Photo of Lighthouse Counseling Christian Ministry, Counselor in Salisbury, MD
Lighthouse Counseling Christian Ministry
Counselor, LCPC, LCSW-C, LMSW, LGPC
Verified Verified
Salisbury, MD 21804
**Accepting New Clients** Our passion's here at Lighthouse Counseling Christian Ministry include Adolescent Counseling, Marriage and Couples Counseling, Addictions Counseling, working through anxiety and depression issues and generally listening and providing solid techniques in conflict resolution of all types. We provide a safe and confidential environment in which to develop trust and confidence. We have a diverse staff willing to walk alongside you in whatever journey you are on. IF LIFE HAS YOU DOWN, PLEASE LOOK US UP!!
**Accepting New Clients** Our passion's here at Lighthouse Counseling Christian Ministry include Adolescent Counseling, Marriage and Couples Counseling, Addictions Counseling, working through anxiety and depression issues and generally listening and providing solid techniques in conflict resolution of all types. We provide a safe and confidential environment in which to develop trust and confidence. We have a diverse staff willing to walk alongside you in whatever journey you are on. IF LIFE HAS YOU DOWN, PLEASE LOOK US UP!!
(410) 973-2211 View (410) 973-2211

Online Therapists

Photo of Karen E Katrinic, Marriage & Family Therapist in Salisbury, MD
Karen E Katrinic
Marriage & Family Therapist, MS, LCMFT
Verified Verified
Chester, MD 21619
Sometimes traditional talk therapy alone is not sufficient, so I employ experiential techniques like art therapy, play & filial therapy, sandtray, and EMDR to help clients access the parts of themselves that are blocked.
I'm experienced working with individuals, couples and families. I help people make the changes they want, either within themselves or in their relationships. I believe everyone has an innate ability to live to their fullest potential, but sometimes need a little help in unlocking their own internal resources. In addition to regular talk therapy, I am certified in EMDR, which is an experiential modality that allows the client to weaken neural networks that are not useful, and strengthen or install more adaptive neural networks. I am licensed to practice in 4 states. Maryland, Virginia, Washington DC, and West Virginia.
Sometimes traditional talk therapy alone is not sufficient, so I employ experiential techniques like art therapy, play & filial therapy, sandtray, and EMDR to help clients access the parts of themselves that are blocked.
I'm experienced working with individuals, couples and families. I help people make the changes they want, either within themselves or in their relationships. I believe everyone has an innate ability to live to their fullest potential, but sometimes need a little help in unlocking their own internal resources. In addition to regular talk therapy, I am certified in EMDR, which is an experiential modality that allows the client to weaken neural networks that are not useful, and strengthen or install more adaptive neural networks. I am licensed to practice in 4 states. Maryland, Virginia, Washington DC, and West Virginia.
(410) 305-9925 View (410) 305-9925
Photo of Emily Kallay, Clinical Social Work/Therapist in Salisbury, MD
Emily Kallay
Clinical Social Work/Therapist, LCSW-C, MEd
Verified Verified
Baltimore, MD 21212  (Online Only)
I offer a wide variety of feminist theory based, client centered treatments incorporating play, art, and sand tray techniques, as well as Narrative and Acceptance and Commitment Therapy based approach to talk therapy.
I have over a decade of professional experience working within the LGBTQ+ community, with specialized skills for kids, adolescents, adults, or families who are navigating a gender journey, a kinky relationship, a non-monogamous connection, sex as employment, as well as many other beautiful different ways we live our lives.
I offer a wide variety of feminist theory based, client centered treatments incorporating play, art, and sand tray techniques, as well as Narrative and Acceptance and Commitment Therapy based approach to talk therapy.
I have over a decade of professional experience working within the LGBTQ+ community, with specialized skills for kids, adolescents, adults, or families who are navigating a gender journey, a kinky relationship, a non-monogamous connection, sex as employment, as well as many other beautiful different ways we live our lives.
(410) 469-8674 View (410) 469-8674
Photo of Esther Saggurthi, Licensed Clinical Professional Counselor in Salisbury, MD
Esther Saggurthi
Licensed Clinical Professional Counselor, LCPC
Verified Verified
1 Endorsed
Rockville, MD 20855
Waitlist for new clients
In addition to talk therapy, I also practice Bibliotherapy, a range of different types of Art Therapy, Mindfulness, Guided Meditation, and Sensorium work.
The mere thought of therapy can be daunting, while in actuality most of us ask for advice from those around us everyday. What makes therapy different from asking a coworker, friend or relative for their advice, is my approach to therapy. I believe therapy is allowing you the space to work out issues, the space to feel free and learn about yourself in new ways. Therapy is looking at your thoughts and behavioral patterns for maximum effectiveness to your desired goals. My approach is best summed up in a quote by Benjamin Franklin, “There are three things extremely hard: steel, a diamond, and to know one’s self.”
