Art Therapy Online (ATOL) is an international, peer-reviewed, open access and index linked journal that addresses theory, practice and research in relation to art therapy as it is known and understood around the world. The journal was founded in 2009 by a consortium of independent art therapists seeking to build international alliances and areas of discussion in the field. The journal is hosted by the Library at Goldsmiths, University of London. ISSN: 2044-7221
ATOL articles are licensed under a Creative Commons Attribution-NonCommercial 4.0 License unless otherwise stated.
Minnas Geschenk: Kunsttherapie mit einer 16-jährigen Jugendlichen in der stationären Jugendhilfe (German Version)
Die Fallstudie ist eine bewährte Methode in der Psychotherapie und bietet die Möglichkeit, die Erfahrungen, Fragen, Erkenntnisse und Reflexionen der Therapeut*in zu artikulieren. Sie ermöglicht einen vertiefenden fachlichen Dialog durch das Erzählen und Teilen von Sitzungsmaterial und unterstützt zugleich den fortlaufenden Prozess der Therapeut*in, die psychologischen Erfahrungen der Klient*in zu konzeptualisieren und zu verstehen. Diese Fallstudie entstand aus meinem Wunsch heraus, das Phänomen des Schenkens meiner jugendlichen Klientin Minna genauer zu erforschen. Minna lebte in einer intensivpädagogischen Wohngruppe und verschenkte regelmäßig ihre Kunstwerke an andere – darunter ihre Eltern und das Betreuungspersonal. In diesem Artikel dokumentiere ich Minnas kunsttherapeutischen Prozess und meine eigenen Reflexionen dazu, die ich in einen psychodynamischen Rahmen und die einschlägige Fachliteratur einordne. Das Verfassen der Fallstudie dient dabei nicht nur als Methode des Nachdenkens, sondern auch als Möglichkeit, sich ihrer Erfahrung anzunähern und einen fachlichen Dialog innerhalb der kunsttherapeutischen Gemeinschaft anzuregen. Key words Kunsttherapie, Adoleszenz, Kinder- und Jugendhilfe, Objektbeziehungstheorie, Schenken, Trauma, Ausstellung
Copyright (c) 2025 Anaïs Héraud http://creativecommons.org/licenses/by-nc/4.0
Mentalisieren in der Kunsttherapie –eine Fallgeschichte (German Version)
Der Beitrag untersucht die wechselseitige Beziehung von psychodynamischer Kunsttherapie und dem Konzept des Mentalisierens vor dem Hintergrund der Objektbeziehungstheorien. Er versteht diese als hilfreiches Konzept Triangulierungsprozesse in der Kunsttherapie als mentalisierungsfördernd zu betrachten und in den bisherigen Literaturüberblick einzuordnen. Die Fallgeschichte untersucht die Entwicklung mentalisierungsfördernder Prozesse im Rahmen einer zweijährigen kunsttherapeutischen Behandlung mit einer 30-jährigen Person im klinischen Setting und in der ambulanten kunsttherapeutischen Praxis. Key words Mentalisieren, Bindung, Objektbeziehungen, Triangulieren, gemeinsame geteilte Aufmerksamkeit, Symbolisieren, Traumatisierung, frühkindliche Bindungstraumata, Depression, Essstörung, Suizidalität.
