Digital Art Therapy

Early computer use and telehealth

A British Association of Art Therapists (BAAT) article by a practicing art therapist reports that Cathy Malchiodi published Art Therapy and Computer Technology: a virtual studio of possibilities in 2000, giving an overview of online counseling and therapy initiatives in North America. The same article says the term telehealth developed in the 1980s and 1990s as technology became cheaper and more widely available, and it cites early online art therapy studies from the late 1990s. It is a practitioner account and not a historical study.

An integrative review of art therapy and digital technology located 13 articles (12 studies) from the United States and Canada, with searches run to July 2020. Survey data it summarizes showed art therapists' in-session use of webcams rising from 2.4% to 9.4%, and of digital art-making tools from 19% to 32%, between 2004 and 2011. The authors note that these survey figures are old and that most of the early literature rests on therapist opinion.

Expansion during the COVID-19 pandemic

The 2021 integrative review was written during the sudden move to online practice in 2020, and its authors call for specialist training and updated ethical guidance. A narrative review of online gallery programs for people with dementia found no evidence of such programs before 2020, and described the pandemic as a catalyst for older adults' technology use. A scoping review of telehealth in arts therapies found that 14 of its 17 included studies were published between 2020 and 2024.

Professional guidance

The American Art Therapy Association (AATA) Ethical Principles for Art Therapists, in the version revised in December 2013 that was opened for this page, include a section on professional use of the Internet and other electronic or digital technology and a separate section on conducting art therapy by electronic means. The second section describes electronic delivery as a continuously evolving application that offers opportunities and also ethical dilemmas. A separate AATA technology guideline was not located during research for this page.

How the term is used

Digital art therapy has no single definition across the literature reviewed. A 2026 scoping review of digital art therapy for adults with cancer applied the term broadly, including immersive virtual reality relaxation (5 studies), digital music therapy (2), online visual art therapy (2) and digital storytelling (1). An earlier integrative review used a narrower frame centered on digital art-making and online delivery, and excluded digital photography, animation and digital storytelling under its inclusion criteria.

Digital media versus online delivery

Two ideas are often joined under this name. One is the use of digital tools as art materials, such as touchscreen drawing apps or three-dimensional drawing in a virtual reality headset. The other is delivery of sessions at a distance by video, audio, chat or email, which AATA's ethical principles call art therapy by electronic means. A session can involve one, both or neither, and the sources reviewed generally do not separate their effects.

Related Machipedia pages

This page is a member of the Art Therapy family on Machipedia and does not repeat the general account given on the Art Therapy page. Related pages include Expressive Arts, which combines several art forms, Collage Therapy, Music Therapy, Therapeutic Photography for photographic work, and Psychotherapy for the wider field. Digital collage and digital music therapy both appear in the studies discussed below.

Digital tools in sessions

The integrative review describes digital art media in art therapy as including iPad and other touchscreen apps and virtual reality drawing with the TiltBrush program. Reported attractions in the literature it covers include reduced inhibition, no mess, and the ability to record how an artwork develops. Reported drawbacks include unfamiliarity with devices, connection problems and the loss of the touch and sensory qualities of physical materials.

A pilot study of immersive virtual reality art-making used Google's Tilt Brush on a headset in two one-hour sessions with healthy adults. Participants described fun, play and relaxation, a learning curve and some physical discomfort. A scoping review in neurorehabilitation lists virtual reality headsets, augmented and mixed reality, tablet apps and sensor-driven art among the technologies combined with art therapy.

Online sessions and blended formats

The integrative review describes online delivery through audio, video, webcam, chat and discussion boards. A BAAT article by one practitioner describes a blended approach in which face-to-face and online art therapy alternate, supported by email and phone contact, with clients photographing artwork and sending it digitally. The article is one therapist's description of her own practice, and it also states that the efficacy of online art-based relational therapies had not been researched.

Guided and self-guided formats

Studies differ in how much a therapist is involved. In the cancer scoping review, the largest effects were in a therapist-guided 12-week virtual painting trial, while single-session or passive interventions showed smaller or non-significant effects. A feasibility study tested an 8-week self-guided digital collage course on a web platform, with weekly themed tasks and surveys and no therapist contact described.

Access and reach

Authors of the reviews describe access as the main attraction. The integrative review reports improved access for rural and mobility-limited clients and greater client autonomy. A narrative review of online gallery programs for people with dementia describes potential reach to rural and remote residents, people with transport barriers and residents of aged care homes, while noting that digital exclusion and equipment are barriers.

The BAAT practitioner article describes online sessions as giving earlier access to mental health services during the 2020 pandemic emergency, and reports from a Welsh palliative care study that patients valued control over timing and a more level relationship with the therapist. These are practitioner and qualitative accounts and not outcome data.

