Ulman's art therapy

1. Introduction

Version followed: Elinor Ulman's position as set out in her chapters in Ulman & Dachinger (eds.), Art Therapy in Theory and Practice (Schocken, 1975; reprinted Magnolia Street, 1996): "Art Therapy: Problems of Definition" (first published 1961), "Therapy Is Not Enough" and "A New Use of Art in Psychiatric Diagnosis" (the Ulman Personality Assessment Procedure, UPAP). For the UPAP this guide follows the four-drawing, single-session version that Tripp (2019) and Steinhardt (2006) describe. The book, Ulman (1965) and the Bulletin of Art Therapy / American Journal of Art Therapy archives are not publicly available, so Ulman's ideas reach this guide through the GWU programme history, papers citing her page numbers, Tripp's (2019) abstract, Steinhardt's (2006) summary of the UPAP, John's (2012) description of her 1976 film, and the two UPAP training-video pages. Confirmed: the UPAP is four drawings made in one session in response to a series of experiential directives (Tripp 2019); in order, a free drawing, a warm-up of three basic movements in the air then carried onto the paper, a drawing developed from a scribble, and a final free drawing or further scribble drawing, on manila paper in colour (Steinhardt 2006, p. 113, summarising Ulman 1992); a three-drawing version appears in her 1976 film (John 2012); named UPAP teachers hold the ATR-BC. [uncertain]: the type of colour medium and paper size, the exact wording of each directive, which three movements are used, and the timing; the content of Ulman & Levy's chapter; and Tripp's case adaptation beyond the abstract. [source: archive.org record; ERIC ED408236 table of contents; ERIC EJ1228909; Taylor & Francis abstract of Tripp 2019; Steinhardt 2006 (ERIC full text); John 2012; GWU history]

What it is. "Ulman's art therapy" is not a manualised therapy. It has three parts: (a) a definitional framework for art therapy, (b) a clinical stance that runs from art studio work to art used within psychotherapy, and (c) one standardised assessment procedure, the UPAP. Elinor Ulman (1910–1991) was a painter. She directed the art therapy programme at District of Columbia General Hospital (1955–65), taught at the Washington School of Psychiatry and at George Washington University (1971–88; she co-founded the GWU programme with Bernard I. Levy), and in 1961 founded the Bulletin of Art Therapy, later the American Journal of Art Therapy. [source: GWU history; dates and posts not in that page: uncertain: secondary, unverified]

Core idea of change. In the cited summaries, Ulman holds that anything "called art therapy must genuinely partake of both art and therapy" (Ulman 1975, p. 13, as cited). Creative activity comes from within the personality. It orders inner chaos and outer impressions, so that inner and outer realities fuse into a new whole. She calls art "the meeting ground of the world inside and the world outside" (p. 21, as cited). Her shared aim for art therapy across settings is "integration or reintegration of the personality" (Ulman 1961, p. 10, as cited). Insight often comes from the art-making process itself, not from verbal interpretation of symbols (p. 22, as cited). [source: Montana State thesis citing Ulman 1961; the 1975 page quotations: uncertain: secondary, unverified]

2. Framework

Ulman's sources contain no phase model, session count or transition criteria. What can be reconstructed is a two-part clinical sequence: assessment first (UPAP), then ongoing art therapy placed somewhere on her art-to-therapy spectrum. Session counts and the criteria for moving between stages below are my [synthesis] unless tagged otherwise.

Stage A: Assessment with the UPAP (one session).

