When I mention I am an art therapist, peoples' responses are usually quite predictable. The first expression of interest, "Oh, I've always wondered about that" is invariably followed by the query, "What is art therapy, anyway?" In its simplest terms, art therapy is a form of psychotherapy that uses art media as the primary means of communication between client and therapist. While its aims are the same as those of more traditional psychotherapy techniques, in art therapy the focus of treatment is shifted from the usual two-way verbal exchange between therapist and client to a three-way interchange among therapist, client, and client art work.  The focus is placed squarely on the client's art work which becomes the vehicle through which healing occurs. Sometimes, when art therapy is at its best, the client's silent viewing of the art work is sufficient to create lasting personal change at the deepest levels. If this process sounds somewhat mysterious--it is. And it is this very mystery that makes defining just how art therapy works so very difficult: many eminent art therapists have tried, with varying degrees of success, to explain how or why art therapy works.

Not only is art therapy a large and complex field, but, because it is an essentially non-verbal process which creates change at a profound level of the psyche, satisfactory verbal definitions are illusive. In this article, and those to follow, I hope to take a peak through the mystique that surrounds art therapy and bring some clarity to just what art therapy is, how it is used, how it works, and how it can heal.

As a treatment modality, the benefits of art therapy cut across all age groups, from the very young to the elderly.  For the very young, art therapy is extremely effective in helping children cope with the uncertainty and fear that often accompany either changes in family structure or moves to a new location or school. Art therapy is also used to help children with learning difficulties or behavioural issues. For the elderly, studies show that art therapy can significantly improve the quality of life for those elders suffering from chronic or debilitating illness. Art therapy is also of great help in preparing elders for life transitions. As well as being of benefit to people of all ages, art therapy is also of benefit to those dealing with a wide range of medical conditions.

Art therapy is now recommended by health agencies and many patients' organizations as either a primary or adjunct therapy for an array of medical problems. In the United Kingdom, for instance, art therapy is recommended--and funded under the National Health Service--as an adjunct treatment for conditions such as meningitis and schizophrenia. A bulletin from the United Kingdom Meningitis Trust states: "It has been proven that art therapy enables those who have had a traumatic experience to ... learn to cope with a sudden, and ... devastating, change in their life." In Saudi Arabia, young men found guilty of terrorist offenses are able to undergo art therapy. To date, over a period of several years, not one act of recidivism by participants of the Saudi program has been recorded.  

Specific conditions for which art therapy is an effective treatment range from mood dysfunction seen in depression, anxiety and bipolar spectrum disorders, to post traumatic trauma, to attention deficit behaviours, to problems with social functioning and bereavement. This list is by no means exhaustive. Art therapy is beneficial to just about everyone, including those who might feel vaguely uneasy about their lives--a kind of 'existential angst' experienced by people who have lost their vision, purpose or sense of direction, or who wish to deepen their understanding of themselves and their place in the world. 

Art therapy helps people see their current difficulties in a new light, develops coping strategies, lessens stress, brings to light unhelpful or dysfunctional attitudes, thoughts, and behaviours, and offers new and more productive ways of dealing with life's difficulties. The art therapy process helps people become more self-aware and achieve greater balance between their inner and outer lives. All that is required on the part of the client is a willingness to engage in self-exploration through art making and an open mind as to how art can bring greater self-knowledge, greater understanding, and healing. Art therapists and their clients know these benefits are achievable, and the ever-increasing list of international, governmental and private agencies now unreservedly recommending art therapy as a preferred treatment, together with research validation and anecdotal evidence, support these findings.

One way of beginning to grasp what art therapy is and the mechanisms by which it works is to look at some common misconceptions about what art therapy is. One such common misconception is that art therapy it is limited to those with an art background or who have artistic talent. Nothing could be further from the truth. Clients are not expected to have any artistic skill or experience. In fact, many therapists prefer to work with those who have had little or no art training; the reason for this is that some accomplished artists find the process of art therapy difficult at first precisely because of their skill and preoccupation with 'technique'. Art therapists are not concerned with correct technique or producing 'good art'; they are concerned with spontaneous self-expression through art media.  Another misconception is that art therapists interpret clients' art work according to a mysterious system of symbols in which certain signs or drawings have certain immutable meanings. Again, nothing could be further from the truth. Art therapists encourage clients to uncover their own personal symbols and their meanings through examination and contemplation of their art work; these meanings are often quite different from what one might expect. Another misconception about art therapy is that it is a form of art instruction. Although art practice is an essential part of the art therapist's training, in their work as therapists they use their skills to guide others through their journeys of self-understanding. Gentle guidance in the use and appropriateness of art materials, when required, is the only art instruction the art therapist provides.

Art therapists work from a traditional art studio in which a variety of materials are available and from which the client freely chooses. Typical materials include several types of paint, papers of various sizes, colours and weights, pencils, charcoal, pastels, chalks, clay, and objects for collage making or expressive play. Other expressive modalities, such as play therapy, photography, writing and literature may be incorporated into the therapeutic work. Clients are encouraged to work with the art media in whatever way they wish. Over the course of therapy, most clients will produce a range of work—many pieces executed quickly and other pieces executed over many sessions. Typically, clients work with a great range of media and engage with the art materials in many different ways. The therapist acts as both a witness to the art making and as a guide through the client's process of finding personal meaning in his or her art work. The therapist provides a safe and contained space in which the client can express his or her self freely and experience, or re-experience, aspects of his or her inner life. Because emotions--which have previously been unrecognized or poorly understood--are now contained within the boundaries of the art, the art maker experiences them as being separate from him or herself. This distancing between inner and outer life creates a sense of safety and detachment that makes working with complex, frightening or distressing feelings less threatening. If the client chooses, he or she can discuss the art process and the personal meaning found in the artwork. Therapeutic work is always based on a collaborative process between the client and the therapist who work together to uncover meaning in the art work. Because the art work is thought to be a reflection of a person's deepest self, art work produced in session is treated with the greatest respect and held in the strictest confidence. The client may choose to take the art work home at the end of each session or to leave it in the safe-keeping of the therapist. It is common practice for art therapists and their clients to review artwork from time to time so that changes in clients' functioning and understanding are given a visual, and, therefore, more concrete dimension. 

Art therapy is an extremely adaptable form of therapy effective for all ages and for many conditions; it is also a wonderful method of gaining greater self-insight, increasing self-expression, or coping with life transitions. The personal changes made through art therapy occur at a profound level and are shown to produce long-lasting changes in the client. Art therapy is a growing field with an exciting future. The potential for art therapy is unlimited for those willing to delve into the materials of visual self-expression.