In addition to talk therapy, I also practice Bibliotherapy, a range of different types of Art Therapy, Mindfulness, Guided Meditation, and Sensorium work.
The mere thought of therapy can be daunting, while in actuality most of us ask for advice from those around us everyday. What makes therapy different from asking a coworker, friend or relative for their advice, is my approach to therapy. I believe therapy is allowing you the space to work out issues, the space to feel free and learn about yourself in new ways. Therapy is looking at your thoughts and behavioral patterns for maximum effectiveness to your desired goals. My approach is best summed up in a quote by Benjamin Franklin, “There are three things extremely hard: steel, a diamond, and to know one’s self.”
(240) 634-9514 View (240) 634-9514
Photo of Susan Marie Sisk Price, Art Therapist in Salisbury, MD
Susan Marie Sisk Price
Art Therapist, LCPAT , ATR-BC
Verified Verified
Elkton, MD 21921  (Online Only)
Art Therapy offers many a voice to share their unique stories, through a variety of mediums.
As an Art Therapist with over 20 years of experience, I specialize in treating female survivors of relational trauma; including Domestic Violence, sexual, and Narcissistic abuse. Have you been the victim of relational trauma, either by a caregiver or a partner? This type of trauma can cause significant damage to the "self." Learning to love and trust yourself again is possible. Your authentic "self" is waiting to be re-born. Learn to embrace your trauma, heal, and discover your unique voice and purpose. No artistic ability is required, just a willingness to engage in the creative process, and explore your spirituality.
Art Therapy offers many a voice to share their unique stories, through a variety of mediums.
As an Art Therapist with over 20 years of experience, I specialize in treating female survivors of relational trauma; including Domestic Violence, sexual, and Narcissistic abuse. Have you been the victim of relational trauma, either by a caregiver or a partner? This type of trauma can cause significant damage to the "self." Learning to love and trust yourself again is possible. Your authentic "self" is waiting to be re-born. Learn to embrace your trauma, heal, and discover your unique voice and purpose. No artistic ability is required, just a willingness to engage in the creative process, and explore your spirituality.
(410) 970-3140 View (410) 970-3140
Photo of Living Deliberately LLC, Clinical Social Work/Therapist in Salisbury, MD
Living Deliberately LLC
Clinical Social Work/Therapist, LCSW-C
Verified Verified
1 Endorsed
Baltimore, MD 21211
We have clinicians that specialize with helping people with autism, Dissociative-Identity Disorders (DID), sex / sexual disorders, couples, art therapy, Mentalization Based Therapy (MBT), EMDR, trauma-focused CBT, and DBT.
Living Deliberately, LLC is dedicated to client-focused and client-forward treatment. We have medication management in addition to multiple skilled practitioners well-versed in the treatment of ADHD, Bipolar disorder, Mood disorders, Anxiety disorders, and associated traumatic events for children / teens / adults. We look forward to working with you on your difficulties to process and break down the barriers that are stopping you from achieving contentment in living. Now offering Transcranial Magnetic Stimulation (TMS) treatment for medicationaly resistant depression, anxiety and OCD.
We have clinicians that specialize with helping people with autism, Dissociative-Identity Disorders (DID), sex / sexual disorders, couples, art therapy, Mentalization Based Therapy (MBT), EMDR, trauma-focused CBT, and DBT.
Living Deliberately, LLC is dedicated to client-focused and client-forward treatment. We have medication management in addition to multiple skilled practitioners well-versed in the treatment of ADHD, Bipolar disorder, Mood disorders, Anxiety disorders, and associated traumatic events for children / teens / adults. We look forward to working with you on your difficulties to process and break down the barriers that are stopping you from achieving contentment in living. Now offering Transcranial Magnetic Stimulation (TMS) treatment for medicationaly resistant depression, anxiety and OCD.
(410) 401-1098 View (410) 401-1098
Photo of Nina Boyd, Licensed Clinical Professional Counselor in Salisbury, MD
Nina Boyd
Licensed Clinical Professional Counselor, LCPC, CSAT-C
Verified Verified
6 Endorsed
Annapolis, MD 21401
I am a strong believer in therapy being a collaborative, healing, and restorative experience. As Pema Chödrön once said, “Let difficulty transform you. And it will. In my experience, we just need help in learning how to not run away.” But that’s easier said than done – what are the steps to getting to a better place? Where do you even start? You are not alone in this journey. I take great pride in building a therapeutic connection and a safe space for you to be your genuine self so that you may find that resiliency within.
I am a strong believer in therapy being a collaborative, healing, and restorative experience. As Pema Chödrön once said, “Let difficulty transform you. And it will. In my experience, we just need help in learning how to not run away.” But that’s easier said than done – what are the steps to getting to a better place? Where do you even start? You are not alone in this journey. I take great pride in building a therapeutic connection and a safe space for you to be your genuine self so that you may find that resiliency within.
(443) 665-8295 View (443) 665-8295