Goal: get several views of the person's psychological state and symbolic expression from a series of four drawings made in a single session, in response to "a series of experiential directives" (Tripp 2019, abstract). [source: ERIC EJ1228909; Taylor & Francis abstract of Tripp 2019]
Format: individual, usually in a psychiatric or hospital setting. The published demonstrations are at Walter Reed Army Medical Center: Ulman with two young women patients, findings presented with Levy at psychiatric Grand Rounds; and Gladys Agell with a 22-year-old patient, 1996. [source: psychotherapy.net UPAP and UPAP & Discussion pages]
Structure: a short informal conversation beforehand (Agell's preference; about 20 minutes in her demonstration); four directives in a set order: (1) free drawing, (2) a warm-up of three basic movements in the air, transferred to the paper, (3) a drawing based on a scribble, (4) a free drawing or another scribble drawing. The sequence moves from an open task toward tasks that draw out more symbolic, emotional projection, and the final drawing is compared with the first when the series is interpreted. The movement and scribble methods derive from Florence Cane. Then the pictures are displayed in sequence and discussed with the client. Afterwards the therapist formulates findings for the team. [source: Steinhardt 2006, p. 113, summarising Ulman 1992; psychotherapy.net; John 2012, pp. 17, 23, citing McNamee 2004 for Ulman's use of the scribble]
Version difference: Tripp (2019, abstract) and Steinhardt (2006, p. 113) describe four drawings in a single session, which matches the four drawings Ulman introduces in the Walter Reed video. John (2012, p. 17), describing Ulman's 1976 film Art Therapy: Beginnings, reports a series of three drawings: a free drawing, a scribble drawing, and a free choice between scribble and free drawing, that is, the four-drawing sequence without the movement drawing. This guide follows the four-drawing version. [uncertain] The paper size, the type of colour medium, the full wording of the four directives, the three movements and the timing are specified in Ulman's own UPAP text (1975, pp. 361–386), which is not publicly available; get that chapter or UPAP training before standardised use. [source: ERIC EJ1228909; Steinhardt 2006; John 2012; psychotherapy.net UPAP page]

Stage B: Ongoing art therapy on Ulman's spectrum.

One pole: art as "a means of nonverbal communication" within psychotherapy. Here the art products help the person understand and work through emotional problems. The other pole: therapy happens through the artistic process itself, and the work is valued for its psychological value. [source: GWU history]
Format, frequency and length: not specified in the available secondary sources [uncertain]. Ulman's own programmes ran in general-hospital psychiatry (DC General), in training (the Washington School of Psychiatry) and in art education for emotionally disturbed children (Ulman 1971, as cited). [source: Montana thesis; Prezi summary: uncertain: secondary, unverified]
Moving A→B [synthesis]: begin after the UPAP has been fed back to the client and the team, and the client has agreed goals that include art-making.
Choosing where on the spectrum to work [synthesis]: move toward the art pole when the client is too disorganised, defended or verbally limited for insight work, or when they gain from the ordering activity of making itself. Move toward the psychotherapy pole when the client can reflect on images and wants to use them for talk-based work. Review at intervals, for example every 6–8 sessions.
Ending [synthesis]: review the body of work in sequence with the client, as in the UPAP review, and agree what has become more integrated.

3. Guiding principles

Both art and therapy, genuinely. Do not run art as a pastime with no therapeutic aim, or talk therapy with token drawing. Each session should have a real art task and a real therapeutic purpose. [source: Ulman 1975 p. 13, as cited in a secondary summary: uncertain: secondary, unverified]
Integration of the personality is the common goal. Judge every directive by whether it helps the person bring inner experience and outer reality together. [source: Ulman 1961 p. 10, as cited in Montana thesis]
The process carries the insight. Watch how the person works (approach, hesitations, changes, energy), not only what the image "means". Hold back from interpreting symbols. [source: Ulman 1975 p. 22, as cited]
Respect the medium. You earn respect only when you respect the art materials and the work. Offer good-quality materials, give the work time, and treat finished pieces with care. [source: Ulman 1975 p. 32, as cited]
Plain language, no jargon. Talk with clients and teams in ordinary words. [uncertain: secondary, unverified]
A series tells more than one picture. Never base an assessment judgement on a single image. Read change and consistency across pictures. [source: Tripp 2019, abstract]
Movement belongs in art-making. The body is part of the work. Warm up before drawing, encourage large free movement, and notice rhythm. [source: Hurst 2008, pp. 29–30, summarising Cane; Cane's methods in the UPAP: John 2012, p. 23]
Interpretation is shared. The client's own account of feelings and intentions comes first. Formulate findings with the client, not about them. [source: Tripp 2019, abstract; Agell demonstration, psychotherapy.net]
The client holds the power in the process. Agell aimed to show the patient that "the power was in his hands". Give choices and explain the purpose. [source: psychotherapy.net UPAP & Discussion]
Structure may matter more than subject. When reviewing work, weigh formal qualities (organisation, integration, line, use of space) as well as content. Ulman & Levy's 1992 study suggested structure may matter more than subject matter. [source: Gantt 2001, p. 124]
Assessment depends on the clinician. Ulman-style evaluations are best treated as sensitive views of a person's process in the hands of a well-trained therapist, not as psychometric tests. [synthesis]
Professional frame. Practise under art therapy credentials. In the US, art therapists are trained at master's level, and licensure varies from state to state [uncertain: secondary, unverified]; the Art Therapy Credentials Board (ATCB) issues the ATR and ATR-BC [source: ATCB, About the credentials]. The credential title held by named UPAP teachers is registered and board-certified art therapist (ATR-BC): Michael Franklin, ATR-BC, who studied with Ulman and Levy at GWU; Tally Tripp, registered and board-certified, who is also a licensed clinical social worker. [source: psychotherapy.net UPAP page; GWU Tally Tripp page] The AATA (founded 1969) is the US professional body, and Ulman was an honorary life member. [source: GWU history] In the UK, "art psychotherapist" and "art therapist" are protected titles that only HCPC-registered practitioners may use [source: HCPC, The professions]; the professional body is BAAT (founded 1964) [uncertain: secondary, unverified]. No separate UPAP certification is described. [synthesis] Do not run the UPAP as an assessment without art therapy training and supervised UPAP practice.

