Doing Art Therapy Via Telehealth
To help support art therapists during this time, we wanted to provide a list of some ideas on doing art therapy via telehealth. When doing art therapy there are many options for doing art in session and outside of a session, this compiled list is to help you navigate using art therapy via telehealth options. However, if you are still practicing in person, here is an article discussing best practices using art supplies: Use Art Supplies Hygienically
Art Therapy alternatives when doing art therapy in session
Art Therapy Interventions
Experiences with Telehealth and Art Therapy
Share Your Experience with Telehealth
To help during this time, I would like to put together a compilation of art therapists sharing their experiences using telehealth. Many therapists have recently added telehealth or switched completely to telehealth at their facility or private practice. As a result, many have had to navigate new and creative ways to incorporate art therapy in therapeutic practices via telehealth. Not to mention, art therapists have noticed new ways art can help clients navigate how they are being affected by COVID19.
This section showcases a few experiences submitted from professional and practicing art therapists:
Claudia Trevithick, ATR-BC of Creative Therapy shared a successful experience and some of the aspects of her practice through telehealth:
“Working with a teen who denied any anxiety re: corona. Had her draw different feelings and she came to the realization that she doesn't go outside because it 'smells like corona and death'...She agreed with wonder that she WAS anxious.”
How has your practice changed?
“I comment more than usual and specifically as I watch them artmaking. "That yellow looks so different from the black". "I see you are thinking about what to do next. Is that right?"
What are some of the therapeutic practices you have tried?
Telehealth Art Therapy With Professional Artists
I work as an Art Therapist at an outpatient HIV clinic in Denver. Since moving to telehealth-only therapy appointments I’ve seen most clients have significantly reduced access to the art-making part of art therapy for various reasons. However, I wanted to share one case where virtual art therapy has benefited a client who is a prolific, large-scale, oil painter. Since the pandemic, I have had the chance to meet with him for 2 virtual appointments in his studio and help him explore in-progress oil paintings that he has previously been unable to work on in sessions. Prior to this, he had been mostly uninterested in working with the art materials I could provide in the clinic. He occasionally brought phone pictures of his paintings into my office, though it seems we are now able to go deeper into his process when he is in the same room with his actual piece. We are also able to look at and compare several pieces at once, which was difficult to do before. He has said that doing art therapy in this way has helped him have a better understanding of how he can gain information about his internal process from his artworks and painting process.
Again, when it comes to most of my caseload, virtual art therapy has been a big challenge for myself and clients. My experience with this one client though does make me think that Art Therapists could have a new opportunity in providing telehealth to practicing artists (if this is not already happening). Especially those who cannot bring their preferred materials, art process, and artworks into the Art Therapist’s office for logistical or safety reasons.”
Andrea Russell, MA, LPCC shared her experience and answered some questions from members about telehealth:
What do you suggest for working with children whose families have limited art supplies and $ to buy them?
“It doesn't have to be fancy or artist quality. Walmart has little packs of crayons, colored pencils, markers, and watercolors for $1 each (the dollar store too). Goodwill and The Arc generally have assembled bags of art materials as well. Not to mention there's nothing wrong with asking to borrow materials from someone who might not be using them at the moment. Lending and borrowing things with someone can be a way for people to grow closer (at this time though, due to Covid-19 I'd just be sure to clean the materials before you give them to the kids). It's also ok for kids to understand that art materials cost money... this can start a conversation about why it's important to take care of our things as well as share what we have with each other so that materials we have can make the most amount of impact (each child does not need their own box of markers, watercolors, glue, scissors, and pencils. They can all share one).
Also, try to always look at everything around you as a possible art material. This can provide you with a lot of free materials. Magazine images and words can be used for collages or multi-media pieces. Food wrappers always have bright pretty colors and designs and can be cut apart and used to create something new. Old t-shirts and sheets with holes or stains can be cut apart as well. Paper bags from the grocery store can become the paper you use for making art with acrylic paint, collage images, colored pencils, and crayons, etc. Ribbons from store bags can be cut off and used again for something new. Save tissue paper... always. Boxes and containers you would normally recycle or throw away can always be reused. Newspapers can be shredded to make nesting material or made into a sculpture by folding and gluing.
