Art therapy is a form of expressive therapy that uses art materials, such as paints, chalk and

markers. Art therapy combines traditionalpsychotherapeutic theories and techniques with an

understanding of the psychological aspects of the creative process, especially the affective
properties of the different art materials.

As a mental health profession, art therapy is employed in many clinical settings with diverse
populations. Art therapy can be found in non-clinical settings as well as in art studios and in
workshops that focus on creativity development. Closely related in practice to marriage and family
therapists and mental health counseling, art therapists throughout the US are licensed as either
MFTs, LPCs, or LPCCs and hold either registration or board certification as an art therapist (see
section on Art Therapy Standards of Practice). Art therapists work with children, adolescents, and
adults and provide services to individuals, couples, families, groups, and communities.

Using their skills in evaluation and psychotherapy, art therapists choose materials and
interventions appropriate to their clients’ needs and design sessions to achieve therapeutic goals
and objectives. They use the creative process to help their clients increase insight and judgment,
cope better with stress, work through traumatic experiences, increase cognitive abilities, have
better relationships with family and friends, and to just be able to enjoy the life-affirming pleasures
of the creative experience. Many art therapists draw on images from resources such
as ARAS (Archive for Research in Archetypal Symbolism) to incorporate historical art and
symbols into their work with patients. Depending on the state, province, or country, the term art
therapist may be reserved for those that are professionals trained in both art and therapy and
hold a master's degree in art therapy or a related field such as counseling or marriage and family
therapy with an emphasis in art therapy. Other professionals, such as mental health counselors,
social workers, psychologists, and play therapists apply art therapy methods to treatment. Many
art therapists in the US are licensed in one of the following fields: creative arts therapy, art
therapy, professional counseling, mental health counseling, or marriage and family therapy.

Art therapists have generated many specific definitions of art therapy, but most of them fall into
one of two general categories. The first involves a belief in the inherent healing power of the
creative process of art making. This view embraces the idea that the process of making art is
therapeutic; this process is sometimes referred to as art as therapy. Art making is seen as an
opportunity to express one's self imaginatively, authentically, and spontaneously, an experience
that, over time, can lead to personal fulfillment, emotional reparation, and recovery (Malchiodi,
2006).

The second definition of art therapy is based on the idea that art is a means of symbolic
communication. This approach, often referred to as art psychotherapy, emphasizes the products
—drawings, paintings, and other art expressions—as helpful in communicating issues, emotions,
and conflicts. The art image becomes significant in enhancing verbal exchange between the
person and the therapist and in achieving insight; resolving conflicts; solving problems; and
formulating new perceptions that in turn lead to positive changes, growth, and healing. In reality,
art as therapy and art psychotherapy are used together in varying degrees. In other words, art
therapists feel that both the idea that art making can be a healing process and that art products
communicate information relevant to therapy are important (Malchiodi, 2006).

Contents
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• 1 Purpose of Art Therapy

• 2 What Does a Typical Art Therapy Session Look Like?

• 3 Art-Based Assessments

o 3.1 The Diagnostic Drawing Series (DDS)

o 3.2 The Mandala Assessment Research Instrument (MARI)

o 3.3 House–Tree–Person (HTP)

o 3.4 Road Drawing

• 4 Art Therapy Standards of Practice in the United States

o 4.1 Board Certification, Registration, and Licensure

o 4.2 General Ethical Principles

o 4.3 Independent Practitioner

o 4.4 Eligibility for Credentials

o 4.5 Standards of Conduct

o 4.6 Disciplinary Procedures

• 5 References

• 6 See also
 • 7 External links

Purpose of Art Therapy

The purpose of art therapy is much the same as in any other psychotherapeutic modality: to
improve or maintain mental health and emotional well-being. But whereas some of the other
expressive therapies utilize the performing arts for expressive purposes, art therapy generally
utilizesdrawing, painting, sculpture, photography, and other forms of visual art expression. For
that reason art therapists are trained to recognize the nonverbal symbols and metaphors that are
communicated within the creative process, symbols and metaphors which might be difficult to
express in words or in other modalities. By helping their clients to discover what underlying
thoughts and feelings are being communicated in the artwork and what it means to them, it is
hoped that clients will not only gain insight and judgment, but perhaps develop a better
understanding of themselves and the way they relate to the people around them. According to
Malchiodi (2006) "Art making is seen as an opportunity to express oneself imaginatively,
authentically, and spontaneously, an experience that, over time, can lead to personal fulfillment,
emotional reparation, and transformation. This view also holds that the creative process, in and of
itself, can be a health-enhancing and growth-producing experience."

