This research explores the experiences and practices of Medical Art Therapists; specifically, how working with clients in a medical setting, often as a part of a multidisciplinary team, impacts the work of an Art Therapist. Researchers reviewed the general literature regarding children and adults’ experiences of hospitalization and utilization of psychosocial services. Medical Art Therapy literature is reviewed next, emphasizing work with children, families, and adults. Informed by the literature, researchers invited Medical Art Therapists to participate in a focus group and/or follow-up survey. Researchers conducted a focus group in which participants discussed their experiences and created response art. A survey was then sent to focus group participants and other respondents who were unavailable for the focus group. Researchers identified four categories that emerged from the survey data: “art as self-expression,” “categorization of Art Therapy,” “considerations specific to the medical setting,” and “range of utility” of Medical Art Therapy. Researchers used these categories to analyze data from the focus group and response art. An additional category emerged from these two data sets: “personal experience.” The response art naturally offered another category for analysis: “features of the art.” Researchers compared findings across all data sets and discovered meanings by setting these findings in the context of the general and Medical Art Therapy literature. Further research is warranted to support expansion in the field of Medical Art Therapy.

This research project is located in the context of Aboriginal health and education, and in particular, emotional and social wellbeing, recognising the critical need for effective mental health services and resilient, well-trained workers in the field of mental health.Mental health is understood to include a broad spectrum of conditions with extreme and chronic mental illness at one end and resilience or wellbeing at the other – the socalled ‘soft end’ of the social health spectrum. While recognising that the lines of demarcation between one category and another are grey, my thesis addresses the problems at the latter end of the spectrum: problems of excessive pain; the grief and despair caused by dispossession, loss of place, family and identity; and the deep frustration, humiliation and anger that results in family violence and child sexual abuse, intergenerational substance abuse, neglect and poor physical health. It is my position that very many Aboriginal people who need to make changes in their lives in order to feel well and functional in the world are not suffering from a Western disease but from the transgenerational consequences of colonisation. In recognition of the notion that Aboriginal wellbeing is everybody’s business, this PhD research project represents my response to these consequences.While popular assumptions are made about the relevance of art to Aboriginal health and many Aboriginal people testify to the fact that their engagement with art (writing, drama, dance, music and visual art etc.) has brought about significant change in their lives, there is no available research in Australia that supports the development of an arts-based approach to learning/therapy/wellbeing that has, for reasons that are well understood, the potential to suit the needs of Aboriginal people.Addressing this gap in the research, I inquire into an experiential, arts-based, emotionfocused, narrative-orientated, constructivist approach to healing in the tradition of humanistic psychology, which emphasises the importance of an emancipatory, clientcentred processes that facilitates the development of awareness, creativity, clarity of expression and critical reflection. The position I take breaks with the traditions of the biomedical model and conforms to the now widely held view that psychology and counselling treatment programs for Aboriginal people must address the whole person, emotionally/spiritually, mentally and physically, responding to the individual in his/her sociopolitical and historical context. Expressive arts therapy, the multi-modal approach to healing explored in this thesis, lays claim to these intentions.In this project, I locate myself as the researcher/practitioner whose life-stance is expressive of the phenomenological principles of experiential learning and reflexivity. Accordingly, I have drawn on a number of closely related research methodologies all of which, I argue, are consistent with phenomenology and Indigenous, participatory research practices: critical action research, art-based research and phenomenological research methodology. These modes of inquiry are linked through principles that value subjective experience and allow for a diversity of ways of knowing. Embracing an expanded field of ways of knowing respectful of Indigenous epistemologies is at the core of the arts-based therapy program under investigation.Expressive arts therapy, in this research project, was delivered in two modes: one was a series of nine full-day group workshops conducted over an academic semester; the other was a series of ten intensive individual therapy sessions with three participants conducted over the period of a year. The participants or ‘co-researchers’ were drawn from the College of Indigenous Australian Peoples and the Education and Art departments at Southern Cross University. Three mature-age Aboriginal students who had engaged in the Masters of Indigenous Studies program emerged as the core participants who, having contributed to the development stage of the project, followed the program through the group workshops to the final interviews at the end of the series of individual sessions.This thesis is, in part, an illustrated narrative of the in-depth work the core participants did with me in both the context of the group and individually. It invites the active participation of the reader. Insights into the nature and impact of expressive arts therapy are offered through a focus on the lived experience of the three core participants, their reflections on the program and their observations of the changes they made in their lives. An important parameter that I set, determined that the ultimate voices of authority were to be those of the participants. I was not at liberty to look for meanings that went beyond their experience and understanding.I argue that the experiences of expressive arts therapy re-presented in this thesis demonstrate that expressive arts therapy is in principle consistent with current approaches to Aboriginal psychology and counselling currently recommended by Aboriginal professionals and spokespeople in the field of Aboriginal health. Furthermore this body of work demonstrates that expressive arts therapy is a culturally appropriate intervention grounded in a creative process that has the potential to facilitate healing and change in the lives of people suffering from the long-term consequences of damaging childhoods.It is my hope that this approach to healing will be further researched and developed and, with culturally appropriate terms of reference, adapted to a wide variety of existing community services – rightfully, Aboriginal and Torres Strait Islander practitioners working for the wellbeing of their own people.

