Art therapy helps family caregivers cope with challenging times

For Michelle McBurney, healing starts with a scribble. 

Quiet and determined, the 41-year-old caregiver draws thick, swirling lines onto a piece of paper—a form of meditation. The sketch resembles veins protruding from flexed muscles. 

“This is just helping me mellow out,” she said. 

Stress colors the contours of her life. McBurney, a native of Pontiac, Mich., cares for her husband’s 65-year-old uncle. She cooks, cleans the house and gives him showers, leaving little time for anything else. 

She forgets her own care, a common fate among 1.7 million family caregivers in Michigan. As the older adult population rises, more people will assume caregiving roles. Burnout has roiled a labor force often described as “invisible,” making them prone to anxiety, depression and grief-related illnesses. 

On a recent Thursday afternoon, McBurney takes a free art therapy class offered by The Art Experience, a Pontiac-based nonprofit nestled on a bare street devoid of noise and foot traffic. 

Intended for caregivers, the 12-week, grant-funded pilot program provides a space for creative self-expression, catharsis and respite. Caregivers learn mindfulness, or an awareness of internal states and surroundings commonly used in cognitive behavioral therapy, self-care and positive psychology. Caregivers also meet one-on-one with an art therapist to share sensitive matters outside of the group. 

Creative skills aren’t required. Instead the program promotes a “come as you are” mantra. Each week, caregivers make art, from puffy paint portraits and magazine collages to dioramas and “joy” jars filled with trinkets. They discover ways to cope with chronic stress, shed negative self-images and surface strengths within themselves. 

“Art is really more of a vehicle to get people to open up and express themselves,” said art therapist Lisa Bennett of the studio.

“If you think about straight talk therapy, it can be very intimidating for people.” 

A need for caregiver relief

Family caregivers take on multiple roles when a loved one loses independence through illness, aging, cognitive decline or limited mobility. Often ill-prepared and armed with meager resources, they must keep someone fed, healthy, safe and alive.  

Those demands erode their well-being. 

A survey from the Glengariff Group revealed caregivers faced physical and mental health challenges as a result of their responsibilities. As the hours devoted to caregiving grew, struggles amplified. The New York & Michigan Solutions Journalism Collaborative commissioned the poll of 1,000 caregivers.  

“Most of the caregivers I work with don’t even realize that they don’t care for themselves,” Bennett said. “They’re so busy caring for others that it’s so natural. They don’t realize how often they’re putting themselves on the back burner.” 

Jennifer Yess, a 62-year-old caregiver living in West Bloomfield, finds comfort within the vast walls of the community arts studio. She paints blue, pink and purple hearts onto a paper during Thursday’s class. They evoke a rabble of butterflies. Each brushstroke brings calm. 

The days spent caring for her 89-year-old mother with dementia and 2-year-old grandson are rewarding yet exhausting. These commitments altered her free time and relationships. As priorities changed, some friends drifted away, breeding a sense of isolation. 

“They just exclude me because I can’t do the things I used to be able to do. I’m in a different place,” Yess said.

She searched for help. Thanks to a support group for grandparents, Yess found art therapy. “It takes the stress off and gives me some respite,” she said. 

The sessions bolstered an optimistic view of life and taught her techniques to battle racing thoughts and self-care. She shows herself grace, taking naps when necessary. Rejuvenated, she can devote more time to her grandson. They’ve sculpted Play-Doh together. 

An unregulated landscape

Art therapy is a growing field that blends art making, creative process and applied psychological theory. 

These mental health professionals hold at least a master’s degree and complete supervised, post-graduate training. They work in schools, hospitals, community clinics or they have established private practices. 

In recent years, the practice has caught the eye of federal agencies. The Departments of Defense and Veterans Affairs launched creative art therapy initiatives for military veterans, their families and caregivers. 

No matter the setting, art therapists aim to boost sensory-motor functions,  self-esteem and social skills and foster emotional resilience. 

Yet an absence of legal oversight stymies the profession.

Michigan doesn’t offer art therapy licenses, meaning anyone can claim to be a practitioner, said Sydney Tremont, president of the Michigan Association of Art Therapy. 

The need for licensure drains talent statewide. Tremont said between 200 and 300 art therapists work in Michigan, yet she’s observed a growing exodus of professionals relocating elsewhere because of the licensure gap. Last year, legislators introduced two bills in the Michigan House to rectify these issues. The bills haven’t advanced for a vote. 

Some training providers undermine the field’s legitimacy. A spate of online programs teaching art therapy, Tremont said, fail to meet ethical and professional standards, which are established by the Art Therapy Credentials Board. 

The unregulated landscape also bodes potential safety risks for clients, Tremont said. For instance, an art therapist treating survivors of sexual trauma would not use glue because the substance could be triggering. 

“Somebody who doesn’t have that training might engage with different art mediums that could be harmful,” Tremont said. “It could create an emotional reaction that they don’t have the ability to reduce.” 

Processing emotions when words fail

The recollection of traumatic or distressing events can be difficult to process if precise language is out of grasp. 

“You might not have the words. A lot of these experiences are sensory,” said Girija Kaimal, a professor at Drexel University in Philadelphia. 

The artistic process holds therapeutic value, Kaimal said, serving as an alternative means of navigating thoughts and emotions and a tool to strengthen a person’s self-efficacy, or confidence in their ability to solve problems. 

“Through the process of making decisions and coming to a resolution, you practice dealing with uncertainty,” Kaimal said.