What Does a Typical Art Therapy Session Look Like?

Malchiodi (2006) provides an example of what an art therapy session involves and how it is
different from an art class. "In most art therapy sessions, the focus is on your inner experience—
your feelings, perceptions, and imagination. While art therapy may involve learning skills or art
techniques, the emphasis is generally first on developing and expressing images that come from
inside the person, rather than those he or she sees in the outside world. And while some
traditional art classes may ask you to paint or draw from your imagination, in art therapy, your
inner world of images, feelings, thoughts, and ideas are always of primary importance to the
experience.

Therapy comes from the Greek word therapeia, which means 'to be attentive to.' This meaning
underscores the art therapy process in two ways. In most cases, a skilled professional attends to
the individual who is making the art. This person’s guidance is key to the therapeutic process.
This supportive relationship is necessary to guide the art-making experience and to help the
individual find meaning through it along the way.

The other important aspect is the attendance of the individual to his or her own personal process
of making art and to giving the art product personal meaning—i.e., finding a story, description, or
meaning for the art. Very few therapies depend as much on the active participation of the
individual (p. 24)." In art therapy, the art therapist facilitates the person's exploration of both
materials and narratives about art products created during a session.

Art-Based Assessments
Art therapists and other professionals use art-based assessments to evaluate emotional,
cognitive, and developmental conditions. There are also many psychological assessments that
utilize artmaking to analyze various types of mental functioning (Betts, 2005). Art therapists and
other professionals are educated to administer and interpret these assessments, most of which
rely on simple directives and a standardized array of art materials (Malchiodi 1998, 2003; Betts,
2005). The first drawing assessment for psychological purposes was created in 1906 by German
psychiatrist Fritz Mohr (Malchiodi 1998). In 1926, researcher Florence Goodenough created a
drawing test to measure the intelligence in children called the Draw–A–Man Test (Malchiodi
1998). The key to interpreting the Draw-A-Man Test was that the more details a child
incorporated into the drawing, the MORE intelligent they were (Malchiodi, 1998). Goodenough
and other researchers realized the test had just as much to do with personality as it did
intelligence (Malchiodi, 1998). Several other psychiatric art assessments were created in the
1940s, and have been used ever since (Malchiodi 1998).

Notwithstanding, many art therapists eschew diagnostic testing and indeed some writers (Hogan
1997) question the validity of therapists making interpretative assumptions. Below are some
examples of art therapy assessments:

The Diagnostic Drawing Series (DDS)

The Diagnostic Drawing Series is an art therapy assessment that is correlated with the diagnosis
of major psychiatric disorders (Mills, 2003). The DDS is a three drawing series that is used by
mental health professionals around the world (Diagnostic Drawing Series website, 2009). In the
first part, subjects are asked to draw any picture using colored chalk pastels on an 18 x 24 inch
piece of paper. Then they are asked to draw a tree in the second part. In the last part of the art
interview, subjects are asked to show how they are feeling using lines, shapes, and colors.
Research regarding the pictures is generally based on the presence and absence of many
elements, such as use of color, blending, and placement of the images on the paper (Cohen,
Hammer, & Singer, 1988).

The Mandala Assessment Research Instrument (MARI)

In this assessment, a person is asked to select a card from a deck with different mandalas;
designs enclosed in a geometric shape, and then must choose a color from a set of colored cards
(Malchiodi 1998). The person is then asked to draw the mandala from the card they choose with
an oil pastel of the color of their choice (Malchiodi 1998). The artist is then asked to explain if
there were any meanings, experiences, or related information related to the mandala they drew
(Malchiodi 1998). This test is based on the beliefs of Joan Kellogg, who sees a recurring
correlation between the images, pattern and shapes in the mandalas that people draw and the
personalities of the artists (Malchiodi 1998). This test assesses and gives clues to a person's
psychological progressions and their current psychological condition (Malchiodi 1998). The
mandala originates in Buddhism; its connections with spirituality help us to see links
with transpersonal art.

