Clinical art therapy

Domain VIII · Creative & expressive arts therapies · Helen B. Landgarten · 1981 · Los Angeles

What it is

Landgarten's books are organised by population and setting, not by a fixed phase sequence; no source gives a manualised stage model or session count. The structure below combines what the sources show with a clearly marked scaffold.

Format

• Landgarten's books are organised by population and setting, not by a fixed phase sequence; no source gives a manualised stage model or session count. The structure below combines what the sources show with a clearly marked scaffold.
• Settings and formats covered in the primary texts

Who practises it, and how they are trained or regulated

• Family assessment as consultation: at LMU, a licensed art therapist conducts the assessment for an outside primary family therapist, then debriefs and writes a report. Thesis work at LMU recommends that the family already has a stable relationship with its primary clinician and that the primary clinician is present in the room.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• psychotic or disorganised imagery escalating distress; keep to the here-and-now and liaise with the ward team.
• never interview a child about abuse through drawings or treat imagery as proof; leave forensic questioning to trained investigators.
• abandonment themes resurfacing in the art near the end (relevant in Landgarten's single-parent and borderline case material); name them openly.
• 'bad' images linked to self-harm, violence or abuse; follow with a calm risk or safeguarding enquiry rather than interpretation (see section 5).
• adapt materials for physical limitations in rehabilitation, pain and older-adult work (thicker grips, collage instead of fine drawing, seated work).

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.