Art Therapy: How It Works & What To Expect

What Is Art Therapy?

Because of its power, art therapy is a tool used in countless mental health and human services settings and professions.¹ Whether the individual in treatment is working to manage their intense symptoms linked to psychosis, their recurrent flashbacks connected to trauma, or their constant cravings for addictive substances, art and art therapy are effective interventions.

Art therapists and other healthcare providers see the benefit of art in two ways:

• Art in therapy: With art in therapy, the professional uses art to aid the overall therapeutic process by increasing comfort, building rapport with the client, or facilitating some other goals. In these situations, the art is only one part of the treatment plan.
• Art as therapy: In this case, art is the therapy. When art is used as therapy, the goal of the session is to engage in some level of art. Here, the complete treatment plan will center around the art.²

Some therapists will blend both options during their sessions, while others will only opt to use only the art in therapy approach.

What Is an Art Therapist?

Art therapists hold a master’s degree or higher and are trained in mental health counseling and art therapy. These clinicians must undergo a rigorous process and meet certain standards set by the Art Therapy Credentials Board (ACTB) to become Registered Art Therapists (ATR). This extensive formation is what sets them apart from a regular psychotherapist offering “expressive arts therapy.”¹

Professional art therapists typically combine traditional psychological interventions and principles with art therapy tools and techniques to guide people through the creative process and teach them about how it can help them enhance their overall wellness. These credentialed practitioners can also work across a variety of settings including hospitals, schools, wellness centers, veteran’s clinics, and in private practice.¹

Art Helps Convey Messages Words Cannot

Art therapists see art as therapeutic because they view it as a deeper form of communication. Through involvement in art, the clients can express themselves in non-verbal, creative, and imaginative ways. This type of communication can convey a level of insight, information, and wisdom that the person cannot deliver otherwise.³

A person who cannot speak may use art therapy as a way to express the feelings they have been physically unable to divulge. Alternatively, a person who has endured a terrible trauma may struggle to put words to the hurt they suffered, but by engaging in art therapy, they could use sessions to communicate and process their hurt.

Art Therapy Is More than Drawing

Despite the limited view some may have of art therapy, the practice is more than drawing with crayons or painting with watercolors. Art therapy and expressive arts therapy are types of experiential therapy  that utilize endless artistic ventures to benefit their clients.

Of course, art therapy may involve a person creating art with markers and paper, but it can also involve numerous other forms of creation, such as:⁴

• Sandplay
• Dance and movement
• Playing and writing music
• Acting out scenes as part of drama therapy
• Sculpting
• Creating puppets and masks
• Writing poetry, fiction, or true stories based on personal experience

Not only does art therapy focus on the creation of art, but it can also include experiencing and appreciating art, like in the case of listening to music.

Art Therapy Is Psychotherapy

When people think of psychotherapy, they commonly imagine one client and one therapist speaking in a room. While art therapy commonly defies this convention, it is considered a psychotherapy by the American Psychological Association and American Psychiatric Association. With this psychotherapy label, art therapy is in the same class as other effective, evidence-based treatments like cognitive behavioral therapy (CBT), interpersonal therapy (IPT), and psychodynamic therapy.⁵

What Can Art Therapy Help With?

For decades, art therapists have been using the concepts and techniques linked to the approach to improve a wide range of mental and physical health issues for populations both young and old. As experts conduct more research over time, the number of benefits art therapy can provide for a variety of conditions continues to increase.

Mental & Behavioral Health Disorders

With its beginnings in mental health, many psychological disorders may improve with art therapy, including:^2,3,4,6,7

• Depressive conditions like major depressive disorder
• Anxiety disorders including phobias
• Eating disorders
• Traumatic symptoms connected to post-traumatic stress disorder
• Substance use disorders and addictions to alcohol and other legal and illicit drugs
• Psychotic disorders like schizophrenia and schizoaffective disorder

In addition to these recognized mental health disorders, art therapy is also helpful in the treatment of stress, tension, and self-injury. People who engage in art therapy commonly report improved levels of relaxation and well-being.⁴

Other Health-Related Issues

People may expect art therapy to create positive changes with mental health and psychological issues, but this psychotherapy style can also greatly benefit physical health-related concerns. Art therapy can also help reduce symptoms connected to other physical health symptoms. Blood pressure, heart rate, physical tension, and experiences of pain all improve with art therapy techniques.⁴

Art therapy can improve the symptoms associated with physical well-being and medical conditions, including:⁷

• Alzheimer’s disease: Through the use of art, the therapist can improve memory, lessen agitation, and help maintain a focus on the here and now.
• Chronic illnesses: Chronic conditions that bring steady levels of pain and tension can benefit from the distraction and relaxation of art therapy.
• Head injuries: With those who have suffered head injuries, art therapy can aid communication, socialization, and expression of thoughts and feelings.
• Physical disabilities: Combined with other physical therapy techniques, art therapy can promote motivation and movement towards goals by making exercises more engaging.
• Developmental and intellectual disabilities: By encouraging cognitive abilities, motor skills, and daily living activities, art therapy helps those with these types of limitations succeed in life.