House–Tree–Person (HTP)
In this assessment, the patient is asked to draw three separate images; a house, a tree, and a
person (Malchiodi 1998). After the patient has finished the drawings, the therapist asks questions
like, "How old is the person in your drawing? What is he or she doing? What is the house made
of? What is the weather in this picture?" (Malchiodi 1998). This assessment can be done
achromatically (one color, such as lead pencil) or chromatically (with various colored markers or
pencils). This is a projective assessment and the house, the tree, and person in the drawing
represent different aspects of the artist and the way the artist feels about him or herself (Malchiodi
1998).

Road Drawing
In this drawing assessment and therapeutic intervention, the patient is asked to draw a road. This
is a projective assessment used to create a graphic representation of the person's "road of life."
The road drawing has the potential to elicit spontaneous imagery that represents the client's
origins, the history of his or her process, experiences to date, and intent for the future - even from
a single drawing (Hanes, 1995, 1997, 2008). The road's reparative features or its need for
"periodic upgrade" can serve as a metaphor for the client's capacity for change and restoration
(Hanes, 1995, 1997, 2008).

Art Therapy Standards of Practice in the United States

Board Certification, Registration, and Licensure

In the United States, art therapists may become Registered (ATR), Board Certified (ATR-BC),
and, in some states, licensed as an art therapist , creative arts therapist (LCAT; NY State only), or
professional or mental health counselor (many states). For more information on these credentials,
art therapists in the US should contact the Art Therapy Credentials Board (ATCB)
at www.atcb.org[1]. A Code of Professional Practice, a 17 page document summarizing the
standards of practice for professional art therapists. The ATCB Code of Professional Practice is
divided into five main categories; General Ethical Principles, Independent Practitioner, Eligibility
for Credentials, Standards of Conduct, and Disciplinary Procedures (ATCB 2005).

For more information on how to become licensed, US art therapists should contact the state
licensure board in the state in the US in which they wish to practice. Art therapy students who are
preparing for practice in the field should consult with their academic advisers about what courses
are necessary to meet board certification and/or licensure requirements. Licensure is generally
needed to obtain reimbursement for services as an independent practitioner and in some states,
is required by law in order to practice independently.

In countries other than the US, art therapists should contact governmental or regulatory boards
that oversee the practice of mental health or health care professions to identify any specific
coursework or education that is needed. Because art therapy is still considered a developing field,
most countries do not regulate its practice and application.

General Ethical Principles

One topic covered in this section describes the responsibility art therapist have to their patients
(ATCB 2005). According to the ATCB, art therapists must strive to advance the wellness of their
clients, respect the rights of the client, and make sure they are providing a useful service (2005).
They cannot discriminate against patient whatsoever, and may never desert or neglect patients
receiving therapy (2005). Art therapist must fully explain to their patients what their expectations
of the patients will be at the outset of the professional relationship between the two (ATCB 2005).
Art therapists should continue therapy with a patient only if the client is benefiting from the
therapy (ATCB 2005). It's against the principles established by the ATCB for art therapist to have
patients only for financial reasons (ATCB 2005).

Another topic of this section discuses the competency and integrity art therapists must possess
(ATCB 2005). The ATCB states art therapist must be professionally proficient and must have
integrity (2005). Art therapist must keep up dated on new developments in art therapy. They are
only supposed to treat cases in which they are qualified as established by their training,
education, and experience (ATCB 2005). They are not allowed to treat patients currently seeing
another therapist without the other therapist's permission (ATCB 2005). Art therapists must also
observe patient confidentiality (ATCB 2005).

Other topics covered in this section discuss other responsibilities of art therapists. This
responsibilities include, “responsibility to students and supervisees, responsibility to research
participants, responsibility to the profession” (ATCB 2005). This section also establishes the rules
by which art therapists must follow when making financial arrangements and when they chose to
advertise their service (ATCB 2005)
Independent Practitioner
Independent practitioners are art therapists who are practicing independently or responsible for
the service they are providing to paying clients. This section covers the credentials for
independent practitioners.

