Introduction

International students can encounter several psychological, physical, and social difficulties, including culture shock and acculturation stress, owing to the malfunctioning of their previous coping strategies (Bertram et al., 2014; Maeshima & Parent, 2020; Zheng & West-Olatunji, 2016; Zhou & Wei, 2020). To effectively support international students’ psycho-social well-being, it is essential for therapists and institutions to remain agile and purposeful in tailoring supportive strategies for their needs (Pedersen et al., 2016). This is particularly germane to students from South-East Asia, who often struggle with self-expression and are reluctant to seek student counselling services to support their well-being (Russell et al., 2008; Skaife & Reddick, 2017).

Talk therapy is one of the most common and well-recognised therapy techniques (Cook et al., 2010; Gabbard, 2009; National Institute of Mental Health, 2024; Sherwood, 2004). However, shifts towards more action-based approaches, not solely reliant on verbal expression, have arisen due to the difficulties posed by resistant, defensive or less vocal clients (Sherwood, 2004). Creative therapeutic modalities such as art, dance, drama, and music are recognised as having potential in contributing significantly to therapeutic processes (Gray, 2022; Sherwood, 2004). The application of these alternative therapies is, however, limited to international students (Lai & Andrews, 2024). Engagement with three-dimensional and tactile art mediums such as clay, which entail physical activities such as flinging or constructing, release repressed feelings, and thereby improve mental and physical well-being (Greenberg & Stone, 1992; Jang & Choi, 2012; Sholt & Gavron, 2011). Although studies are increasingly focusing on the use of art expression, such as drawing and painting, little attention has been given to working in three-dimensional mediums such as clay. Embodying a primal form of expression, clay, with its powerful tactile experiences, makes authentic communication and integration of emotions possible as it swiftly catalyses the articulation of emotions (Sholt & Gavron, 2011). Its malleable, three-dimensional representational capability can elicit affective reactions, including the emergence of memories, thoughts, and fantasies (Anderson, 1995). Additionally, the symbolic objects created with clay can convey profound levels of subjective significance and meaning (Graziano, 1999). Exploring the use of this therapeutic medium is worthwhile for international students. While there are two authors of this article, Berlinda, as an international student, writes from the first person and draws on her experience and research to inform the content.

As a child, I, Berlinda, found solace in shaping plasticine into figurines and scenes that conveyed emotions and stories beyond the capacity of words. This creative play offered a safe space where I could explore a world of fantasy and imagination without fear of judgment, creating and recreating narratives that brought me comfort and joy. As I matured, my relationship with clay evolved, yet it remained a significant outlet of expression. I often found myself instinctively rolling the clay into a ball and flattening it, a repetitive action that provided me with a sense of control.

Upon arriving in Australia as an international student from Singapore and embracing the role of a researcher, I was presented with a plethora of new experiences while transitioning into postgraduate studies in Australia. Early on, I seemed to experience cultural shock and aspects of acculturation stress, as I noticed my own susceptibility to psychological issues, such as depression and anxiety (Altinyelken et al., 2020). In my search for ways to support my own well-being and coping mechanisms, I was reminded of the role clay had played in my life. This reflection led me to explore this research topic under the Mental Health Research Thesis, a requirement of the University of Queensland (UQ) Master of Mental Health (Art Therapy) program.

With insufficient research available on international students using clay work as a therapeutic means of enhancing well-being, I chose to explore the impacts of clay on coping mechanisms and mental well-being, especially for international students, like myself, who are culturally shaped by various Asian influences. Current literature underscores the unique challenges international students face in pursuing their education abroad. Integrating into a new environment can elicit acculturation stressors and difficulty maintaining well-being. Additionally, international students, who may lack familial support, can be hesitant in seeking counselling. Action-based approaches to support their transition offer a modality more suitable for enhancing their well-being (Malchiodi, 2007). Clay work, in particular, has numerous therapeutic qualities that enable the expression of emotions and the release of tension (Nan et al., 2023; Suputtitada, 2021). Yet, to date, there are few if any journal articles detailing the use of clay work by international students for coping. This heuristic study, in which the researcher is also the participant, was granted ethical clearance from UQ’s Ethics Committee, and explores the potential of clay as a coping mechanism for an international student’s well-being.

Literature review

International students and acclimatisation

The phrase ‘international student’ encompasses a diverse range of students from various countries, irrespective of their immigration permit or legal documentation standing (McKinley, 2019). An alternative term is a ‘sojourner’, one who journeys to a foreign land to achieve a stated objective within a predefined timeframe (Li et al., 2014). International students support globalising education, with Australia seeing 580,373 overseas students enrolling with Australian education agencies in January–February 2023 (Australian Government, Department of Education, 2023). Despite the presence of faculty support services, challenges faced by international students are prominent as they struggle to acclimatise to academic expectations and life in Australia (Davis, 2010).