Copyright (c) 2025 Anette Kuhn http://creativecommons.org/licenses/by-nc/4.0
瓦礫堆中找大象：地震後創傷兒童在藝術治療中的重複 、修通與涵容 (Traditional Chinese Version)
本文探討一位地震後遭遇急性創傷壓力危機的兒童倖存者在藝術治療中修通與復原的歷程。本文以客體關係藝術治療的角度來理解和詮釋個案，探討藝術治療師如何為創傷個案準備和調整藝術治療媒材，並創造安全的情境，讓個案在藝術治療中進行創傷再現。本文重點將放在個案如何透過重覆的藝術創作與遊戲，將創傷外化為具體的象徵，進行宣洩、修通、重新定義以及修復與客體的關係。本研究發現，災後創傷兒童在治療過程中出現的重複遊戲，不只是與受災經驗相關，也可能源自早年的不安全依附與創傷經驗。當個案能修通早年創傷經驗，重複遊戲就停止，使用媒材與創作的方式也會隨之轉變，個案內在心理狀態從被涵容者轉為涵容者，倖存者轉為藝術家。 Keywords關鍵字 自然災害（Natural Disaster），地震（Earthquake）, 藝術心理治療(Art psychotherapy), 重複性象徵遊戲（Repetitive symbolic play）, 客體關係理論（Object relations theory）, 台灣（Taiwan）
Copyright (c) 2025 侯宜君 Yi-chun Ho http://creativecommons.org/licenses/by-nc/4.0
Jenseits des Aschenbechers (German Version)
Ashtrays portray a recurrent theme in the art therapy sessions with people dealing with addiction, often provoking ambivalent reactions to the therapist. Approaching the complex dynamics of addiction, I have found many similarities between the needs which both the addictive substance and the creation of the ashtray aim to cover. Through the creative process and the support of the therapeutic relationship, there can be a shift in the function of this artwork, from the destructive usability to the constructive symbolism. The ashtray can thereby pose a metaphor for integration and containing, representing the development of a more resilient and autonomous self. Key words art therapy, addiction, symbol, self-destruction, self-healing, containing
Copyright (c) 2025 Alkistis Karouli http://creativecommons.org/licenses/by-nc/4.0
Beide Werke stammen aus meiner kunsttherapeutischen Praxis in einer Grundschule in Berlin. Thomas und Marius kommen seit ca. einem Jahr zu mir in die Kunsttherapie. Thomas gestaltete in seiner Handinnenfläche mit einer selbst hergestellten Masse aus Klebstoff und roter Farbe eine Art Trompe-l'oeil-Wunde in seiner rechten Handfläche. (Abb. 1). Nach der Fertigstellung sagte er: "Mit dieser [Wunde] werde ich meinen Vater erschrecken. Dafür nehme ich eine Säge aus seinem Werkzeugkasten." Dazu ist es jedoch nicht gekommen, da sich die „Wunde“ über den weiteren Schultag hindurch verwischte.
Copyright (c) 2025 Christin Herm http://creativecommons.org/licenses/by-nc/4.0
Editorial: The Power and Potential of Case Studies in Art Therapy
This special issue of ATOL is dedicated to the case study — a foundational yet contested method that has shaped art therapy practice, education, and research. Case studies offer a unique lens into the therapeutic process, allowing for close observation of transference, symbolism, aesthetics, institutional influences, and relational dynamics. Case studies have served as a means for therapists to make sense of their work, connect theory with practice, and reflect deeply on the complexity of human experience. Yet the method also raises important questions about bias, ethics, consent, and power. A therapist’s understanding is inevitably partial, and the potential to misrepresent or even harm clients remains a challenge. On the one hand, these are valid criticisms of the case study. On the other, we recognise its role in our learning and development as art therapists, as well as our deep, ongoing connection to it. It is these mixed feelings that inspired ATOL to create this special issue, inviting perspectives and reflections from the art therapy community on this enduring and contested form of writing.
Copyright (c) 2025 The ATOL Editorial Board http://creativecommons.org/licenses/by-nc/4.0
On Ethics in Practice: The use of client narratives and creative outputs in community and Not-for-Profit art therapy settings
Across 15 years of professional engagement in art therapy within homelessness, family violence and public and community mental health services in Victoria, Australia, I have repeatedly encountered organisational requests to procure client narratives and creative outputs from those accessing therapeutic programs. From art works to personal stories and more, these requests typically stem from institutional imperatives to evaluate service efficacy, substantiate program legitimacy, promote organisational services and secure ongoing funding—a process well-documented in the literature on community-based interventions (Gilroy, 2006; Rossi et al., 2019). Such expectations necessitate the provision of concrete evidence, including client stories, artworks and testimonials, so as to demonstrate measurable outcomes. However, this practice often foregrounds profound ethical tensions for art therapists, particularly regarding the authenticity of informed consent, the dynamics of power within therapeutic relationships and the potential long-term ramifications of disseminating personal material as circumstances change and evolve over a lifetime.
