Art Therapy in Veterans’ Rehabilitation

In 2015, the Defence Force launched the Australian Defence Force Arts for Recovery, Resilience, Teamwork and Skills (ADF ARRTS) trial program. This four-week residential initiative supports people facing health and wellbeing challenges related to service in the ADF, ACT Emergency Services, or the Australian Federal Police. Health issues that may be addressed through this program include PTSD, combat trauma, military sexual trauma, complicated grief, substance abuse, anxiety, depression, and difficulties transitioning to civilian life.

In 2024, I applied to participate in this course with no idea what to expect. I knew it had something to do with art.  But how it was going to help me was the big question.

We were a group of 23 individuals, all strangers who were participating in the program for their own reasons.

The program we were set to participate in was designed to provide training and mentorship from a team of psychologist, nurse and physiotherapist provides support to participants suffering physical and psychological injuries. Three art practitioners across different disciplines: visual arts, music and rhythm, and creative writing.

On the first day of the program, participants were given journals to document their experiences or thoughts voluntarily. The activities included writing exercises, experimenting with different media such as clay, paints and wood, and collectively playing various musical instruments. The first day was notably overwhelming, but it introduced a sense of change.

The program required everyone to participate in all streams initially, and then select one stream to focus on while occasionally attending classes from the other streams.

This marked the beginning of my journey towards self-discovery and understanding of the significant role that art therapy can play in mental and physical healing, especially when it comes to Veterans.

What is Art Therapy, and how has it played a role in Veterans’ Rehabilitation?

In the words of Malchiodi (pg. 3), “Art therapy is a dynamic therapy, requiring one to participate in one’s own treatment, in this case through art making. Therefore, truly understanding art therapy requires first-hand experience“.

Art therapy is a therapeutic approach that utilises various media, including writing, painting, and music, as a means of self-expression. This method enables both clients and therapists to examine the psychological and emotional elements reflected in the produced artwork.

The purpose of art therapy is to also address emotional and psychological challenges. Unlike other forms of therapy, which may focus primarily on conversation, art therapy encourages individuals to engage with their experiences through artistic creation. During sessions, participants use creative processes to explore and understand their thoughts and emotions.

Art therapy involves uncovering, releasing, exploring, learning, and understanding thoughts and feelings. In the Military, individuality is often diminished over time, which can lead to forgetting one’s true self. Art therapy can provide a means to regain a sense of control and self-awareness.

 Art therapist such as Naumburg, thought that the real meaning of art expression came only from the people who made them. Naumburg believed art had projective qualities and this would be where the Art Therapist would help the participant find spontaneous meaning to the content in the artwork.  I would say this is a very similar to the words of Malchiodi (above), and a statement by Peter London’s “Art can be said to be – and can be used as – an external map of our interior self” (Pg. 1 Malchiodi). In my humble thoughts, by expressing art externally this can draw out what is stirring within.

Art therapy in wartime

History records show that various forms of art therapy have been utilised to support the recovery process of veterans during both past and present wartime periods.

 For example, during the First World War, English hospitals used embroidery—known as “fancy work”—as art therapy for British, Australian, and New Zealand soldiers recovering from physical and mental injuries. Examples of their embroidery are displayed in locations such as Te Papa Museum in Wellington, the Australian War Memorial, St Paul’s Cathedral in London, and other institutions (Biggs, Australian War Memorial).

During the Second World War, artists such as Adrian Hill worked with individuals who were wounded in the war. Hill concentrated on the potential therapeutic aspects of artmaking and based on his direct experiences, observed that art could address underlying issues. (Hogan 2001, Laban and Murphy).

Art activities were also conducted in the Art Hut at Hollymoor Hospital in Birmingham. Sergeant Laurence Bradbury was assigned to facilitate free expression sessions for groups of wounded veterans. (Laban and Murphy).

There were other activities, including beadwork and woodworking, regarded as forms of occupational therapy intended to aid soldiers in recovering from physical injuries while also providing mental relaxation.

Another type of therapy to help boost the morale of the troops through the ages of war was to send actors and entertainers to the war to bring the troops joy and comfort. The Red Cross established dances, set up cafes and played music to help the troops escape the reality of war.

Following the tradition, while current defence members have been deployed to the middle east, The Australian and American performers and artists still go over to the war to perform a series of live concerts. This provides the defence members a break from routine, stress, and boredom, as well as the opportunity to reconnect with the world they had left behind. (Gehrmann Page 128).

Currently, as previously discussed, art therapy is utilised in addressing diverse experiences related to military service. It has seen increased use in addressing Post-Traumatic Stress Disorder (PTSD) among veterans. Although traditional talk therapies are commonly used for PTSD, evidence shows that around 70 percent of military personnel continue to meet diagnostic criteria after such treatment. This highlights the potential value of exploring alternative therapeutic methods. (Bowen – Salter)

Research also indicates that specific elements of art therapy provide benefits particularly suited for veterans. Creative arts have been shown to improve veterans’ mental health by helping them connect with others, overcome isolation, and heal from trauma (Seymour).

