How Art Therapy Can Work-A Case Study

Along with many art therapists, I sometimes struggle to articulate exactly how art therapy works. In response to this question recently posed by Cathy Malchiodi, I am going to attempt to explain it via a case study. Details have been changed to protect the identity of the client, who has since passed away.

Many years ago, I worked extensively in nursing homes. One resident was in the late stages of an illness that was greatly exacerbated by his diet. Many battles ensued between him and nursing staff over his constant intake of food that worsened his condition. The attending psychiatrist asked me to work with him to address this problem. I imagined that our work would focus on his body image (as he was morbidly obese), his declining health and the struggles with nursing staff.

This case ended up being a lesson for me in person-centered planning. He had no interest whatsoever in focusing on what I considered to be the primary problems. He was, however, very interested in painting even though he had never done it before. During our first session, he pulled out a book of postcards that depicted various nature scenes on the West Coast. The time he spent living in that part of the country was the happiest time of his life and he wanted to capture these images in paint. I brought him a set of acrylic paint, some brushes and paper and we were off and running.

Over the course of time, nursing staff started to notice that he was quite gifted as a painter. He painted all weekend instead of eating all of his favorite snacks. Nurses checked in to admire what he was working on instead of to scold him for what he was eating. A few even commissioned works from him. While he painted, he reminisced about his time on the West Coast and his younger days.

We never spoke of his diet, his weight, his battles with nursing staff. We talked about line, shape, form, color, harmony, and composition. I listened while he told me of adventures from his youth, his life and loves. I accompanied him on his journey. By the time he was discharged from the nursing home, his relationship with the staff was a positive one and his diet had improved.

So how did art therapy work in this case? Art became a healthy coping skill, allowing this client to engage in a positive activity to manage his feelings, rather than burying them in food. It became a conduit in his relationships with others, allowing them to see his strengths rather than focusing on his deficits. Art was the language that joined us together in our relationship. He benefited from the time and attention I gave him and from my willingness to follow him where he needed to go in therapy.

This case was a good lesson for me. I had to let go of my ideas about what this client needed and not impose my treatment priorities on him. And guess what? He found exactly what he needed.


I do not “do art.”

I was recently asked how I make time for my art. Posing the question this way makes art making sound about as interesting as doing laundry (to me anyway.) How do I make time for anything important in my life? Do I make time for loved ones, or do loved ones permeate my life and my activities? Do I make time for spirituality, or is it something that informs my thoughts and actions daily? Do I make time for love, or does it fill all the crevices of my heart?

When I think about my priorities, art falls right in there with loved ones, spirituality and love. So why do I need to “make time” for it? Shouldn’t it be part and parcel of everything I do? Since starting this blog almost a year ago, I have given a great deal of thought of how to incorporate more art into my life. The conclusion I am arriving at is that art is not a discrete activity that I partake of when I have or make the time for it. It is something that is tightly intertwined with my physical and spiritual being, it informs my thoughts, vision and actions.  It is not something I need to make time for, because it is a constant companion on my journey. It is infused into my worldview.

There are times when this infusion looks like sitting down in the studio to make a concrete piece of art. But other times, it is about how I see the world, how I think, what I surround myself with.  Art is not something I find the time to do, art is something I live and breathe. As I tell my students all the time, I will not teach you to “do art therapy,” but I will teach you to “be a therapist.” An important distinction, as therapy is not about “doing to” but about “being with.” Likewise, I do not “do art,” I live art. You can too.

What This Art Therapist Does Not Do

I get a lot of hits to my blog from people searching on the topic of “a day in the life of an art therapist” and “what does an art therapist do?” I want to add to this conversation by telling you what I as an art therapist do NOT do.

I do NOT analyze your artwork  seeking out clues to your psyche.

I do NOT interpret imagery in your artwork to fit my theory about you.

I do NOT tell you what kind of artwork to make, as though to prescribe a cure.

I do NOT diagnose you based only on your artwork.

I do NOT share your artwork with anyone except other providers at the site, as it is confidential healthcare information.

I do NOT reveal your name or other identifying information if you have given me explicit written permission to share your artwork.

Here are some things I DO:

Provide you with the materials, space, instruction and time to create the artwork you want to make.

Support you in exploring the  imagery, themes and content of your work.

Give suggestions if you feel you are stuck in your artwork or want to explore something further.

Walk with you on your healing journey of the heart.

There are many misconceptions about what art therapists are and what they do. I won’t even go into the whole debate about “arts and healing” vs. “art therapy.” Art therapists are trained clinicians, yes clinicians, who have had years of schooling and internships to better assist our clients in exploring their challenges and struggles. Call it what you want, but I proudly call it Art Therapy.

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