Page 107 - ART FORM AND MENTAL HEALTH - Ingrid Pénzes

INTRODUCTION
Formal elements like “color” and “movement” have long been used in art therapy assessment, leading to much discussion about the pros and cons of their application. The assumption that art products are related to clients’ mental health can be traced back to the beginning of the 20th century (Plokker, 1963; Prinzhorn, 1919) and projective drawing tests, whose development goes back to the 1940s, assume that the content of an art product represents unconscious psychological conflicts (Buck, 1948; Murray, 1943; Naumberg, 2001; Simon, 2001; Ulman & Bernard, 2001). From a psychometric perspective, these tests are, however, not reliable as they need interpretation, which introduces subjectivity (Betts, 2006; McNiff, 1998). The focus subsequently shifted from symbolic content to the formal elements of art products, such as “line”, “color”, and “movement” as these were considered to be more objective (Gannt, 2001, 2004; Thomas & Cody, 2012).
Formal elements originate from art theories and concern the “form” analysis of art. Formal elements refer to the observable pictorial qualities of art and according to art theorists, “form” analysis is the most objective way of analyzing it (Acton, 2009; De Visser, 2010). In art therapy, the underlying assumption is that formal elements in an art product represent the way clients interact with art materials in order to express themselves and that they are related to clients’ mental health (Gantt & Tabone, 1998, Gant, 2001, 2004; Gilroy, Tipple & Brown, 2012; Hinz, 2009, 2015; Nan & Hinz, 2012; Pénzes, et al., 2014, 2015). Several art therapy assessment instruments have been developed to measure these formal elements and relate them to clients’ mental health problems (e.g. Cohen, 1986, 1994; Cohen et al., 1986; Elbing & Hacking, 2001; Hacking, 1999; Stuhler-Bauer & Elbing, 2003). These instruments have been subject to serious psychometric critique regarding their reliability and validity, however. It has been argued that the existing instruments use poor rating methods (Nan & Hinz, 2012) and inappropriate statistical procedures for measuring inter-rater reliability (Eitel et al., 2008; Hacking, 1999 cited in Betts, 2006; Schoch, Ostermann & Gruber, 2017). The existing instruments also allow, and even need, subjective interpretation based on art therapists’ own clinical experiences with different client groups and different training orientations (Betts, 2006; Eitel et al., 2008; Schoch et al., 2017). This introduces all manner of interpretations, which can negatively affect the reliability. We still do not know to what degree
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