Practice Paper: Integrating Art Therapy in Educational Counselling Services
Introduction
This paper demonstrates the effectiveness of integrating art therapy into school environments and highlights the benefits of embedding therapeutic practices within educational systems. Drawing on data from an external audit of the service I worked for, The Bright Programme, I reflect on establishing an art therapy practice within an existing counselling service, addressing both challenges and advantages.
Educational settings are complex, involving intricate interpersonal dynamics among staff and students. The hierarchical nature of these systems presents challenges for therapists in navigating their roles and supporting both clients and colleagues. This reflection aims to showcase The Bright Programme as a unique model of excellence in providing counselling within an Irish secondary school, emphasising art therapy’s role in fostering inclusivity and collaboration among students, counsellors, staff and the school system as a whole.
Context
I joined The Bright Programme as a school counsellor in 2018, becoming the first Creative Arts Therapist to work with the service since its establishment in 2010. Based at Trinity Comprehensive School in Ballymun, Dublin, the program, a registered charity funded by Dublin City Council, consists of a director and three on-site counsellors. The three counsellors share a 5-day working week and hold a caseload of over 45 students.
The Bright counsellors work alongside the school’s guidance counsellor and chaplain to form the school’s Counselling Team. Referrals for counselling come from the school’s care team and are assigned each week to an appropriate member of the Counselling Team during their team meeting. The Counselling Team collaborates with other support services available in the school and in the external community.
In addition to individual counselling, The Bright Programme conducts crisis interventions, psychoeducational workshops, emotional support for whole classes, and staff training. It also leads collaborative events, such as ‘Stand-Up Week’, and provides support for staff to embed student well-being in the school culture.
‘Misneach’ (The sculpture outside of Trinity Comprehensive School ), John Byrne, 2010
School Culture
Trinity Comprehensive School, formed in 2005, benefits from a wide range of in-school support services due to its demographic context. Ballymun is a community founded in the 1960’s to house inner city Dublin families that were living in overpopulated and underdeveloped housing. In moving the families to an underfunded and isolated suburb, they suffered the effects of mass displacement and societal neglect. This legacy has led to a high prevalence of intergenerational trauma, high levels of alcohol and substance dependency, poverty and community and domestic based violence (Garvey, Martins de Carvalho, 2022).
In response, the school plays a vital role in supporting the local community, providing meals, extracurricular activities, and trauma-informed approaches in managing students' needs. In addition to the Counselling team there is also a behavioural support programme, a nurture room, the School Completion Programme, and a third level educational support programme.
Clinical Practice within The Bright Programme
I was employed for three days a week by the Bright Programme. My position involved meeting with school management and managing a caseload of 18 students weekly, often exceeding this number due to high demand. I helped streamline the referral process and enhance communication within the counselling team.
Some students were specifically referred for art therapy, but often allocations were based on the availability within the Counselling Team. I viewed my role in the Counselling Team and school as that of a ‘facilitative leader’, seeking to develop collaboration and dialogue in the school team to support the students assigned to me. In order to provide an effective service for the clients that we work with, we must create provisions for the systems that they are involved in. Art therapists should uphold the values of inclusivity, social justice, and empowerment in our work (Baines, 2013; Frostig, 2011; Gipson, 2015; Hinz, 2017; Kapitan, 2015; Sajnani, 2012; Talwar, 2015).
Individual Sessions
Engaging with young people could at times be difficult owing to absenteeism or the reluctance from students to engage in art therapy or counselling. Many students did not want to be singled out in front of their peers or to let it be known that they were engaging with me.
Initially, I followed the established Bright Programme protocol of ringing a parent or caregiver of a student referred to me, before meeting with a student. Though this was in line with good practice, I found this to be unhelpful in establishing a therapeutic alliance. From the time of my phone call with their parents, some students would have formed a negative idea of what I was offering.
I therefore redesigned the intake process by informally engaging with students first. Students were invited to visit the art room, learn a little about me and my role, and then decide whether they wanted to engage in art therapy. If they did, I would give them a permission slip to get signed and then ring their parents and organise the first session.
Art Therapy Room: for individuals and small groups, G.Lee, 2024
I am very interested in the idea of art therapy as a collaborative process between the therapist and client. This initial act of inviting the student to meet sets the precedence of how the power dynamic may be held in future sessions. Springham and Xenophontes (2021, p.1) speak of how co-production in art therapy can counterbalance the historic foundations of mental health treatment, which held factors of “power abuse, stigma and exclusion”.
