In this episode of the Therapist Thrival Guide podcast, Miranda Barker, LICSW dives into the world of art therapy with two expert guests, Chelsea Wire, a licensed professional counselor from Missouri, and Kailah Tuttle, a licensed professional counselor and co-clinic director from Michigan.
The discussion covers their backgrounds, the education required to become an art therapist, and various techniques and benefits of art therapy. The guests share
- Insights on using art in therapy sessions for both children and adults
- The role of art therapy in treating trauma and anxiety
- Provide practical prompts and methods for therapists looking to incorporate art into their practice.
This episode is a valuable resource for therapists and anyone interested in the power of art therapy. Listen here:
Read the transcript:
Miranda: Welcome to the Therapist Thrival Guide. My name is Miranda Barker. I’m a licensed clinical social worker here at Ellie, and today we’re talking about art therapy. So we have two amazing art therapists on the podcast with us today. Do you two want to go ahead and introduce yourselves? Chelsea, you can go first.
Chelsea: Yes, my name is Chelsea Wire. I’m a licensed professional counselor in Missouri. I’m working out of the new Ellie Wentzville offices just outside of St. Louis.
Kailah: My name is Kailah Tuttle and I am a licensed professional counselor and also a co-clinic director at the Ellie in Ann Arbor, Michigan.
Miranda: Awesome. So how long have you two been practicing as therapists and specifically art therapists?
Chelsea: Hi, Chelsea speaking. I graduated in 2011. Since then, I’ve received a graduate degree art therapy counseling.
Kailah: I’ve been practicing counseling for seven years now, and art therapy specifically for about four years.
Miranda: What’s your graduate degree in?
Kailah: Clinical mental health counseling.
Pathways to Becoming an Art Therapist
The American Art Therapy Association website clearly defines and explains that to be an art therapist, one MUST attend a master’s level program in the field of art therapy, but it’s important to realize that any therapist can incorporate art into their practice.
Kailah: I know there are kind of some different pathways of how to get there of like we have an intern starting with us who is dual doing both mental health counseling and art therapy.
So you can kind of do them in tandem through graduate work. But I actually did a continuing education program. It was a two year program all online, all different sorts of courses, and it was very trauma informed. So, expressive art therapy is kind of the umbrella that we operate under.
Miranda: That sounds great. So, theoretically, I mean, I’m a social worker, so I could do a could do like a [training] and then and then it sounds like you would receive supervision to and then you could have those additional letters behind your name.
What about if I’m just a regular therapist? Can I do art therapy skills in sessions without being full trained or certified.
Kailah: Absolutely.
Miranda: I mean, that was kind of like a leading question because I mean, yes, I, I do art therapy skills with the kids that I work with and like the college students, but it’s one of those, it’s one of those funny things where it’s like, yes, I like, maybe I’m not a play therapist, but you can do play therapy. Without the additional training, you can’t call yourself an art therapist, but you can use art in therapy.
Kailah: Yes.
Understanding Art Therapy
Miranda: So what is art therapy?
Kailah: Yeah, art therapy is kind of like an extension of therapy and expression to me. So, there’s something about art and expression that gets to somewhere that language can’t. A lot of trauma is pre verbal, so it can be helpful to use other types of therapy modalities for that.
Art just gets to some of those areas that we can’t always through general speaking.
Chelsea: I agree with Kailah. It’s experiential. This helps with problem solving, understanding something that, especially if you don’t have the words for yet that can be creative that you can see, feel.
Miranda: No, that makes sense. I think that when I initially think of art therapy, I think of that one assessment – the house, tree and person assessment. I don’t even know what this assessment is for.
If you’re not familiar with this assessment, it’s, it’s essentially like you have your client draw a house, a tree, and a, a person, and this assessment says that you can psychoanalyze different things about it. So they might be like, wow, you drew yourself the size of the house. Maybe that means you have a big ego. That’s not really what one of the assessment things is, but that’s kind of the spirit of the assessment that I understand.
So I imagine art therapy is that you sit with your client and you’re like, okay, draw me a picture. And then you kind of psychoanalyze a bunch of it and you’re like, okay, this means you have a bunch of trauma or this means that you don’t have a good relationship with your mom or something.
But, I know there’s more to it, but is, is that a part of art therapy that you do or is that, am I like way off?
Kailah: I don’t really use it as like diagnostic criteria. I think that’s actually pretty discouraged. I think of it as like an extension of like what we’re already doing in therapy of like, it kind of builds concepts or kind of brings things home that we’re already talking about or working on.
