TREE-HOUSE-PERSON TEST (H-T-P) IN ADOLESCENTS OF HD - CET

FROM THE NURSING FIELD

AUTHORS

Sara Arribas Mesonero

Sandra Suárez De Figueroa Díaz
Elena Castro Sánchez
Maria Jesus Pineda Navas
Suyai Tania Caravello Hernández
Juan Alberto Bella Fernández

INTRODUCTION

John Buck was a clinical psychologist who, in 1948, developed the House-Tree-People Test or
HTP (House-Tree-Person). It was originally based on the Intelligence Scale of
Florence Goodenough used it as a measure of intelligence.
Later, he aimed to assess personality, and this is how it is used.
currently. Updated the technique in 1969.

Graphic projective tests are an important reference in clinical and educational assessment.
and forensic, in psychology, psychiatry, nursing, social work; it is also a test
significant in the different areas of human and social resources, in guidance and
professional selection.

Within the Nursing Care Plan, the graphic projective techniques would be
reflected within the Nursing Interventions Classification (NIC)
Interventions Classification) such as: Art therapy (4330), defined as the facilitation
of communication through drawings or other forms of art. Next,
they list the most notable activities:

Discuss the description of drawings or artistic creations with the patient.

Spend some time with the patient during the use of the artistic medium.
Observe the patient's approach to the artistic medium (with doubts, meticulous or
aggressive).
Encourage the patient to describe their drawings or artistic creations.
Discuss with the patient the reason for drawing, giving a direct or indirect approach, if applicable.
Use drawings of human figures to determine the concept the patient has of
himself.
Interpret the meaning of the important aspects of the drawings, incorporating the
patient assessment data and literature on art therapy.

Drawing is an attractive task as it is a very suitable tool in the

situations where direct verbal communication about conflicting issues is difficult
due to the various obstacles existing in the motivational field or in the ability
verbal.

The person's attitude when facing the task can reveal certain characteristics: that
draw with joy or irritation, silently or talkatively, tense or calm, with one eye
put in the interviewer or with absolute negligence.

The following briefly describes what each drawing of the Test would analyze:

Lacasagenera creates a mix of conscious and unconscious associations referring to the

home and the most intimate interpersonal relationships. In the case of children, it seems
highlight the degree of adaptation towards siblings and parents, especially towards the
mother. It is an indicator of the person's ability to critically analyze the
problems created by events that occur within the home. Other aspects to
interpret refers to the accessibility of the subject, their level of contact with reality and
its degree of rigidity.

The tree generates more preconscious and unconscious associations than the other two.
drawings and represent a graphic expression of the sense of balance that one feels
person and their point of view on the resources that their personality has to obtain
satisfaction in their environment. Other additional aspects can also be interpreted.
like contact with reality and feelings of intrapersonal balance.

The character generates more conscious associations than those of the house or the tree.

including the direct expression of body image. The quality of the drawing reflects the
subject's ability to maintain personal relationships and to subdue his self and his
interpersonal relationships to a critical and objective evaluation. Sometimes, it brings forth
feelings so intense that some people sometimes refuse to do it. Other areas
what can be interpreted are those that refer to the concept that the subject has about their
sexual role and its attitude towards interpersonal relationships.

OBJECTIVES

General:
Facilitate the expression of emotions of a group of adolescents at the Day Hospital
through the graphic projective technique H-T-P.

Specific:
Observe the level of involvement of each of them during the test.
Encourage participation, once the test is completed, in the explanation of the drawings.

DEVELOPMENT

MATERIAL
A4 size white paper.
Pencils.
Erasers.
Group room with tables and chairs.
Ambient music.

The H-T-P test is conducted during a Health Workshop at the Day Hospital with 7
teenagers.

The objectives were explained and they were placed at a distance so that each one could
focus on their drawings and there would be a lower probability of 'contagion' as opposed to
to carry it out or by abandonment. Next, it was requested that they first make the drawing.
from a house the best they could, then a tree and to finish, a person. Each
one of them on a different sheet of paper.
The order of performing the H-T-P Test is from what generates the least resistance to what
what else. During its development, when it came to the part of drawing a person, one
the teenager initially opposed doing it by saying: "I don't know how to do it in another way"
manner.” Several verbal restraining measures were taken in the form of resolving doubts and
support for them to continue.

Once finished, and gathered in a group, they were asked to explain what they wanted.
to express or represent each one with that drawing. One was chosen, it was passed
in an orderly manner and gave the opportunity for others to participate by making a contribution,
comment or reflection. The group continued another day during a Socialization Workshop.
Below are some of the drawings they made:

Male, 15 years old

House:

In terms of size, it occupies almost all the available space,

what generally indicates feelings of frustration, irritability, and hostility towards an
restrictive environment.
Destaca la dimensión vertical; señala una posible búsqueda de la fantasía y una huída del
contact with reality.
The central location of the drawing usually indicates that the person tends to display behaviors.
excessively rigid to compensate for their anxiety and insecurity.
The apparent distance is shown with a car passing in front of the house.
Details: Emphasis on the peripheral or 'containment' lines, for example, on the roof,
seem to indicate a conscious effort to maintain control. The eaves of the roof
reinforced reflect a defensive and generally suspicious attitude.
The opaque windows (except for one that has glass) are generally found in
people with oppositional tendencies.
Tree

Regarding the size, it is large and robust. It reveals the

search for compensatory satisfaction in action or in fantasy. It denotes

mainly has a strong need for dominance.
Movement is perceived since the wind is blowing strongly and the tree is losing.
leaves. It is possible that the person has the impression that they are being undressed
Psychologically, he is losing the ability to hide his thoughts and
emotions and experiences strong feelings of guilt. The shading of the cup
indicates the anguish she feels about that area and its function (thoughts and fantasy).
The wind symbolizes the pressures caused by situational or personal forces.
environmental. It blows diagonally from right to left, which may reveal
regressive trends due to intrapersonal or environmental tensions.

