Page 141 - ART FORM AND MENTAL HEALTH - Ingrid Pénzes

Gannt & Tabone, 1998; Hacking, 1999; Stuhler-Bauer & Elbing, 2003). This shows the richness embedded in the clinical practice of art therapy, but at the same time it leads to challenges due to the huge number of formal elements to be studied, as well as the lack of sound empirical studies on formal elements. Again, we have tried to clarify some of the elements in this complexity.
Despite the diversity and complexity, our studies have revealed that only seven formal elements appear to be clinically relevant and at the same time can be operationalized reliably. We were able to limit the formal elements based on three criteria, i.e., objectifiable (unambiguous), clinically relevant, and reliable. Some of the many elements used in previous research could not be considered as observable pictorial qualities – formal elements – of art, e.g., ‘implied energy,’ ‘problem-solving,’ and ‘developmental level’ (Chirila & Feldman, 2012; Nan & Hinz, 2012). By returning to art theories on formal elements and examining the formal elements that are observable qualities of art, it was possible to describe and limit formal elements. Moreover, some formal elements derived from art theory are not considered clinically relevant according to art therapists. Despite the different perspectives and backgrounds of these art therapists, our studies show that they agree on a limited number of formal elements, which are mentioned in combination with each other. These findings indicate that at least some of these formal elements have the potential to transcend and bridge the diverse art therapy perspectives.
Regarding operationalizing formal elements reliably, our studies have led to the conclusion that for some formal elements the inter-rater reliability is problematic. Low to fair agreement between individuals rating formal elements in art products is a major problem in several studies. This becomes evident when formal elements are grouped in larger categories (Eitel et al., 2008), thereby leaving the inextricable complexity untouched. Insufficient agreement between raters is also found when a large number of formal elements are investigated together (Bucciarelli, 2011; Schoch et al., 2017). Our results highlight the need to disentangle the formal elements and to focus on just a few formal elements to obtain satisfactory inter- rater agreement. Again, the focus on these formal elements is certainly a simplification of the rich clinical field, and other aspects in the art product could be of value, e.g., contextual aspects and symbols (Eitel et al., 2008). However, limiting the number of formal elements appears to be promising in creating a solid base for further research and practice.
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