Skip to main content
SearchLoginLogin or Signup

Art therapy

Art therapy is the main representative of a broader group of creative and expressive therapies.

Published onJul 07, 2019
Art therapy

Art therapy is the main representative of a broader, relatively new group of creative/expressive therapies, which also includes dance therapy, music therapy, poetry/bibliotherapy, (some include psychodrama and drama therapy). Art therapy is specifically focused on the visual arts (primarily painting, drawing and sculpting).

Brief historic overview

Art therapy developed and evolved throughout the 20th century alongside the development of psychiatry, psychotherapy and psychoanalysis and new art trends such as surrealism and expressionism. It gets its modern form in the 1940ies when it starts being officially called art therapy. In the UK, artist Adrian Hill is generally acknowledged to be the first person to use the term ‘art therapy’ to describe the therapeutic application of image making. For Hill, who had discovered the therapeutic benefits of drawing and painting while recovering from tuberculosis, the value of art therapy lay in ‘completely engrossing the mind (as well as the fingers)… and releasing the creative energy of the frequently inhibited patient’. This, Hill suggested, enabled the patient to ‘build up a strong defense against his misfortunes’. At around the same time psychologist Margaret Naumberg also began to use the term art therapy to describe her work in the USA. Naumberg’s model of art therapy based its methods on releasing the unconscious by means of spontaneous artistic expression; it has its roots in the transference relation between patient and therapist and in the encouragement of free association. It is closely allied to psychoanalytic theory. Treatment depends on the development of the transference relation and on a continuous effort to obtain the patient’s own interpretation of his symbolic designs. The images produced are a form of communication between patient and therapist; they constitute symbolic speech.


Art therapy today is based on a synthesis and subtle interactions between the creative process itself and the nature of the relationship established between the client and therapist. In art therapy this dynamic is often referred to as the triangular relationship. Within this triangular relationship greater or lesser emphasis may be placed on each axis (between, for example, the client and their artwork or between the client and the art therapist) during a single session or over time.

In practice, art therapy involves both the process and products of image making (from crude scribbling through to more sophisticated forms of symbolic expression) and the provision of a therapeutic relationship. It is within the supportive environment, fostered by the therapist–client relationship, that it becomes possible for individuals to create images and objects with the explicit aim of exploring and sharing the meaning these may have for them. It is by these means that the client may gain a better understanding of themselves and the nature of their difficulties or distress. This, in turn, may lead to positive and enduring change in the client’s sense of self, their current relationships and in the overall quality of their lives.

Art therapists are highly skilled professionals and require certain qualifications in artistic and therapeutic work. Art therapy has to be differentiated from occupational therapy and in their discussion of this issue, Atkinson and Wells identify four main areas of difference between art therapy and the use of art in occupational therapy. They distinguish these as: education and training, the use of a single art based medium, the importance attached to the artwork, and the level of direction evident within the therapeutic approach.

Main uses

Clients who are referred to an art therapist do not need to have previous experience or skill in art, the art therapist is not primarily concerned with making an aesthetic or diagnostic assessment of the client’s image. The overall aim of its practitioners is to enable a client to effect change and growth on a personal level through the use of art materials in a safe and facilitating environment. A wide range of people may benefit from engaging in art therapy: people who experience illness, trauma, or challenges in living, and people who seek

personal development. All age groups are included. Recently, a growing body of evidence has confirmed this. Some of the disorders noted are schizophrenia, depression, dementia, PTSD, stress and trauma related disorders (in adults and children), eating disorders, borderline personality disorder, suicidal behavior, etc. as well as some somatic disorders where quality of life has been reduced, especially in the field of psycho-oncology.

Comment from an expert

I became… a diligent and leisurely composer of precise pencil productions, each of which, in the terms of my restricted medium, sought to express my personal reactions to the unreality of my existence.” (Adrian Hill, 1945).