Extended Reflections from the Editorial Board
Copyright (c) 2025 Ange Morgan http://creativecommons.org/licenses/by-nc/4.0
On the Difficulty of Writing Anything about Anybody: navigating alternative forms of writing in a therapeutic art studio community
I am going to briefly describe some of the tangle of issues I encounter when I consider writing about people I have worked with. These issues need unpicking as they are about ethics, power and hierarchy. They are about relationships, and as such are also emotional. These complex considerations are part of any writing by therapists about clients, as evidenced in this current issue of ATOL on case studies. I have found versions of these dynamics exist in a particular way in the therapeutic community type setting where I work. In this brief reflection I will introduce the dynamics of my setting, and then present three of my attempts to navigate writing about my setting. These involved finding ways of writing with rather than about the members of this community. The writing took the form of interviews and editing artist statements (Omand 2022b), co-authoring (Omand 2022a), and reflective writing on my own art practice (Omand 2022c).
Copyright (c) 2025 Helen Omand http://creativecommons.org/licenses/by-nc/4.0
Both works come from my art therapy practice in a primary school in Berlin. Thomas and Marius have been coming to me for art therapy for about a year. Thomas created a kind of trompe l'oeil wound in the palm of his right hand using a self-made mass of glue and red colour. (Fig. 1). After completing it, he said: "I'm going to scare my father with this [wound]. I'll take a saw out of his toolbox for it." However, this did not happen as the "wound" faded over the rest of the school day.
Mentalization in Art Therapy – a case study (English Version)
This article examines the reciprocal relationship between psychodynamic art therapy and the concept of mentalisation against the backdrop of object relations theories. It considers this to be a helpful concept for viewing triangulation processes in art therapy as promoting mentalisation and for classifying them in the existing literature review. The case history examines the development of mentalisation-promoting processes in the context of a two-year art therapy intervention with an adult individual in a clinical setting and in outpatient art therapy. Key words Mentalisation, attachment, object relations, triangulation, joint shared attention, symbolisation, traumatisation, early childhood attachment trauma, depression, eating disorder, suicidality
Achtsame Wandlung und Erkenntnis in der Kunsttherapie: Vergleich von drei Fallstudien (German Version)
Diese Gemeinschaftsarbeit untersucht die Anwendbarkeit des Modells der ‚Vier Phasen der Achtsamen Wandlung‘ nach Starke (2014, 2019) auf kunsttherapeutische Prozesse zur Analyse des Erkenntnisprozesses von Klient:innen. Ausgangspunkt und theoretische Grundlage dieser Arbeit war die Fallstudie von Reiter (2022), die sich dieser Fragestellung in Bezug auf die Wirksamkeit kunsttherapeutischer Begleitung widmete und diese anhand von Interviews mit Klient:innen belegen und erweitern konnte. Die von Andergassen (2021) und Wiesinger (2021) unter anderen Rahmenbedingungen und Settings durchgeführten Studien wurden herangezogen, um zu ergründen, ob sich diese Modell-Phasen auch hier identifizieren lassen und welche Schlussfolgerungen für die weitere Forschung gezogen werden könnten. Die vorliegende Studie liefert Anhaltspunkte dafür, dass sich Starkes Modell als Analyseinstrument zur Untersuchung der Wirksamkeit der Kunsttherapie in Bezug auf den Erkenntnisprozess bei diesen drei Fällen eignete. Jedoch müssen die Ergebnisse durch weitere Fallforschung verifiziert werden. Key words Achtsame Haltung, Erkenntnisprozess, Vier Phasen der Achtsamen Wandlung, Gestaltungsprozess, Gestaltungselement, Wandlungsprozess
Copyright (c) 2025 Monika Andergassen, Katrin Reiter, Friederike Wiesinger http://creativecommons.org/licenses/by-nc/4.0
Mindful Transformation and Insight in Art Therapy: Comparison of three case studies (English Version)
This collaborative work examines the applicability of Starke's (2014, 2019) model of the 'four phases of mindful transformation' to art therapy processes for analysing the insight process of clients. The starting point and theoretical basis for this work were the case study by Reiter (2022), which addressed this question in relation to the effectiveness of art therapy and substantiated and expanded on it through interviews with clients. The studies conducted by Andergassen (2021) and Wiesinger (2021) under different conditions and settings were used to investigate whether these model phases could also be identified in this context and to draw conclusions for further research. The present study provides evidence that Starkes' model was suitable as an analytical tool for investigating the effectiveness of art therapy in relation to the cognitive process in these three cases. However, the results must be verified by further case studies. Key words Mindful attitude, cognitive process, four phases of mindful transformation, creative process, creative element, transformation process
