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Welcome to Part One of my Literature review into mental health, art therapy, and personal storytelling. This paper is called Art therapy in Mental Health: A Systematic Review of Approaches and Practices. It’s a 2015 paper by Theresa Van Lith and a great place to begin. Below are excerpts from the paper that may prove useful in my own work and some notes and definitions. Information of most importance is italiced for future reference.

Please note this is largely not my own work and merely part of a data collection exercise.


This systematic review aims to develop a bridge between what art therapists know and what they do in supporting those with mental health issues. Research undertaken between 1994 and 2014 was examined to ascertain the art therapy approaches applied when working with people who have mental health issues, as well as to identify how art therapy approaches were used within the clinical mental health system.

Thirty articles were identified that demonstrated an art therapy approach to a particular mental health issue. The search strategy resulted in articles being grouped into four diagnostic terms: depression, borderline personality disorder, schizophrenia, and post-traumatic stress disorder. A synthesis of the identified articles resulted in the identification of research areas that need advancement.

Future studies could incorporate more details on the art therapy approaches used to enhance transferability of practice. Moreover, adding art therapists’ critique about the art therapy approach from their applied perspective, would assist in the development of evidence-based practice that is not just current, but feasible, too.

Finally, the client voice needs to be incorporated in future studies to address questions of the relationship  between client expectations and the perceived success of art therapy. 

Art Therapy Orientations


Also known as psychodynamic psychology, in its broadest sense, is an approach to psychology that emphasizes systematic study of the psychological forces that underlie human behavior, feelings, and emotions and how they might relate to early experience.


(Phenomenological, gestalt, person centered). Humanism is a philosophical and ethical stance that emphasizes the value and agency of human beings, individually and collectively, and generally prefers critical thinking and evidence over acceptance of dogma or superstition. The meaning of the term humanism has fluctuated according to the successive intellectual movements which have identified with it.


(Behavioral, cognitive behavioral, developmental). Psychoeducation is an evidence-based therapeutic intervention for patients and their loved ones that provides information and support to better understand and cope with illness.


(Family and group therapy). Relating to a system, as opposed to an individual part. Holistic, looking at connections and interrelations.

(Jones, 2005; Rubin,2001, 2005)

Those using an observant stance would suggest their role is to be a witness to the experience of the inherent process of knowing the self (Allen, 2008). Those valuing a more interventionist engagement would suggest their role is to elicit meaning making by engendering new perspectives(Karkou & Sanderson, 2006), or to form a supportive alliance, which nurtures trust and safety (McNiff, 2004; Spaniol, 2000). Finally, those valuing a more intentional direction would see their role as evoking multiple sensations of human experiences, including the sensory-motor, perceptual, cognitive, emotional, social and spiritual aspects of a person (Bruscia, 1988).

Systematic Review: AT Methodologies (Depression)

The anthroposophic therapy approach (AT)

In the study by Hamre et al. (2006), AT included participation in creative activities, movement exercises, rhythmical massage, counselling if necessary, and medication. Anthroposophic art therapy (AAT) was defined as engagement with various art mediums including clay modeling, speech exercises, painting or drawing (Hamre et al., 2006). 

Anthroposophy is a philosophy founded by the 19th century esotericist Rudolf Steiner that postulates the existence of an objective, intellectually comprehensible spiritual world, accessible to human experience. Followers of anthroposophy aim to develop mental faculties of spiritual discovery through a mode of thought independent of sensory experience


The AAT component of the study was found to show a level of improvement in 91% of participants from baseline to 12-month follow up. (Hamre et al., 2006). 

The Art Psychodynamic Method

The art psychodynamic method used in the study by Thymeet al. (2007) was based on the model by Schaverien (1995) and emphasized the transference relationship between the patient and artwork.

Findings showed that the Psychodynamic verbal and art therapy approaches had similar results such as improvement in reduced stress levels and decreased number of depressive symptoms, and these were maintained at 3-month follow-up (Thyme et al., 2007) 

Therapeutic Factors

Blomdahl et al.(2013) summarized 16 articles and found eight common therapeutic factors that art therapy was found to address. These were:

Self-exploration (the examination and analysis of one’s own unrealized spiritual or intellectual capacities)


Understanding and explanation

Symbolic thinking


Sensory stimulation

Direct and Indirect

Blomdahl and colleagues (2013) indicated two categories that the therapeutic approaches could be divided into: direct and indirect.

The direct approach addressed current problems with the intention that the “clients are aware that the exercise relates to them, so may consciously influence the content of the session” (Blomdahl et al.,2013, p. 329).

On the other hand, the indirect approach concentrated on the clients’ internal world with the intention of addressing “problems slowly and perhaps more playfully” (Blomdahl et al.,2013, p. 329).