It allows for veterans to process traumatic memories in a safe environment, while creating an outlet for emotional regulation and creating distance from painful memories. Art therapy can considerably assist with the alleviation of symptoms for PTSD, as well as anxiety and depression.

“In my experience, being in civilian attire without discussing rank and using first names provides a different relaxed experience. Wearing civilian attire removed the formal barriers that often comes with the uniform. Not knowing anyone’s rank or background made me feel like we were just a group of people together going on a journey of discovery. Starting with a blank slate, sharing what we wanted to, it created that safe space.”

A Veteran’s Perspective on Art Therapy

Since commencing the Certificate of Clinical and Educational Art Therapy Course, I have identified various methods that were implemented during my involvement in the ADF AARTS program in 2024.

The ADF AARTS program reflects more of an Expressive Arts Therapy Approach. It models Natalie Rogers’ “person-centred expressive arts therapy” integrating many different modalities such as movement, drawing, painting, sculpting, music, writing, sound and meditation. This approach is in a client-centred setting. Although the ADF AARTS program was set up in a small group setting. It still helped to foster connection, express feelings, communicate and encouraged inner healing and self-discovery through the art process. ( N. Rogers, Rubin, Pg 230)

During the program, mentors were present but did not provide direct guidance; they encouraged self-direction. This approach leans into Carl Rogers’s Person-Centred Theory, a humanistic approach to psychotherapy that emphasises the client’s capacity for self-understanding and personal growth. The person-centred approach focuses on the client’s (participant’s) responsibility and capability to discover ways to fully encounter reality. (In this case, being in the moment) (Corey).

Art “as” Therapy

On the first day of the program, participants were given journals to document their experiences or thoughts voluntarily. The activities included writing exercises, experimenting with different mediums such as clay, paints, string, material, and wood, and collectively playing various musical instruments.

The mentor directing the exercise asked if anyone would like to share how the art piece they were creating made them feel. Some responses were about the texture and others were about their personal feelings. For me, the clay was, both hard and soft, it smelled earthy and reminded me of playing with clay by the dam on the farm when I was a child.

This can be described as art “as” therapy, as outlined in module one of the courses (Gray 2020), where the focus is on exploring the process and opening the mind to new or old experiences.

In the first few day’s participants were given the opportunity to pick which stream they would like to mainly participate in over the next four weeks. The three streams were visual arts, writing and music.

 The large group was separated into 3 smaller groups. Each day, all participants were encouraged to do an activity together, usually picked from one of the streams. Part of the experience was as one big group; we would write, produce and sing a song together, and at the end of the program, we would present a showcase to our small group of family and friends.

I chose visual arts with five others.

One afternoon, I wrote in my journal about an experience with an activity that involved black ink and walnut ink. My writing reflected my growing annoyance with myself because I didn’t know how to start the exercise of making a card using the ink. Nothing creative was coming!  Our mentor (M) offered me some advice, “Rose, you must let go of the ego and begin—trust in the process.”

Put the quill on the paper and let go, don’t think, just let go! This interaction marked a significant turning point for me. I realised that I needed to release control, stop overthinking the process, and embrace the present moment. This insight proved to be not only applicable to my artwork but also served as a valuable life lesson.

According to Gerald Corey (Theory and Practice of Counselling and Psychotherapy, p. 69), Freudian theory states that the id remains immature, the ego acts as the personality’s regulator, and the superego serves as its moral authority.

My “id” wanted to achieve success on the first attempt, though my ego recognises that this was unlikely given my lack of experience. My superego aims for high standards, while my ego acknowledges difficulty in meeting the expectations of both the id and superego, hence my frustration in getting started.

These words below from Carl Rogers just reinforce my mentor (M) words.

From the inner condition of creativity, it is clear that they cannot be forced, but must be permitted to emerge. Carl Rogers. (Rubin Pg 230)

Art “in” Therapy

Another assigned task focused more on Art “in” Therapy, examining the content of the picture.

Participants were instructed to depict their current self-perception by creating head-only representations through photography and painting.

The example provided below reflects my own self-perception.

This painting expresses my loss of self after 30+ years in Defence.

The photo and the painting are both black and white as a form of self-expression; colour was not used. The bubbles represent thoughts about the future. After over 30 years of military service, the transition to retirement raised questions about what life would look like next and what new purpose might emerge. At the time, it was difficult to see a clear path forward or focus on the present.

This reminded me of Margaret Naumburg, “releasing the repressed(unconscious) through imagery as curative, in a cathartic as well as a communicative way” (Rubin pg. 74).

This exercise allowed participants to discuss their art and its meaning, not only visually but also through conversations with our mentor and the group.

In the second painting, the concept of “Intentionality and Meaning” is evident. During this phase, the mentor encourages the participant to engage in a thoughtful examination of their work, fostering openness to new interpretations and perspectives that may emerge from the creative process.

According to Laurie Wilson (Rubin pg. 24), this maybe one of art therapy’s most important contributions to psychotherapy (a form of therapy that uses talking to help individuals understand address emotional, psychological, and behavioural issues) and phenomenology (a philosophical approach that focuses on the study of the subjective experience and consciousness, exploring how things appear to the individual). because art therapy pays attention to the authentic experience in two-fold ways.

