Cross-contamination, Part I
Should your clients see images created by other clients? Many therapists post these, typically at a client’s request, in their offices. The operating premise behind this is that it will contribute to the self-esteem of the client whose art is on the wall. But what does it do to the other clients?
A clinician at one of my trainings said she went to a workshop where the speaker likened the display of client artwork in one’s office to the posting of sticky notes, each featuring a verbal excerpt from a therapy session, all over the office walls. The speaker went on to say that both convey information derived within the context of a therapy session and that neither is appropriate for viewing by others in the therapist’s care (or by anyone else, for that matter, unless you have a release to display such things) due to the influence these artifacts of previous sessions would have. Point well articulated! Confidentiality might be violated if clients can figure out who created (or said) what. At the very least, comparisons would be made and cross-contamination would occur.
I’m a nomadic school-based art therapist; I serve a whole district and thus have to lug a huge portfolio of papers and a smaller suitcase of supplies. In addition to papers, the portfolio also contains two smaller portfolios, one for works in progress and one for completed works that will be transported back to my office for storage until termination or the end of the school year, whichever comes first. (Note that I don’t have a way to transport or store 3-D works!) I’m acutely aware of the effect it has on a client when I bring out either of these smaller portfolios, which I occasionally have to do during a session, as each of the students I serve knows that these portfolios contain evidence that they aren’t “the only one” and that—even worse—they’ve been forced to mingle symbolically with the others who compete for my attention. Comparison and cross-contamination can thus come into the picture, even when preventive measures have been taken.
Those of you who’ve ever asked people in a group to make art know the influence image can have over others. Sometimes the influence is positive, sometimes it’s negative. If you’re still not sold on the idea that it’s inadvisable to display client artwork in a treatment setting, what would you do if a client asked you to hang a provocative image? A track record of posting client art upon request would leave you in a position of having to display the provocative image too. Or you could deny the request, which would send the client a message that you’ve judged her or him. Thus a track record of posting client art upon request will inevitably put you between a rock and a hard place.
When I worked in a partial hospitalization program, the walls in the room where art therapy groups took place were kept free of client artwork. A man in the program was a particularly difficult client, and others in treatment found him to be obnoxious. On his last day he presented the staff with an image of a swan scene (it hadn’t been made in art therapy—in fact, it was a commercial print) and asked that it be hung in the art therapy group room to remind the other clients of him. It wasn’t an offensive image; one of the other clinicians thought it looked like it should have been a shower curtain. But that’s why the treatment team ultimately decided not to display the image. Even though it didn’t bear his fingerprints or brushstrokes, its out-of-place-ness in the art therapy room would attract attention and serve as a haunting presence among a group of people who were actually glad to see this man go.
Images symbolically represent the person who creates them (or bestows them). If you let one client see the image of another, you are providing an opportunity for one client to influence another. You’re probably prepared for such comparison and cross-contamination in a group therapy situation. But group therapy aside, is that what you want to facilitate in your other therapy sessions? It’s natural for all of us to want to know where we stand in comparison to others. But in a clinical situation, it’s generally contraindicated to allow opportunities for cross-contamination. It’s a creative balancing act to walk that fine line between letting your clients know the reality of the fact that you see others and preventing your clients from unnecessary exposure to each other.
With appreciation for the important work you do,
Megan February 2014