4. Intervention inventory

Scope: these are the procedures the secondary sources attribute to Ulman, to the UPAP, or to the Cane techniques built into it. The step wording is the writer's operational wording [synthesis]. Wherever the exact UPAP wording, materials or order are unconfirmed, the step is marked [uncertain] and you should follow Ulman (1975, pp. 361–386) or your UPAP training. All example language is (illustrative).

4.1 Pre-assessment conversation (Agell's practice)

Purpose / when: before the UPAP. Builds rapport, gathers context, and shows the client they have control over the process. [source: psychotherapy.net UPAP & Discussion]
Steps: (1) Meet the client informally before the art session. Agell talked for about 20 minutes while walking with the patient to and from the room. (2) Ask about their current situation and their experience of art. (3) Explain what will happen, why, and who will see the results. (4) Make clear that they can decline or stop and that they decide what to make. (5) Get consent for the pictures to be kept, shown to the team, or recorded.
Example language (illustrative): "Before we start, I'd like to hear a bit about you. In a few minutes I'll ask you to make four pictures. There's no right way to do them, and you decide what goes on the paper."
Watch for: suspicion, fears about being "tested", and shame about drawing ability. It is working when the client asks questions, relaxes and starts the first directive without being pushed.

4.2 Introducing the four-picture series

Purpose / when: at the start of the UPAP. Sets the frame for a sequence of four directives in one session. [source: psychotherapy.net UPAP page (Ulman "introduces the four drawings"); Tripp 2019, abstract]
Steps: (1) Say there will be four pictures and that one involves movement. (2) Show the materials and let the client handle them. (3) State a rough time frame. (4) Give the directives in the published order: free drawing (4.5), movement drawing (4.3), scribble drawing (4.4), then free drawing or scribble (4.5) [source for the order: Steinhardt 2006, p. 113]. (5) Keep each picture once finished; do not discuss pictures until the series is complete [synthesis — consistent with the published end-of-series review, not verified as Ulman's rule].
Materials and safety [synthesis]: chalk or soft pastels give off fine dust. Use non-toxic, certified products. Do not blow dust off the paper; wipe or tap it into a bin. Have wipes and hand-washing available. Ask about asthma or other respiratory problems. If you fix the work, use the fixative away from the client in a ventilated space. The UPAP drawings are made in colour on manila paper (Steinhardt 2006, p. 113); the paper size and the exact colour medium are [uncertain] (see section 2).
Example language (illustrative): "I'll ask you for four pictures, one at a time. A couple of them start with moving your arms. I'll keep each one as you go, and at the end we'll look at all four together."
Watch for: performance anxiety, and requests for exact instructions. Answer briefly and hand the choice back to the client.