I do think that there can be some insight glint. So like, for example, if someone’s like, I really hate this person, and I don’t want them in my life anymore, but then maybe we are doing, a common technique like a safety island where it’s like, bring all your safe people, and then they put this person on the island, then I might say “well before that you said you hate this person,” and just kind of point that out. It just kind of like builds that bridge between that internal world and that external world that they’re expressing.
Art Therapy Techniques and Tools
Miranda: Okay, what is a safety island? It might be something worth talking about but, what is that?
Kailah: Yes, so you can do this in any number of ways I really like it but I have people make this island and it’s like all the things that would bring you safety, so, like if you think of like a calm safe space, like typically I have people go through their senses and say, you know, I see these things and they bring safety or calm.
Miranda: Are you having them draw it, or like paint it?
Kailah: Yeah, you can draw it, you can paint it, you can do it with mix media or however you want. But then, and the waters around it are like those things that are dangerous that they’re trying to like get away from. So like in the waters might be like depression, anxiety, like self harm, like whatever the thing is that they’re trying to create safety from.
Miranda: Oh, I love that. Chelsea, what do you think about kind of the art therapy as a diagnostic thing versus like just kind of a tool that you’re using in therapy? How, how do, how do you use it?
Chelsea: Sure. So really it’s more about what comes up for the client, but what something means. And we can infer some things, you know, like you mentioned the, like the person is as large as the house.
Like, what’s this person like in comparison to this other person that was drawn in the image, or if you were to draw another person, what size might they be, you know, or how might you place them in the space that keeps them more open to how they might interpret.
In regard to diagnostics one that’s good that that I remember learning about in graduate studies with art therapy was it’s called the Levick Emotional and Cognitive Art Therapy Assessment, aka LACATA, and it’s a series of several different drawings that can help give kind of an idea about what themes keep popping up and did something shift between like this drawing or that utilize more so with, with kiddos.
So that one has been good because it’s been reliable and valid within sessions, but in regard to diagnostics to like that can come between session to session and what comes up in that space, you know, any themes, patterns.
Miranda: So do you just kind of leave it super open ended or do you have it more as like directed? In play therapy terms you’ve got like non-directive and directive play. Is it similar with art therapy?
Chelsea: I think so. It kind of depends on the kiddo and your relationship with them thus far. Like, is it their first session? Is it their seventh session?
Have they expressed, “I’m willing to try this” or “I can’t draw,” (and I’m using air quotes in that). That’s something that comes up a lot, especially with adults that I’ve worked with, and so that’s something more to explore, “where did that come from for you, and has that shown up in other areas?”
I might introduce it kind of like, well, “let’s just play,” or “if you’re willing, you know, let’s try this.”
I might say, “this can be, you know, if it’s a canvas or whatever is there, this can be that container,” or you can say, “what does that drawing or that creation look like for you?”
Miranda: I love that. I’m sure you both have clients that come to you that are like, I don’t do art. So what do you do with people who are like “I don’t know. I’m not very creative.”
Kailah: Yeah, I, I think that’s such a, a myth and or misconception in art therapy of like I have to be creative to do art therapy and that’s not true. That’s why I like kind of calling it more like expressive therapy sometimes or talking about expressive interventions because you do not need to be artistic at all.
In fact, I usually find that the more “artistic” people will sometimes be a lot more perfectionistic. They’re like overanalyzing their work or they’re tearing it up or they’re like, this didn’t come out how I wanted when that’s done. It’s kind of the opposite of what you’re supposed to be doing is more like that in the moment expression.
I’m like, I’ve done art therapy with grown men and kiddos. Like, there’s like a wide spectrum who can benefit from this.
If they’re saying this but are for a loss at words, then sometimes I might pull out a piece of paper or a canvas or something, like, “do you think you could kind of like, at least do some like symbols or shapes or colors that it would be?” And they’re like, “Yeah, actually.” So then it’s a little more informal, just based on like whatever’s in the moment.
But sometimes, like if someone’s like, “I’m really struggling with this thing.” We have all these interventions and kind of approaches in mind, but it’s more just finding like what’s that fit in the moment based on the client experience.
Miranda: Maybe it’s our second session. We’ve done the diagnostic assessment and we’re just like, I want to get to know you.
This is going to sound silly, but I do the wordle every single day and it’s like, I have a couple of go-to first wordle words, right? Like audio, pearl, you know, whatever. But but so do you, so in, in therapy or in art therapy, do you have a couple of like, here are my initial like prompts that I like to start out with?
