Assessment

Art therapy assessments are used by art therapists to: determine a client’s level of functioning; formulate treatment objectives; assess a client’s strengths; gain a deeper understanding of a client’s presenting problems; and evaluate client progress (Betts & Groth-Marnat, 2014). To ensure the appropriate use of assessments, evaluation of instrument validity and reliability is imperative.

According to Bornstein (2011; see Table, below), a “constructive” test requires that the client “create or construct a novel image or written description within parameters defined by the tester,” such as the Draw-a-Person test (Harris, 1963) (Bornstein, p. 538). A “performance-based” test derives scores from the client’s “unrehearsed performance on one or more structured tasks designed to tap on-line behavior and responding” such as the Bender Visual-Motor Gestalt Test (Bender, 1938), a brief test of visual-motor integration that yields information about a client’s neurological and psychological functioning (Bornstein, 2011, p. 538).

In this Table, art therapy assessments have been added to Bornstein’s table, to demonstrate how art therapy instruments under development fit into this clinical evaluation framework.

Table: Bornstein’s (2011) Process-Based Framework for Classifying Psychological Tests* – with the inclusion of art therapy procedures (Betts & Deaver, 2019)

Test Category (Bornstein, 2011)

Key Characteristics (Bornstein, 2011)

Representative Psychological Tests (Bornstein, 2011)

 

Representative Art Therapy Procedures Under Development

(Betts & Deaver, 2019)

Self-Attribution (Bornstein, 2011) Test scores reflect the degree to which the person attributes various traits, feelings, thoughts, motives, behaviors, attitudes, or experiences to him- or herself. NEO Personality Inventory.             Strong Vocational Interest Blank.        Beck Depression Inventory.  N/A.
Stimulus-Attribution (Bornstein, 2011) Person attributes meaning to an ambiguous stimulus, with attributions determined in part by stimulus characteristics and in part by the person’s cognitive style, motives, emotions, and need states. Rorschach Inkblot Method.            Thematic Apperception Test. Draw a Story: Screening for Depression.
Performance Based (Bornstein, 2011) Test scores are derived from person’s unrehearsed performance on one or more structured tasks designed to tap in vivo behavior and responding. Wechsler Adult Intelligence Scale. Bender Visual-Motor Gestalt Test. Face Stimulus Assessment.        Levick Emotional and Cognitive Art Therapy Assessment.          Silver Drawing Test of Cognition and Emotion.
Constructive (Bornstein, 2011) Generation of test responses requires person to create or construct a novel image or written description within parameters defined by the tester. Draw-a-Person Test. Qualitative and Structural Dimensions of Object Relations. Bird’s Nest Drawing.  Human Figure Drawings.       Person Picking an Apple from a Tree. 
Observational (Bornstein, 2011) Test scores are derived purely from observers’ ratings of person’s behavior exhibited in vivo, or in a controlled setting. Spot Sampling. Behavior Trace Analysis. N/A.
Informant Report (Bornstein, 2011) Test scores are based on knowledgeable informants’ ratings or judgments of a person’s characteristic patterns of behavior and responding. SWAP-200.  Informant-Report version of the NEO Personality Inventory. N/A.
Comprehensive Art Therapy Assessments (Betts & Deaver, 2019) Protocol requires person to engage with variety of media and yields information integrated from multiple sources, including direct observation as well as person’s comments; and formal elements scores assigned to the art products and/or impressionistic interpretations. N/A. Art Therapy Projective-Imagery Assessment. Diagnostic Drawing Series.      Expressive Therapies Continuum.      Ulman Personality Assessment Procedure.

*from Table 3 in Bornstein, 2011, p. 538.

References

Bender, L. (1938). A visual-motor gestalt test and its clinical use. New York, NY: American Orthopsychiatric Association.

Betts, D. J. (2003). Developing a projective drawing test: Experiences with the Face Stimulus Assessment (FSA)Art Therapy: Journal of the American Art Therapy Association, 20(2), 77-82.

Betts, D. J. (2013). The Face Stimulus Assessment (FSA) Rating Manual (2nd ed.). Department of Art Therapy, George Washington University, Washington, DC.

Betts, D. J., & Deaver, S. P. (2019). Art therapy research: A practical guide. New York, NY: Routledge.

Betts, D. J., & Groth-Marnat, G. (2014). The intersection of art therapy and psychological assessment: Unified approaches to the use of drawings and artistic processes. In L. Handler & A. Thomas (Eds.), Figure drawings in assessment and psychotherapy: Research and application (pp. 268-285). New York, NY: Routledge.

Bornstein, R. F. (2011). Toward a process-focused model of test score validity: Improving psychological assessment in science and practice. Psychological Assessment, 23(2), 532–544.

Cohen, B. M. (1985/1994/2012). The Diagnostic Drawing Series Rating Guide. Self-published manual, Alexandria, VA.

Cohen, B. M., Hammer, J. S., & Singer, S. (1988). The Diagnostic Drawing Series: A systematic approach to art therapy evaluation and research. Arts in Psychotherapy: Special Research in the creative arts therapies, 15(1), 11-21.

Deaver, S. P. (2009). A normative study of children’s drawings: Preliminary research findings. Art Therapy: Journal of the American Art Therapy Association, 26(1), 411.

Deaver, S. P., & Bernier, M. (2014). The Art Therapy Projective-Imagery Assessment. In L. Handler & A. Thomas (Eds.), Figure drawings in assessment and psychotherapy: Research and application (pp. 131-147). New York, NY: Routledge.

Gantt, L. (1990). A validity study of the Formal Elements Art Therapy Scale (FEATS) for diagnostic information in patients’ drawings. Unpublished doctoral dissertation, University of Pittsburgh, Pittsburgh, PA.

Gantt, L., & Tabone, C. (1998). The Formal Elements Art Therapy Scale: The Rating Manual. Morgantown, WV: Gargoyle Press.

Hinz, L. D. (2009). Expressive Therapies Continuum: A framework for using art in therapy. New York, NY: Taylor & Francis.

Kagin, S. L., & Lusebrink, V. B. (1978). The Expressive Therapies Continuum. The Arts in Psychotherapy: An International Journal, 5, 171-180.

Kaiser, D. H., & Deaver, S. (2009). Assessing attachment with the Bird’s Nest Drawing: A review of the research. Art Therapy: Journal of the American Art Therapy Association, 26(1), 26-33.

Koppitz, E. M. (1968). Psychological evaluation of children’s human figure drawings. New York, NY: Grune & Stratton.

Levick, M. F. (2001). The Levick Emotional and Cognitive Art Therapy Assessment (LECATA)Boca Raton, FL: The South Florida Art Psychotherapy Institute.

Naglieri, J. (1988). Draw A Person: A quantitative scoring system. San Antonio, TX: The Psychological Corporation.

Silver, R. A. (1983). Silver Drawing Test of Cognitive and Creative Skills. Seattle, WA: Special Child Publications.

Silver, R. A. (2002). Three art assessments: The Silver Drawing Test of Cognition and Emotion; Draw a Story: Screening for Depression; and Stimulus Drawing Techniques. New York, NY: Brunner-Routledge.

Ulman, E. (1965). A new use of art in psychiatric diagnosis. Bulletin of Art Therapy, 4, 91-116.

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