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Art Therapy

Intervention Overview

The world of art therapy is where Picasso meets psychology and creativity becomes the

canvas for change. Imagine a therapy session where instead of reclining on a couch, you're using

a paintbrush or molding clay. It's not just about creating a masterpiece; it's about discovering the

masterpiece within yourself. Art therapy offers a unique sense of self-expression and

psychological exploration. It is a dynamic form of psychotherapy that utilizes the expressive and

creative process of making art to foster personal growth and healing (American Art Therapy

Association, 2022). Based on the belief that artistic expression goes beyond language barriers, art

therapy provides a unique avenue for individuals to explore and share their thoughts, feelings,

and experiences. Through various mediums such as painting, sculpting, drawing, and collage,

individuals engage in a therapeutic process guided by a trained art therapist. This process allows

clients to dive into thoughts and emotions they struggle to express, confront unresolved issues,

and gain insight into their psychological well-being (Malchiodi, 2012).

While the history of art therapy can be traced back for centuries, its formal development

as profession and therapeutic tool began in the early 20th century. The use of art as a therapeutic

tool can be seen in various ancient cultures, where creating art was often intertwined with

spiritual and healing practices. The 19th century saw the emergence of psychiatry as a medical

discipline, with pioneers like Sigmund Freud and Carl Jung exploring the subconscious mind and

the symbolic meaning of art (Gussak & Rosal, 2016, pp. 7–16). In the early 1900’s psychiatrists

and educators such as Margaret Naumburg and Edith Kramer began to incorporate art into their

work with children and adults with mental health challenges. Naumburg developed

"psychoanalytic art therapy," emphasizing the symbolic meaning of art as a reflection of inner
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thoughts and emotions earning the title “Mother of Art Therapy” (Malchiodi, 2012). In recent

decades, art therapy has continued to evolve and expand, with practitioners working in diverse

settings with different populations such as hospitals, schools, community centers, and within

corrections. In 1969, professional organizations such as the American Art Therapy Association

(AATA) were established to promote standards and research in the field further solidifying its

recognition as an evidence-based practice (Adelphi Psych Medicine Clinic, 2017). Research into

the effectiveness of art therapy interventions has grown, contributing to its recognition as a

valuable approach for addressing mental health challenges and promoting well-being.

Art therapy is an integrative field that draws upon multiple theoretical frameworks, rather

than being dominated by a single primary theory. However, if one were to identify a foundational

theory that has significantly influenced art therapy, it would likely be psychodynamic theory.

Psychodynamic theory, originating from Freudian psychoanalysis, emphasizes the role of

unconscious processes in shaping behavior and experiences. In art therapy, these psychodynamic

principles are applied to help understand how artmaking can serve as a means for accessing and

expressing unconscious thoughts, emotions, and conflicts (Kozman, 1993). While

psychodynamic theory provides a foundational understanding of art therapy, it is important to

note that art therapy is a diverse field that incorporates elements of several theories including

humanistic, existential, cognitive-behavioral, and systemic approaches. Ultimately, art therapists

often combine multiple theories and techniques based on the needs and preferences of their

clients, as well as their own clinical expertise and theoretical orientation.

Intervention Strategies

Art therapy is guided by several key principles, also referred to as tenets, that inform and

guide its practice and effectiveness. These tenets emphasis the complex nature of art therapy and
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its potential to promote growth and change across diverse populations and settings. They provide

a framework for ethical and effective practice, guiding art therapists in their work with clients.

Art therapy recognizes the value of nonverbal communication in expressing thoughts, emotions,

and experiences by providing a means of communication for individuals who may struggle to

articulate their feelings verbally (Malchiodi, 2012). Furthermore, the creative process itself is

seen as therapeutic, allowing individuals to explore and express themselves in a non-threatening

manner. Engaging in artmaking helps foster a sense of self-discovery, problem-solving, and

emotional release (Rubin, 2016). As art therapists are often working with visual images, art

therapists understand that the artwork often contains symbolic meaning that reflects unconscious

thoughts, emotions, and conflicts. Exploring the symbolism and metaphorical content of artwork

can promote insight and self-awareness (Gussak & Rosal, 2016). Often individuals are

encouraged to explore various hobbies such as art to develop their coping strategies on their own.

