Art Therapy

United Kingdom pioneers

A 2015 historical article describes Edward Adamson (1911-1996) as a pioneer of art therapy in the United Kingdom. It reports that he worked with the artist Adrian Hill at the British Red Cross and that, in 1946, he joined Netherne psychiatric hospital as what the article calls the first artist employed by a National Health Service hospital in the country. This is the account of one author writing about one collection and one institution.

The source reviewed does not trace the origin of the term art therapy, and it is not a global history. Dates for the first use of the term, the founding of professional associations, and the development of the practice in the United States, Ireland and elsewhere were not verified from a reliable source for this draft, so none is stated here. A dated account from a scholarly history is still needed.

Professionalisation and regulation in the United Kingdom

In the United Kingdom the practice is now a regulated profession. The Health and Care Professions Council (HCPC) lists art psychotherapist and art therapist as titles protected by law, alongside dramatherapist and music therapist, and states that a person must be registered with the HCPC to use them. The British Association of Art Therapists (BAAT) gives the same account of title protection and registration.

Neither page was found to give the date on which regulation began, and the pages describe the position at the time of access (5 October 2026). Modern practice therefore reflects a process of professionalisation that this draft cannot yet date, and it should not be read as continuous with earlier uses of drawing or painting in hospitals.

Art therapy and art psychotherapy

BAAT describes art therapy as an established form of psychotherapy delivered by trained art therapists, who are also known as art psychotherapists. The two titles are used interchangeably by the professional body and are both protected in the United Kingdom. The HCPC groups art therapists with dramatherapists and music therapists under the wider label of arts therapists, defined as psychological therapists whose primary mode of communication is drama, music or art.

Definitions and the role of artistic skill

A Cochrane review quotes the BAAT definition: a form of psychotherapy that uses art media as its primary mode of communication, for which clients need not have experience or skill in art. The same quotation states that the therapist is not primarily concerned with making an aesthetic or diagnostic assessment of the image. The aims in that definition are the association's own description of its practice and are not findings.

The American Art Therapy Association (AATA) describes art therapy as a mental health profession that uses active art-making, the creative process and applied psychological theory within a psychotherapeutic relationship. It names the credentials ATR and ATR-BC and a master's-level degree. These are professional-body statements about the United States; state licensure and legal protection of titles there were not verified.

Research usage differs from professional usage

Research reviews use their own labels. A 2024 meta-analysis studied what it called active visual art therapy and included trials comparing it with any control not using it. It did not restrict itself to a single professional model, so findings from that review describe a research category and may not map exactly onto therapy delivered by a registered art psychotherapist.

Therapist, relationship and materials

Professional bodies describe sessions as taking place within a therapeutic relationship with a trained therapist, with art-making used as the main way of communicating. BAAT states that the practice aims to reduce distress and improve social, emotional and mental health by promoting insight, self-compassion and a sense of agency and self-worth. These are stated aims, not evidence of effect.

Formats described in trials

The sources reviewed describe delivery only through trials. In the UK MATISSE trial, group art therapy ran weekly for 12 months in groups of up to eight members, each session lasting 90 minutes. Members had access to a range of art materials and were encouraged to use them to express themselves freely. The activity-group comparator in that trial did not use art or craft materials.

In the two dementia trials in a Cochrane review, group art therapy was compared with simple calculation activities over 12 weeks and with recreational activities over 40 weeks. Format, length and setting therefore vary considerably, and trial protocols may differ from how a private or community practitioner works.

Intake, consent and what participants may experience

The sources reviewed do not describe assessment or intake procedures, individual sessions, privacy arrangements or what participants commonly experience, so this draft does not describe them. As a general editorial point, a person can ask a prospective therapist about their registration, the format and length of sessions and how images and records are handled, and may decline to take part in an activity or stop a session.

Aims stated by professional bodies

BAAT states that art therapy aims to reduce distress and improve social, emotional and mental health. The AATA states that the profession seeks to enrich the lives of individuals, families and communities. These are the associations' own descriptions of purpose and are separate from the outcomes that research has tested.