To be happily occupied is at all times a gift from the gods, and in a period of long convalescence, it is a positive saving grace… The Art germ once it becomes firmly planted in the mind and the heart, is far more difficult to dislodge than another germ with which you are all more familiar. Indeed the former germ can help enormously in banishing the latter bug.” (Adrian Hill, 1945)


  • Rubin JA. Introduction to Art therapy: Sources and resources / USA: Routledge, 2010

  • Liebmann M, Weston S. Art therapy with physical conditions/ United Kingdom: Jessica Kingsley Publishers, 2015

  • Edwards D. Art therapy / London: Sage Publications Ltd, 2004

  • Buchalter, SI. A Practical Art Therapy / United Kingdom: Jessica Kingsley Publishers, 2004

  • Kaplan, FF. Art, Science and Art Therapy: Repainting the Picture / United Kingdom: Jessica Kingsley Publishers, 2000

  • Gilroy, A. Art Therapy, Research and Evidence-based Practice / London: Sage Publications Ltd, 2006

  • Malchiodi, CA. Handbook of Art Therapy / New York: The Guilford Press, 2003

  • Schroder D. Little Windows into Art Therapy: Small Openings for Beginning Therapists / United Kingdom: Jessica Kingsley Publishers, 2005

  • Rubin JA. Child Art Therapy / New Jersey: John Wiley & Sons, 2005

  • Kramer E, Art as Therapy: Collected Papers / United Kingdom: Jessica Kingsley Publishers, 2000


  • Ruiz MI, Aceituno D, Rada G. (2017) Art therapy for schizophrenia? Medwave 17(Suppl1):e6845

  • Baker FA, Metcalf O, Varker T , O'Donnell M. (2018) A systematic review of the efficacy of creative arts therapies in the treatment of adults with PTSD. Psychological trauma:theory, research, practice and policy. 10(6):643-651.

  • Chancellor B, Duncan A, Chatterjee A. (2014) Art therapy for Alzheimer's disease and other dementias. Journal of Alzheimer's disease. 39(1):1-11.

  • Wood MJM, Molassiotis A, Payne S. (2011) What research evidence is there for the use of art therapy in the management of symptoms in adults with cancer? A systematic review. Psycho-Oncology 20, 2, 135–145.

  • Lock J, Fitzpatrick KK, Agras WS , Weinbach N, Jo B. (2018) Feasibility Study Combining Art Therapy or Cognitive Remediation Therapy with Family-based Treatment for Adolescent Anorexia Nervosa. European eating disorders review: the Journal of the Eating Disorder Association 26(1):62-68.

  • Blomdahl C, Gunnarsson BA, Guregård S, Rusner M, Wijk H, Björklund A. (2016) Art therapy for patients with depression: expert opinions on its main aspects for clinical practice. Journal of mental health (Abingdon, England) 25(6):527-535.


American Art Therapy Association (AATA)

Association of Art Therapists of Québec (AATQ)

The Canadian Art Therapy Association (CATA)

Ontario Art Therapy Association (OATA)

British Columbia Art Therapy Association (BCAT)

Australian and New Zealand National Art Therapy Association (ANZATA)

Brazilian Union of Art Therapy Associations (UBAAT)

Chilean Art Therapy Association

British Association of Art Therapists (BAAT)

Art Therapy Italiana Association

Northern Ireland Group for Art as Therapy (NIGAT)

Germany Association of Art Therapy

The Swedish National Association for Art Therapists (SBRT)

The Israeli Association of Creative and Expressive Therapies (ICET)

Korean Academy of Clinical Art Therapy (KACAT)

The Hong Kong Association of Art Therapists (HKAAT)

The African Consortium of Art Therapy (ACAT)

Art Therapists’ Association Singapore

International Expressive Arts Therapy Association (IEATA)

European Federation of Art Therapy

Art Therapy Without Borders

Australian, New Zealand and Asian Creative Arts Therapies Association (ANZACATA)


Chapter written by Ana Papić and Nikola Žaja, psychiatry trainees from University Psychiatric Hospital Vrapče, Zagreb, Croatia

No comments here
Why not start the discussion?