Photo of Embrace Therapy - Michali Friedman, Clinical Social Work/Therapist in Salisbury, MD
Embrace Therapy - Michali Friedman
Clinical Social Work/Therapist, LCSW-C
Verified Verified
Baltimore, MD 21208  (Online Only)
To our Dear Future Client, If you're reading this, chances are you may have noticed that something does not feel right in your relationship. Perhaps you have known this for quite some time or maybe you have only now come to realize an important truth - that this is not how you want to feel, not where you want to be, & it's time for change. Change can be really scary and overwhelming, maybe even foreign. Of course, evolution doesn't happen overnight, so naturally you may ask how & when does it happen? Good questions!
To our Dear Future Client, If you're reading this, chances are you may have noticed that something does not feel right in your relationship. Perhaps you have known this for quite some time or maybe you have only now come to realize an important truth - that this is not how you want to feel, not where you want to be, & it's time for change. Change can be really scary and overwhelming, maybe even foreign. Of course, evolution doesn't happen overnight, so naturally you may ask how & when does it happen? Good questions!
(646) 663-5368 View (646) 663-5368
Photo of Liberty Deffenbaugh, Counselor in Salisbury, MD
Liberty Deffenbaugh
Counselor, LGPC
Verified Verified
1 Endorsed
Hanover, MD 21076  (Online Only)
Accepting New Clients for Kick Ass Therapy! I specialize in marginalized populations including LGBTQIA+, ethically and consensual non-monogamy/polyamory, BDSM and Leather, with authentic space, support, solutions and celebration of identity. Looking for a real person to talk to? Looking for someone who walks the walk and talks the talk, where you don't have to educate your therapist about your lifestyle or automatically have it blamed for all your issues? From sex therapy to self acceptance, I specialize in unique individuals, couples & polycules. I meet clients where they are emotionally, helping them progress and heal. You matter!
Accepting New Clients for Kick Ass Therapy! I specialize in marginalized populations including LGBTQIA+, ethically and consensual non-monogamy/polyamory, BDSM and Leather, with authentic space, support, solutions and celebration of identity. Looking for a real person to talk to? Looking for someone who walks the walk and talks the talk, where you don't have to educate your therapist about your lifestyle or automatically have it blamed for all your issues? From sex therapy to self acceptance, I specialize in unique individuals, couples & polycules. I meet clients where they are emotionally, helping them progress and heal. You matter!
(443) 706-8783 View (443) 706-8783
Photo of First Choice Community Counseling, LLC, Clinical Social Work/Therapist in Salisbury, MD
First Choice Community Counseling, LLC
Clinical Social Work/Therapist, LCSW-C, LICSW, MSW
Verified Verified
Camp Springs, MD 20746
1st Choice Therapists want to help you feel less tired, less frustrated on a daily/weekly basis. We know many of our potential clients are dealing with grief and loss from loved ones that have succumbed to COVID related deaths. At First Choice, we want you to learn how to heal, naturally without a co-dependency on psychotropic medications.
1st Choice Therapists want to help you feel less tired, less frustrated on a daily/weekly basis. We know many of our potential clients are dealing with grief and loss from loved ones that have succumbed to COVID related deaths. At First Choice, we want you to learn how to heal, naturally without a co-dependency on psychotropic medications.
(240) 255-9874 View (240) 255-9874
Photo of Mary Lesser, Clinical Social Work/Therapist in Salisbury, MD
Mary Lesser
Clinical Social Work/Therapist, LCSW-C
Verified Verified
Edgewater, MD 21037  (Online Only)
Waitlist for new clients
I utilize a wholistic approach to psychotherapy. I am interested in helping families heal from disagreement, emotional pain, trauma, loss and change through the use of individual, couples, family, and group therapy. I believe that each one of us has a strong inner voice that we need to find and connect with in order to be well. When difficult feelings surface, our energy or connection to ourselves and others can become weakened and we feel drained or blocked from living to our fullest potential. I am eclectic in my approach. I seek to assist clients to understand their true potential.
I utilize a wholistic approach to psychotherapy. I am interested in helping families heal from disagreement, emotional pain, trauma, loss and change through the use of individual, couples, family, and group therapy. I believe that each one of us has a strong inner voice that we need to find and connect with in order to be well. When difficult feelings surface, our energy or connection to ourselves and others can become weakened and we feel drained or blocked from living to our fullest potential. I am eclectic in my approach. I seek to assist clients to understand their true potential.
(301) 852-6698 View (301) 852-6698
Photo of Emily Lamoreaux, Pre-Licensed Professional in Salisbury, MD
Emily Lamoreaux
Pre-Licensed Professional, MA, LGPC
Verified Verified
2 Endorsed
Middle River, MD 21220  (Online Only)
Are you seeking a safe space to explore your sexuality, strengthen your relationships, get to know yourself deeper, heal from past traumas, and embrace your authentic self? Look no further. It can be difficult to make the first step to find a therapist! Just by reading this, and attempting to connect with a professional, you are one step closer to your goals. Therapy with me is meant to be grounded in a deep respect for individual authenticity and lived experience.