Lastly, if you are struggling to figure out how to reuse something, a good thing to do is just ask your child. Children have amazing imaginations and will likely be able to come up with a way to make something new out of anything even if we as adults can't see it yet. We don't have to come up with all of the ideas for them. Allowing them to say, "let's make a duck out of this milk carton" is a way for them to practice creativity and learn agency, independence, and confidence.”
How do art therapists suggest transitioning from school to summer, with the isolation and social distancing, while still keeping up professionalism and self-care?
“Make art. Take a deep breath and try to accept that things are different and difficult right now, and that's ok.”
How have you incorporated art therapy via telehealth?
“For my art therapy groups at community corrections I have made a simple little bag for each client that they will use throughout the pandemic and not share it with anyone else. Each bag has a couple pieces of paper and just a few art materials (all of which can be sanitized so germs are not spreading by living on surfaces for days or clients sharing materials). The materials include a few markers, a safety scissors, and a glue stick. I also put a packet of handouts and discussion questions in the bag that the clients will need for the next few weeks so clients can also write about their experience each session and have written instructions in front of them. When I'm doing a tele-health group session I just direct the clients to pull out whichever handout they need with the discussion questions and expressive art activity. Obviously I'm not able to roll in with a whole cart of a variety of art materials like I normally would. However, I have found that the clients really don't care. They have just voiced being thankful to have group or use art materials at all. Also, even though the materials are limited the clients have voiced that they could see there was effort put into setting them up with a limited amount for each individual in a safe way, which helps them to know that they are cared for. I usually play music for the clients during art making time when I'm doing in person groups (of songs they request), so I've continued to do that during tele-health groups as well. I just use my phone and play it on my end, but they can still hear it. I feel like it helps the group relax and get into a quiet space where they can make art and reflect. I also think doing this provides a sense of comfort and normalcy that we are continuing to do some of the same things we have always done despite many other things being different.
What is your overall experience with art therapy and telehealth? (limitations, and benefits)
“Limitations I've run into mostly include poor WiFi connections at facilities.”
What has helped you in doing art therapy via telehealth?
“Remembering that it's ok if it isn't perfect... no one else is expecting this, it's just a stupid thing that I put on myself that gets in the way.”
What art interventions have been successful via telehealth?
“At the community corrections I run a Seeking Safety group which addresses healing from trauma and overcoming addiction. At this particular location I am able to prepare materials they will use during the tele-health session. I did a group session recently about "Control" where I provided 2 magazine images to each client in their individual art bags and I asked them not to trade images with anyone. Then I asked the clients to "make a piece of art" (anything they wanted) "with the request that they use the images provided." Afterward we spoke about how this experience created a situation where the clients were not in control (they did not get to pick the images provided). However, they did have control of their reactions to the situation. We then discussed some of the different client reactions (being super flexible and going with the flow, complaining briefly, complaining a lot, walking away to take a break, choosing to use the back side of an image rather than another side they did not like, asking for help for peers, asking for help from the therapist, etc.). Then we talked about how each client's response might show up in their own lives when they are faced with feeling out of control. We spoke about how a sense of control or loss of control might interact with the use of substances or other destructive coping skills. We also spoke about how their sense of control is coming up for them now during the pandemic where there are even more rules and regulations than normal (which is A LOT in community corrections), and how they can care for themselves at this time (what do they have control over). I suppose if you were doing this group and were not able to prepare materials for people you could give each client a few words or names of items and ask them to include it somehow in an art piece, or you could email pictures for them to either print out or just use as inspiration. I was amazed (but not at all surprised) with how creative clients were able to be in making art with two images of someone else's choosing that were completely unrelated and how they were able to instinctively relate the images to their own lives and current experience without me stating that in the instructions at all.”
Answering Questions About Telehealth
If you would like some training about doing telehealth at home here is a resource: An In-Depth Look Into Using Telehealth in Therapy - Simons Therapy. This video is 2 hours and covers APA guidelines for doing telehealth. There is training on PESI, but it is long and perhaps more in-depth than currently needed.
Here are a few questions about doing video sessions with telehealth.
Q: What should I have in the background when I do video sessions? It is ok to have my artwork up?
