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Adina Silvestri
Apr 10, 2015

Art Therapy and Anxiety- Part deux

As counselors, engaging individuals suffering from anxiety can be a challenge. In my practice, almost 50% of individuals suffer from some form of anxiety. When talk therapy does not work, is it time to break out the Crayola crayon box? 

I am lucky in that my clients trust me just enough to allow their stick figures to come alive.  First, I ask if they are willing to “experiment” with me. There is usually a grin or a bemoaning expression (depending on the age of the client) but afterwards, the feedback is positive. It is essentially a giving up of power. Clients allow themselves to be free from judgment and enter a world wherein the only rule is to let go.

I recently had a couple that created art together. One comment that stuck with me was when one partner said, “I could have done this better on my own.” This, of course, led to deeper insight regarding the couple’s communication.

I have also used crayons and paper for the addictions population. What was once solely an intervention for young people is now an intervention for all people.  Crayons and paper is the method I recommended to a client with an eating disorder. Later on, she told me when she was in crisis, the first thing she thought of was coloring! Coloring helped to keep her mind off of food. Tracing outlines of body figures or using repetitive patterns found with Zen doodling helps clients relax and focus on the here and now.

Does this intervention work for everyone? No. But the outcomes have been very positive

The Art of Goal Setting

One technique I use for goal setting is asking a client to draw what makes him or her feel healthy.  This enables each individual to identify who he or she wants to be. They choose 3 words that describe that person. They choose 1 color and shape for each word. And they combine all 3 elements to create a drawing.  Sometimes, I will ask what miracle needs to occur in order for them to become the identified person.

The Art of Empowerment

One powerful art technique asks each individual what he or she is proud of, seeking a new level of personal empowerment. First, have the client draw a head shape. Then write any inspirational quote (spiritual or life changing) along the outline of the head, using a Sharpie to promote a feeling of permanence. Have the client write positive aspects about themselves on the inside of the head, and then have them use watercolor paints to emphasize the head shape. In my practice, some clients found this activity difficult. They have to write positive things about themselves and the inner critic will want to take over. Encourage them to start with positive things others say about them, and write those words and phrases on the outside of the head.

The Art of Relaxation

When individuals are told to paint bands of color in blue, purple, and green acrylic paint, this process relaxes the sympathetic nervous system by allowing an individual’s ocular membrane to move in a left-right fashion.

This modality not only relaxes us, it heals us. Art therapy with brain imaging allows us to pinpoint which areas of the brain are affected. It promotes EEG rhythms to increase alpha waves thus decreasing behavioral symptoms of anxiety.


Does anxiety ever go away? Like many practitioners, I constantly see patients wanting to be cured of this debilitating disorder. I wish I could say, “Yes!” Instead, I say, “You will never be 100% rid of it, but you will learn how to not let it ruin your life.” I work with individuals to diminish their anxiety and feel comfortable in it like how a pair of worn out blue jeans feel on one’s body. I believe the most powerful gift we as clinicians can give is to arm our clients with the tools necessary to help themselves. Art Therapy provides a relief, a visual tool for communication, a window into the imagination, and a motivation for making connections between one’s thoughts and feelings

One of my favorite authors, T.S. Eliot, once wrote, “Anxiety is the hand maiden to creativity.” As counselors, it’s time we embrace the idea. The more art that flows before us, the more valuable our assistance can truly be.


Lusebrink, V. B. (2004).   Art Therapy and the Brain:  An Attempt to Understand Processes of Expression in Therapy. Art Therapy Journal, Volume 21, Number 3, 125-135.

Adina Silvestri is a licensed professional counselor, researcher, and counselor educator who works with adults and children in her private practice, Life Cycles Counseling.It is her passion to work with individuals with addiction through counseling, research and advocacy efforts with the hope of raising awareness to the lack of gender specific treatment and recovery programs. Read more about her at 

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  1. 2 Sarah Deaver 19 Jun
    Hi Adina,

    I commend your use of art activities in counseling sessions in an effort to alleviate clients’ anxietyand am pleased that you have noticed positive outcomes in your clients.  However, your use of these art activities cannot ethically be called “art therapy.” As a board certified art therapist, for the sake of your clients and readers of this blog, I need to clarify that art therapy is a distinct mental health profession, not a modality that can be learned by non-art therapists in workshops or online.  While using art in counseling sessions for decreasing anxiety or distraction from overwhelming anxiety may seem relatively harmless, individuals attempting to use art therapy methods and techniques with clients without appropriate or adequate clinical training and appropriate master’s level education in art therapy may pose significant risk to the emotional stability of the individuals they are counseling.

    The American Art Therapy Association, the professional association for art therapists in the US, has established the educational standards for the 60+ credit art therapy master’s degree. Art therapy master’s level education requires courses in, for example, the psychology of creativity, human psychological development, symbolism and metaphor, group therapy, art therapy assessment, psycho-diagnostics, research methods, processes and materials of art therapy, and multicultural diversity competence.  In addition to coursework, graduates have completed over 700 hours of supervised direct art therapy services.  Some universities offer 30 credit post-mastersmaster’s degrees for persons in related fields who want to become bona fide art therapists.  For counselors who wish to integrate art activities in their practice, I urge you to visit the websites of the American Art Therapy Association ( and the Art Therapy Credentials Board ( for further information.  Please also consider speaking with an art therapist in your area about the ethical dimensions of non-art therapists introducing art into client sessions, and when to refer a client to an art therapist. Lastly, please read Hammond and Gantt’s excellent 1998 article on this topic, “Using Art in Counseling: Ethical Considerations” in the JCD, 76(3), 271-276".  

    Sarah Deaver, PhD, ATR-BC

  2. 1 Adina Silvestri 20 Jul
    Thank you for your interest in my posts. According to my licensing body-ACA Code of Ethics: A.1.a., A.2.a., A.4.a., C.2.a., C.3.a, C.4.a., C.4.b., and I.1.b. states art and creativity are techniques and tools and therefore individuals do not need to be licensed in art therapy to use them.
    Thanks again for your feedback!



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