An Encyclopedia on Art Therapy for Addiction

Art therapy is a mental health therapy that involves using the art and creative process to facilitate a therapeutic experience2. Through creating and appreciating art, a person in substance abuse recovery is ideally able to express themselves where words cannot. This therapy approach is frequently utilized in substance abuse treatment as a means to help relieve anxiety, reduce conflicts and build a person’s self-esteem and self-awareness in recovery. While art therapy is rarely the only therapy a person in recovery utilizes, it can be a significant complement to medication management and talk therapy or psychotherapy.

Art therapists believe that allowing a person to express themselves through art enables the person to tap into thoughts and emotions they may not be able to express in words. Art therapy also incorporates a variety of skills, such as sensory, motor and cognitive functions. An individual may be able to use art to catalog their life experiences and find the motivation to move forward as a sober individual.

History of Art Therapy

The National Institutes of Health (NIH) began researching the benefits of art therapy in 19581. A researcher from the NIH noted that art therapy sessions helped people explore their family dynamics and express their feelings about conflicts and concerns through the art they created.

Throughout the 1960s and 1970s, the NIH continued to move their scientific research forward, which garnered more interest in therapeutic approaches from other therapists on a national and international scale. In 1969, the American Art Therapy Association was founded as a non-profit professional and educational organization. In the 1970s, several key researchers at the NIH either left the organization or passed away. As a result, funding for research started to diminish and less research was conducted for almost 20 years.

However, in the 1990s, researchers across multiple specialties, including addiction care, started to once again turn their attention toward art and recreation therapy. Since that time, art therapy has become more of an accepted complementary approach to substance abuse treatment. Today, art therapists continue to research how art therapy may increase a patient’s motivations to stay sober as well as reduce the incidence of substance abuse relapse.

Art Therapy Projects

Art therapists have used art therapy for both short- and long-term treatment approaches. For example, some inpatient rehabilitation programs have in-house art therapists who work with patients who are participating in art therapy on a short-term basis4. Other people may continue to participate in art therapy on a longer-term basis through group classes.

The First Step Series

While not all art therapists utilize a specific treatment plan and program, there are some standardized art therapy approaches. One example is a five-stage art directive series known as “The First Step Series”. Through this art series, participants are encouraged to complete five separate art pieces.

These pieces include:

  1. Crisis Directive: The client completes a drawing that describes their current situation or the incident that led them to the recovery process.
  2. Recovery Bridge Drawing: This is a drawing where a person is asked to describe where they have been, then where they are now and at the end of the bridge depict where they want to be in their recovery.
  3. Cost-Benefits Collage: This collage is one a person creates to relay the benefits of staying sober.
  4. Future Depiction: Future depiction asks a person to depict themselves in the future as a sober person as well as their future if they do not continue a sober lifestyle.
  5. Barriers Imagery: In this picture, a person is asked to depict the stresses, factors, and issues that could keep them from staying sober.

Other projects

Even if a client in art therapy does not complete the five-step series, common art therapy exercises are to complete one or more of these projects. Other popular art projects an art therapist may use include a “Hypothetical Greeting Card,” where a person is asked to create a card from themselves to send to a person they care about. This exercise allows a person to evaluate who and what they care about.

Misconceptions About Art Therapy

A common misconception about art therapy is that the products of a person’s artistic efforts are “judged” or “diagnosed.” However, art therapy is more about the process of making art, not about the technical skill or value of the end result. Therefore, a person does not have to be a great or experienced artist to benefit from art therapy. They simply have to be willing to be a part of the process.

Effectiveness of Art Therapy

While art therapy has been studied and practiced for several decades, very large-scale studies are not widely available to put scientific backing behind art therapy or certain approaches to therapy. One reason why it is challenging is that it is difficult to assign numerical and scientific values to the creative process. However, there are many written reports and anecdotes about art therapists’ experiences and approaches to art therapy with their clients and the benefits they experienced. For example, a 2007 report found that art therapy used in conjunction with the principles of 12-step programs like Alcoholics Anonymous helped to prevent relapse by encouraging patients to visualize their relapse triggers and other potential barriers to recovery.

The Benefits of Art Therapy Include:

  1. Boost Social Skills
  2. Improve Cognitive Functions
  3. Increase Emotional Resilience
  4. Enhance Self-Esteem
  5. Boost Self-Awareness
  6. Promote Change
  7. Resolve Conflicts

One meta-analysis of art therapy approaches does exist. The meta-analysis examined study results from seven qualitative studies. At the conclusions of reviewing the studies, the authors concluded that art therapy helped participants to cope with their emotions as well as explore emotions of anxiety and grief and also identify opportunities for growth and positive changes in their lives.

Scientists theorize that one reason why art therapy can be effective in substance abuse treatment is that the creation of art and the achievement motivations the creation of an art project creates increases the amount of dopamine, a neurotransmitter associated with pleasurable feelings in the brain.

Decreased dopamine levels are associated with depression and anxiety while increased levels can help a person in recovery feel physically better. Ideally, art therapy allows a person to confront the challenges and rewards of sobriety in new ways.

What Training Is Required for Art Therapy Staff?

Many art therapists hold a master’s degree in art therapy or psychology with a specialty certification in art therapy. Those pursuing an art therapy degree must have 60 graduate-level hours of studio art, psychological development, group therapy, research methods and assessment.

Art therapists train across mediums such as drawing, painting and sculpture. In addition to classroom work, masters-level art therapists also complete 100 hours of a supervised practicum and 600 hours of supervised art therapy via a clinical internship3.

Once a person completes their education, an art therapist can seek certification via the Art Therapy Credentials Board. The board offers three levels of credentials. The first is a Provisional Registered Art Therapist (ATR-P), which is a therapist who has a master’s degree and is practicing under approved supervisors.

The second is a Registered Art Therapist, which means the therapist has completed a certain number of clinical hours and supervision.

Registered Art Therapists can qualify for the board certifying exam to become ATR-Board Certified therapists5. Not all people who practice or teach art therapy have a master’s degree. Some universities offer undergraduate art therapy programs and other resources offer art therapy certificates.

Art therapy has an element of psychological expression. Sometimes an art teacher or artist may work in conjunction with a therapist, such as a psychologist or a psychiatrist, in the same session.

Finding Art Therapy

The American Art Therapy Association has a link on their website titled “Art Therapist Locator.” Through this search function, a person can locate a masters-level art therapist in the United States. The Art Therapy Credentials Board also has a “Find a Credentialed Art Therapist” feature on their website to help a person locate an art therapist in their area.

Integrating Art Therapy After Treatment

While art therapy is often regarded as a short-term therapy, some clients may choose to continue their art therapy through individual or group art therapy sessions.

A person is also encouraged to continue exploring their creative process outside of substance abuse-related art projects. Pursuing art through painting, drawing, sculpting or other mediums can provide a positive artistic outlet for expression and help relieve anxiety in recovery.