I found this approach lessened the stigma in working with me and allowed the young people to have an autonomous voice in the initial process. After receiving permission and meeting with caregivers, I would open the session to the student to lead about what they would like to create, talk about, and bring into the sessions. The students had a diverse range of presenting issues including: self-harm, suicidal ideation, anger, anxiety, PTSD, trauma related behaviours, as well as developmental concerns around gender, sexuality and peer relationships.
Referrals came mostly from teaching staff, although sometimes the school or a teacher would be contacted for a student to engage with The Bright Programme. When referrals came from parents or the students themselves, it was usually for a very specific reason, either behavioural or following a bereavement or potentially traumatic incident. Sometimes students expressed a belief that “I just am this way”. and expressed fear in not knowing why they were behaving the way they were.
I created psychoeducation materials that I could use to explain why we may feel particular things, or behave in certain ways, due to experiences that we have had. I used these resources to educate the students, their families and also the school staff. During COVID-19, these images were transformed into short videos and uploaded onto The Bright Programme website.
Understanding fight/ flight/ freeze responses using Polyvagal Theory, G.Lee, 2020
Understanding the effects of trauma and PTSD on our brain and in our bodies, G.Lee, 2020
Feedback from parents who had engaged in the Bright programme was collected by the external auditor (Ní Sheanlaoich, 2024):
Parents report feeling better equipped to support their children and benefit from their access to counsellors to gain understanding and get advice.
Art therapy students have the opportunity to show art to their parents, which allows the parents to better understand the child and improve the parent-child connection as well as parental appreciation for mental health services and education.
Group Sessions
The Bright Programme would typically offer individual sessions to 10% of the student population. I initiated an open studio group in the school library to provide a safe, creative space during lunch for all students to access. This visibility helped reduce stigma, as students who attended the group, could get to know me in an informal setting.
The group fostered informal discussions about school and home life, allowing students to benefit from the support of each other. As Kapitan (2008, 2) states: "Something happens when the narrative of the profession shifts from the individual expert to the living reality and power of the collective".
I was aware of who I was to the students, coming from a middle-class, third level educated background, and addressed themes of difference whenever they emerged. I found the ideas of intersectionality really useful as a lens to better understand students’ perspectives. Kuri (2017, 118) describes intersectionality as “a way to understand how marginalized, intragroup identity differences simultaneously intersect to create and exacerbate experiences of oppression” .
Feedback from the audit noted that the lunchtime art therapy group was seen as a fun and acceptable mental health resource, promoting engagement and reducing stigma
“The weekly lunchtime art therapy group in the library is viewed both as an opportunity for children to access the Bright Programme, a chance to identify if there are deeper needs and an open statement that mental healthcare is fun and acceptable.”
After commencing this group, a lot of newly referred students, knew who I was in advance, either by working with me directly or through their friends. This led to greater commitment and readiness from students to attend sessions with me, and led to a lessening of stigma around therapy. Sometimes students referred for individual sessions would invite their friends into the space to see the room, or to introduce them to me or ask for a referral on their behalf.
Class-Based Groups and Whole School Engagement
The Bright Programme also offered whole class presentations and workshops to students to address general issues that they may be experiencing, such as bullying, anxiety, sleep hygiene and exam stress. Sometimes these would involve collaborations with classroom teachers or external agencies.
After the school closure during COVID-19, The Bright Programme created online resources to support students and parents, which could be accessed through our website. Upon reopening, I was asked to create banners for each year group and to create a ritual to support students returning to school. I worked with the school chaplain to incorporate an interactive art mural, “Sunrise of Hope”, into a ceremony to help students process their experiences during the pandemic. Each student was given a foam dove on which to write a message of hope, for themselves, a loved one or their peers.
Sunrise of Hope, G. Lee, 2021
The project fostered connection and reflection. Students expressed grief, humour, and gratitude in their messages. According to the auditor (Ní Sheanlaoich, 2024):
“Class support and group art therapy allow the students to experience therapy and have a positive association. It also allows the counsellor to identify any student with acute needs."