Painting My Heart Songs: My Journey with an Art Therapist
I started working with my current art therapist in 2020. I had been diagnosed with an autoimmune disease on top of ongoing chronic fatigue and severe Complex PTSD resulting from trauma. Prior to my autoimmune diagnosis, I was working in a leadership position professionally and excelling in this context. In the months following my diagnosis, it became apparent I was no longer able to work in the role and I had to resign. I was experiencing ongoing pain, severe fatigue and mental health challenges. I have an extensive mental health history with multiple hospital admissions, different forms of therapies and ECT. My diagnosis of complex PTSD also included dissociative identity disorder and depersonalisation. This had been stable between 2018 and 2020. Unfortunately, being forced to resign from a job I was passionate about resulted in a re-emergence of dissociative symptoms, grief and an unclear sense of identity. I knew it was time to seek a therapist.
The Voice of an Art Therapy Service User
Copyright (c) 2025 JAC http://creativecommons.org/licenses/by-nc/4.0
Working with the ‘Glasgow Effect’ in Art Therapy through a Whole-School Approach
The realities of poverty and deprivation extend across the globe, often to an extent that creates despair in communities, where the tension and violence amongst its individuals are palpable and the emotional suffering is passed down from generation to generation. This is the reality of a community in Glasgow, a major industrial city in the west of Scotland. Thus, in this paper I will describe a whole-school art therapy service, presenting three art therapy vignettes that illustrate how this model addressed the complex needs of the children, and how art therapy supported them to express and understand their experiences and developed a sense of integration. The art therapy work is contextualised through reference to the children’s community throughout the paper using the voice and experience of the art therapist. Key words poverty, community conflict, gangs and violence, whole-school approach, children and art therapy
Copyright (c) 2025 Marcela Andrade del Corro http://creativecommons.org/licenses/by-nc/4.0
PEEKABOO! In Search of the Elephant in the Rubble: A Case Study of Art Psychotherapy with a Child Earthquake Survivor (English version)
Children are particularly vulnerable when exposed to natural disasters. Beyond immediate harm, they may also suffer from long-term psychological deficits, especially those who have experienced insecure attachment during early childhood. Taiwan frequently experiences damaging natural disasters, including earthquakes and typhoons. This paper explores the object-relations approach to art psychotherapy intervention from a cultural perspective. A case study is presented, detailing the journey of art psychotherapy with a 7-year-old earthquake survivor who suffered from acute post-traumatic stress symptoms, including anxiety, sleep disturbances, and hypervigilance. This case study illustrates how the child externalised traumatic experiences and represented them through repetitive symbolic play and art-making. This repetition provided a space for the child to reenact, regress, and redefine the traumatic events. The paper discusses how the art therapist created a secure holding environment by preparing art materials, enduring the child’s attacks, and collaboratively exploring the multiple layers of trauma. Key words Natural Disaster, Earthquake, Art psychotherapy, Repetitive symbolic play, Object relations theory, Taiwan
Copyright (c) 2025 Yi-chun Ho http://creativecommons.org/licenses/by-nc/4.0
Minna´s Gift：A Case Study of Art therapy with a 16 year-old Adolescent in Residential Care (English Version)
The case study is a well-established methodology in psychotherapy, providing a means to articulate the therapist’s explorations, questions, insights, reflections, and formulations. It enables in-depth dialogue within the professional community through the sharing of session material, while also supporting the therapist’s ongoing process of conceptualising and understanding the client’s psychological experience. This case study arises from my wish to explore more deeply the phenomenon of gift-giving of my teenage client, Minna, who lives in a residential care facility and consistently gives her artworks as gifts to others, including her parents and the care staff. In this paper, I document Minna’s art therapy process alongside my own reflections, developing thoughts, and formulations, which I situate within a psychodynamic framework and relevant literature. Writing Minna’s case serves not only as a method of thinking, but also as a way of moving closer to her experience and opening dialogue within the art therapy professional community. Key words Art Therapy, Adolescence, Residential care, Object Relations Theory, Gift-giving, Trauma, Exhibition
