Original scientific paper
https://doi.org/10.63614/t.3.3.12
Silenced by Structure: The Quiet Crisis of Arts Therapists’ Professional Identity in Child Life Hierarchies
Susanne Bifano
Supplements: 06 transfer3 2025 ENG ON-LINE Bifano.pdf
Abstract
This qualitative study examined how hierarchical organizational structures
shape and, at times, silence the professional identity of pediatric hospital–
based art therapists. Eight art therapists from children’s hospitals across the
United States participated in semi-structured interviews analyzed thematically
using Braun and Clarke’s (2006) framework. Guided by Structuration Theory
(Giddens, 1984) and Social Identity Theory (Tajfel & Turner, 1979), the study
investigated how institutional systems, departmental placements, particularly
within child life, and managers’ discipline affect visibility, perception, and
professional efficacy. Four themes emerged: (1) Professional Identity Challenges,
(2) Organizational Structures and Support, (3) Emotional and Professional
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Bifano
Challenges, and (4) Perceived Value of Hospital Art Therapy. Findings reveal
how systemic factors, such as departmental misalignment and reporting to nonmental health providers, influence perceptions of art therapy, its tokenization,
ethical decision-making, professional growth, and practitioner well-being.
Despite these structural barriers, art therapists demonstrated integrity through
advocacy, adaptation, and interdisciplinary collaboration. The study highlights
the quiet crisis of role misrepresentation and misuse that persists in child-lifedominated departments. Stronger institutional frameworks, discipline-specific
supervision models, and organizational reforms that align hospital leadership with the role and clinical value of art therapy are crucial to sustaining,
strengthening, and advancing pediatric hospital-based art therapists.
Keywords
art therapy; pediatric hospital; professional identity; organizational structure; interdisciplinary collaboration
Hrčak ID:
344011
URI
Publication date:
31.12.2025.
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