Are you seeking a safe space to explore your sexuality, strengthen your relationships, get to know yourself deeper, heal from past traumas, and embrace your authentic self? Look no further. It can be difficult to make the first step to find a therapist! Just by reading this, and attempting to connect with a professional, you are one step closer to your goals. Therapy with me is meant to be grounded in a deep respect for individual authenticity and lived experience.
(443) 429-1654 View (443) 429-1654
Photo of One Alkaline Life Virtual Therapy, Licensed Professional Counselor in Salisbury, MD
One Alkaline Life Virtual Therapy
Licensed Professional Counselor, MA, LPC
Verified Verified
Waldorf, MD 20603  (Online Only)
One Alkaline Life, LLC, offers comprehensive, compassionate mental health care for adults and adolescents. Through the online telemedicine platform, the team assesses and treats a wide range of mental illnesses, including depression and anxiety, and post-traumatic stress disorder (PTSD).
One Alkaline Life, LLC, offers comprehensive, compassionate mental health care for adults and adolescents. Through the online telemedicine platform, the team assesses and treats a wide range of mental illnesses, including depression and anxiety, and post-traumatic stress disorder (PTSD).
(803) 770-5063 View (803) 770-5063
Photo of Jessica Lynn Lefler, Clinical Social Work/Therapist in Salisbury, MD
Jessica Lynn Lefler
Clinical Social Work/Therapist, LCSW-C
Verified Verified
Fallston, MD 21047
Specializing in adolescent and young adult life transitions, collaborative family therapy, gender dysphoria, OCD, ADHD, anxiety and depression. Solution focused treatment utilizing Cognitive Behavioral Therapy and other eclectic approaches. I believe wellness is rooted in vulnerability, connection, acceptance and movement. It's more than just therapy. Insurance accepted via Superbill.
Specializing in adolescent and young adult life transitions, collaborative family therapy, gender dysphoria, OCD, ADHD, anxiety and depression. Solution focused treatment utilizing Cognitive Behavioral Therapy and other eclectic approaches. I believe wellness is rooted in vulnerability, connection, acceptance and movement. It's more than just therapy. Insurance accepted via Superbill.
(443) 233-0188 View (443) 233-0188
Photo of T.j. Jones-Rouse, Clinical Social Work/Therapist in Salisbury, MD
T.j. Jones-Rouse
Clinical Social Work/Therapist, LCSW-C
Verified Verified
Arnold, MD 21012
Waitlist for new clients
Over the course of my career I have become increasingly aware of a demand in the community for Sex Therapy, and have decided to recalibrate my practice accordingly. I am engaged in a comprehensive training program facilitated by the Sexual Health Alliance on my path to becoming an AASECT-certified Sex Therapist. My background in substance abuse and trauma has largely informed this decision. I continue to serve individuals seeking to manage compulsive behaviors, AD(H)D, anxiety disorders, and mood symptoms through this transition to a sex-centered practice.
Over the course of my career I have become increasingly aware of a demand in the community for Sex Therapy, and have decided to recalibrate my practice accordingly. I am engaged in a comprehensive training program facilitated by the Sexual Health Alliance on my path to becoming an AASECT-certified Sex Therapist. My background in substance abuse and trauma has largely informed this decision. I continue to serve individuals seeking to manage compulsive behaviors, AD(H)D, anxiety disorders, and mood symptoms through this transition to a sex-centered practice.
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Photo of Simone Walton, Clinical Social Work/Therapist in Salisbury, MD
Simone Walton
Clinical Social Work/Therapist, DSW, LMSW
Verified Verified
Silver Spring, MD 20906
Dr. Walton is dedicated to working with communities, organizations, and individuals to develop applied solutions to challenges affecting vulnerable and marginalized populations. Her professional experience includes working within international humanitarian organizations, the legal arena and doing this work living on every continent except Antarctica. Dr. Walton is passionate about systems and the people who function in them. She is a wife, a mother, a caregiver and a daughter of immigrants.
Dr. Walton is dedicated to working with communities, organizations, and individuals to develop applied solutions to challenges affecting vulnerable and marginalized populations. Her professional experience includes working within international humanitarian organizations, the legal arena and doing this work living on every continent except Antarctica. Dr. Walton is passionate about systems and the people who function in them. She is a wife, a mother, a caregiver and a daughter of immigrants.
(301) 701-2262 View (301) 701-2262
Photo of Kitt Klassen, Counselor in Salisbury, MD
Kitt Klassen
Counselor, LGPC
Verified Verified
Towson, MD 21204
Hi, I'm Kitt! I'm the owner of Defiant Therapy, LLC, a practice that offers an affirming space for clients to embrace "defiance" - a sense of trust in oneself that leads you to challenge expectations. I value creating relationships with clients that allow them to be free to discover their expansiveness, care for the parts of themself that need tenderness and fierce compassion, and get clear about the change they need and the acceptance they deserve. I work with individuals (adults and adolescents), relationships of two or more, and families who want and need this radical space.