The Case for Case Studies: Art psychotherapy as a feminist methodology with women in prison
The castigation and criminalising of women is a systemic catastrophe that cannot be understood only through a standardised positivist methodology. Forensic art psychotherapy case studies seek to utilise stories and images to reframe misogynistic public perceptions of criminalised women as “unnatural” and “monstrous” by visualising their experience as complex and layered. This paper advocates for the inherent importance of case studies as a significant feminist methodology in understanding the value of art psychotherapy, the fundamental importance of ethical considerations including consent, and the explicit acknowledgment of power, prejudice and human fallibility. It concludes with a criminalised individual’s reflections on her own art psychotherapy experience in prison. This privileges her voice and evidences the value of feminist research methodologies that include listening, embodiment, relationality, reflexivity, emotions and intersectionality, as critical additions to classic case study psychodynamic interpretation. Key words Art psychotherapy, women, prison, reflexivity, embodiment, emotion
Copyright (c) 2025 Jessica Collier http://creativecommons.org/licenses/by-nc/4.0
As the ATOL editorial team gathered together before this issue was conceived, we found that we shared a common desire to spend more time in creative processes, as we considered matters arising from the inclusion of visual material within the journal generally, and more broadly, its representation within our published and presented work as clinicians and academics. As art therapists, lecturers, supervisors, researchers and artists ourselves, there was a shared longing for time to create and discover.
Copyright (c) 2024 Silke Hilgers, Ange Morgan http://creativecommons.org/licenses/by-nc/4.0
Book Review: The Gallery of Miracles and Madness: Insanity, Modernism, and Hitler’s War on Art By Charlie English (2021)
All books are written, published and read in a context, be this historical, cultural, political and/or personal. This being so, I begin my review of Charlie English’s important book with a personal preface.
Copyright (c) 2024 David Edwards http://creativecommons.org/licenses/by-nc/4.0
Book Review: Art Psychotherapy Groups in the Hostile Environment of Neo- Liberalism: Collusion or Resistance? Edited by Sally Skaife and Jon Martyn (2022)
This book contains a lot to think about. Reviewing it has taken me a long time because it concerns a discussion of many important issues in my life and my work. It unpacks the challenges of working and living in a world dominated by austerity politics. In particular, the book looks at the impact of austerity on art therapy and art psychotherapy groups. Sally Skaife and Jon Martyn explain how their experiences of political activism enabled them to work together on editing and shaping their book. It is unusual and yet welcome to me when therapists discuss the effects of the political world on their theory and practice.
Copyright (c) 2024 Chris Wood http://creativecommons.org/licenses/by-nc/4.0
He estado sufriendo de síndrome de estrés postraumático y esto afectó el desarrollo de mi carrera y el cumplimiento de los sueños de la infancia. Empecé a practicar arteterapia por recomendación de mi terapeuta. Esa práctica me ayudó a mejorar mis síntomas. Este trabajo habla tanto de mi análisis del pasado como de mis expectativas sobre el futuro.
Copyright (c) 2024 Jésica Frustaci http://creativecommons.org/licenses/by-nc/4.0
I have been suffering from post-traumatic stress syndrome which impacted on my career and the fulfillment of childhood dreams. I started practicing art therapy at the recommendation of my therapist. That practice helped me improve my symptoms. This work speaks about my analysis of the past as much as my expectations about the future.
The Book Paradox was created as part of my studies in creative arts and health at the University of Tasmania. I was encouraged to work mostly within only one medium, and I chose paper. This inspired me to create something with repurposed materials both out of my own curiosity, and from a sustainability viewpoint.
Copyright (c) 2024 Susannah Morrison http://creativecommons.org/licenses/by-nc/4.0
Stay Alive was made on placement as a trainee art therapist with a National Health Service (NHS) Arts Therapies team, at an acute adult Mental Health unit in a diverse London borough. The drawing was a visual response to attending patient review meetings with families and representatives from the multidisciplinary and community teams, present both in-person and remotely.
