In 2003, Time magazine reported a Mayo clinic's findings that “children between age five and nineteen have at least a 7.5% chance of being found to have ADHD [Attention Deficit Hyperactivity Disorder], which amounts to nearly 5 million kids.” Children with ADHD or ADD (Attention Deficit Disorder) experience challenges that intensify around the age of five with the addition of school curricula. These challenges include impulsivity, sensitivity, anger, anxiety disorders and depression. Secondary effects inevitably arise, such as humiliation, labeling, frustrated teacher and peer relationships, and family and sibling stress. Medications present additional hurdles: side effects and appropriate dosage timing during school days.

One of the biggest challenges for the ADD/ADHD child, however, is the emotional and psychological issues that they face. These children have unusual needs and are often unable to build stable or close relationships. They can also suffer from acute loneliness, and often feel like “the black sheep” in their families. For such reasons, ADD/ADHD children benefit from art therapy as a formal inclusion in their treatment. The gift of art therapy for children struggling with ADD/ADHD lies in the opportunities it provides for them to safely express feelings that are possible sources of confusion or pain. With art as the focal point, the child engages in a process that both releases creative energy and simultaneously supports the verbalization of deep emotions. The satisfaction generated from creating art enhances and nurtures a child's self-esteem. Additionally, group art therapy with ADD/ADHD children can support the social and relationship-building skills they so desperately require.

Current thought on treatment for ADD/ADHD children pushes far beyond traditional drug therapy. As noted in Time, leading experts in the medical field believe that drugs are actually most effective when combined with talk therapy or other counseling since “not even the drug companies argue that pills alone are the ideal answer to mental illness.” Indeed, some doctors have been willing to admit that the usage has outstripped their knowledge base. Dr. Glen Elliott, director of the Langley Porter Psychiatric Institute's Children's Center at the University of California, San Francisco goes so far as to claim, “Let's face it, we're experimenting on these kids without tracking the results.”

The environments of home, school and family, and the self are the “first step in treatment,” says Daniel Amen. Amen recommends that psychotherapy accompany suitable biological treatment, focusing on exploring themes of negative belief systems, isolation, low self-esteem and depression. Amen's typical treatment models combine social support, pro-active parenting styles, medication, vitamins, diet supervision, self-regulation, organizational support and school organization strategies. Art therapy is a natural fit with these new models and can help attain primary psychological and social treatment goals.

The art process is a healing process. Encouraging children to be creative supports powerful expressive experiences that help them establish self-identity. Rudolph Steiner, one of the founders of the Waldorf Schools, contends that creative expression “is an inner urge, an inner longing.” The Waldorf method promotes teaching young children through imagination, not intellectualism. Children naturally and easily adopt art as a vehicle of expression. Art therapists explore the child's world through the use of imagination and fantasy, permitting the child's own creativity to spark and guide desired change. Through art therapy, the child has a space of safety and playfulness, as well as the possibility to look at issues from unusual or unanticipated perspectives. Art techniques further allow for re-creation, i.e., for de-constructing and re-constructing on literal, visual and metaphorical levels.

Art therapists are trained in the use of various media and techniques (painting, drawing, beading, sculpting and printmaking, for example). Each art task is specifically chosen to elicit content. Children usually do not have the vocabulary or language skills to accurately or coherently express their feelings of psychic pain or trauma. This difficulty is eased through art – the image produced often speaks for itself. However, the creative process can lead from conversation about the art directly into conversation about the relevant area of conflict, which the child could not have pinpointed without having first produced the art. The art thus stimulates both verbal and nonverbal communication skills. Also, unlike the awkward stiffness that frequently characterizes the traditional psychotherapy relationship, using art as a tool allows the therapist to coexist with the client in a working environment that fosters more intimacy and comfort.

The trend in post-modern therapy appears to be the in-gathering and assimilation of various modalities to support greater personal growth and the psychological integration of the client. Art therapy provides many rich communication possibilities at many levels, and may prove particularly powerful for children who are more fluent in the visual rather than the verbal realm. Especially in our image-saturated culture, developing a sense of self through one's own visual and tactile efforts seems exceptionally important. For ADD/ADHD children, who struggle constantly against the effects of poor self-awareness and low self-esteem, art therapy offers a pathway to health and transformation that uniquely meets their expressive needs.

References
Amen, Daniel. (2001). Healing ADD. New York: Berkley Books.
Kluger, Jeffrey. (2003, November 3). Cover article. Time, 162, 48-58.
Steiner, Rudolph. (1995). The kingdom of childhood. (Helen Fox, Trans.). (Rev. ed.). New York:
Anthrosophic Press.

Cameron M. Plagens, M.A.A.T., practices Gestalt Art Therapy at Westbay Counseling Center in Westlake, Ohio. She specializes in working with ADD/ ADHD children. She can be reached at (440) 871-6700.