Cultural shock and acculturation stress

International students like me encounter a myriad of difficulties, such as adapting to unfamiliar cultures, language barriers and prejudices, loneliness, and improper treatment from academic staff, among other obstacles (Maeshima & Parent, 2020). Newton et al. (2021) reinforce that the added pressure of acclimating to a new environment, building new relationships, and juggling a demanding academic workload while maintaining work obligations can lead to the emergence of anxiety, stress, or depression.

During what is often defined as cultural shock (Winkelman, 1994), individuals can experience a multitude of emotions from positivity, elation, and enthusiasm for the newfound culture, to negative emotions accompanying individual crises. Acculturation is described as an alteration in cultural and psychological aspects that arises from consistent, direct interaction between different cultures and people (Zheng & West-Olatunji, 2016). During the adjustment period, acculturative stress may manifest when international students encounter psychological, physical, and social difficulties (Bertram et al., 2014; Zhou & Wei, 2020). This is due to the malfunctioning of one’s previous coping strategies and the absence of such mechanisms in the current surroundings (Zheng & West-Olatunji, 2016).

Factors that can affect sojourners can include cultural shock, cultural distance, lack of support network, stress and apprehension, linguistic difficulties, and learning environment, thereby negatively impacting mental health (Zhou & Wei, 2020). Importantly, Koo and Nyunt (2022) found that Asian international students often undergo overwhelming stress and anguish, thus triggering intense psychological distress. These unique stressors can affect their overall well-being.

Well-being

Well-being is a subjective concept – influenced by individual perspectives and diverse interpretations within similar cultural and linguistic backgrounds (Huang et al., 2022). Schmidt and Hansson’s (2018) definition of well-being goes beyond health and sickness, and includes one’s identity, physiologically, emotionally, inter-relationally, spatially, and temporally. In contrast, Dodge et al. (2012) assert that well-being is an equilibrium between one’s available resources and the adversities the individual encounters. Achieving well-being is akin to maintaining a delicate balancing act between psycho-social and physical resources to tackle the difficulties posed by these aspects of life. Should one side of this complex equation be out of balance, it could have a detrimental effect on the overall state of wellness (Dodge et al., 2012).

International students have an elevated likelihood of experiencing psychological issues such as rumination and stress-related concerns (Altinyelken et al., 2020), with the majority of the foreign students universally recognising health and well-being as an incorporation of physical and mental health (Newton et al., 2021). It also includes a balance between physical, mental and spiritual health, sense of safety, feeling of accomplishment or fulfilment, and a sense that one’s life is worthwhile (Tseng & Newton, 2002). Nevertheless, it is crucial to acknowledge that the variations in cultural heritage and ethnic origin, spiritual beliefs, or the experience of studying overseas can contribute to an array of unique perspectives on well-being (Tseng & Newton, 2002). Being able to employ coping strategies is essential for this cohort.

Coping strategies and promoting well-being

Coping strategies refer to the techniques employed by individuals to cope with stressful situations (Alharbi & Smith, 2018). They can be interpreted as continuous cognitive and behavioural attempts to overcome internal or external obligations, perceived as exerting excessive strain on one’s personal resources (Lazarus, 1993). The efficiency of the diverse coping mechanisms relies on the category of stressors and one’s experiences (Alharbi & Smith, 2018). To gain control of stressful situations, individuals can take a primary or secondary approach (Szabo et al., 2016). In the former, proactive measures are employed to acquire influence over the situation. Secondary approaches involve adjusting one’s expectations and assumptions to accommodate the new environment (Szabo et al., 2016).

Tseng and Newton (2002) identified eight coping strategies for international students: 1) understanding oneself and others; 2) creating, nurturing, and sustaining friendships; 3) broadening one’s horizons; 4) seeking assistance and resolving challenges; 5) developing cultural and societal networks and connections; 6) establishing ties with mentors and educators; 7) acquiring competence in the English language; and 8) practising the art of ‘letting go’. However, the implementation of adaptative coping mechanisms varies across diverse cultural backgrounds (Cao et al., 2021).

To promote psychological well-being, Seligman (2011) suggests the mnemonic PERMA, which comprises the pursuit and achievement of one or more of these essential components: “positive emotion, engagement, meaning, positive relationships, and accomplishment” (p.16). Positive emotion encompasses subjective experiences of fulfilment, happiness, delight, and optimism. Engagement, embodying the concept of flow, signifies the act of immersion in or concentration on a task or activity (Kovich et al., 2023). Positive relationships refer to the establishment of affection, care, and support for one another (Patnaik, 2014). Meaning denotes the belief in serving a purpose beyond and greater than self (Jayawickreme et al., 2012). Lastly, accomplishment, usually associated with a persevering mindset (Seligman, 2011), emphasises that the success that brings satisfaction can positively impact an individual’s well-being (Patnaik, 2014).

Art for well-being

Art creation has been found to enhance well-being due to the emotional satisfaction it brings (Moon, 2016). The element of self-discovery through art facilitates the exploration of the unconscious, acquiring insights, recognition, and acceptance of emotions. It also aids in the development of intuition and problem-solving skills, reframing thoughts of worry, and releasing pent-up tension and energy (Tompkins Rosa, 2023). Emerging globally, the utilisation of creative expression as a therapeutic means is capable of fostering personal growth and alleviating burden, thus effectively managing stressors (Depret et al., 2020). Offering beneficial healing experience, it promotes transformation in behaviour, fortifying self-worth and confidence, which ultimately affects overall health and well-being (Depret et al., 2020).

