In art therapy, you create visual art (drawing, painting, sculpting, collaging) while working with a licensed therapist who helps you explore what comes up during and after the creative process. It’s not an art class, and you don’t need any artistic skill. The focus is on what the process of making something reveals about your emotions, memories, and patterns of thinking.
A typical session lasts 45 to 60 minutes and combines hands-on art-making with guided conversation. What you actually do varies widely depending on your goals, your therapist’s approach, and what you’re working through. Here’s what that looks like in practice.
How a Session Usually Unfolds
Most sessions follow a loose three-part structure: a warm-up, a main creative activity, and a reflection period. You might start with something simple like fast scribbling on paper, which research has shown to be the most mentally relaxing form of drawing. These quick, unstructured warm-ups help you shift out of your thinking mind and into a more open, expressive state.
From there, your therapist introduces a directive, which is essentially a creative prompt designed to surface something meaningful. Sometimes the directive is open-ended (“use these materials to express how you’re feeling right now”), and sometimes it’s more structured (“create a mask showing how others see you on the outside and how you see yourself on the inside”). Your therapist chooses the prompt based on your treatment goals and where you are in the therapeutic process.
After you finish creating, you and your therapist talk about the experience. This isn’t the therapist “diagnosing” your artwork or telling you what your colors mean. Instead, they ask questions that help you notice things for yourself: what you felt while making it, what surprised you, what a particular shape or image reminds you of. The art becomes a starting point for conversation, especially when feelings are hard to put into words directly.
Common Activities and Exercises
Art therapists draw from a wide range of specific exercises, each designed to access different emotional territory. Some of the most commonly used include:
- Self-portraits: You create a representation of yourself through painting, drawing, or abstraction, focusing on capturing your emotions and inner thoughts rather than physical accuracy.
- Mandala drawing: You draw patterns, shapes, or images inside a circle. The structured, repetitive nature of this exercise promotes calm and focus.
- Collage making: You cut images and words from magazines to assemble something that reflects your identity, goals, or current emotional state. This is especially useful if drawing feels intimidating.
- Mask making: You decorate the outside of a mask to show how you present yourself to the world, and the inside to show your private, inner experience.
- Painting to music: You listen to a song and translate its rhythm and emotional texture into color and movement on paper.
- Color your mood: You create a pie chart where each slice represents an emotion, assigned a color and sized according to how much space that feeling takes up in your life.
- Mindful doodling: You draw with your eyes closed, making lines and shapes purely based on how they feel, with no concern for what they look like.
- Story stones: You paint images on smooth stones and use them to build and tell narratives, helping you explore themes and experiences that matter to you.
Your therapist selects or adapts these based on what you’re working on. Someone processing grief might be asked to create a timeline collage. Someone struggling with anxiety might work with repetitive pattern-drawing to practice staying present.
Why Different Materials Matter
The materials you use aren’t random. Art therapists choose specific mediums because each one interacts with your body and mind differently.
Drawing, especially fast or loose drawing, tends to be mentally calming and works well for warming up or releasing tension quickly. Watercolors are fluid and harder to control, which can help people practice letting go of perfectionism. Markers and colored pencils offer more precision and control, which can feel grounding when emotions are overwhelming.
Clay is a distinct experience. Research comparing drawing and clay work found that clay demands more mental and physical effort, but nondirective clay tasks (where you shape freely without specific instructions) stimulated the most creative thinking and evoked the most positive emotions of any medium studied. The physical, three-dimensional nature of clay engages your body in a way flat media can’t, making it especially useful for people who hold stress physically or who struggle to access emotions through words alone.
What Happens in Your Brain
Art therapy isn’t just emotionally helpful. It produces measurable changes in your body. Studies measuring the stress hormone cortisol found that most participants had reduced levels after art-making sessions. Some participants actually showed increased cortisol, which researchers attributed to the stress of working with unfamiliar materials, but even those people reported feeling positive about the experience afterward.
Creating art activates areas of the brain involved in emotion processing and memory, including the same regions engaged during rest and meditation. Brain imaging studies have confirmed that art-making stimulates both hemispheres of the brain simultaneously, a phenomenon called bilateral activation that’s also used in trauma processing therapies. This bilateral engagement may be part of why art therapy helps people access and process experiences that feel “stuck” or hard to articulate verbally.
The physical, sensory nature of art-making, touching clay, watching paint spread, moving your hand across paper, engages your mind and body together in ways that talking alone doesn’t. This is one reason art therapy can reach people who haven’t responded well to traditional talk therapy.
What It Helps With
Art therapy is used across a broad range of conditions, but it’s particularly effective for situations where language falls short.
For people with PTSD, art therapy provides a way to express traumatic experiences without having to verbally recount them, which can trigger re-traumatization. It helps contain overwhelming emotions, gives visibility to internal suffering, and can chart a visual timeline so you can actually see how your feelings are changing over time. People dealing with hypervigilance or panic can use art to convey what those states feel like and begin identifying where they stem from.
For anxiety and depression, art-making promotes relaxation, reduces blood pressure, and offers a structured activity that interrupts rumination. The creative focus required to complete a directive naturally pulls your attention into the present moment, functioning as a form of active mindfulness.
Art therapy is also used with children and toddlers, where it helps develop communication skills, emotional regulation, turn-taking, and confidence. For parents and young children together, creating art side by side gives parents a less threatening way to reflect on their emotions and practice mirroring their child’s feelings.
How It Differs From Doing Art on Your Own
Making art at home can be genuinely therapeutic. But art therapy and recreational art-making are fundamentally different things. The critical distinction is the therapeutic relationship. Art therapy happens within a professional relationship where a trained therapist is observing your process, selecting interventions based on clinical goals, and guiding you through reflection in ways that produce real psychological change.
A coloring book or painting class might help you relax, and that’s valuable. But an art therapist is tracking patterns across sessions, noticing how you approach materials (do you always stay small in one corner of the page? do you avoid certain colors?), and using what emerges in your art to help you understand yourself more deeply. The art is a tool within a larger treatment plan, not the treatment itself.
Who Leads These Sessions
Art therapists hold master’s degrees with coursework spanning both studio art and mental health. The credentialing process through the Art Therapy Credentials Board requires a minimum of 700 supervised practicum hours, with at least 350 of those hours providing direct art therapy services to individuals, groups, or families. They also complete at least 18 credit hours of studio art coursework and maintain a GPA of 3.0 or higher across all qualifying coursework.
This dual training in art and psychology is what allows them to select the right materials, craft effective directives, and facilitate the kind of reflection that turns a creative exercise into genuine therapy. If you’re considering art therapy, look for someone with ATR-BC credentials, which indicates they’ve met both educational and supervised clinical practice requirements and passed a national examination.