Hi, I'm Kitt! I'm the owner of Defiant Therapy, LLC, a practice that offers an affirming space for clients to embrace "defiance" - a sense of trust in oneself that leads you to challenge expectations. I value creating relationships with clients that allow them to be free to discover their expansiveness, care for the parts of themself that need tenderness and fierce compassion, and get clear about the change they need and the acceptance they deserve. I work with individuals (adults and adolescents), relationships of two or more, and families who want and need this radical space.
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Photo of Julia Sanders, Counselor in Salisbury, MD
Julia Sanders
Counselor, LCPC
Verified Verified
1 Endorsed
Baltimore, MD 21230  (Online Only)
Julia has worked with cases of acute psychosis, trauma, SUD, adults struggling with homelessness, and mental illness. Julia now a has focus on helping clients foster self-confidence, healthy coping skills, social-emotional skills, and problem-solving abilities. Julia enjoys looking for creative solutions to problems and brings that aspect of creativity to therapy. She focuses her practice on a Person-Centered, Strength Based approach. Julia strives to focus therapy on each individual’s abilities, strengths, and needs and collaborates with clients on their goals and approaches to treatment.
Julia has worked with cases of acute psychosis, trauma, SUD, adults struggling with homelessness, and mental illness. Julia now a has focus on helping clients foster self-confidence, healthy coping skills, social-emotional skills, and problem-solving abilities. Julia enjoys looking for creative solutions to problems and brings that aspect of creativity to therapy. She focuses her practice on a Person-Centered, Strength Based approach. Julia strives to focus therapy on each individual’s abilities, strengths, and needs and collaborates with clients on their goals and approaches to treatment.
(443) 665-8385 View (443) 665-8385
Photo of Sherri Joynes, Licensed Professional Counselor in Salisbury, MD
Sherri Joynes
Licensed Professional Counselor, LCPC, NCC, MS
Verified Verified
2 Endorsed
Glen Burnie, MD 21061  (Online Only)
Our individual experiences play a role in shaping our personalities, how we see the world, and how we view ourselves. My goal is to help increase your self-awareness through self-exploration and world-exploration. This approach requires openmindedness, flexibility, and hard work. As a poet, I take a creative approach to nearly all I do, particularly therapy. Life is all about balance and therapy can be emotionally draining work. So I like to make therapy as fun and interesting as possible. I love working with people who are willing to learn, are open to trying new things, who want to grow and like to have fun in the process.
Our individual experiences play a role in shaping our personalities, how we see the world, and how we view ourselves. My goal is to help increase your self-awareness through self-exploration and world-exploration. This approach requires openmindedness, flexibility, and hard work. As a poet, I take a creative approach to nearly all I do, particularly therapy. Life is all about balance and therapy can be emotionally draining work. So I like to make therapy as fun and interesting as possible. I love working with people who are willing to learn, are open to trying new things, who want to grow and like to have fun in the process.
(410) 862-3778 View (410) 862-3778
Photo of Mindology Counseling and Wellness Center in Salisbury, MD
Mindology Counseling and Wellness Center
Verified Verified
1 Endorsed
Silver Spring, MD 20904
IF YOU HAVE BEEN FEELING: Worried about future; Stressed about work; Discouraged and not motivated for life; Feeling I am not good enough; Feeling lost, loneliness, hopeless, and confused...WE WILL HELP YOU FEEL: Fulfilled life with purpose and joy; Ready for whatever life obstacles are ahead of you; Connected with the people who you are close to! You have been struggling for some time with negative thoughts and feelings that just won't seem to go away. You are in the right place. We can help! Mindology is a professional and licensed private counseling practice that is specialized in treatment for Trauma, Substance Abuse and other mental/behavioral disorders, in order to empower and help our clients to overcome day-to-day life challenges; achieve personal goals and improve the qualities of life.
IF YOU HAVE BEEN FEELING: Worried about future; Stressed about work; Discouraged and not motivated for life; Feeling I am not good enough; Feeling lost, loneliness, hopeless, and confused...WE WILL HELP YOU FEEL: Fulfilled life with purpose and joy; Ready for whatever life obstacles are ahead of you; Connected with the people who you are close to! You have been struggling for some time with negative thoughts and feelings that just won't seem to go away. You are in the right place. We can help! Mindology is a professional and licensed private counseling practice that is specialized in treatment for Trauma, Substance Abuse and other mental/behavioral disorders, in order to empower and help our clients to overcome day-to-day life challenges; achieve personal goals and improve the qualities of life.
(301) 701-2481 View (301) 701-2481