Art therapy

Art therapy (AT), according to the British Association of Art Therapists, is a type of psychotherapy that employs art mediums as the main tool for expressing and communicating oneself. It does not serve as a diagnostic instrument, but an avenue to communicate and explore perplexing and stressful emotional struggles (Crocker & Carr, 2021). AT is founded on the principle of accessing the unconscious through uninhibited expression (Rubin, 2016). AT relies on the transference relationship between the individual and the therapist, coupled with the fostering of free association, thus rendering its closeness to psychoanalytic therapy (Rubin, 2016). The pictorial expression enables the unconscious content to evade censorship, thus hastening the therapeutic process. Benefits of AT include enhancement of cognitive and sensorimotor abilities, nurturing of self-esteem and self-realisation, improvement of emotional resilience, encouragement of insights, strengthening of interpersonal skills, mitigation and resolution of dispute and tension, and promotion of societal and ecological transformation (Feldwisch, 2022). AT has also been found to have positive effects and decrease stress levels (Visnola et al, 2010).

In the practice of AT, the choosing of appropriate art materials serves as a fundamental component of the language used, acting as a platform for dialogue between the therapist and the client, offering a glimpse into the client’s internal experience (Snir & Regev, 2013). In addition, comprehending the material’s therapeutic abilities and distinctive characteristics can aid in the development of appropriate interventions for the clients (Malchiodi, 2007).

Clay work in art therapy

Clay work is known as the act of “handling, manipulating and sculpting clay and the process of these activities” (Sholt & Gavron, 2011, p.66). The tactile experience of clay work can promote the development of three-dimensional perception (Malchiodi, 2012). Clay’s natural state provides tactile properties, making it highly versatile, with an ability to be moulded, scraped, sliced, folded, smashed, and even compressed, presenting endless opportunities to be reshaped (Crocker & Carr, 2021). Possessing therapeutic healing and cathartic properties, it has the capacity to evoke playfulness and sensory experience (Crocker & Carr, 2021). In addition, it compels individuals to confront their inner challenges in an unguarded state, away from defence mechanisms (Sherwood, 2004).

Identifying objects through touch was the beginning point of Clay Field Therapy (Elbrecht, 2013). Haptic perception is the sense of touch through the skin or commonly the hands, and establishes a means of communication that predates visual communication (Grunwald, 2008; Paterson, 2007). Not only does it offer implicit, intimate, and accurate information, it has the potential to reconnect us to the essence of our identity. The sensation of the skin is intricately associated with sensory awareness, allowing one to differentiate the physical properties in clay and the projection of emotional attributes (Elbrecht, 2013). Engagement with the medium provides a tactile and sensuous experience that can trigger emotions and form connections with feelings while concurrently engaging the imagination and the world, resulting in the creation of metaphorical experience (Crocker & Carr, 2021).

Clay can evoke a range of distinct and contrasting emotions; accompanied with the construction and deconstruction process, it enables individuals the opportunity to observe their creations from various perspectives, which facilitates regression as a means for growth, development, and assimilation (Snir & Regev, 2013). Furthermore, concentrating on its sensory elements can promote mindfulness, while serving as a grounding tool in the here-and-now.

Methodology

Heuristic self-inquiry

This research employs a heuristic self-inquiry approach. The approach is extensively acknowledged for fostering both individual and professional growth (Etherington, 2004). According to Moustakas (1990), the term ‘heuristic’ signifies uncovering and discovery, and lends itself to inner dialogue and self-discovery. Heuristic methodology is well aligned with this study, in which I could be both researcher and subject, thereby deeply reflecting on my professional and personal growth. As a researcher, I was a first-year international student pursuing art therapy in the Master of Mental Health program and undertaking my independent research course. And as a subject, I was a 35-year-old female from Singapore, acclimatising to life and academia in Australia on my first overseas study trip, away from home, family, and friends.

Sultan (2019) maintains that seven key concepts – “identifying with the focus of inquiry, self-dialogue, tacit knowing, intuition, indwelling, focusing and the internal frame of reference” – underpin the approach (p.81). These concepts can be applied across the six stages of heuristic process (Given, 2008), which encompass: “initial engagement, immersion, incubation, illumination, explication, and creative synthesis” (Sultan, 2019, p.94). These guided the data-analysis plan for the six months of the research course, where I immersed myself, reconnected with the data, and identified themes from the information collected (Sultan, 2019).

Methods

To begin, I immersed myself in the literature review and began to formulate the research question. During the immersion stage, I set aside five 100-minute sessions over a period of five weeks to create clay works. These were thoughtfully structured to align with the practical constraints, including time and resources. Additionally, I engaged in self-dialogue, and recorded and reflected on the feelings, thoughts, and experiences that arose working with clay in a journal. Each session followed a format, as outlined in Table 1.