Person:
 Regarding the proportion, the trunk is disproportionately
great reveals the presence of many unfulfilled impulses that a person may feel
in a very pronounced way. A long and thin trunk also carries connotations
schizoid.
The upper limbs are asymmetrical; it could indicate poor coordination and
impulsivity, physical clumsiness, and confusion of lateral dominance.
The position of the feet, diametrically opposed, can indicate feelings.
ambivalent.
The shading of the hands and the waist indicates the possible existence of concern and
conflicts in the expression and control of sexual impulses.
The emphasis on the peripheral lines of the head reveals great efforts to maintain the
control against disturbing fantasies or obsessive ideas. Emphasizes the strong stroke as
possible indicative of impulsivity.

Woman, 13 years old:

In all the drawings, the large number of erasures and redrawn parts stands out.
Making insubstantial attempts to achieve perfection and in some cases, erasures.
followed by a deterioration of form. They could indicate a very strong emotional reaction
towards the object or towards its symbolic meaning.

House
 Regarding the location, the central point of the drawing moves away.
upwards; it may indicate that it tends to seek satisfaction more in intellectualization and
in fantasy than in reality.
It highlights the vertical dimension, pointing out, as previously, a possible search for
satisfaction in fantasy.
Regarding the proportions, a large door is observed which would be indicative of a
excessive dependence on others.
The excessive emphasis on the lines of the roof and walls, also called lines
peripherals or 'containment' seems to indicate a conscious effort to maintain the
control. The reinforced roof eaves reflect a defensive attitude and generally
suspicious.
The windows allow for less direct and immediate forms of interaction with the environment.
that the door.

Tree:
 A trunk with a wide base is observed but narrows.
upward; it would indicate an early environment lacking affection and stimulation
you.
The strong and repeated strokes outlining the trunk indicate a certain
impulsivity. There is confusion or lack of clarity regarding the boundaries.
The lack of branches would indicate that the person has few resources to connect with
the others.
Within the non-essential details one would find fruits. It is common in children.
dependents draw apple trees.

Person:
 Regarding the size of the head, it is too big; for
what the person prioritizes is fantasy and intellectualization as a source
satisfaction.
Short arms in proportion to the body would be indicative of apathy or absence of
ambition and having difficulty connecting with others. Being glued to the
The sides of the body also denote a rigid internal control.
Among the non-essential details would be the omission of the neck, which may indicate
he feels that he is at the mercy of his bodily impulses, which often
results are overwhelming.

Male, 16 years old:

House

Situation of the drawing at the bottom of the page would indicate

tendency towards the concrete, depression, insecurity, and feelings of inadequacy.
Use the bottom edge of the paper as a base, which is indicative of the need for support.
It is called 'drawing to the limit' because it touches the edge of the paper but does not extend further.

there.
Uses a small part of the available space. Generally reveals the existence of
feelings of inadequacy and a tendency to isolate oneself in the environment.
Regarding the position, there is a lack of depth. It denotes a rigid and somewhat
committed to trying to compensate for certain feelings of inadequacy and insecurity.
Presence of movement. Any indication of it is pathological and expresses a risk.
imminent collapse of the self before the threat of extrapersonal pressures or
intrapersonal.
The roof and the walls generally represent the person's self. They are observed
inadequate contour lines that suggest a feeling of collapse
inevitable and poor self-control.

Tree:

The small size suggests strong feelings of

inadequacy when facing the environment.
Regarding the essential details, the broken or dry branches that could be pointed out would be...

to represent some type of traumatic event experienced by the person.

There is no organization between the branches and the trunk; the resources for the search for

satisfactions are below normal. Their lines are broken and fragmented,
suggesting insecurity, shyness, and low assertiveness.
Greater emphasis on drawing branches on the right side, just like extending the crown towards
this side; indicate an imbalance caused by a strong tendency to avoid or delay the
emotional reward.
Persona:

Like the previous drawings, it is a 'drawing at

limit”, using the bottom edge of the base paper. It indicates a need for support,
tendency towards the concrete, depression, insecurity, and feelings of inadequacy.
Start the drawing on the right side of the paper and erase it; continue in the center and it
delete again. Finally, it makes a third on the left side. Only it
these erasures in the drawing of the person could indicate a reaction
very strong emotional attachment to the object or its symbolic meaning.
The final situation of the drawing at one end could indicate the need for support, evasion and
escape.
The review of the stroke, reaching the shading at one of the ends, would denote
impulsivity and distress due to that area and its function.

Among the non-essential details would be the omission of the neck, which may indicate
he feels that he is at the mercy of his bodily impulses, which often he
results are overwhelming.

CONCLUSIONS

Graphic projective techniques, in this case the H-T-P Test, are complementary data.
to be taken into account in the Nursing Care Plan. As has been stated, they are
contemplated in the Classification of Nursing Interventions.

In adolescents, it facilitates the expression of emotions through drawing, which in

on occasions they do not know or cannot express in another way.
It could be observed objectively that the involvement and participation of some and others
they varied according to the motivation, the abilities, and the level of exposure in which they found themselves.

It is important to provide a safe environment so that each of them can

express oneself openly.

It can be said that the pencil stroke, when resting on the sheet of paper, brings with it
inevitably, according to the words of Robert Henri (American artist) 'the state
exactly in which the person is at that moment; that state remains there,
ready for everyone who is able to understand it to see and read it
signs.

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