Studies show art therapy can treat a range of health problems, from diabetes to post-traumatic stress disorder. Two states, Maryland and New Mexico, offer health insurance reimbursement for art therapy services. 

However, more evidenced-based research could promote more mainstream acceptance of the practice across the healthcare sector, including hospital systems and insurance companies.  

“We need more of that. And we’re building that base,” Kaimal said. 

Kaimal helped lead a study on the effects of coloring and art therapy on family caregivers of cancer patients and oncology nurses, therapists and physicians. After these sessions, study participants reported increased pleasure and decreased burnout. Among caregivers, cortisol levels, a way to measure stress, also declined. 

“People found meaning and value in something that you might think is mindless, like coloring,” she said. “The ones who said they had some prior art experience tended to show better outcomes.” 

Tools to cope when difficult days come

With a booming voice and shock of red hair, Lisa Bennett tries to brighten the caregivers’ spirits inside the studio. The casual atmosphere is judgment-free, so self-expression and vulnerability can flourish.  

Art can speak volumes. As part of the job, Bennett pays attention to a client’s aesthetic choices. Certain colors could represent strong memories and emotions. 

Positive psychology, a branch promoting happiness and emotional wellness, also powers each session. The therapeutic approach explores strengths and emphasizes connection, gratitude and awareness to enhance quality of life versus solely focusing on negative traits and experiences. 

“I help people to look at how they’re talking to themselves,” Bennett said. 

Are they too self-critical? 

Usually, the answer is yes, so Bennett uses a metaphor to disarm caregivers of negative thoughts. She tells them to imagine wearing invisible tool belts around their waists. Each tool, like a mindfulness technique, helps them cope when the hard days come. 

Across cultures, people don’t always perceive themselves as caregivers, which is often a fluid identity, despite engaging in such tasks. They see caregiving as a fulfillment of family obligations. 

Among caregivers, self-care, Bennett said, can be disruptive. 

“Suddenly, you’re putting yourself up there as a priority,” she said. “This can sometimes cause some friction with other people around you who don’t like it. ” 

‘It gives you a skill set’

On a neurological level, the artistic process can stimulate feel-good chemicals in the brain.

“Whenever we are creating work, we’re basically activating our natural reward system,” said Kelly Darke, an art therapist for Henry Ford Health’s Creative Mindfulness with Art. “Serotonin, oxytocin can help stabilize our mood.”  

The free virtual program for adults began in 2020. Some participants are caregivers who engage in a mix of independent art-making and discussions over computer screens. 

Across sessions, Darke stresses the benefits of creative practice—there are no definitive rules nor pressure to show off work to the group. “I try to make it as comfortable and as open as possible,” she said. “There’s no right or wrong way to do this.” 

Simple words are also powerful catalysts. Concentrating on a single word, Darke said, encourages the brain to search for feelings the word evokes. For example, Darke showed the word “gratitude” to the group. People wrote the word and embellished their papers with designs. Then, she told them to describe their relationship to that word. “That really helps them visualize intention,” she said.

From her Harrison Township home, Carolyn Roach Tokarz, a 67-year-old Henry Ford Health retiree, takes the virtual art therapy class. Pencils and crayons are her go-to creative instruments. During these sessions, Tokarz often thinks about her mother, whom she once cared for.   

Pencil drawings chronicle shared moments across a lifetime. Her mother holds her hand while they sit on a bed. Her mother, smiling, walks her down the aisle during her wedding. 

Then came the hard times missing on the paper. Eventually, her mother stayed in a nursing home and developed dementia. Tokarz was worried. 

“I was working full time a lot of hours and spent every available time going over to see her and spend time with her,” she said. 

Art therapy helps Tokarz navigate vestiges of grief that haven’t gone away. “It gives you a skill set, you know, a way to process,” she said. “It doesn’t end your world when someone dies. I’ve had enough experience to know that life goes on.” 

The last drawing shows Tokarz embracing her mother as she dies. 

Her name was Annamary.  

Recognizing strengths

Caregiving gives McBurney satisfaction and purpose. But she once walked into the studio stuck in the doldrums of negativity and depression. “Some people don’t understand the continuous energy it takes to care for the elderly,” she said. 

The light-heartedness of the caregiver group softened her. They drew, painted and built connections, chatting about weight loss and marriage. Soon, self-criticism began to fade. “Everybody’s so friendly,” she said. “It’s got me to open up a little bit.”

As the weeks rolled by, McBurney perfected an art that’s become a habit of stress relief. Whenever she’s overwhelmed, she’ll grab a piece of paper and draw lines over and over again. She’s learned to recognize her strengths and given them names. Inside those lines, she’s written words she hopes never to forget. Resilient. Brave. Caring. Strong.

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Where to get art therapy

The Art Experience
The Pontiac-based nonprofit organization offers a range of art therapy programs. 

Birmingham Bloomfield Art Center 
The Art of Caregiving series includes free art workshops focused on a variety of mediums, from ceramics to jewelry making. 

Creative Arts Therapies, Inc. 
Serving southeast Michigan, the organization offers a range of creative art therapies for all ages and skill levels. 

Creative Mindfulness With Art 
Established by Henry Ford Health, the free, virtual sessions provide self-care tools to participants.  

Hannan Center 
The Detroit-based organization offers art therapy and music therapy classes for older adults living with dementia as part of its DayBreak Program.