Not every client can talk their way through a hard feeling, and that's where art-based activities earn their place in a session. Drawing, collage, and other creative exercises give clients a second language for emotions that words don't reach, especially with trauma histories or younger clients. Here are 15 activities to adapt into your practice, along with the scope-of-practice and documentation basics that come with using them.
Key Takeaways
Emerging, adjunctive evidence: Research supports expressive-arts approaches as a helpful addition to talk therapy, particularly for trauma and populations who struggle with verbal processing. The evidence base is still growing and isn't established as a first-line, stand-alone treatment.
Use as an adjunct, adapted to your setting: These activities work best folded into an existing treatment plan, matched to your modality, and adjusted for the client or group in front of you.
Know the scope line: "Art therapy" is a credentialed profession. If you're not a Registered Art Therapist, what you're offering is an art-based or expressive intervention, not art therapy proper.
What Art-Based Activities Offer in Therapy
Creative activities give clients a way to externalize feelings that are hard to name out loud. A drawing, a collage, or a piece of clay can hold a feeling steady long enough for a client to look at it, which is often the first step toward talking about it.
Here's the important distinction to hold onto: art therapy is a distinct, credentialed profession requiring graduate-level training and a credential from the Art Therapy Credentials Board (ATCB), such as the Registered Art Therapist (ATR) or Board Certified Registered Art Therapist (ATR-BC).
If you're a licensed counselor, social worker, psychologist, or psychiatric provider without that credential, the activities below are best described as art-based or expressive interventions, not art therapy. That's not a technicality—it protects you, your documentation, and your client's understanding of the service they're receiving. With that framing set, the activities below can be woven into sessions across modalities, from CBT to psychodynamic work to family therapy.
Activities for Emotional Expression and Regulation
These activities help clients name and regulate emotions they don't have words for yet.
Color-your-feelings mapping. The client colors a body outline or simple diagram using colors that match where and how they feel different emotions physically.
Emotion collage. Using magazine images or printed photos, the client builds a collage representing a feeling that's hard to describe in words alone.
Anger iceberg drawing. The client sketches an iceberg and labels the visible anger above the waterline versus the hidden emotions underneath. This pairs naturally with a deeper conversation using our anger iceberg framework.
Grounding through texture and color. The client works with textured materials or a color palette to shift attention into the present moment, which overlaps with the grounding techniques covered in our grounding techniques for therapists guide.
Safe place drawing. The client draws or paints a place—real or imagined—where they feel calm and secure, useful as a resource to return to across sessions.
Activities for Trauma and Stabilization
Trauma-focused art-based work calls for extra caution. These activities are meant for stabilization and expression, not trauma processing. Processing trauma content through art requires specialized training, and pushing a client toward reliving or narrating traumatic material without that training can do more harm than good. A systematic review of art therapy with traumatized refugee children found some benefit but noted the overall evidence base is still limited, which is a useful reminder to treat these activities as a supportive adjunct rather than a stand-alone trauma treatment.
Container drawing. The client draws a container—a box, jar, or vessel—and uses it to visually "hold" a difficult memory or feeling until they're ready to work with it further.
Body mapping. The client outlines their body and marks where tension, calm, or sensation shows up, supporting body awareness without requiring a verbal trauma narrative.
Resource collage. The client builds a collage of people, places, and strengths they can draw on when distress rises.
Sensory material work. Clay, sand, or textured fabric gives clients a grounding, tactile activity that regulates the nervous system without asking them to revisit traumatic content directly.
Activities for Children and Teens
Kids and teens often communicate more freely through art than through direct conversation, which makes these activities especially useful in that age range. For more non-art options to round out a session, our 25 therapy activities for teens guide pairs well with the ideas below.
Comic-strip narrative. The client tells a recent experience as a comic strip, which lowers the pressure of direct disclosure.
Worry monster drawing. Younger clients draw their worry as a monster or character, then describe what it does and how it might be "tamed."
Sand-tray-inspired drawing. Without a full sand tray setup, clients can arrange drawn or cut-out figures on paper to represent relationships or a recent conflict.
Family kinetic drawing. The client draws their family doing an activity together. Treat any interpretation cautiously and use it as a conversation starter, not a diagnostic tool.
Activities for Groups and Couples
Shared creative work builds connection and gives couples or group members a low-pressure way to communicate.
