Clients’ perspectives and reflections on change factors in art therapy

Background: Recent studies have highlighted the importance of examining clients’ perspectives on factors of change in art therapy to gain a deeper understanding of the therapeutic process. Objectives: To ascertain the factors influencing the contribution of art therapy from the clients’ viewpoint. Method: Fifty-one adult clients took part in semi-structured interviews for this qualitative study. They were asked to reflect on moments in art therapy when they experienced change. A thematic analysis was used to analyze the data. Results: The analysis identified two main themes related to change factors involving the therapist–client relationship and engagement with art and artmaking. The first theme, called ‘relational factors’, included two categories: transformative connections, which highlight the therapist’s role in shaping clients’ self-perception through trust, empathy, and conflict resolution, and shared observation and verbal analysis, referring to cognitive and emotional insights gained through reflecting on artwork. The second theme, called ‘art engagement’, also includes two categories. The first category focuses on processing trauma through sensory involvement, emphasising the symbolic and embodied aspects of creative work. The second category concentrates on art as a calming and self-regulating experience, highlighting the relaxing and emotionally balancing qualities of artistic activity. Conclusion: The findings highlight a dynamic system comprising two key processes: the therapeutic relationship and embodied, kinesthetic, creative artmaking. They emphasise the importance of the body–mind connection in art therapy, which develops during the creative process. Implications for practice: The findings underscore the impact of symbolic and embodied/kinesthetic cognitive-emotional regulating processes of art for clients’ development. Plain-language summary: This study explored how clients experience changes during art therapy. Fifty-two adult clients were interviewed about moments in therapy when they felt something changed. The analysis identified two key elements that drive this change: the therapist-client relationship and the artmaking process. The therapeutic bond was essential to building trust, empathy, and the ability to work through conflicts. Artmaking allowed the clients to access and process emotional content, primarily through observing their artwork, using the art materials to work through trauma, and experiencing art as a calming and regulating activity. Together, the clients felt that these connected processes supported emotional growth and highlighted the body–mind benefits of art therapy. These findings suggest that focusing on both the relational and the creative aspects of art therapy can increase the therapeutic impact.