A Conversation with Silvana Castellucchio & Charlotte Coles at ArtAICare

Q: Could you start by introducing yourselves and telling us how you became involved with the ArtAICare project?

I'm Silvana Castellucchio, an art therapist, and I'm part of the EFAT, the European Federation of Art Therapy. My journey in art therapy was initially driven by my interest in using creativity and exploring its possibilities in the therapeutic process. I got in touch with the ArtAICare project because I'm part of EFAT's research committee, and we were directly contacted by Bereket, the project leader. After a very first conversation, I decided to jump into this project.

I'm Charlotte Coles, a child and adolescent psychologist. I'm not yet an art therapist, although I aim to be one in the future. I found out about this study when Bereket got in touch with me. We had our first Zoom call, and his passion was just intoxicating, so I decided to take part, and I have not regretted it for a moment.

Q: That's wonderful to hear! As observers and taking part as facilitators of the studies, what were some of the key therapeutic elements that impressed you the most, especially regarding visual exposure and the immersive virtual reality experience?

Silvana Castellucchio: After participating in the studies as an observer, I was truly impressed by some key elements derived from the visual exposition of the participants. The most touching element was the memories that these experiences were able to enable in the participants. Many of them remembered elements, experiences, and feelings from their childhood or youth, or they recalled other sensorial aspects linked to their memories. I'm really wondering how this research could contribute to the study of memories and image exposure, and the possibility of using these aspects as therapeutic elements able to create a new narration of their previous experiences.

Charlotte Coles: I've been thinking about that too. From a therapeutic point of view, I think it could really speed up the process for therapists in trying to find something that genuinely resonates with the patients. The VR, in particular, introduces a very new, immersive element to therapy, which is often seen more for gaming. However, it really helps to make the experience immersive, allowing participants to more easily leave their usual surroundings and focus entirely on the paintings and their experience in the moment. This allows for a lot more exploration than previously, effectively opening up new doors.

Silvana Castellucchio: I totally agree with you, particularly about virtual immersive experiences. Participants often told us that they were able to enter a new environment very quickly. They were impressed by how fast the process was. They could immediately enter a different situation that was completely unlike their everyday life. One participant, I remember, told us it was magnificent, a possibility to completely shift from everyday life concerns and move into what they truly liked – nature, the woods, the possibility to walk there, to breathe fresh air. This process, for sure, can speed up reaching turning points in the therapeutic process. It doesn't mean it's the only answer, but for the therapist, it can be a tool that empowers us in the process. Even the most sceptical at the very beginning confirmed that they had at least a positive experience, if not announcing something specific, then at least something calm and relaxing, which means the paintings resonated with their needs.

Q: Let's talk about the role of Artificial Intelligence. Many people, including perhaps therapists, might have reservations about AI in such a sensitive field. What has your experience taught you about AI's integration into ArtAICare?

Charlotte Coles: I think it's really important that AI is included to help choose paintings that are particularly relevant for that specific person. Not only does this speed up the process for therapists, meaning we don't have to spend hours going through paintings and considering how each might resonate, but it also means that AI can come up with options that we didn't even consider, which may speak to that person in a completely different way than we're expecting. I think that's a really interesting and important development in real-time therapy.

Silvana Castellucchio: Integrating AI in therapy is something that, at the very beginning, I wouldn't have considered possible. The project initially might seem scary from some points of view, with concerns that it's "putting a distance between therapist and client because of the AI." Instead, it's different. I've experienced this here, being there during the user studies, hearing their feedback, and seeing their body language after the session. I have to say that I can confirm that it is possible to integrate AI and the therapist. Of course, the therapist will remain the leader of the therapeutic process, but he or she can be supported by technology.

Charlotte Coles: Before I came to this study, I actually thought that using AI in therapy was counterproductive. I knew of young people who use AI as therapists, and that was really concerning for me, especially after reading articles about both the negative and positive effects. I worried that many people are very influenceable, and you really need someone to be overseeing it. However, in the study, speaking to participants beforehand and then again afterwards, hearing their responses, and then them saying, "So you saw what I responded to this painting?" and then going a lot deeper into their experiences – I think that's really important. Even though AI helps and speeds up the process and facilitates it, the human aspect still needs to be there so that they feel more able to open up and feel more supported.

Q: Beyond the artistic and AI components, the ArtAICare platform also includes a dashboard with biomedical data. How has this data contributed to the therapeutic process, and what insights have you gained from it?

Silvana Castellucchio: After testing the dashboard included in the ArtAICare platform, I would say that the data the therapist collects through the system is very useful because they are explained in a very clear way. The therapist is able to see those biomedical elements and combine them with what he or she is already seeing in the therapeutic relationship and process. I was surprised how sometimes the biomedical data told us something more compared to the self-perception of the participant. For example, some elements raised the awareness that the positive feelings shown by the patient in reality were quite different and perceived by the body itself. These elements allowed us to talk much more in detail about the relationship between body and thinking, because they helped us as therapists to find out when this balancing might be missing, or support us in giving a mark point that says "pay attention, something different compared to what is shown is happening inside." Of course, only the physiological data could provide and sustain this. So, the platform offers us new tools, and we as therapists should not be scared of this, because if we consider them as tools, as a part of our job, they can be very useful during our process.

Q: What has your experience been like working with the ArtAICare team during the study?

Charlotte Coles: I absolutely loved being part of the ArtAICare team. Really, from the first day, it felt like I was part of the team, and that's not an experience you get frequently. Bereket's passion is a huge part of this; you can see with every single participant how much it means to him to understand from their perspective how it helped them and how it can be improved, and how it can influence the future of therapy. His goals for the future are incredible. With Saravana, he's incredibly funny and a really nice person, and he's great at these tech things. He's just a joy to be around. And Pavin, she's so nice and so proactive in trying to learn all of this. It's just been a really nice experience getting to know everyone and learning about all of this.

Charlotte Coles: I do not come from a tech background at all; I didn't understand what they were talking about most of the time. I had no idea what fNIRS was; I thought an EEG was something you could only have at a hospital. But they've explained everything to me in a really simple way that's actually made it possible for me to understand. Saravana explained the fNIRS, how the color changes depending on your state, like a leaf blowing in the wind – when you're more worked up, it's higher and more red, and as you calm down, it floats closer to the ground and shows more blue because you're more relaxed. It was really nice to actually have them explain things in a way that I could understand, and it really helped me to feel part of the team.

Silvana Castellucchio: I absolutely agree with you; I had the same experience. I felt very, very welcome by all the team, and I absolutely confirm what you said. I'd like to add that I jumped into this process almost two years ago when EFAT was contacted by Bereket. I had the same feeling, not as a participant in the user study, but as a professional. I've been involved by Bereket and his team like a professional, and they were willing to know what I think about this, how we could change things. The team was very open to changing their way of thinking, their way of seeing things, according to my perspective, the perspective of an art therapist. You are right, it's not so common, because you are trusted as a professional, and this is very important because it means that the path of this project is drawn in a very clear and intellectually honest way.

Charlotte Coles: They're really open to changing and adapting to what the therapist needs, what the participants need, and to try to always improve, rather than sticking to their original idea, their original plan, and being like, "Okay, this is what we intended, this is how we're going to do it." Which a lot of startups and tech companies do. But with ArtAICare, it's completely different; they're constantly evolving and trying to think of new ways that they can help, and I think that's a wonderful experience.

Silvana Castellucchio: Absolutely. You can find it in the name itself: "Art AI Care" – three parts of the same elements. It's a sign because words give meaning to reality, and so deciding to use this title means that only the three of them combined can bring forth the full potential.

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