Art Therapy for Children

Art therapy can be a valuable therapeutic tool that can benefit children in various ways. For instance, children with autism typically find the creative process to be a viable method to communicate, children with ADHD may experience a boost in their ability to concentrate, and children who are hospitalized may feel comforted with art therapy.^8,9

Not only can art therapy help children with special needs, but it can also provide psychological support to enable children to express and process distress related to traumatic life events.¹⁰ Additionally, art therapy can be effective in improving a child’s self-esteem, fostering emotional resilience, enhancing social skills, decreasing problematic behaviors, and fostering an overall sense of wellness.¹¹

Art Therapy Techniques

The techniques used during art therapy sessions are limited only by the creativity of the client and the therapist. Because art therapy is not restricted by the boundaries of other psychotherapies, nearly any creation of art or experience with art could be a helpful technique.

Some examples of common art techniques include:

Making Art

Perhaps the most obvious example of an art therapy technique is for the client to create art by drawing, painting, sculpting, making collages, fashioning items from wood and metal, or using some other medium. The therapist may offer a specific prompt of what to create, or they could allow the client the freedom to explore as they wish. In either case, the therapist will attend to the client’s experience and process of creating, rather than focusing on the finished product.

Music Engagement

In the context of art therapy, music engagement or music therapy is more complex than merely pressing play and listening to music. Art therapists can create a dialogue to explore favorite types of music, or play various selections for the client to see what types of thoughts, memories, and feelings the music evokes. Clients may bang a drum or tap on piano keys to create sounds that match their feelings.

Movement-Based Artistic Expression

Whether the movement is dance, expressive movement, forms of exercise, or acting out a scene from a play, movements can effectively communicate and process feelings that may be too complicated to share verbally.

Expressive Writing

Poetry, memoirs, and works of fiction can improve health and wellness on many levels. Like with other forms of art therapy, the therapist may guide the process or only act as the facilitator for the client.⁴

Some art therapists will choose to combine various aspects of art therapy into a melting pot of creative expression.

Is Art Therapy a Good Fit for You?

Regardless of your artistic abilities, art therapy can be an enjoyable endeavor and an unconventional yet efficient therapeutic approach that can enhance your overall wellness.¹²

You may want to opt for art therapy if:¹¹

• You want to explore an alternate methods to cope with depression, anxiety, or other psychological concerns
• You want to build self-confidence
• You have difficulty opening up and expressing your feelings
• Traditional psychotherapy hasn’t worked for you or you want to add it to supplement your existing therapy plan
• You’ve experienced trauma and want to process it¹³
• You’re experiencing life-changing events or health-related stressors and want to manage more effectively¹⁴
• You enjoy or feel connected to the creative process (painting, writing, music etc.)

Art Therapy Is Not for Everyone

Like other psychotherapeutic modalities, art therapy may not be appropriate for everyone. Some people may experience damaging effects, including increased stress or anxiety, inability to process emerging emotions, or difficulty coping if therapy ends too soon. At this point art therapy may worsen someone’s distress and even make them resistant to other suitable forms of treatment.

Art therapy for individuals with a chronic psychological condition is not recommended as the sole treatment but rather to be integrated into their existing therapy. Art therapy may be a bad fit also for people who are skeptical about its efficacy because they think they need to be artistically inclined or perceive it as “arts and crafts” instead of a legitimate therapeutic medium.

Art Therapy Examples

With the numerous techniques and populations that may benefit from art therapy, it can be challenging to imagine how the treatment occurs in practice, so consider these examples of art therapy in action.