4.3 Movement warm-up before drawing (Cane-derived)

Purpose / when: the second UPAP drawing, and in ongoing sessions. Loosens the body, links movement to mark-making, and frees spontaneous imagery. Cane began work by releasing the body's rhythms through breathing, movement and sound, holding that for imagination to be free "the whole muscular and nervous system must be active and alert". [source: Hurst 2008, pp. 29–30, quoting Cane p. 42] In the UPAP the second directive is a warm-up of three basic movements made in the air and then transferred to the paper, and Ulman saw the exercise and scribble as a "dynamic stimulus" that shows where a person is likely to go as well as where they are now. [source: Steinhardt 2006, p. 113, quoting Ulman 1992, p. 88]
Steps: (1) Clear floor space and check for obstacles, slippery floors and nearby furniture. Offer a seated version. (2) Demonstrate a large, full, balanced movement, such as swinging the arms or the motion of throwing a ball; in the UPAP there are three basic movements in turn. (3) Invite the client to repeat each rhythmically in the air, at their own pace and range. (4) Ask the client to transfer the movement to the paper, encouraging large free strokes that carry the rhythm. [source for three movements in the air, then transferred to paper: Steinhardt 2006, p. 113; rhythmic arm movement: Hurst 2008, p. 30, summarising Cane; ball-throw example: uncertain: secondary, unverified; which three movements and their wording: uncertain]
Example language (illustrative): "Let's loosen up first. Swing your arms like this, big and easy, only as far as is comfortable. Now take that swing onto the paper."
Watch for: pain, dizziness, mobility limits, and embarrassment at moving in front of someone. Adapt or skip without making a fuss. It is working when strokes get larger and freer and the client's posture relaxes. Safety: this step is no-touch. Do not guide the client's arms by hand (see section 5).

4.4 Scribble drawing (Cane's technique as used in the UPAP)

Purpose / when: inside the UPAP and in ongoing work. Brings out spontaneous, less-controlled imagery in a way similar to free association. Ulman (1965) used the scribble in an assessment tool (McNamee 2004, as cited in John 2012, p. 23). Her series is said to show how the client responds to the "thought loosening process of the scribble drawing" (John 2012, p. 17). [source: Gantt 2001 p. 126 notes scribbles "such as the ones used by" Ulman 1975; John 2012]
Steps (Cane's sequence): (1) Stretch or warm up (4.3). (2) Draw a freely flowing, continuous line across the paper, with eyes closed if the client is willing, so the hand moves without being steered. (3) Open the eyes and look at the line from several angles, turning the paper. (4) Find a form or association in it. (5) Develop that form into a picture by adding and emphasising lines and colour. [source: secondary summaries of Cane 1951, uncertain: secondary, unverified; how the UPAP uses this step in detail: uncertain]
Example language (illustrative): "Close your eyes if that's OK and let one line wander over the whole page without lifting your hand. Now open them and turn the page around. Is anything in there? Bring out what you see."
Watch for: refusal to close the eyes, which is common with trauma histories, so offer a lowered gaze. Also watch for "I see nothing" (allow more turning, or let the client add a few lines first) and for frightening images (see section 5). It is working when the client finds an image and develops it with some absorption.

4.5 Free drawing (first picture) and the free-or-scribble choice (fourth picture)

Purpose / when: the first and last UPAP drawings. The UPAP gives "a range of directives" across four pictures, so that the person can be seen in more than one mode (Tripp 2019, abstract). It opens with an open task, a free drawing, and closes with the client's choice of a free drawing or another scribble drawing; the culminating picture is shaped by what came before it and is compared with the first when interpreting. [source: Steinhardt 2006, p. 113, summarising Ulman 1992]
Steps: (1) First picture: invite a drawing of anything the client chooses, with no set subject. (2) After the movement (4.3) and scribble (4.4) drawings, fourth picture: offer the choice of a free drawing or another scribble drawing, and note which the client chooses. (3) In the review (4.6), set the first and fourth pictures side by side and look at what has changed. [source for the order and the first–last comparison: Steinhardt 2006, p. 113; the same free / scribble / choice pattern appears in the three-drawing film version, John 2012, p. 17] [uncertain] Ulman's exact wording of these directives is not publicly available; do not call a session with substituted tasks a UPAP. Process notes to record for every picture [synthesis]: how the client started, approach to the materials, hesitations, erasures or reworking, verbal comments, energy and pace, and finishing behaviour.
Watch for: fatigue over four pictures. Offer a pause between directives [synthesis].