This is because art provides a safe outlet for individuals to express and process difficult

emotions, leading to catharsis and emotional release. Creating art can help individuals cope with

trauma, grief, and stress (Waller, 2006). Art also allows the individual to experience a sense of

control and agency over what they are creating leading to a sense of self-efficacy and mastery of

a skill in turn increasing one’s confidence and resiliency factor (Klorer, 2017; Richardson, 2016).

Art therapy encompasses a rich mixture of techniques designed to unlock the expressive

potential within everyone. Just as there are many forms of art itself, there are several techniques

and specific strategies or interventions that can be used within art therapy. One technique is Free

Drawing as clients are encouraged to freely draw or doodle without specific prompts or

guidelines. This technique allows for spontaneous expression and exploration of inner thoughts

and feelings (Malchiodi, 2012). To expand on free drawing, therapists encourage individuals to
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utilize art journals or a visual journal where they create art regularly to document their thoughts,

emotions, and experiences. Visual journaling promotes self-reflection, insight, and personal

growth over time and can be done outside of the therapy session (Klorer, 2017). Others include

mask making, body mapping, sculptures and 3D art, painting, and collage making. These art

therapy techniques offer diverse avenues for self-expression, emotional processing, and

therapeutic exploration, each supported by research and clinical practice within the field. To

facilitate these types of interventions, it is highly recommended to have a wide variety of art

supplies and mediums as to adapt an intervention to the clients’ strengths and needs.

Client Fit

Determining the suitability of art therapy for clients involves considering various factors,

including their presenting concerns, personality traits, and willingness to engage in creative

expression. Gillroy et al. (2012) shares that while conducting research into the assessment

process for art therapy, they discovered that the main criteria for an individual to benefit from art

therapy is determined by their “capacity for relationship and change and for thinking

psychologically and metaphorically”. Diagnoses is recommended to not be included as a

determining factor (2012). Due to this broad set a criterion, art therapy can be beneficial for a

wide range of individuals with certain characteristics that can indicate a good fit for this

approach. One of the initial population that art therapist would be suitable for is clients who

experience difficulty expressing emotions verballing. Individuals who struggle to articulate their

thoughts and feelings through words may benefit from art therapy, as creative expression

provides an alternative means of communication (Malchiodi, 2012). Additionally individuals

with a preference for nonverbal modes of learning and communication may thrive in art therapy,

where visual and tactile expression are preferred over verbal communication (2012). Research
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has shown art to be invaluable to such individuals, especially children, with limited

communication as it provides them with the ability to express thoughts and feelings visually

(Adelphi Psych Medicine Clinic, 2017). Other populations that would benefit from art therapy

are individuals with a history of trauma and/or abuse as well as individuals with anxiety or

depression. For individuals with a history of trauma or abuse art therapy can be particularly

effective as it allows for the expression and processing of difficult emotions in a safe and

supportive environment (Gussak & Rosal, 2016). Clients experiencing symptoms of anxiety or

depression may find relief through art therapy, as creative expression can promote relaxation,

self-awareness, and emotional release (Rubin, 2016).

While art therapy can be beneficial for many individuals, there are certain cases where it

may not be the most appropriate or effective form of treatment. Foremost, art therapy would not

be ideal or beneficial for individuals who are resistant to art or lack an interest in it. Clients who

have a strong aversion to art or creative expression may not be receptive to art therapy

interventions and may struggle to engage in the process (American Art Therapy Association,

2022). Others include clients with severe cognitive impairments as it may hinder their ability to

engage with the art in a meaningful manner such as symbolic thinking, following directions or

simply manipulating the art materials (Malchiodi, 2012). Additionally, clients who are needing

immediate crisis intervention or demonstrate an inability to stay safe to themselves or others

around art materials may not be suitable for art therapy (Gussak & Rosal, 2016). It's important

for art therapists to conduct thorough assessments and consider the individual needs, preferences,

and readiness of each client before recommending art therapy as a treatment option.