Emotional well-being and engagement

Studies of digital art-making and virtual reality art tasks are presented by their authors as ways to explore relaxation, mood and engagement. Researchers who ran a virtual reality art-making pilot in healthy adults framed it as examining well-being outcomes, and a feasibility study framed digital collage as a possible way to reduce anxiety. The scoping review in cancer care groups outcomes under anxiety, depression, distress and pain.

Rehabilitation settings

In neurorehabilitation, researchers combine art therapy with technology to add motivation and engagement to physical and cognitive therapy. A trial in stroke replaced part of the usual upper-limb therapy with virtual art sessions, and a scoping review in neurological conditions reports good feasibility and acceptance, particularly for home-based formats.

Reviews

The 2021 integrative review of art therapy in the digital world included 13 articles from 474 records, mostly qualitative or mixed methods, with only three studies reporting client experiences. Its authors state that no meta-analysis was possible, no formal quality appraisal was done, and findings rest largely on therapist opinion. A 2024 scoping review of telehealth in arts therapies included 17 studies, of which only 2 concerned art therapy specifically and 13 concerned music therapy, with all studies reporting positive outcomes and the authors flagging possible positive-results bias.

The 2026 scoping review of digital art therapy for adults with cancer included 10 studies (434 patients), 6 of them randomized trials. Anxiety, depression, distress and pain generally decreased, but about two-thirds of studies had moderate to high risk of bias, follow-up was short and the review maps evidence without grading effectiveness. A 2026 scoping review of art therapy with technology in neurorehabilitation included 19 studies and concluded that high-quality evidence of benefit for motor or non-motor outcomes is not yet available.

Individual trials and pilot studies

A single-blind trial of 40 people with subacute stroke replaced three weekly upper-limb sessions with 12 virtual art sessions over 4 weeks, and reported better Barthel Index change and some strength outcomes than conventional therapy alone. It was single center, had no follow-up, did not report adverse events, and measured rehabilitation outcomes, so it should not be read as evidence about mental health.

A randomized pilot of virtual reality art-making in 24 healthy adults found one significant difference between conditions: lower negative affect when a lavender fragrance was added. Anxiety, stress and life satisfaction did not differ between conditions. A single-group feasibility study of 22 analyzed participants found no significant overall reduction in anxiety after an 8-week digital collage course, though people with higher starting anxiety scored lower afterwards. Its authors list regression to the mean and the lack of a comparison group as limits.

Dementia and comparison with traditional media

For online gallery programs in dementia, the narrative review describes evidence that is limited, mostly qualitative and drawn from small samples without controlled comparisons. Its authors state a significant need for research on efficacy and suggest comparing online and onsite delivery directly.

None of the sources reviewed here compared digital media directly with traditional art materials in a controlled trial, and the feasibility study's authors recommend a traditional art-making control group in future work. Searches of PubMed for digital, online, tablet, virtual reality and telehealth art therapy were run for this page, and studies by Kaimal and colleagues on digital media other than the virtual reality pilot were not located.

Privacy and confidentiality

AATA's Ethical Principles ask art therapists who offer services by electronic transmission to inform clients of the risks to privacy and the limits of confidentiality, to discuss the merits and detriments of recording sessions, and to obtain informed consent describing the technology used. They also ask therapists to discuss the limits of encryption, the permanent nature of posted messages and public access to artwork posted digitally, and to take reasonable steps to confirm client identity.

The BAAT practitioner article states that confidential online file storage can be hacked or lost, and describes saving client images to a password-protected drive. The reviews summarized here report concerns about confidentiality and interruptions at home, and the cancer scoping review found privacy addressed only in passing, with one platform described as HIPAA-compliant.

Physical effects and platform limits

In the virtual reality art-making pilot, one participant withdrew because of cybersickness, and others reported headaches, overheating and discomfort from the headset. In the cancer scoping review, no serious adverse events were reported, and minor transient vertigo occurred in 2.9% of participants in one immersive trial. Reviews also report unstable internet connections, poor audio synchronization and limited tactile materials. The sources reviewed do not assess the effects of screen time.

Suitability and therapist competence

AATA's principles ask art therapists to discuss the benefits and limits of digital art therapy with interested clients, to determine that clients have the cognitive abilities to use it, to become proficient with the technology, and to avoid technology that is beyond their training and scope of practice. The 2021 review reports that only 36.5% of therapists had received training in technology by 2011. The BAAT article advises that online art therapy be used with precaution and preferably with training, with clear safety protocols and risk assessment, particularly at assessment, because therapist and client do not share a space in a crisis.

Training, registration and care boundaries

In the United States, the Art Therapy Credentials Board, which AATA describes as independent of the association, administers the Registered Art Therapist (ATR) and Board Certified (ATR-BC) credentials. BAAT states that practicing as an art therapist in the UK requires a Health and Care Professions Council (HCPC) approved master's course and registration with the HCPC, which keeps a public register. The sources reviewed describe no separate qualification for digital art therapy. This page is information only and is not a substitute for mental health care, and necessary care should not be delayed or replaced.