4.6 Sequential display and shared review of the four pictures

Purpose / when: at the end of the UPAP. Lets the client and therapist read the series together, and puts the client's own account first. [source: psychotherapy.net UPAP & Discussion (Agell and the patient display the four pictures in sequence and discuss each in detail, the patient describing the feelings and intentions he depicted); Tripp 2019, abstract, on shared interpretation]
Steps: (1) Pin up or lay out the four pictures in the order they were made. (2) Ask the client to look at all of them before commenting. (3) Go through them one at a time: what they were trying to do, what they felt, and what they see now. (4) Then look across the series: what changes, what repeats, and which picture feels most or least like them. (5) Offer your observations tentatively, about process and structure, not symbolic decoding. (6) Ask what they would want the team to understand.
Example language (illustrative): "Here are all four in the order you made them. Take a moment with them. Which one would you like to start with?" / "I noticed the strokes got bigger after the arm swings. What was that like for you?"
Watch for: the client deferring to you as the expert; turn the question back to them. Watch also for distress at seeing the series together. It is working when the client speaks about their pictures in their own terms and adds information that wasn't available before.

4.7 Formulating and reporting findings to the team

Purpose / when: after the UPAP in a multidisciplinary setting. Ulman and Levy presented their findings at psychiatric Grand Rounds. Agell's discussion with observers shows how knowledge of other psychological and projective tests can inform interpretation of the process and drawings. [source: psychotherapy.net both pages]
Steps [synthesis on structure]: (1) Describe what was observed: process behaviour per picture, formal qualities, and the client's own statements. (2) Separate observation from inference. (3) Link to the referral question and to other assessment data. (4) State the validity limits in the report. The UPAP is a clinical, process-based evaluation with no published reliability, validity or normative data [uncertain]. Tripp's (2019) case for the UPAP rests on clinical reasoning and a case study, not on psychometric data. John (2012, p. 17) notes that the Ulman series does not appear in contemporary literature. (5) Share the gist with the client first, or at the same time, where the setting allows. [source for limits: ERIC EJ1228909; John 2012]
Example language (illustrative, to team): "Across four pictures, organisation was strongest when she had a free line to develop and weakest under open instruction. She described the last picture as 'the calmest'. This is a process observation, not a diagnostic test result."
Watch for: team members reading a single image as proof of pathology or of abuse. Correct this explicitly (see section 5).

4.8 Attending to formal structure in artwork

Purpose / when: whenever reviewing work, in assessment or in ongoing therapy. Ulman and Levy's research on judging psychopathology from paintings (their 1992 patient/non-patient study) concluded that structure may matter more than subject matter. [source: Gantt 2001 p. 124; ERIC ED408236 lists Ulman & Levy, "An Experimental Approach to the Judgement of Psychopathology from Paintings"]
Steps [synthesis]: note use of space, integration of parts, line quality, colour use, completeness, and energy. Compare across pictures and across sessions. Do not assign meanings to single symbols.
Watch for: pastels can make line quality hard to judge (Gantt 2001 p. 127, about FEATS rating). Interpret line features cautiously with soft media.

4.9 Art-as-therapy studio work (the "art" pole)

Purpose / when: ongoing sessions in which the healing comes from the artistic process itself and the work is valued for its psychological value. Suits clients for whom making brings order ("Therapy Is Not Enough" argues for art's own contribution to general-hospital psychiatry — title only verified; content inferred) [source: GWU history; ERIC ED408236; Ulman 1975 p. 13, as cited]
Steps [synthesis built on Ulman's principles]: (1) Offer good-quality materials and enough time. (2) Let the client choose subject and medium, or offer a simple starting point such as a warm-up or scribble. (3) Support craft: help with technical problems so the client can realise what they intend. (4) Keep verbal processing light and process-focused. (5) Store and respect finished work.
Example language (illustrative): "What would you like to work on today?" / "The colour's going muddy. Do you want to try letting that layer dry first?"
Watch for: sessions drifting into recreation with no therapeutic aim. Check against "both art and therapy". Signs it is working: longer absorption, more organised or more personally owned work, and better coping outside sessions.

