Skip to main content

Verified by Psychology Today


Art Therapy’s Achilles Heel

Sometimes the truth is both a blessing and a pain.

Ouch! on band-aids

Art therapy is a field based on the concept that art making and the creative process can be leveraged to support health and well-being in children, adults, families and groups [see “Defining Art Therapy in the 21st Century”]. It is an approach that is clearly demonstrating an important role in health and mental health and more importantly, art therapy is gradually proving itself to be an effective intervention in enhancing overall quality of life and perceptions of wellness.

Most art therapists will agree that art making as a health-enhancing practice is not really a new concept. From an evolutionary biology perspective, it has been part of human “healthcare” practices throughout recorded history. In brief, the expressive arts—visual expression, music and rhythm, dance and movement, and drama and ritual-- most likely emerged because they are health-enhancing behaviors. In other words, these practices enabled humans to feel better in times of crisis, trauma or loss. Possibly before the arts were ever used to make art for art’s sake, humans enjoyed the satisfaction of rhythm, novelty, order, pattern, color, play and body movement as forms of self-regulation. In brief, humans engage in the arts because the sensory experience helps them not only to express and make meaning as well as to repair and renew.

So it’s not surprising that the therapeutic uses of art are not only found in art therapist-driven services, but are in fact ubiquitous. For example, there are mental health counselors, psychologists and social workers using creative arts in therapy with their clients; artists, psychiatric nurses and child life specialists in hospitals drawing with patients at bedside; play therapists offering art as part of play therapy with children and families; activity, recreation and occupational therapists applying art-based directives with clients; professional coaches capitalizing on visual media and the creative process; and expressive arts therapists using art within integrative approaches to treatment. There are international humanitarian programs that provide arts as emotional relief and crisis to individuals who have endured and survived disaster, terrorism and war. Even vulnerability researcher Brené Brown is preaching the value of the art journal as a route to exploration of the “gifts of imperfection” in massively marketed online mini-courses.

There are also those who find art’s healing forces on their own, often in times of trauma, crisis or loss, or simply as a means to reduce stress. Many of us who are passionate about art therapy discovered our calling because we have had transformative experiences with art. Similarly, returning military are embracing the arts and have initiated art-based programs to help soldiers overcome posttraumatic stress and express their experiences of war and active combat. Individuals who are challenged by mental illness or disability also find self-help, rehabilitation and hope through developing their creative identities at drop-in open studios.

Despite the many helping professionals who use art-based interventions in therapy and counseling and large numbers of individuals who discover art making as a form of self-help, art therapy education has become a flourishing industry, promoting the need for graduate level education for those who want to learn to apply the visual arts in therapy and obtain a board certification in the field. But while art therapy education flourishes for the moment, the profession called “art therapist” has struggled. Some propose that art therapy’s difficulties are due to a lack of evidence-based art therapy research. In truth, there are enough studies and trending data to indicate that art therapy is effective for many people, particularly those with medical illness, cognitive and neurological disorders, and stress-related conditions [see “Yes, Virginia, There is Some Art Therapy Research”].

But what art therapy research has not yet demonstrated is that the presence of an art therapist makes a measurable difference in supporting health and well-being. In other words, does it make a difference if a social worker, counselor, artist, activity therapist or an art therapist provides a specific art-based, therapeutic experience? And are there circumstances where art itself is the “therapist,” helping an individual to find wellness, self-worth and meaning, without a great deal of professional intervention? These questions rankle those who are trying to establish a clearly defined scope for art therapy professional practice, largely because they magnify a very painful vulnerability— that it is difficult at best to regulate and legislate a widely used and often self-help approach. This is art therapy’s proverbial Achilles heel.

Art therapists are currently working at regulating the practice of their trade in many states in the US. The daunting challenge [aka “heel”] to this endeavor is the widespread use of creativity and art making in therapy by many others without formal art therapy education--counselors, psychologists, social workers, artists in hospitals, coaches, activity specialists, and play therapists; it likely always will be. Art’s reparative powers also will be perpetually discovered by anyone who instinctively reaches for a pencil or paintbrush during the dark night of the soul. But like the mythological Achilles, the field has considerable strength, grounded in historical and contemporary indications that the creative process of art making is an effective intervention for people of all ages. Until art therapy fully achieves recognition as a profession, perhaps at best we can only reframe the meaning of our vulnerable heel and find our strength in our stewardship of a powerful tradition of healing.

Keep calm and call an art therapist,

Cathy Malchiodi, PhD, LPCC, LPAT, ATR-BC, REAT

© 2014 Cathy Malchiodi

For information on Trauma-Informed Art Therapy®--- visit Trauma-Informed Practices and Expressive Arts Therapy Institute at

Follow Planet Art Therapy Twitter at

Art Therapy on Pinterest at