A: Neutral color backgrounds such as white, tan, gray, or blue are best. In terms of artwork, you may need to check in with yourself. Would you be ok if a client asked you about the artwork? This is a possibility when doing video sessions with someone. If the artwork is too personal and you wouldn’t like questions, it may be best to take the artwork down or cover it up. Make sure artwork is appropriate if you are ok with leaving it up. Some video conferencing programs do allow you to use digital backgrounds, if you prefer.
Q: How do I help clients orient to the space when doing telehealth?
A: Talk to them about how telehealth sessions are different in terms of disclosure, interacting, what to expect, etc. Show them the space you are working in and if you have animals let them know so they are familiar with the sounds, etc. If you are working in your bedroom, see if you can get a partition or sheet to make a “wall” if you don’t want clients to see your bedroom. Also, dress completely for the sessions, do not wear pajamas.
Q: My client is nervous about doing video sessions, what do I do?
A: See if the client is willing to do sessions via phone. Move slowly and when the client is ready you may be able to segway to video.
Q: What are some HIPPA compliant platforms?
A: VSee, DoxyMe, Simple Practice, and the paid HIPPA compliant version of ZOOM are some of the options for HIPPA compliant platforms.
Art Therapy alternatives when doing art therapy in session
- You can assign art therapy interventions as “homework” and ask if the clients are able and willing to send pictures or scanned images of their artwork prior to the session. Use the session to process the work.
- If using video platforms like Zoom check to see if there is a white board option for the client to be able to draw on the screen.
- Using the simple paint program on the computer to create art.
- Talk with your client about the best ways to show art and lighting in a room when doing art in session.
- Create art on sticky notes, they are small enough to show even in bad lighting.
- Have clients use the share screen option to share photos, images, or artwork that they have uploaded on their computer.
- If the client has space and created a larger art piece, see if there is a way to put up artwork on a blank wall behind them. They may be able to position a camera if working on a wall or easel.
- If available to the client, doing art on a white board or chalkboard.
Art Therapy Interventions
- Reach out to a friend, family member, or other support person through video. Trace that person’s hand on the screen.
- Do visual meditations with your client like “Clearing the space” by Rappaport.
- Create positive affirmations on sticky notes and place them where you will read them everyday.
- Create a paper gratitude quilt of 3” x 3” pieces of paper, can be any kind of paper.
- Draw or paint using lines, shapes, or colors to music.
- Use Powerpoint or google slides to create a collage.
- Use Powerpower or google slides to create a digital narrative, timeline, storyboard, digital comic, etc.
- Paint with water on the driveway/sidewalk or color paper. If clients don’t have paint brushes, they may be able to use towels, Q tips, sticks, leaves, feather, yarn, or other found objects.
- Make a short 1 minute video of a major theme: identity, self-care, coping, autobiography, etc.
- Create a music playlist to help you relax. Start with how you are currently feeling (i.e. angry, sad, anxious) and choose songs relating to that then gradually add songs to that make you feel more happy or calm.
- Print out/look up lyrics to a song the client likes and another that the client doesn’t like, cut up/mix up the words, have the client create poems from the lyrics. Can create an image based on the poems they create. Can do as many as they’d like but would have to use the remaining words.
- Chalk art in backyards or on driveway/sidewalk if the client is ok with it.
- Grab a random book, open to a random page, read a random paragraph. Create art or process how this can relate to the client.
Experiences with Telehealth and Art Therapy
Share Your Experience with Telehealth
To help during this time, I would like to put together a compilation of art therapists sharing their experiences using telehealth. Many therapists have recently added telehealth or switched completely to telehealth at their facility or private practice. As a result, many have had to navigate new and creative ways to incorporate art therapy in therapeutic practices via telehealth. Not to mention, art therapists have noticed new ways art can help clients navigate how they are being affected by COVID19.
This section showcases a few experiences submitted from professional and practicing art therapists:
Claudia Trevithick, ATR-BC of Creative Therapy shared a successful experience and some of the aspects of her practice through telehealth:
“Working with a teen who denied any anxiety re: corona. Had her draw different feelings and she came to the realization that she doesn't go outside because it 'smells like corona and death'...She agreed with wonder that she WAS anxious.”
How has your practice changed?
“I comment more than usual and specifically as I watch them artmaking. "That yellow looks so different from the black". "I see you are thinking about what to do next. Is that right?"
What are some of the therapeutic practices you have tried?