The Bright Programme also organised annual events like Neurodiversity Week and Stand-Up Week, encouraging school-wide participation. These initiatives fostered community and acceptance, particularly for vulnerable students. For these occasions we collaborate with the student body to organise events and try to encourage whole school participation. In the past I have run art competitions and aimed to develop interactive activities for staff and students to participate in.
Stand-Up week is an incentive lead by the LGBT+ youth service, BelongTo. The week is to promote LGBT+ awareness and to ‘Stand-Up’ to homophobic bullying within schools. Each year there is a given theme. ‘You Belong Here’ was the theme for last year with the focus on creating an inclusive space for LGBT+ students within the school. In response to this theme, I created an ‘Ally board' using the ally symbol as a template. Any staff or student who wished to state that they were an ally was given a coloured triangle to fill in, to be added to the board. This was then displayed in the school canteen for staff and students to witness.
Ally Board, G. Lee, 2023
Although these were one off, or annual activities, they have fostered a sense of school community and acceptance for the students of minority in the school. These students are perhaps the most vulnerable, and creating a sense of belonging is paramount for their learning and well-being (Hussain et al., 2015). Students fed back the following to the external auditor (Ní Sheanlaoich, 2024):
Overall students feel safer, that school is a safe space and/or that they have a safe space in school; this feeling extending to other students as well due to the knowledge that the (Bright Programme) service is available.
Critical Incidents and Staff Support
The support of The Bright Programme was also available at any time to teaching staff, who often would have to work with students with aggressive or challenging behaviour. We would meet with staff members individually following an upsetting incident. We also offered presentations and workshops to upskill staff and to adhere to the trauma informed principles of the school.
I offered reflective practice groups to staff and a Ballint group for school management and year heads, but owing to the restrictions of the school timetable and the busyness of the environment, these were very difficult to run consistently.
In 2023, the school suffered the sudden death of a student, which had a devastating impact on the whole school community. The National Educational Psychologists (NEPS) came into the school to help manage the immediate situation for students, parents and staff. The Bright Programme and the other members of the Counselling Team were asked to offer a triage of support..
I ran art-based groups in the staff room, offering a space for any teacher who wanted to talk, and a classroom based activity for classmates of the student. The rest of the school counselling team met with students and assessed their need for counselling at the time.
Being embedded within the school culture meant that we were able to offer continuous support, not just at the moment of crisis but also through the school year that followed. I was later asked by School Completion staff to collaborate on providing follow-up support to students and staff. School Completion had worked extensively with the student’s class group. Together we liaised with their class tutor and created a four-week art-project for students to engage in. We used a tree as a symbol for change and built our workshops around this theme.
Week 1: Tree in Autumn
We discussed change, loss, anger and resilience. Students wrote about personal changes they desired on fallen leaves and placed these at the tree's base. We spoke about how these leaves returned nutrients back into the soil before winter
Week 2: Tree in Winter
We looked at the difficulties that change could bring and emphasised resilience and the importance of supporting each other. Each student received a wooden heart to decorate with their name and attach to the tree trunk.
Week 3: Tree in Spring
Students recognised the tree's growth and change. We acknowledged that the tree had strengthened in the winter and the new leaves were not the same ones as before. They wrote their hopes for the term on green leaves, which were contributed to by school leaders, who attended this session.
Week 4: Tree in Summer - Anniversary
As the school year ended and the student’s anniversary approached, we decided where to display the finished tree and discussed potential anniversary activities. The students’ feedback was taken on board, and the class spent the day together outdoors.
Fallen Leaves from the Classroom Tree, G. Lee, 2024
Completed Classroom Tree, G. Lee, 2024 (identifying names have been blacked out)
The anniversary of the student also held significance for staff. I was asked to facilitate a workshop for the staff team. I led a stone painting exercise, acknowledging how difficult loss is and how one experience of loss may resonate with others. I asked staff members to choose a stone and to remember somebody whom they had lost and to celebrate them through the artwork. The stones were then to be placed around a tree in a ‘Memory Garden’ in the school courtyard, to be added to by staff and students when needed. Group art making has been found to very effective in helping education leaders to share experiences and learn about each other (Kaimal et al., 2014).
‘Memory Stones’, G. Lee 2024
Sustained Effects of Therapeutic Engagement
It is often difficult as practitioners, to ascertain the benefit our work may have with our clients, when there is always the bias of relationship to be considered in any evaluation of outcome measures. It can be also be challenging to assess the broader impact that the work may have on a wider community.