Copyright (c) 2024 Clare Mitten http://creativecommons.org/licenses/by-nc/4.0
Gedanken zu einem Fragment (German version)
Als Kind war ich fest entschlossen, Archäologe zu werden - jemand, der versteckte, oft zerbrochene, manchmal schöne Dinge ausgräbt, die wie Linsen wirken. Dinge, die uns helfen, die Vergangenheit zu betrachten und besser zu verstehen. Ich muss etwa acht Jahre alt gewesen sein, als ich ein Fragment eines Puttenkopfes aus einer baufälligen, überwucherten Trockenmauer in meiner Straße barg. Ihm fehlte der obere Teil, der Stein war durch die Augenlinie hindurch gespalten (Abb. 1). Trotz Suchen blieb der fehlende Teil des Kopfes, einschließlich des größten Teils der Augenpartie, verloren. Ich erinnere mich wie wichtig es mir war, ihn mitzunehmen, ihn vor dem Vergessen zu „retten", ihm Würde und ein Zuhause zu geben. Und ich erinnere mich an meinen starken Wunsch, ihn weiter zu betrachten. Fünf Jahrzehnte später muss ich gegenüber meinem jüngeren Ich zugeben, dass ich nicht Archäologe, sondern Kunstpsychotherapeut geworden bin. Als Beruf hat er vielleicht viel mit der Archäologie gemeinsam. Fragmentierte mentale und emotionale psychische Anteile zu halten, Erinnerungssplittern - oder dem, was man für Erinnerungen hält – zu helfen, an die Oberfläche zu dringen und sich durch das Schaffen von Kunst zu transformieren, ist eine Art Archäologie.
Copyright (c) 2024 Uwe Herrmann http://creativecommons.org/licenses/by-nc/4.0
Reflections on a Fragment (English version)
As a child, I felt determined to become an archaeologist – someone digging up hidden, often fractured, sometimes beautiful things that act like lenses. Things that help us to look at and better understand the past. I must have been about eight years old when I recovered a fragment of a putto head from a dilapidated, overgrown drywall in my street. It was missing its upper part, the stone split across the eye line (fig. 1). Though searching, the head’s missing part, including most of the eye section, stayed lost. I remember feeling compelled to take it, ‘rescue’ it from oblivion, to give it dignity and a home. And I remember my strong wish to keep looking at it. Five decades later, I must admit to my younger self that I did not become an archaeologist, but an art psychotherapist. As a profession, it may have much in common with archaeology. Holding mental and emotional fragmentation, helping splinters of memories - or what is thought of as memories – to surface and to transform through the making of art is archaeology of sorts.
Eine Geschichte in Bildern aus der Kunsttherapie in der pädiatrischen Onkologie Bilder von Marco, Texte von Ulrike Holtermann
Copyright (c) 2024 Ulrike Holtermann http://creativecommons.org/licenses/by-nc/4.0
A story in pictures from art therapy in paediatric oncologyPictures by Marco, words by Ulrike HoltermannFig.1: Marco: "Hai!"(SHARK!), white paint pen on postcard, DIN A4
Art as thinking: MA Art Psychotherapy staff artmaking group in the context of the neoliberal university
In this piece we present a visual ‘snapshot’ of artworks made in a staff art making group for tutors on the Art Psychotherapy training at Goldsmiths University, London, as we start the academic year 2023-24. In the group, which happens twice termly, the teaching team gather in the studio to talk, make artworks, and reflect on their meanings for the staff group in the dynamic context of the training. Our art making as a team has come to signify a place for critical thinking, connecting, and creating together in a way that feels authentic and that has become an essential part of our cohesion and survival as a team. We decided to show this aspect of our practice to foreground the role of art to think about personal, political, social and institutional dynamics. We believe that the value we place on art making as art psychotherapists can be part of our functioning and resistance in ‘the hostile environment of neoliberalism’ (Skaife and Martyn 2022).
Copyright (c) 2024 The MAAP Team 2023-24 http://creativecommons.org/licenses/by-nc/4.0