Chelsea: One thing that I’ve done before is I will take a piece of paper. It could be eight and a half by 11 is fine. And I’ll say, you know what I’d like you to share a little bit about you. And I’m going to share with you a little bit about myself too. And I’m going to start on one end of the page.
And you’re going to start on that end of the page. We’re just going to make some, some marks together. You’re going to make marks down there and I’m going to make marks over here in all different colors. That’ll let them pick, you know, markers or oil pastels, they can choose material. And so. They’ll make some marks and I’ll make marks and eventually we’re somewhere in the middle, we’re going to figure out what we’re going to do with that space.
And so to me, that’s like, okay, like that could be like, you know, what might their boundaries be like in that space? Are they having, are they playful? Are they cautious? You know, how do I want to support them on the page in that space? So to me, I’ve found that that’s helpful with meeting clients kind of where they are and they can get to know me a bit too.
And I invite also like, if they want to share more during that time. Or if they want to, if they have any questions about me, you know, I might share about that. So just again, depending on the client about what’s planned for them and what they’re ready for, because we might not talk, we might share a little bit, we might talk a lot.
Kailah: One of my favorite getting to know you activities is creating a name tag – about how you would introduce yourself. And that’s like more than your name, right? So they can like write their name, however they want. And then here are some things about me and I make one as well.
I think that’s another piece of art therapy that’s very important– the co-regulation of doing it with them is very important. You’re not just sitting and staring at them with a clipboard, and making these notes or observing. But when you’re doing it with them, like, you’re being vulnerable with them, and you’re sharing the process of “this is what I’m feeling or noticing,” or “this is what I want to include.”
Miranda: I love that.
Art Therapy for Different Age Groups
Miranda: So, I forget, do both of you work with like kind of all ages or, or do either of you like specialize in kids or adults?
Kailah: Yeah, I work with all ages. I mostly see adults now just because I have my own little one at home. So, I work pretty daytime hours and that tends to be when mostly adults and college students are working and more so needing services. I do see a few kiddos. I started working with kids primarily when I first started therapy, but mostly adults and typically adults with trauma is my thing.
Chelsea: Same answer on my side.
Miranda: Like exactly the same. Oh, that’s so interesting. I can relate. I became a parent for the first time two years ago. I also started initially seeing kids and then I have shifted more to college students and teenagers so I can be home more in the evenings with my kids.
How does it vary, or like, what are some of the differences between seeing kids in art therapy and seeing adults in art therapy?
Kailah: Kids are naturally a lot more expressive and willing to do playful, kind of like in the moment things.
I’ve never really had to convince a kid to do art therapy. They’re just like, cool, like, here’s some markers, here’s some paper, whatever. They’re a lot more playful. We’ll just kind of go with it. I mean, they’re like very, the kids that I’ve seen are very, like, you can give them any sort of prompt and they’ll just kind of like take it as their own.
I find that adults are a lot more like, wait, “what was I supposed to be doing?” Or like, “what did you want me to do here?” And kids are just like, “Okay, yeah, you give me a general concept, and I’ll just have fun with it.” It’s the imagination potential.
Chelsea: I like how you said that imagination potential. It’s not that adults are not imaginative per se. It’s just that it seems like they’re not as used to doing that on a day-to-day basis, possibly. Like, if it’s not something that they bring into whether it’s like their workplace or at home. And so it’s like they’re going back to, you know, Kind of like, well, what do I know about these materials or what do I know about this?
So yeah, I like using that phrase and shifting it to like, “well, let’s play with these materials” because it kind of helps break that if there’s a perceived barrier. There seems to be less of a sense of like inner critic that comes up with kiddos.
Miranda: That’s a good way to put it. Yeah. I mean, I think that I’m a very creative person.
I like creating things, but as soon as you put me in a room with another adult and the adult is like, “Hey, create this.” I’ll be like, “Ooh, okay. Are you going to psychoanalyze this?” I don’t know, are you going to tell me I, I drew this wrong or something?
What are some of your other, like, favorite go to prompts when you are working with adults or kids? Thanks.
Kailah: Yeah, I really like doing emotion wheels. That’s a good example of how there are really easy ones to implement are going to be things that already there’s kind of like a template for.
Like, these are things that you don’t have to be an art therapist for. You can find these things on Pinterest, Teachers Pay Teachers. There’s all sorts of different resources out there. But anyways, the emotions wheel helps to talk about like how you can feel more than one emotion at once.
So, you draw a general circle and kind of section that off into four pieces or eight pieces or however many feelings that you wanted to include and then just kind of jot down like here are all the emotions that I’m noticing and then how would I represent those in the pieces and you can use that for adults too but it’s just kind of gets at how I can feel insecure and anxious, and I can also be really excited about something, but we have all these different complexities to our emotions and expression gets at that.