The data we submitted to Dublin City Council was mostly quantitative. While we could state that a caseload of 45 students was being held by the Bright Programme, it was difficult to offer a qualitative summary of what those experiences was like.
The external evaluator was able to meet, as an intermediatory, with a cohort of beneficiaries of the service and collate data, with a lesser bias. A past student that I worked with was quoted as saying the following:
“The Bright Programme changed my attitude towards life. When you don’t have role models to look to, nothing seems attainable or reachable. I didn’t see the point of education and didn’t want to come to school. I hadn’t thought about college and had no ambition. Then I started counselling and I started to believe in myself.”
The external evaluator (Ní Sheanlaoich, 2024), summarised the benefits of the Bright Programme in the following topics:
- Attendance: Improved student attendance, lower drop-out rates, higher propensity to complete the school day. Previously, students would literally run out of the school during the day because they couldn’t cope. The Bright Programme has provided them with a safe space or person within the school that they can turn to.
- Reduced propensity to engage in criminal activity: Some counselling beneficiaries who “act out” are pre-disposed to gravitate towards gangs involved in drug dealing and other crime, and counselling can help them reflect and gain confidence to move away from this.
- School counselling referral system: As indicated earlier, the school now has a comprehensive system to address students’ mental health needs through its referral system.
- Improved academic performance and entry to third level education: There are clear cases where students performed better academically due to capacity to have better relationships with teachers.
- Culture of openness and counselling: A culture shift in the school to a place where students speak openly about their feelings and counselling is accepted and embraced is attributed to the Bright Programme. Children are comfortable to be taken out of class by counsellors and mental health services are considered accessible and normal.
- Breaking intergenerational poverty cycles: One past pupil ... broke the cycle of generations of abuse, neglect, addiction and poverty. A teacher who is from the area could see the possibility of current students also breaking that cycle with the support of the Bright Programme.
Conclusion
Schools have long been identified as being in a “unique position to identify and support those who are experiencing distress and to provide an environment which encourages young people to bring to attention any incidents or issues of concern” (Department of Education, 2013). The accessibility of schools in supporting young people and families align with national policy goals, including Ireland’s National Strategy to Reduce Suicide 2015-2020 and the Mental Health Lifecycle included in the Sharing the Vision 2020-2030 mental health strategy. In a recent survey however, 88% of young people in Ireland did not feel that their mental health was adequately supported in schools (Kenneally et al, 2023).
The audit of the Bright Programme found it to be an effective model in addressing the needs of students and the school community. Areas for development included expanding staff support and small student support groups, particularly for second-year students.
The Irish Department of Education has implemented a Counselling Pilot Scheme to offer support to primary school students. Creative Arts Therapists have not been invited to participate. No programme as of yet has been launched for post-primary schools. It is my hope that pre-existing services in schools that support students’ mental health, such as the Bright Programme, will be consulted, and that Creative Arts Therapists will be considered for future mental health initiatives, given the efficacy of our work.
In reflecting on my practice, I am reminded of the important role Creative Art Therapists can play as leaders within the systems that we work in. As Kaimel et al. (2017) write: “Through purpose, practice, and careful attention CATs (Creative Arts Therapists) can foster the growth of effective leaders and facilitate change in the communities each CAT serves.
References
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Gerard Lee
Gerard Lee trained as an art therapist with MTU in Cork and has worked as an art therapist in Ireland, Haiti, Wales and England. Gerard is currently employed as lecturer on the MSc Art Psychotherapy course in University of Ulster. Gerard is a member of the Irish Association of Creative Arts Therapists (IACAT), British Association of Arts Therapists (BAAT), and the Health and Care Professionals Council (HCPC), and has previously served as Council Secretary for IACAT.
Gerard has been an annual visiting lecturer on the Dublin Principles of Art Therapy course for over ten years and has previously worked as an assistant lecturer on the MTU art therapy course. Gerard has also lectured on the Cork Art Therapy Summer School and on the Arts and Health course in MTU. He has presented at the All-Ireland Convocation in TCD, Grange Gorman and for international students in Trinity College’s Global Brain Health Institute.
Gerard upholds a personal art practice and regularly exhibits in Dublin-based group shows.