This research project is located in the context of Aboriginal health and education, and in particular, emotional and social wellbeing, recognising the critical need for effective mental health services and resilient, well-trained workers in the field of mental health.Mental health is understood to include a broad spectrum of conditions with extreme and chronic mental illness at one end and resilience or wellbeing at the other – the socalled ‘soft end’ of the social health spectrum. While recognising that the lines of demarcation between one category and another are grey, my thesis addresses the problems at the latter end of the spectrum: problems of excessive pain; the grief and despair caused by dispossession, loss of place, family and identity; and the deep frustration, humiliation and anger that results in family violence and child sexual abuse, intergenerational substance abuse, neglect and poor physical health. It is my position that very many Aboriginal people who need to make changes in their lives in order to feel well and functional in the world are not suffering from a Western disease but from the transgenerational consequences of colonisation. In recognition of the notion that Aboriginal wellbeing is everybody’s business, this PhD research project represents my response to these consequences.While popular assumptions are made about the relevance of art to Aboriginal health and many Aboriginal people testify to the fact that their engagement with art (writing, drama, dance, music and visual art etc.) has brought about significant change in their lives, there is no available research in Australia that supports the development of an arts-based approach to learning/therapy/wellbeing that has, for reasons that are well understood, the potential to suit the needs of Aboriginal people.Addressing this gap in the research, I inquire into an experiential, arts-based, emotionfocused, narrative-orientated, constructivist approach to healing in the tradition of humanistic psychology, which emphasises the importance of an emancipatory, clientcentred processes that facilitates the development of awareness, creativity, clarity of expression and critical reflection. The position I take breaks with the traditions of the biomedical model and conforms to the now widely held view that psychology and counselling treatment programs for Aboriginal people must address the whole person, emotionally/spiritually, mentally and physically, responding to the individual in his/her sociopolitical and historical context. Expressive arts therapy, the multi-modal approach to healing explored in this thesis, lays claim to these intentions.In this project, I locate myself as the researcher/practitioner whose life-stance is expressive of the phenomenological principles of experiential learning and reflexivity. Accordingly, I have drawn on a number of closely related research methodologies all of which, I argue, are consistent with phenomenology and Indigenous, participatory research practices: critical action research, art-based research and phenomenological research methodology. These modes of inquiry are linked through principles that value subjective experience and allow for a diversity of ways of knowing. Embracing an expanded field of ways of knowing respectful of Indigenous epistemologies is at the core of the arts-based therapy program under investigation.Expressive arts therapy, in this research project, was delivered in two modes: one was a series of nine full-day group workshops conducted over an academic semester; the other was a series of ten intensive individual therapy sessions with three participants conducted over the period of a year. The participants or ‘co-researchers’ were drawn from the College of Indigenous Australian Peoples and the Education and Art departments at Southern Cross University. Three mature-age Aboriginal students who had engaged in the Masters of Indigenous Studies program emerged as the core participants who, having contributed to the development stage of the project, followed the program through the group workshops to the final interviews at the end of the series of individual sessions.This thesis is, in part, an illustrated narrative of the in-depth work the core participants did with me in both the context of the group and individually. It invites the active participation of the reader. Insights into the nature and impact of expressive arts therapy are offered through a focus on the lived experience of the three core participants, their reflections on the program and their observations of the changes they made in their lives. An important parameter that I set, determined that the ultimate voices of authority were to be those of the participants. I was not at liberty to look for meanings that went beyond their experience and understanding.I argue that the experiences of expressive arts therapy re-presented in this thesis demonstrate that expressive arts therapy is in principle consistent with current approaches to Aboriginal psychology and counselling currently recommended by Aboriginal professionals and spokespeople in the field of Aboriginal health. Furthermore this body of work demonstrates that expressive arts therapy is a culturally appropriate intervention grounded in a creative process that has the potential to facilitate healing and change in the lives of people suffering from the long-term consequences of damaging childhoods.It is my hope that this approach to healing will be further researched and developed and, with culturally appropriate terms of reference, adapted to a wide variety of existing community services – rightfully, Aboriginal and Torres Strait Islander practitioners working for the wellbeing of their own people.

This quasi-experimental study examined the effects of three interventions with international college students referred for adjustment and language difficulties. Fifty-four international students were assigned to treatment groups including expressive group counseling (n = 14), group speech therapy (n = 14), interdisciplinary counseling/speech intervention (n = 13), and the no treatment control (n = 13). Three null hypotheses were analyzed using a two factor repeated measures analysis of variance to determine whether the four treatment groups behaved differently across time according to pre- and posttest results of the ASR Total and Internalizing Problems scales and the CCSR total scores. Two null hypotheses were rejected at the alpha .05 level of statistical significance with large treatment effects. Post hoc analyses were conducted when a statistically significant interaction effect was found. The no treatment control group was established as a baseline to examine how each intervention group performed over time when compared to the no treatment control group. Results of the post hoc analysis for Total Problems indicated that international students in all three treatment groups demonstrated statistically significant improvements in total behavior problems at the alpha .025 level (Expressive counseling: p = .002, Speech: p = .01, and Interdisciplinary: p = .003) and large treatment effects (partial η2 = .33, .24, and .31, respectively), thus indicating all three may be considered effective mental health treatments to target international students' total behavior problems. Results of the post hoc analysis for Internalizing Problems indicated that the interdisciplinary counseling/speech intervention was statistically significant (p = .02) in lowering internalizing problems and had a large treatment effect (partial η2 = .22). The expressive group counseling intervention also demonstrated a large treatment effect (partial η2 = .15) although not a statistically significant level (p = .04). The large treatment effects obtained for both interventions highlight the benefit of expressive group counseling as a sole intervention, as well as when combined with group speech therapy, for ameliorating international students' internalizing problems.

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