- asking clients to be sure to have paper and art supplies at the DESK or TABLE. (not in bed)
- I ask clients to order Sakura oil pastels if they have no crayons. If they can.
- literally show me your room - develops pride and fosters relationship with therapist
- Mandalas
- look for magazine photos between sessions. That may not be an option for many.
- How it feels inside the home
- kinetic family drawing
- when I first felt this way
- hopes for the future
- how it feels to walk outside (or choose not to)
Telehealth Art Therapy With Professional Artists
I work as an Art Therapist at an outpatient HIV clinic in Denver. Since moving to telehealth-only therapy appointments I’ve seen most clients have significantly reduced access to the art-making part of art therapy for various reasons. However, I wanted to share one case where virtual art therapy has benefited a client who is a prolific, large-scale, oil painter. Since the pandemic, I have had the chance to meet with him for 2 virtual appointments in his studio and help him explore in-progress oil paintings that he has previously been unable to work on in sessions. Prior to this, he had been mostly uninterested in working with the art materials I could provide in the clinic. He occasionally brought phone pictures of his paintings into my office, though it seems we are now able to go deeper into his process when he is in the same room with his actual piece. We are also able to look at and compare several pieces at once, which was difficult to do before. He has said that doing art therapy in this way has helped him have a better understanding of how he can gain information about his internal process from his artworks and painting process.
Again, when it comes to most of my caseload, virtual art therapy has been a big challenge for myself and clients. My experience with this one client though does make me think that Art Therapists could have a new opportunity in providing telehealth to practicing artists (if this is not already happening). Especially those who cannot bring their preferred materials, art process, and artworks into the Art Therapist’s office for logistical or safety reasons.”
Andrea Russell, MA, LPCC shared her experience and answered some questions from members about telehealth:
What do you suggest for working with children whose families have limited art supplies and $ to buy them?
“It doesn't have to be fancy or artist quality. Walmart has little packs of crayons, colored pencils, markers, and watercolors for $1 each (the dollar store too). Goodwill and The Arc generally have assembled bags of art materials as well. Not to mention there's nothing wrong with asking to borrow materials from someone who might not be using them at the moment. Lending and borrowing things with someone can be a way for people to grow closer (at this time though, due to Covid-19 I'd just be sure to clean the materials before you give them to the kids). It's also ok for kids to understand that art materials cost money... this can start a conversation about why it's important to take care of our things as well as share what we have with each other so that materials we have can make the most amount of impact (each child does not need their own box of markers, watercolors, glue, scissors, and pencils. They can all share one).
Also, try to always look at everything around you as a possible art material. This can provide you with a lot of free materials. Magazine images and words can be used for collages or multi-media pieces. Food wrappers always have bright pretty colors and designs and can be cut apart and used to create something new. Old t-shirts and sheets with holes or stains can be cut apart as well. Paper bags from the grocery store can become the paper you use for making art with acrylic paint, collage images, colored pencils, and crayons, etc. Ribbons from store bags can be cut off and used again for something new. Save tissue paper... always. Boxes and containers you would normally recycle or throw away can always be reused. Newspapers can be shredded to make nesting material or made into a sculpture by folding and gluing.
Lastly, if you are struggling to figure out how to reuse something, a good thing to do is just ask your child. Children have amazing imaginations and will likely be able to come up with a way to make something new out of anything even if we as adults can't see it yet. We don't have to come up with all of the ideas for them. Allowing them to say, "let's make a duck out of this milk carton" is a way for them to practice creativity and learn agency, independence, and confidence.”
How do art therapists suggest transitioning from school to summer, with the isolation and social distancing, while still keeping up professionalism and self-care?
“Make art. Take a deep breath and try to accept that things are different and difficult right now, and that's ok.”
How have you incorporated art therapy via telehealth?