4.10 Art within psychotherapy (the "nonverbal communication" pole)

Purpose / when: when art is used as "a means of nonverbal communication" within psychotherapy, so that the products help the person understand and work through emotional problems. [source: GWU history]
Steps [synthesis]: (1) Invite an image related to current concerns, or a free image. (2) Ask the client to describe it and their process. (3) Explore associations and feelings, led by the client. (4) Link these to the problems being worked on. (5) Remember Ulman's caution that insights often come from the process rather than from interpreting symbols (p. 22, as cited).
Example language (illustrative): "What was it like to make this?" / "If this picture could speak about what's been going on this week, what might it say?"
Watch for: intellectualising, and the client making pictures to please you. Switch toward the studio pole if talk replaces making.

4.11 Contemporary integrated UPAP (Tripp 2019)

Purpose / when: using the UPAP today. Tripp learned the procedure as Ulman's student in 1978. She argues that its psychoanalytic roots are often sidelined as dated, but that it stays relevant when combined with relational, somatic and trauma-informed approaches. The advantages she names are a sequence of images rather than one drawing, the capture of movement, a range of directives, and shared interpretation. Her article presents a contemporary case study of an expanded use of the protocol. Tripp directs the GW Art Therapy Clinic and is certified in EMDR and Sensorimotor Psychotherapy. [source: ERIC EJ1228909 and Taylor & Francis abstract of Tripp 2019; GWU Tally Tripp page. Case details beyond the abstract: uncertain]
Steps [synthesis]: these steps are the writer's way of applying the three lenses Tripp names. They are not her published steps. (1) Relational: treat the session as a collaboration and name the relationship ('we are looking together'). (2) Somatic: track breath, posture and arousal during the movement and scribble steps, and invite the client to notice body sensations. (3) Trauma-informed: give choices at every step (eyes open or closed, standing or seated), allow stopping, and ground the client before the review.
Example language (illustrative): "You can keep your eyes open or closed, whichever feels safer. What do you notice in your body right now?"
Watch for: changes that alter standardisation. Record every adaptation in the report.

5. Handling problems

The available sources give almost no troubleshooting guidance. Agell's emphasis on rapport and on the client's control is the only directly sourced item; everything else is [synthesis] built on Ulman's stated principles.

"I can't draw" / performance anxiety. Prevent it with the pre-assessment conversation (4.1, sourced). Then [synthesis] reframe the task as movement and exploration rather than skill, start with the warm-up or scribble, and never comment on talent. Illustrative: "This isn't about drawing well. It's about what happens when you move the chalk."
Refusal of a directive or of the whole UPAP. [synthesis] Respect it: Agell's aim was that "the power was in his hands". Ask what makes it hard, offer an adapted version (eyes open, seated, smaller paper), and record the refusal and the reason as data. Do not pressure the client.
Stuck or blank ("I see nothing in the scribble"). [synthesis] Have them turn the page, look from a distance, and add a few lines. Accept an abstract result. In ongoing work, move toward the studio pole and set simpler material tasks.
Overwhelm, frightening imagery or dissociation, especially with eyes closed or during scribbling. [synthesis] Stop the directive. Have the client open their eyes and orient (feet on floor, name objects in the room). Turn the picture face-down if they wish. Return to a structured, low-arousal task. Do the shared review only when they are settled. Screen beforehand: with active psychosis, recent trauma or dissociative presentations, offer eyes-open options as standard and consider shortening the series.
Physical problems in the movement step. [synthesis] Offer a seated or reduced-range version, stop at pain or dizziness, keep the space clear, and use non-slip footwear and flooring. Touch: do not move or guide a client's arms by hand. If physical demonstration help is ever offered, ask explicitly first, keep it to hand or forearm only, make opting out easy, and never touch the client sexually or near the genitals. Be aware of trauma and cultural norms around touch.
Non-adherence in ongoing work (missed sessions, refusing to make art). [synthesis] Explore the meaning with the client. Offer choice of medium. Let the client stay with talk briefly, but come back to making, because Ulman's definition requires both art and therapy.
Ruptures (feeling judged, "analysed", or that the pictures were used against them). [synthesis] Name it and own your part. Re-explain who sees the work and why. Return interpretive authority to the client, as in shared interpretation (Tripp 2019, abstract).
Over-interpretation by the team or the clinician. Validity limits: no published reliability, validity or normative studies of the UPAP are known [uncertain]. The 2019 revisit argues for its clinical value through a case study, not psychometric data (Tripp 2019, abstract). Gantt (2001) shows how hard it is to get inter-rater reliability for global art variables. Never present UPAP pictures as diagnostic evidence of a disorder or of abuse. Report them as process observations, integrated with other assessment data. [source: ERIC EJ1228909; Gantt 2001 pp. 125–127]
Disclosures of harm. [synthesis] If the client discloses abuse or risk while making or discussing art, follow your local safeguarding and adult-protection procedures and do a standard risk assessment for self-harm or suicide. The disclosure is what triggers action, not the content of the image.
Children and young people. Ulman wrote about art education for emotionally disturbed children (Ulman 1971, as cited in the Montana thesis), but the UPAP demonstrations are with adults or young adults. [synthesis] With children, get parental or carer consent and the child's own assent, explain limits of confidentiality in age-appropriate words, shorten the series and the movement step, follow mandatory-reporting duties, and agree with carers how artwork will be stored and shared. Do not use the UPAP's adult norms or interpretations for children [uncertain: no child norms were found].
Modality-specific: fidelity drift. [synthesis] The order of the four directives is published in summary (Steinhardt 2006), but the exact wording, the three movements, the paper size and the timing are [uncertain]. The main implementation risk is calling a home-made four-drawing session "the UPAP". Obtain Ulman (1975, pp. 361–386) or GWU-lineage training, and say in reports which version you used.
Modality-specific: "art or therapy?" drift. [synthesis] Review every few sessions which pole you are working at and why. If the work has become pure recreation, or talk with no art, re-contract.
Materials safety. [synthesis] Pastel and chalk dust: use non-toxic certified products, don't blow off dust, ventilate, and take care with asthma. Keep fixatives and solvents away from clients. Clean up after messy media.