Visual Arts Therapy With Heart Disease

People with heart disease face numerous mental and medical influences of the condition and commonly feel sad, anxious, and pessimistic about their condition. The art therapist may work to explore these feelings by asking their client to “draw” their disease. By noticing the style of drawing, the colors used, and the person’s experience while drawing, the therapist can help to reduce and relieve these unwanted feelings.⁴

Art Therapy for Depression

If a client presents with depression and self-injurious behaviors, the art therapist may direct them to create a puppet. Using a therapeutic tool called sublimation, the puppet becomes a healthier way to release strong feelings, rather than the client resorting to self-harm.²

The puppet may help to represent the client or the struggles the client finds themselves trying to manage. The project can last for weeks or months of therapy as a way to approach difficult feelings and concerns in a non-threatening, indirect way. As the time in therapy continues, symptoms begin to resolve because art therapy brings them to light.

Movement-Based Art Therapy With Anxiety

People with anxiety tend to have worried thoughts and tense muscles. After assessing the symptoms and presenting problems, an expressive arts therapist who uses movement could engage the client in some form of dance that emphasizes freedom and relaxation. While the body becomes calm, the therapist will help the person shrink feelings of hesitation and judgment to promote increased self-acceptance.

The act of dance can simultaneously minimize the cognitive and physical effects of anxiety. With repetition, the symptoms diminish, and the individual can continue the practice of dance and movement whenever there is a symptom flare.

How to Find an Art Therapist

Art therapists are widely available in a multitude of settings and locations. Art therapists work in places like:¹

• Hospitals
• Schools
• Community agencies and private practices
• Psychiatric inpatient and substance abuse rehabilitation facilities
• Crisis centers
• Nursing homes and senior communities

Art therapists are located across the country, and using the American Art Therapy Association Locator Tool can help the process of finding providers in a specific area.

Alternatively, a person can identify a reputable art therapist by:

• Speaking with friends and family members who have experience with art therapy
• Requesting a referral from a primary care physician
• Consulting with a mental health professional for a list of available providers

Who May Provide Art Therapy Sessions?

Any person seeking an art therapist must practice caution as there could be some practitioners who advertise or market themselves as art therapists without having acquired the training, experience, and education needed to carry that title. An art therapist will have a master’s degree in counseling, psychology, or a related field as well as specific training, supervision, and practice performing art therapy.¹

Other mental health and physical health professionals may offer the use of art therapy techniques while not necessarily being a credentialed art therapist, and this is generally referred to as “expressive arts therapy.” Each person should make an informed choice about what treatment they want, and who it is that will provide the treatment.

Cost of Art Therapy and Does Insurance Typically Cover It?

The cost of art therapy could range anywhere from nearly free to over $100 per session. Many art therapists will accept insurance, while others will require cash payment for their services. Be sure to get upfront pricing information and inquire about sliding scales based on income as needed.

Art therapy is a widely recognized and approved form of psychotherapy, which means that mental health insurance will cover art sessions as they would other forms of treatment like CBT and psychodynamic therapy. A person hoping to use insurance to cover their art therapy appointments should always check with the company to ensure coverage. They should also account for any out-of-pocket expenses like copays, deductibles, and coinsurance.

What to Look For in an Art Therapist

The things to look for in an art therapist are practically the same as with a regular therapist. Below is a list of certain characteristics traits and other factors to look at:

• Professional qualifications: Are they Registered Art Therapists (ATR) credentialled by the Art Therapy Credentials Board (ACTB)? Did they attend a program endorsed by the American Art Therapy Association (AATA)? Are their diplomas and license/certifications on display?
• Training experience: How long have they been practicing? What populations do they mainly work with? What conditions do they address?
• Personality: Are they compassionate, flexible, good listeners? Do they make you feel comfortable and/or do you feel a connection with them?
• Insurance: Do they take your health insurance, if not what are their fees? Do they offer a sliding scale?
• Specific technique and medium: What art medium or media are you interested in? Do they offer it?
• Do they thoroughly explain how art therapy works and what you can expect?
• Type of therapy provided: What type of therapy are you interested in, individual or group? Do they provide it?
• Location and setting: Where will sessions take place, their office or a studio? Is it in an area that is close to you and easy to get to?

Key Questions to Ask an Art Therapist

Asking an art therapist questions at the outset of treatment can reaffirm the idea that this form of psychotherapy is an appropriate fit for your current symptoms and desired goals.

Consider asking an art therapist:¹⁶

• Would art therapy be an effective way to improve my symptoms?
• Are you a licensed and credentialed art therapist?
• What are the benefits of art therapy?
• Will you mix other forms of psychotherapy into these sessions?
• What will a typical art therapy session look like?
• How long is the course of treatment?
• What steps do you take to protect my privacy and confidentiality?

Reputable therapists will be happy to offer frank answers to these questions and any others you may have.