Chelsea: Yeah, it’s hard to choose just one to share. One that comes up for me is I call it like a resiliency rock tool. And so you have like river rocks, around the size of you palm.
And then I bring in, pre-cut words from magazines. And I have them hold the rock. It’s like a mindfulness exercise and just noticing the texture, the temperature, maybe the color. And they’re noticing any significant features about the rock. And a lot of times the rock like starts off feeling kind of cool and it warms up in their hand as they’re holding it.
And they’re like starting to feel that weight in their hand. And then I invite them to go through these pre-cut words. And because I found that if I give them a magazine, a lot of people just like end up looking at the magazine versus if there’s pre-cut words and it’s like, okay, it’s all there.
And they can choose what jumps out to them about what has helped them through those (pun intended) rocky, harder, or heavy times. And they might pick out, for example, like maybe recognizing that it was a transition to something different.
And then these are the different things that have helped them keep going, even though it’s been difficult, or a challenge, so to speak. And so then we use Mod Podge and place those on the rock and then it’ll dry clear. And so they have this rock, you know, you can’t dismiss that this has happened.
Yes, this, you had this experience and what helped you through that process. And so they have that reminder there.
Miranda: I love that. Oh my gosh. So actually just keeping on that same kind of, or that same topic.
Art Therapy for Trauma and Anxiety
Miranda: Kailah, you talk about doing. a lot of trauma work within art therapy. I’m assuming you’re not just going, “Hey, paint a picture of the worst thing that’s ever happened to you.”
So what does art therapy look like when you are kind of doing some trauma interventions?
Kailah: So a lot of trauma and how art therapy can get at that at a very basic level is really getting in touch with the body because there’s so much disconnect between internal experience and then so many people are in like a freeze or dissociated or numb state after trauma.
So getting in touch with those bodily emotions is a really common starter. One starter intervention I would do is, body scans. I’m also an EMDR therapist (Link to EMDR blog), so I kind of, like, use both of those about, like, like, how would you represent this in your body?
That’s a really good one where you can just pull up a template of a body and just kind of notice how they’re feeling. If people are having trouble with that, sometimes music can also be a really good cue into that of like, if they have a certain artist that makes them feel some type of way, like putting that artist on and just kind of like, we’re just going to sit here and just kind of jot down what comes up with colors and symbols and just kind of thinking through that internal experience. It’s like we’re trying to proactively get in touch with what’s already there and then make meaning and wisdom out of what we have in our internal landscape.
Chelsea: Yeah, trauma is so much in the body with, you know, muscle tension or just those bodily sensations.
Again, like, it’s nonverbal. It’s what that sensation is. And you brought up EMDR earlier. Another intervention, too, is a bilateral drawing. You can use a larger paper, but like using both hands, you know, right and left together, use different colors or multiple and moving them together in tandem.
You have them create that back and forth. I’ve seen this done standing up or sitting or I’ve seen people lay down on their bellies, even a lot of adults, it seems like they get a lot from that too. It’s not just kids.
Miranda: Very cool. Are there other diagnoses that you feel like are helpful with art therapy?
Kailah: Yeah, I mean, there’s so much, like, I don’t think there’s necessarily a bad place to start, but it’s, if you think about anything where people are, like, struggling with something internally and they’re looking to get it outside of them, like, that’s kind of what I think of with expression.
I mean even like general life stressors, or anxiety is a really good one because there’s just so much floating around in our head, we ruminate and we just like go over and over and over. But sometimes it just takes that, it’s the same thing with therapy, right? Like people will say, Oh, I didn’t even realize that until I just said it out loud.
And you’re like, okay, yeah, like it’s a similar thing of like drawing it out or expressing it through movement or whatever it is. It’s just one another layer to understanding.
Favorite Art Therapy Prompts and Tips
Miranda: Do either of you have a prompt or like something that you’ll do with someone if they’re feeling anxious or if they are needing to process any anxieties.
Chelsea: I’ve asked people to consider if they could create that anxiety through something tangible. I brought up inner critics earlier. It seems like that can be one source of anxiety too. Whenever they make that, whether it’s on paper or you have like random materials, like aluminum foil or yarn, like they’ll create that.
And then if they’re into writing, like I might ask them too, “okay, how could you create that?” It could be like floating in the ocean together side by side. Or it could be like, okay, well, the light shining on this anxiety and maybe the shadows not as big as I thought that it was, you know? You’re creating that that experience outside of ourselves.