Sources

Web sources:

Books and articles cited:

Ulman, E. (1961). Art therapy: Problems of definition. Bulletin of Art Therapy, 1(2), 10–20.
Ulman, E., & Dachinger, P. (Eds.) (1975). Art Therapy in Theory and Practice. New York: Schocken (reprinted 1996, Magnolia Street). It includes Ulman's "Art Therapy: Problems of Definition", "Therapy Is Not Enough" and "A New Use of Art in Psychiatric Diagnosis" (pp. 361–386), and Ulman & Levy's "An Experimental Approach to the Judgement of Psychopathology from Paintings".
Ulman, E. (1971). Art education for special groups: The emotionally disturbed. In L. C. Deighton (Ed.), The Encyclopedia of Education, Vol. 1.
Cane, F. (1951). The Artist in Each of Us (reprinted 1983).
Gantt, L. (1992). In memory of Elinor Ulman. Art Therapy, 9(1), 6–11.
Agell, G. (1992). Elinor Ulman (1910–1991). Art Therapy, 9(1), 12–13.
Tripp, T. (2019). More than an image: Revisiting the Ulman Personality Assessment Procedure. Art Therapy: Journal of the American Art Therapy Association, 36(3), 133–140. doi:10.1080/07421656.2019.1649546 [abstract via ERIC and the publisher]
Gantt, L. M. (2001). The Formal Elements Art Therapy Scale. Art Therapy, 18(1), 50–55.
Ulman, E. (1965). A new use of art in psychiatric diagnosis. Bulletin of Art Therapy [volume and pages: uncertain].
John, D. L. (2012). Drawing as self-expression with normally functioning adults: A 10-week technique (Expressive Therapies Dissertations, 38). Lesley University.
Steinhardt, L. (2006). The Eight Frame Colored Squiggle Technique. Art Therapy: Journal of the American Art Therapy Association, 23(3), 112–118.

[uncertain]: the primary UPAP chapter (Ulman 1975, pp. 361–386), Ulman (1965) and the Bulletin of Art Therapy / American Journal of Art Therapy archives are not publicly available. The order of the four directives and the use of colour on manila paper rest on Steinhardt's (2006) summary; the paper size, colour medium, full directive wording, the three movements and the timing are unconfirmed. The number of drawings differs across versions (four in Tripp 2019 and Steinhardt 2006; three in the 1976 film, per John 2012). Tripp (2019) is cited at abstract level only.

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