Nearby Art Therapy Searches for Salisbury

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Art Therapy

How does art therapy work?

The process of making art allows people to express themselves. Art-making can take many forms, such as painting, collage, or sculpting. The therapist asks questions that the work elicits, such as how the person felt while creating their piece, or if any memories surfaced that they can discuss. The therapist will then work with the patient to process their experience, understand themselves better, and work toward change.

Does art therapy help with trauma?

Art therapy can be a valuable treatment option for those suffering from trauma. Traumatic experiences such as combat, rape, or childhood abuse can be so painful that articulating them can be too scary or painful; creating art allows people to express themselves without words, and tell their story in a different way. The physical nature of creating art can also help people feel rooted in the body, which may benefit those who feel disconnected from their body in the aftermath of trauma.

How long does art therapy last?

The duration of art therapy varies, but a common length for treatment is 10 to 15 weekly sessions. Some people may see improvement in just a few weeks, while others may choose to remain in therapy longer term. Patients should periodically discuss their goals with their therapist to make sure the two are aligned on process and progress.

What are the limitations of art therapy?

Art therapy is helpful for many people, but a limitation is that it doesn’t have as robust an evidence base as other forms of therapy, such as cognitive behavioral therapy or acceptance and commitment therapy. The evidence on art therapy is mixed; some research demonstrates its benefits, while other research suggests that it has little impact on patients.