So it’s something that is a part of me and isn’t who I am. And then by that, having that tangible creation, okay, now what? What do we want to do with that? And how do you want to navigate that moving forward? It becomes like a, kind of, Holding that space with them.
Kailah: I like doing safe spaces a lot. That’s a good one. I’m just like building your safe space and those elements. Kind of like the safety island idea. I also really like monster making. Like, especially with kiddos. That’s fun.
Like if your anxiety was a monster or a bully, or if the clients likes video games– like a final boss. Like, what would it look like? Like, what kind of details would it have? And then you can kind of get a sense of, it usually gives some insight into what it is that they’re really anxious about. Like, does this monster look like someone?
Or I’ll ask, “does it remind you of an experience from your past?” Because so much of that anxiety is rooted in past experiences of whether it was like, rejection or different types of fears that have happened over time. But just kind of getting in touch with, okay.
I think of like the scene in, there’s a scene in Harry Potter where they like make their fears into something funny, but it’s like, you can draw it out and then you start to look at it and you’re like, actually, like, why does this thing have so much power over me? It’s pretty ridiculous when you think of it.
Miranda: Absolutely. Oh, I love that. Any other things that we feel like we’re missing? I mean, you, you both have given so much good information. What are some of your other like favorite parts about art therapy or things that you think we missed?
Kailah: If you’re looking for a good place to start, like templates, like there’s so many workbooks and art therapy techniques, I love, Pinterest is a really good resource too, I go on there and scroll for techniques all the time. People think “I have to be an art therapist or I have to be creative or have to be this or that.”
And no, it’s just kind of like meeting your client where they’re at. If you already have a client that’s creative, like, or that wants to utilize some art, like that’s, that can be a really good place to start.
And art when I say art, that’s like art and expression is such a broad term. So this is not just drawing and painting. It can be sound making and movement and expression of all different kinds. It can really be anything that’s. Like expression as an extension of the body.
But just, you know, kind of find your element. Like expression can be so large and art therapy makes such a good intersection to other therapeutic techniques, like finding your thing.
And like, if you love CBT or ACT, like there’s so many intersections between these worlds. So just kind of finding like your own rhythm and your own style and just kind of see like, how could I incorporate more expression or how could I help this client really bring this.
Chelsea: Mm hmm. Yeah, I found too especially in my internships and I’ve started to get back into it just recently is that I’m so glad is starting to make some art on my own whether it’s like just a little bit in between sessions or during a break or at the end of the day, just to kind of have my own container, put this in of like, you know, “where have I started?” and “where am I now?” Just to help get it out of, of my own head.
In regard to materials, I’ve seen so many people create so many neat things from various objects too. And then they get to choose what to do with that. One thing that I did learn over time, is that the art and the process belongs to the client, just like, you know, any of their expressive therapy, or even like someone’s experience overall. We can provide that space and it’s you know, but what they create and take with them. That’s for them.
Miranda: I’m curious, do you ever have clients that like create art and then they want to destroy it?
Chelsea: Yeah, and you said the right word “being curious” about it. Depending on what was created, it could be pretty, pretty glaring of like, “okay, I can see why they did destroy it,” whether it represented something I’ve noticed that could bring closure, or it could bring a sense of control over what was created or what they want to do next with that process or insights that were made. Yet really it’s what’s helpful for the client in that space.
Kailah: Yeah, I think it’s all about the intention of destroying it, of like, this is something that I’ve come to terms with, so I want to burn it, burn it, or rip it, or shred it, but, like, that’s very different than, “Oh, this isn’t good enough” and then that, but that creates its own line of conversation of like, “why do you think this isn’t?”
Because no matter what they express, we can do something with it. But yeah, if it’s from like a perfectionism mindset and they’re trying to destroy it, that’s, that kind of leads you into another level of insight too.
Chelsea: Definitely. And depending on too, like where that comes from and what you find out when you’re like being curious and wondering perhaps that could invite maybe transforming it to something new if they would like to.
Final Thoughts and Takeaways
Miranda: Any other last thoughts before we, before we go? This has been such a good introduction to art therapy.
Kailah: I feel like when I think of art, I always think of Miss Frizzle from the Magic School Bus. She is one of my heroines, but she always says, “Take chances, make mistakes and get messy.” And I feel like when we’re talking about art therapy—like what better wisdom to leave you with?
Chelsea: I agree a hundred percent. I would say too, stay curious and you won’t be disappointed. Whether it be a client or therapist.
Miranda: I love that. Awesome. Well, thank you both so much for joining!
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