Cultural Attunement
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Art therapy, like all forms of therapy, must be culturally attuned to effectively meet the

needs of diverse populations. Cultural attunement in art therapy involves understanding and

respecting the cultural backgrounds, values, beliefs, and norms of clients and integrating these

considerations into therapeutic practice. Just as social workers and other therapists, art therapists

should strive to develop cultural competence, which involves awareness, knowledge, and skills

for working with individuals from diverse cultural backgrounds. This includes understanding

cultural values, norms, communication styles, and worldviews (American Art Therapy

Association, 2020). With a developed sense of cultural competence, an art therapist should be

able to work with many diverse populations as long as it is a fit as previously addressed. Art is a

universal language per say; cultures worldwide use art in many ways specific to their beliefs and

values. Art can help therapists navigate cross-cultural communication by considering language

barriers, nonverbal cues, and cultural nuances. They may use interpreters, visual aids, or

alternative forms of communication to help facilitate understanding and connection with clients

from diverse cultural backgrounds (Rubin, 2016). Malchiodi (2012) reminds practitioners to

approach all clients with cultural sensitivity through understanding their cultural norms, values,

communications styles as well as how the others cultures define art and ensure they are

implementing elements that align with the clients’ beliefs and practices. With many of the

specific interventions and techniques used within art therapy, many of them require interpretation

of the clients art. Therapists are to support a client when making meaning of their art and should

avoid a racially neutral position or stance or implement color blindness. Their culture is a part of

their art and should be recognized as such to fully support a client interpret their art.

Summary
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Art therapy is a form of psychotherapy that utilizes creative expression, such as drawing,

painting, sculpting, and other art forms, as a mechanism for change. It offers a unique and

versatile approach to therapy, allowing individuals to explore and express their thoughts,

emotions, and experiences in a non-verbal and symbolic manner. A few of the primary strengths

of this form of therapy and intervention include non-verbal communication for individuals who

struggle to articulate their thoughts, emotional processing for individuals to externalize their

emotions and work through them and the overall flexibility of the techniques. Limitations to art

therapy can include lack of access to art materials, misinterpretation or misunderstanding of

artwork may occur, specialized training and education as effective implementation of art therapy

requires specialized training and expertise in both art and psychology. Additionally due to the use

of various art materials and mediums, it not the best fit for individuals who may present as a

threat to themselves or others to ensure safety for all parties involved.

In researching art therapy, I quickly learned how valuable something as simple as a

drawing can be in helping clients make meaningful change in their life. While I am not an artist,

I can recognize the value of being able to draw my thoughts and feelings rather than trying to put

this to words. Additionally, I see much crossover between art and music therapy as a board-

certified music therapist. Art helps provide practitioners with a non-invasive and non-

intimidating means of change that can additionally help teach a variety of coping strategies and

skills. As a social worker, I learned that talking is not the only option for working with clients

and that such therapies that include a creative element such as art or music can help further

facilitate a culturally sensitive and competent intervention and care.

References

Adelphi Psych Medicine Clinic. (2017, July 5). The History of Art Therapy. Adelphi Psych

Medicine Clinic. https://adelphipsych.sg/the-history-of-art-therapy/

American Art Therapy Association. (2022). About Art Therapy. American Art Therapy

Association. https://arttherapy.org/about-art-therapy/

American Art Therapy Association. (2022). American Art Therapy Association.

https://arttherapy.org/

Gilroy, A., Tipple, R., & Brown, C. (2012). Assessment in art therapy. Routledge.

Gussak, D., & Rosal, M. L. (2016). The Wiley handbook of art therapy (pp. 7–16). John Wiley &

Sons.

Klorer, P. G. (2017). Expressive Therapy With Traumatized Children. Rowman & Littlefield Pub

Inc.

Kozman, K. H. (1993). Art Therapy-What Is It? A Case Study Using an Integration of Theories.

Canadian Art Therapy Association Journal, 7(2), 27–42.

https://doi.org/10.1080/08322473.1993.11432198

Malchiodi, C. A. (2012). Handbook of art therapy (2nd ed.). Guilford Press.

Multicultural Committee. (2015). American Art Therapy Association.

https://arttherapy.org/multicultural-committee/

Richardson, C. (2016). Expressive arts therapy for traumatized children and adolescents : a

four-phase model. Routledge.

Rubin, J. A. (2016). Approaches to Art Therapy: Theory and Technique (3rd ed.). Routledge.

Waller, D. (2006). Art Therapy for Children: How It Leads to Change. Clinical Child

Psychology and Psychiatry, 11(2), 271–282. https://doi.org/10.1177/1359104506061419