Populations and outcomes that have been studied

A 2024 review of randomised trials reports that treatment indications included mental, neurological and other somatic disorders, and prevention, with most outcome measures concerning depression, anxiety, self-esteem, social adjustment and quality of life. Separate reviews have examined adults with cancer, looking at anxiety, depression and quality of life, and people with dementia. A UK trial examined group art therapy as an addition to standard care for established schizophrenia.

NICE guideline CG178 includes a 2009 recommendation to consider offering arts therapies to people with psychosis or schizophrenia, particularly for negative symptoms. That wording refers to arts therapies in general and predates the MATISSE trial, which is discussed under research and evidence.

What the sources do not cover

The sources reviewed do not document why people say they seek art therapy in everyday life, nor do they provide traditional or historical indications. This section therefore records stated aims and studied populations only. Inclusion of a condition here does not mean that art therapy has been shown to help that condition.

Broad review of randomised trials

A 2024 systematic review and meta-analysis in JAMA Network Open searched databases for trials before March 2021 and included 69 randomised studies with about 4200 participants aged 4 to 96 years. Meta-analyses covered 50 studies, 217 outcomes and 2766 participants. The authors report that art therapy was associated with improvement in 18% of the 217 outcomes compared with 1% for controls, while 81% showed no improvement.

The standardised mean difference was 0.38 (95% confidence interval 0.26 to 0.51) for change from baseline and 0.19 (0.12 to 0.26) for post-test analyses. The authors judged overall study quality to be low. This reading is based on the published abstract. The result mixes many populations, comparators and outcomes and cannot be transferred to a single condition.

Schizophrenia: a null trial and older guidance

The MATISSE trial randomised 417 adults with schizophrenia at 15 UK sites to 12 months of weekly group art therapy plus standard care, activity groups plus standard care, or standard care alone. At 24 months, global functioning and symptoms did not differ between arms. The adjusted difference between art therapy and standard care was -0.9 (95% CI -3.8 to 2.1) on the global assessment of functioning scale. Secondary outcomes did not differ either.

The trial authors concluded that referral to group art therapy as delivered in the trial did not improve functioning, mental health or other health outcomes. NICE CG178 states that arts therapies should be provided by an HCPC-registered arts therapist, in groups unless access or engagement indicates otherwise. The recommendation to consider them dates from 2009 and predates MATISSE, so its wording does not reflect that trial.

Dementia and cancer

A 2018 Cochrane review found two trials of group art therapy for dementia, with 60 participants analysed from 88 randomised. Neither reported clear differences from active controls on the outcomes measured, and the review rated certainty as very low. It concluded that evidence was insufficient, which differs from showing that art therapy has no effect.

A 2020 systematic literature review in adults with cancer included seven studies, four randomised and three not, published between 2009 and 2019. Four reported positive effects on anxiety, depression or quality of life. The authors describe these effects as possible, cite heterogeneity and limited methodological quality, and call for further research. This reading is based on the abstract, and the publisher page was not opened.

What the reviewed sources report about harms

No source reviewed for this draft was dedicated to the safety of art therapy, and the abstracts read for the JAMA review, the MATISSE trial, the Cochrane review and the cancer review do not report adverse-event findings. Full-text reporting of harms was not checked, and the absence of reported harms is not evidence that none occur. Common effects, rare serious events and the frequency of distress during sessions therefore remain undescribed here.

Suitability and delivery

The sources reviewed give no contraindication data. Where guidance exists, NICE CG178 specifies that arts therapy for people with psychosis or schizophrenia should come from an HCPC-registered arts therapist with previous experience of working with those conditions, and normally be delivered in groups. Trials included people from childhood to older age, but these reviews do not establish suitability for any individual.

Regulation, training and care boundaries

In the United Kingdom, art psychotherapist and art therapist are protected titles, and anyone using them must be registered with the HCPC. The AATA names the ATR and ATR-BC credentials in the United States, but state licensure and title protection there were not verified, and the position in Ireland and other countries was not established. Requirements differ by country.

As general editorial guidance, a person can ask about a therapist's registration and training and may pause or stop a session at any time. Art therapy is described by professional bodies as a form of psychotherapy and is not a substitute for assessment of physical or mental health problems or for prescribed treatment. Urgent concerns, including thoughts of self-harm, need prompt help from emergency or health services.