Collage Therapy

Collage in modern art

Tate states that the word collage derives from the French papiers collés and that collage was first used as an artists' technique in the early twentieth century. Its entry on papier collé says Georges Braque first used the technique, drawing on imitation wood-grain paper pasted onto white paper, and that Braque and Picasso both made such works in late 1912 and early 1913. Picasso swapped the wood-grain paper for pages of the newspaper Le Journal to bring everyday reality into his pictures.

Tate's entry on Merz describes Kurt Schwitters, a German dada artist, as inventing the word Merz for collage and assemblage works made from scavenged scrap materials, taking it from the fragment of a bank name on a piece of paper in one of his collages. Tate says he founded a dada group in Hanover, where he was based from 1919. These art-historical sources concern collage as an art form, not as a therapeutic method.

Adoption in art therapy

A 1997 book review in the Canadian Journal of Counselling describes Helen Landgarten's Magazine Photo Collage: A Multicultural Assessment and Treatment Technique, published in 1993 by Brunner/Mazel in New York. The reviewer reports that Landgarten had used the technique for over 25 years and presents it as a collage method that counselors from different backgrounds could adapt to ongoing work with clients.

The sources opened for this page do not trace who first used collage in therapy, nor how it spread between countries, and they do not provide a full history of collage within art therapy beyond Landgarten's 1993 book. The review also reports that Landgarten stated the technique had not been validated with empirical research.

Names in use

The terms therapeutic collage, collage art therapy and collage therapy are used for activities in which people make images from cut or torn pictures, paper and found materials as part of therapy or counseling. Magazine Photo Collage is the name of one specific technique described by Landgarten. Some studies use collage therapy for named programs, such as a Transactional Analysis based program studied in Japan, so the term does not refer to a single standard method.

Art therapy and who uses collage

The American Art Therapy Association describes art therapy as a mental health profession that uses art-making, the creative process, psychological theory and a psychotherapeutic relationship. Collage is therefore one technique within art therapy rather than a separate profession. The 1997 reviewer of Landgarten's book reports having seen hospice nurses, adolescent group facilitators and music therapists use Magazine Photo Collage, which indicates the technique is not limited to art therapists.

Machipedia covers the wider family on a page named Art Therapy, which this page does not duplicate. Related pages include Therapeutic Photography, Digital Art Therapy, Expressive Arts, Mandala Therapy and Psychotherapy. Vision boards, which are collages of images of desired outcomes made outside therapy, are a popular use of collage and are addressed separately below.

General description

Collage in a therapy setting involves selecting, arranging and attaching images and materials to make a composition, often followed by talking or writing about what was chosen. The 1997 review of Landgarten's book describes picking out pictures, pasting them down and telling or writing about the selections. The British Association of Art Therapists states that art is the main mode of expression alongside talking with the therapist, and that no skill in art is needed.

Formats reported in studies

Studies describe several formats. A Japanese randomized trial used an individual program of life review-based collage book making with long-term inpatients with schizophrenia. A later trial from related authors used digital collage activity based on a life review with patients with cancer and their families, in three sessions over about 10 days. A pilot study in a US art therapy clinic examined a structured collage protocol developed by an art therapist for clients who had experienced trauma.

Vision boards

A vision board is generally understood as a collage of pictures and words representing goals or a desired future, usually made without a therapist. The sources reviewed for this page do not give a standard method for vision boards, and none of the clinical studies below used the term. Vision boards are not equivalent to collage made within a therapeutic relationship, and the evidence for one should not be carried to the other.

Assessment, expression and life review

Landgarten's book presents Magazine Photo Collage as both an assessment and a treatment technique, and the reviewer describes it as intended to be simple for the therapist to administer and for the client to produce. The reviewer also states that the tasks are not sufficient for client assessment on their own, and that other data such as interviews and standardized measures should be used.

Stated aims of art therapy and trauma protocols

The British Association of Art Therapists states that art therapy aims to reduce distress and improve social, emotional and mental health, including after difficult or traumatic experiences. The authors of the trauma-focused collage pilot study describe their protocol as a structured way of acknowledging and managing comfortable and disturbing emotional experiences, and suggest it may help clinicians assess readiness for trauma therapy. These are authors' and practitioners' statements of intent, not established effects.

General art therapy evidence

A systematic review for the UK Health Technology Assessment programme (Uttley and colleagues, 2015) included 15 randomized trials of art therapy in people with non-psychotic mental health disorders (777 participants). Meta-analysis was not possible. Art therapy was associated with significant positive symptom changes versus control in 10 of the 15 studies, four reported no significant group difference, and one favored the control group. The authors rated the trials as generally low quality.

This review concerns art therapy as a whole and does not isolate collage, so it is not collage-specific. No Cochrane review of art therapy was opened for this page, and none is summarized here.

Collage-specific studies

A randomized trial of life review-based collage book making in long-term inpatients with schizophrenia (Kaneko and colleagues, 2024) reported a significant group effect on the confusion subscale of a mood scale, and smaller patient and staff rating discrepancies in those with large initial gaps. A randomized trial of digital collage activity in older patients with cancer (Sakaguchi and colleagues, 2026) assigned 42 participants, 21 per group, and 13 and 16 completed. It reported significant interactions for some self-efficacy subscales and for family caregiver quality of life, but no significant group differences on self-esteem or depression scales.

A pilot study of a trauma-focused collage protocol (Tripp and colleagues, 2019) reported a statistically significant decrease in anxiety in 22 participants who completed it; the abstract describes no randomized comparison group. A Japanese study of a Transactional Analysis based collage therapy program in 31 adults found decreases in attachment anxiety and avoidance, and its author states the analysis is correlational and does not support causal conclusions.

Limits of the collage evidence

The collage-specific studies found are few and small, use different populations and formats, and the two controlled trials come from related research groups in Japan. PubMed searches combining collage with art therapy, depression, dementia, cancer and trauma returned no controlled trial of collage in depression or dementia, and none using the name Magazine Photo Collage. The sources do not show that collage differs in effect from other art materials or talking therapies.

Vision boards and goal imagery

No study of vision boards was located in the searches run for this page. The closest research concerns thinking about the future: Oettingen and Mayer (2002) distinguished expectations from fantasies in four studies, including job seekers and hip-replacement patients, and reported that positive expectations predicted high effort and successful performance while positive fantasies predicted the reverse. That work did not involve vision boards or collage and is not evidence about them in either direction.

Machipedia covers related ideas on pages named Manifestation and Guided Visualization. No source opened here links vision boards to either, and this page makes no claim about that relationship.

Emotional distress and care boundaries

The qualitative review within the 2015 art therapy assessment identified potential harms of art therapy related to activation of emotions that were then unresolved, lack of skill of the art therapist and sudden termination of therapy. The sources reviewed for this page do not report harms specific to collage, and they do not cover physical hazards of materials such as adhesives or cutting tools. Because emotional activation is reported for art therapy generally, a person who becomes distressed while making or discussing images may need support from a qualified professional.

This page is educational and is not a substitute for assessment or treatment by a qualified mental health professional. Collage should not delay or replace necessary care for depression, trauma, psychosis, dementia or cancer.

Training and registration

The American Art Therapy Association states that art therapists hold master's-level or higher degrees, and uses the credentials ATR for a registered art therapist and ATR-BC for a board-certified one. The British Association of Art Therapists states that in the UK the titles art therapist and art psychotherapist are protected and that practitioners must be registered with the Health and Care Professions Council. The 1997 reviewer of Landgarten's book states that reading the book does not make someone an art therapist.