While painting this artwork, I explored my life’s journey. I depicted a clock with ages instead of hours, a rose for myself, a dove symbolising mortality, and grey clouds suggesting adversity. Encouraged by my mentor to reflect, I began to see new meanings: perhaps the clouds were parting, offering hope, and the rose signified growth and self-direction after years of living by military rules. The blue sky, a nod to my favourite colour and past, represents clarity, while its faded patches inside the clock mirror aging. The dove prompted me to reconsider my life’s purpose.

Four weeks in a supportive setting enabled participants to express themselves through art. Art therapy offered alternative communication, fostered connection and reminded participants they are not alone.

My final art piece embodies the theme of change. The black bust serves as a reflection of my past, while the dragonfly—symbolic of transformation, adaptability, freedom, intuition, and connection—serves as a reminder to embrace change and remain true to myself.

By the end of the course, participants expressed regret at concluding their involvement with the AARTS program. Regardless of whether art was applied “in” therapy or “as” therapy, notable progress was observed among all participants. The process of healing through expressive arts enabled most participants to feel empowered by the new skills and techniques they had acquired for their personal growth. Additionally, the group has maintained ongoing communication and continues to offer one another mutual support.

Comments from several participants

Art therapy allowed me to step back in time and find the creative and imaginative part of me I’d forgotten for over 30 years a part that is active 2 years later. (Participant AARTS program)

Art therapy allowed me the time and space to start focusing on my rehabilitation. It gave me a creative output to express my feelings, which helped me heal by unpacking some of my trauma had experienced in my past. (Participant AARTS program)

Art therapy has helped me to slow down and live in the moment by encouraging me to focus on the creative process rather than worrying about the outcome. (Participant AARTS program)

In summary, Peter London states that “Art can be said to be—and can be used as—an external map of our interior self” (Pg. 1 Malchiodi). I agree art has not only helped me to express myself outwardly it has helped me uncover my purpose in life.

In conclusion, from the perspective of an art therapist in training, Gerald Cory’s view suggests that therapists should not aim to change clients or solve their problems. Instead, therapists should promote healing through genuine communication and authenticity and additionally be able to explore their own growth and life challenges as well. Teaching the client through the behaviour they model themselves. In his words “you are your very best technique”. This resonates with me, being in tune with the client to help the client find their own solutions, building their confidence along the way. It has played a significant role in my transition from participating in art therapy to training as an art therapist. Important elements for me included care and support I received, the empathy and understanding, the encouragement to think outside the box do things that were out of my comfort zone, which helped me build confidence and the provision of a safe environment. Clear communication and patience helped me process things calmly and remain present, without feeling pressured. As this was a live in group program it allowed me to make new life friends along the way.

 I’ve always loved art, from designing clothes as a teen to expressing creativity through cooking during my military service. After shifting careers to support my family, I lost touch with that artistic side. During my service in defence, I encountered personal experiences with bullying and depression, and witnessed colleagues facing challenges such as depression, bullying, marital difficulties, post-deployment PTSD, and suicide. To try and assist my colleagues, I completed qualifications including Mental Health First Aid, a trial course called “Keep Ya Mates Safe” on mental health peer support, and annual Suicide Awareness training. Throughout my career, I have aspired to retire in a role that truly inspires me, although for some time I was uncertain how to articulate or even identify that passion. Through my involvement in the AARTS program, I have been able to identify a purposeful direction for my career. Building on the knowledge I have learnt so far through the College for Educational and Clinical Art Therapy (CECAT) and experience I have gained through just doing the art exercises, I am actively pursuing the necessary qualifications to support fellow veterans as an art therapist.

References

ADF Arts for Recovery, Resilience, Teamwork and Skills | ADF Members & Families | Defence

Approaches to Art Therapy – Theory and Technique Judith Aron Rubin

Art Therapy with Veterans: Comprehensive Review of the Literature with Recommendations.

Linny Wix Med, ATR LPAT

Science Direct – Reach article – Understanding the role art therapy can take in treating veterans with chronic post -traumatic Stress -Hogan 2001, Janice Labban and Dominic Murphy.

Heather Seymour, the founder of the Veterans Arts Initiative with Central Ohio VA.

https://www.awm.gov.au/about/our-work/projects/sufferings-of-war-and-service

National Library of Medicine – The Battle Against Mental Health Stigma: Examining How Veterans with PTSD Communicatively Manage Stigma – Rikki A Roscoe

ADF Arts for Recovery, Resilience, Teamwork and Skills | ADF Members & Families | Defence

ADF Arts for Recovery, Resilience, Teamwork and Skills Program (ARRTS) – Part 2 | Defence International Training Centre

Theory and Practice of Counseling and Psychotherapy, Sixth Edition – Gerald Corey

Anzac Square Memorial Gallery – Entertainment in World War II | Stories | Anzac Square

Richard Gehrmann – Entertaining Australian troops at war in Afghanistan and Iraq – University of South Australia.