life, which then leads to greater complications with the readjustment process.
In addition to the mental health and psychosocial issues tied to readjustment, there is a cultural adjustment that veterans may experience when returning home. A military mindset that is developed as service members are socialized into military culture may present challenges in the process of readjustment to civilian life (Coll & Weiss, 2011). Military culture contrasts greatly with civilian culture in many ways. A strong sense of camaraderie comes from being a member of a military unit, holding a shared mission, and knowing that fellow service members are looking out for one’s safety and wellbeing; this strong sense of group cohesion is not easily found in civilian society (Coll & Weiss). At home many veterans lack proximity to their military support network and lose the familiar structure of military culture. Veterans must negotiate the gulf of difference between civilian and military cultures while often lacking the much-needed social support to navigate this process successfully.
Art Therapy
Currently, research on art therapy and veterans has focused on the treatment of posttraumatic stress (e.g. Collie, Backos, Malchiodi & Spiegel, 2006; Johnson, Lubin, James, & Hale, 1997; Loban, 2014; Morgan & Johnson, 1995). Literature in related fields also emphasizes treatment of symptoms and neglects to deal with the broader psychosocial implications of veteran readjustment. Readjustment is impacted by posttraumatic stress; however, readjustment also carries distinct challenges that are connected to both military and civilian culture. Art therapy provides veterans an alternate, multifaceted approach to address the complex needs associated with posttraumatic stress disorder (PTSD) and readjustment. The treatment model that I developed for the center includes individual art therapy sessions, drop-in studio groups, and veteran art exhibits. Each one of these component services addresses a distinct area of need.
Individual therapy sessions in this model are designed to address mental health symptoms and psychosocial stressors using an approach that builds on the veteran’s strengths and operates from an understanding of how trauma impacts an individual’s overall psychosocial functioning. I have observed that many veterans may not be ready to talk about their experiences in traditional therapy; the military mindset can reinforce a “soldier on” mentality that protects resistance to disclosure and vulnerability. Rather than putting words to emotions and experiences, they can be expressed through art making. Because expression can be communicated indirectly and through symbolic or metaphoric forms, art making can instill a sense of safety and control. Thus, veterans find they are able to contain painful emotions and experiences within the art work they create. I have witnessed the benefits of individual art therapy first-hand with veterans who have used it to heal from past traumas, improve relationships, develop new ways to manage stress, and start to define themselves with a new identity that is “creative.” In my experience, this therapeutic work supports success and achievement in relation to the tasks veterans face when transitioning home and readjustment to civilian life.
Drop-in or open studio group sessions offer the opportunity to mitigate the social isolation often experienced by veterans struggling to reintegrate and readjust. The studio environment and its uniquely creative culture functions as a safe place that inspires creative risk taking through engagement with art materials, the physical environment, image making, and group energy that develops among participants who make art together, and in the presence of a facilitator who models commitment to art making (Allen, 1995; Luzzatto, 1997; McNiff, 1995; Moon, 2010). The studio environment can foster a welcomed sense of camaraderie among veteran participants as they share workspace and materials with others while creating their own individual artwork. Art making is a way to communicate and share stories among veterans, forming as a culture of support and friendship. Also, in the studio space veterans can normalize and honor each other’s struggles and successes with reintegration and readjustment though symbolic and verbal sharing.
Additional benefits are reinforced in the gallery components of art therapy. Gallery exhibits are much more than a formal display of artwork; public exhibition raises awareness and understanding within the general public. Formal art openings validate and legitimize the artwork of veterans by bringing it into the broader art community as well (Howells & Zelnik, 2009). The experience of professionally displaying one’s own artwork in a public venue can be particularly validating for populations who feel marginalized from the mainstream (Vick & Sexton-Radek, 2011). As exhibiting artists, veterans self-advocate and inform the public of their experiences, externalizing and taking ownership of their own perspective (Block, Harris, & Laing, 2011). Thus, the gallery becomes another intervention to decrease isolation and disconnection between veterans and the civilian community they call “home.”
Based on my experience working with veterans in a community-based setting, I have found that these particular approaches to art therapy target treatment for readjustment that are not addressed in traditional individual and group therapy settings. To further investigate the effectiveness of the art therapy studio and gallery in readjustment, I have initiated a participatory action research study with a group of 10 veteran co-researchers. The study design includes a series of focus groups involving dialogue and art making from which the co-researchers have developed a list of concerns felt to be pivotal to veteran transition. Through exploration of their personal experiences with art therapy treatment, they have begun to identify ways that art therapy can address the particular needs associated with transition from military service to life at home. The research team is currently in the process of collating the data and will be presenting it to the Rochester community in the form of an art exhibition. A common theme among participants thus far is identity loss at the time of separation and the rediscovering or recreating of identity through the art making process in art therapy.
Veterans who are involved in this program routinely remind me of the value and efficacy of art therapy. Many have stated that it has saved their life. Alternative and complimentary treatments can be a lifeline to veterans who are reluctant and unprepared to engage in more traditional forms of therapy. It is our responsibility as providers working with veterans to document and share our outcomes in order to best advocate for these vital services.
Jennifer DeLucia is a Doctoral Candidate at Mount Mary University. The Veterans Outreach Center is located in Rochester, New York.