What to Expect At Your First Art Therapy Appointment

Initial art therapy appointments will differ between providers, with some opting to explore the impact of art immediately and others using that first session to gather information about a client’s chief complaint and formulate a treatment plan.

Generally, the first art therapy session involves meeting one another and working to establish a positive working relationship. By building trust and rapport through a shared vision, the client can feel comfortable moving forward.

The therapist will likely show each client the space and materials used to create or experience art. They may encourage a short and direct art therapy technique to offer an example of what to expect in future sessions.

Is Art Therapy Effective?

One undisputed truth is that art therapy is a very effective psychotherapy option for many medical and mental health issues. Both the American Psychological Association and the American Psychiatric Association endorse art therapy as a sound treatment for numerous conditions.

Art therapy is an often-studied form of psychotherapy, and the findings are generally encouraging. One meta-analysis of art therapy studies found:⁴

• Music engagement helps with relaxation, anxiety, heart rates, and feelings of well-being
• Visual arts improves depression, grief and loss issues, stress levels, anxiety, social interactions, and self-worth while distracting from life problems
• Movement-based expression can aid physical symptoms, body image, mood improvement, and grief and loss
• Expressive writing studies show the act can improve anger levels, mood, perception of pain, fatigue, relationship problems, sleep, and overall feelings of well-being

As if these findings were not impressive enough, studies also show that art therapy is helpful with many different populations including:⁶

• People with cancer
• Those with medical issues like obesity, HIV/AIDS, and heart failure
• People who have various mental health issues like schizophrenia, depression, anxiety, and trauma
• Incarcerated people
• Elderly adults
• People with high levels of stress and burnout from their careers including nurses and caretakers

Risks of Art Therapy

Like any mental health treatment, art therapy carries some risks, but with a trusted clinician, the risk is reduced (though not eliminated). The inherent risk comes when vulnerable people or people with powerful symptoms begin expressing their state. Doing this may cause feelings to intensify as they are uncovered. The goal of treatment is to bring these feelings to the surface and then lessen their impact.¹⁷

Criticisms of Art Therapy

The most common criticisms of art therapy likely come from people without firsthand experience of the treatment. They may believe that “fingerpainting” cannot possibly help address something as serious as physical and psychological health issues. Of course, a multitude of studies and research proves these people wrong.

How Is Art Therapy Different from Other Therapy Techniques?

When setting out to find effective treatment for a mental or medical problem, comparing and contrasting available treatments is essential. Some treatments frequently compared to art therapy are:

Art Therapy Vs. CBT

Cognitive behavioral therapy (CBT) is a form of talk therapy that aims to identify and modify a person’s irrational thinking styles in hopes of changing their feelings. Though art therapy and CBT are quite different, CBT therapists may employ art therapy techniques in sessions to help understand problematic thoughts and encourage healthy behaviors.⁵

Art Therapy Vs. Psychoanalytic / Psychodynamic Therapies

Psychodynamic and psychoanalytic therapies focus on the influence of childhood experiences and their impact on the present. These therapies work to bring the unconscious thoughts that are fueling motivation into conscious awareness to create change. Psychodynamic and psychoanalytic therapies may seem to have little overlap with art therapy, but in reality, all of these therapies value the content of the unconscious mind and believe bringing them to light will improve symptoms.⁵

Art Therapy Vs. Expressive Arts Therapy

The terms “art therapy” and “expressive arts therapy” may be synonymous to some and very different to others. In some settings, art therapy may be reserved for visual arts therapy where a client creates art, and expressive arts therapy will include all forms of art therapy, including music, dance, expressive writing, and others. Commonly, these terms are used interchangeably.

The History of Art Therapy

Since humans were scrawling on cave walls, people noted the therapeutic effects of artistic expression, but formalized art therapy is more of a recent development. Pioneers in both the U.S. and Europe laid the foundation of art therapy during the 1940s.

Adrian Hill, an Englishman, was the first person to use the term “art therapy” when he noticed the healing influence of art on his own body and mind during tuberculosis treatment. Edward Adamson, also in England, added to Hill’s work by providing art therapy to people institutionalized in psychiatric hospitals with the goal of allowing free expression of thoughts and feelings without the intervention of a therapist.

In the U.S. during the 1940s, Margaret Naumburg and Edith Kramer were driving forces of art therapy. Naumburg had a particular influence with her belief that art therapy could uncover the unconscious mind, which resulted in symbolism worthy of analysis from the therapist.¹⁸

Art therapy continues to change and adapt to the current trends in holistic health treatments. With increasing interest in the mind-body connection, art therapy will continue to evolve to meet the needs of many.