Independent practitioners must provide a safe and functional environment to conduct art therapy
sessions (ATCB 2005). According to ATCB, "this includes but is not limited to: proper ventilation,
adequate lighting, access to water supply, knowledge of hazards or toxicity of art materials and
the effort need to safeguard the health of clients, storage space for art projects and secured
areas for any hazardous materials, monitored use of sharp objects, allowance for privacy and
confidentiality, and compliance with any other health and safety requirements according to state
and federal agencies which regulate comparable businesses" (2005).

This section also establishes the standards for independent practitioners to follow when dealing
with financial arrangements (ATCB 2005). Basically it states that the art therapist must provide a
straight forward contract to the payer of the therapy sessions (ATCB 2005). It also states that the
art therapist must not deceive the payers or exploit clients financially (ATCB 2005).

The last topics this section sets standards for address treatment planning and documentation
(ATCB 2005). Art therapists must provide a treatment plan that assists the patients to reach or
maintain the highest level of quality of life and functioning (ATCB 2005). This involves using the
clients’ strengths to help them reach their goals and address their needs (ATCB 2005). Art
therapists are also required to record and take notes that reflect the proceedings of the events of
therapy sessions (ATCB 2005). According to ATCB, the following is the minimum of which must
be documented: “the current goals of any treatment plan, verbal content of art therapy sessions
relevant to client behavior and goals, artistic expression relevant to client behavior and goals,
changes (or lack of change) in affect, thought process, and behavior, suicidal or homicidal intent
or ideation” (2005) and a summary of the "clients response to treatment and future treatment
recommendations" (2005).

Eligibility for Credentials

This section of the ATCB Code of Professional Practice outlines the process by which art therapy
students receive their credentials. It discusses the standards for eligibility and describes the
application process. It also states that the ATCB certificates are the property of the ATCB and
that any art therapist who loses their certificate and still claim to have ATCB credentials can be
punished legally. It also discusses the procedure to follow when accused of wrong doing related
to art therapy. Lastly, it discusses the wrong doings related to art therapy that therapists can be
convicted for with a felony or another criminal conviction. These wrong doings include rape,
sexual abuse, assault, battery, prostitution, or the sale of controlled substances to patients.

Standards of Conduct
This section of the ATCB Code of Professional Practice addresses in detail confidentiality, use of
clients’ artwork, professional relationships, and grounds for discipline (ATCB 2005). [[Media: Art
therapists are not permitted to disclose information about the clients’ therapy sessions. This
includes “all verbal andItalic text/or artistic expression occurring within a client-therapist
relationship” (ATCB 2005). Art therapist are only allowed to release]] confidential information if
they have explicit written consent by the patient or if the therapist has reason to believe the
patient needs immediate help to address a severe danger to the patients life (ATCB 2005). Also,
therapists are not allowed to publish or display any of the patients work without the expressed
written consent of the patient (ATCB 2005).

The standards of a professional relationship between art therapists and clients are covered in this
section. Within a professional relationship, art therapists are banned from engaging in exploitative
relationships with current and former patients, students, inters trainees, supervisors, or co-
workers (ATCB 2005). The ATCB defines an exploitative relationship as anything involving sexual
intimacy, romance, or borrowing or loaning money (ATCB 2005). Within professional
relationships, therapists are to do what they feel is best in the clients interest, shall not advance a
professional relationship for their own benefit, and shall not steer their patients in the wrong
direction (ATCB 2005).

The breaking of any of the standards established in this section is grounds for discipline (ATCB
2005). OK

Disciplinary Procedures
The content contained in this section of the ATCB Code of Professional Practice specifically
discusses in legal and technical detail the entire disciplinary procedures for wrong doings in art
therapy (2005). Main topics covered in this section cover: “submission of allegations, procedures
of the Disciplinary Hearing Committees, sanctions, release of information, waivers,
reconsideration of eligibility and reinstatement of credentials, deadlines, bias, prejudice, and
impartiality” (ATCB 2005).

While the ATCB oversees disciplinary procedures for art therapists, if an art therapist is licensed,
the state board through which the art therapist is licensed carries out disciplinary action for
violations or unethical practice.
Effectiveness Art Therapy has bona fide research in various venues: phenomenological, heuristic,
quantitative, qualitative, etc. Numerous articles, books, NIH reports, etcetera are replete with
information that attests to the efficacy of Art Therapy as evidence-based, effective treatment.