“For my art therapy groups at community corrections I have made a simple little bag for each client that they will use throughout the pandemic and not share it with anyone else. Each bag has a couple pieces of paper and just a few art materials (all of which can be sanitized so germs are not spreading by living on surfaces for days or clients sharing materials). The materials include a few markers, a safety scissors, and a glue stick. I also put a packet of handouts and discussion questions in the bag that the clients will need for the next few weeks so clients can also write about their experience each session and have written instructions in front of them. When I'm doing a tele-health group session I just direct the clients to pull out whichever handout they need with the discussion questions and expressive art activity. Obviously I'm not able to roll in with a whole cart of a variety of art materials like I normally would. However, I have found that the clients really don't care. They have just voiced being thankful to have group or use art materials at all. Also, even though the materials are limited the clients have voiced that they could see there was effort put into setting them up with a limited amount for each individual in a safe way, which helps them to know that they are cared for. I usually play music for the clients during art making time when I'm doing in person groups (of songs they request), so I've continued to do that during tele-health groups as well. I just use my phone and play it on my end, but they can still hear it. I feel like it helps the group relax and get into a quiet space where they can make art and reflect. I also think doing this provides a sense of comfort and normalcy that we are continuing to do some of the same things we have always done despite many other things being different.
What is your overall experience with art therapy and telehealth? (limitations, and benefits)
“Limitations I've run into mostly include poor WiFi connections at facilities.”
What has helped you in doing art therapy via telehealth?
“Remembering that it's ok if it isn't perfect... no one else is expecting this, it's just a stupid thing that I put on myself that gets in the way.”
What art interventions have been successful via telehealth?
“At the community corrections I run a Seeking Safety group which addresses healing from trauma and overcoming addiction. At this particular location I am able to prepare materials they will use during the tele-health session. I did a group session recently about "Control" where I provided 2 magazine images to each client in their individual art bags and I asked them not to trade images with anyone. Then I asked the clients to "make a piece of art" (anything they wanted) "with the request that they use the images provided." Afterward we spoke about how this experience created a situation where the clients were not in control (they did not get to pick the images provided). However, they did have control of their reactions to the situation. We then discussed some of the different client reactions (being super flexible and going with the flow, complaining briefly, complaining a lot, walking away to take a break, choosing to use the back side of an image rather than another side they did not like, asking for help for peers, asking for help from the therapist, etc.). Then we talked about how each client's response might show up in their own lives when they are faced with feeling out of control. We spoke about how a sense of control or loss of control might interact with the use of substances or other destructive coping skills. We also spoke about how their sense of control is coming up for them now during the pandemic where there are even more rules and regulations than normal (which is A LOT in community corrections), and how they can care for themselves at this time (what do they have control over). I suppose if you were doing this group and were not able to prepare materials for people you could give each client a few words or names of items and ask them to include it somehow in an art piece, or you could email pictures for them to either print out or just use as inspiration. I was amazed (but not at all surprised) with how creative clients were able to be in making art with two images of someone else's choosing that were completely unrelated and how they were able to instinctively relate the images to their own lives and current experience without me stating that in the instructions at all.”
Answering Questions About Telehealth
If you would like some training about doing telehealth at home here is a resource: An In-Depth Look Into Using Telehealth in Therapy - Simons Therapy. This video is 2 hours and covers APA guidelines for doing telehealth. There is training on PESI, but it is long and perhaps more in-depth than currently needed.
Here are a few questions about doing video sessions with telehealth.
Q: What should I have in the background when I do video sessions? It is ok to have my artwork up?
A: Neutral color backgrounds such as white, tan, gray, or blue are best. In terms of artwork, you may need to check in with yourself. Would you be ok if a client asked you about the artwork? This is a possibility when doing video sessions with someone. If the artwork is too personal and you wouldn’t like questions, it may be best to take the artwork down or cover it up. Make sure artwork is appropriate if you are ok with leaving it up. Some video conferencing programs do allow you to use digital backgrounds, if you prefer.
Q: How do I help clients orient to the space when doing telehealth?
A: Talk to them about how telehealth sessions are different in terms of disclosure, interacting, what to expect, etc. Show them the space you are working in and if you have animals let them know so they are familiar with the sounds, etc. If you are working in your bedroom, see if you can get a partition or sheet to make a “wall” if you don’t want clients to see your bedroom. Also, dress completely for the sessions, do not wear pajamas.
Q: My client is nervous about doing video sessions, what do I do?
A: See if the client is willing to do sessions via phone. Move slowly and when the client is ready you may be able to segway to video.
Q: What are some HIPPA compliant platforms?
A: VSee, DoxyMe, Simple Practice, and the paid HIPPA compliant version of ZOOM are some of the options for HIPPA compliant platforms.