Collaborative mural. Group members contribute to one shared canvas or large sheet of paper, then discuss what they notice about how the piece came together.
Bridge drawing. Couples draw a bridge representing where their relationship is now and where they'd like it to go, then talk through what's missing in the middle.
Documenting Expressive-Arts Interventions
Documentation for these interventions should capture more than "client completed a drawing activity." Note the specific activity, the clinical rationale, the client's observable response, and how it connects to the treatment plan. A note like "used color to represent anger, then identified underlying sadness during discussion" carries far more clinical value than a checkbox for "art activity."
This is where Berries AI can lighten the load. Berries AI listens during the session and drafts documentation that reflects what actually happened clinically—including expressive-arts interventions—so you're not reconstructing details from memory after a full caseload. Try it with a 20-session free trial to see how it handles documentation for sessions that include creative, non-verbal work.
FAQs
Do I need to be a certified art therapist to use art activities?
No, but you do need to describe what you're offering accurately. According to the Art Therapy Credentials Board, becoming a Registered Art Therapist (ATR) requires graduate-level art therapy education and supervised post-graduate clinical experience. The Board Certified Registered Art Therapist (ATR-BC) credential is a further distinction, awarded to ATRs who pass a national board certification exam. Clinicians without either credential can still use creative activities in session, but should call them art-based or expressive interventions rather than art therapy.
Is art therapy evidence-based?
The evidence is promising but still developing. A 2026 systematic review and meta-analysis in the Journal of Psychiatric and Mental Health Nursing describes art therapy as a promising adjunctive intervention for reducing depressive symptoms, not an established first-line treatment. A separate review of art psychotherapy in children found mostly small, quasi-experimental studies with few randomized controlled trials, though it did find some benefit for children with trauma histories or PTSD symptoms. The research base overall supports these as an adjunct, not a stand-alone treatment.
What art therapy activities help with anxiety?
The research specific to anxiety is thinner than for depression or trauma. A systematic review of controlled trials on art therapy for anxiety in adults found only three studies that met inclusion criteria out of hundreds screened, which limits how much can be concluded. In practice, grounding-focused activities such as texture work, color-based exercises, or safe place drawing give an anxious client something concrete to focus on, but it's worth treating these as a supportive tool rather than a researched anxiety protocol.
Can art therapy activities be done in telehealth?
Yes, with some adjustment. Clients can draw on their own paper and hold work up to the camera, use a shared digital whiteboard, or complete an activity between sessions and discuss it on the call. Check materials and privacy at the client's location beforehand.
What materials do I need?
Most activities only need basic supplies: paper, colored pencils or markers, magazines or printed images for collage, and simple modeling clay or textured fabric for sensory work. You don't need specialized art therapy materials to use these as adjunctive interventions.
This article is for informational purposes only and is not a substitute for professional clinical judgment, supervision, or continuing education. Therapists should consult current clinical guidelines and use their professional discretion when applying this information to individual client cases.
Sources
Art Therapy Credentials Board. (n.d.). Registered Art Therapist (ATR) Process. https://atcb.org/registered-art-therapist-lp/registered-art-therapist-atr/
Art Therapy Credentials Board. (n.d.). 2026 Registration Standards for ATR-P. https://atcb.org/registered-art-therapist-lp/2026-registration-standards-for-atr-p/
Qiao, Y., et al. (2026). The Effectiveness of Art Therapy on Adults With Depression: A Systematic Review and Meta-Analysis. Journal of Psychiatric and Mental Health Nursing. https://onlinelibrary.wiley.com/doi/10.1111/jpm.70127
National Center for Biotechnology Information. (n.d.). A Systematic Review of Empirical Evidence on Art Therapy With Traumatized Refugee Children and Youth. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9189733/
National Center for Biotechnology Information. (n.d.). Review: Systematic Review of Effectiveness of Art Psychotherapy in Children With Mental Health Disorders. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9135848/
Abbing, A., Ponstein, A., van Hooren, S., de Sonneville, L., Swaab, H., & Baars, E. (2018). The Effectiveness of Art Therapy for Anxiety in Adults: A Systematic Review of Randomised and Non-Randomised Controlled Trials. PLOS ONE. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6296656/
National Institute of Mental Health. (n.d.). Psychotherapies. https://www.nimh.nih.gov/health/topics/psychotherapies