ATCBE Study Materials

This resource I created (with the help of AI creating the tables) helped me prepare for the exam. This document is not a comprehensive guide of all you need to know but was helpful for me to see the categories of test content in table format. This document is in no order.

What I used to study:

605 Quizlet flash cards (found online): https://quizlet.com/884921411/atcbe-exam-flash-cards/

Another set of flashcards I found useful: https://quizlet.com/320200795/atcb-exam-flash-cards/?funnelUUID=53f870d5-a81a-4032-87db-9c0d2d5b8fba

Know Code governing Standards of Practice, Eligibility for and Regulation of Credentials, and Disciplinary Procedures: https://atcb.org/ethics-appeals-lp/code-of-ethics-conduct-and-disciplinary-procedures/

“Red Book” Study Guide (I purchased) by Laura Seftel and Barbara Faith Cooper

I can’t find a link online to share, I think they stopped making it.

Things I wish I had studied more:

Family art therapy assessments, Key concepts in research: reliability, validity, qualitative study, quantitative study, double blind, analyzing results, art based research, steps in a survey project, designing the questionnaire, ethnographic research.

AT assessments: Paper color, paper sizes, and media and the amount of media (e.g. 8 pack of markers) needed for the standardized assessments.

Psychoanalytic Approach
Defense mechanisms of the Ego

-automatic, unconscious strategies for reducing anxiety
-avoidance, denial, disassociation, Displacement, fantasy, identification, identification
with the aggressor, intellectualization, introjection, isolation of affect, projection,
rationalization, reaction formation, regression, repression, symbolism, undoing

🎨 DW WINNICOTT & OBJECT RELATIONS — What You Need to Know

🔑 Key Concepts:

Concept	Meaning
Holding environment	A psychological space of safety and emotional containment, like a “good enough” caregiver provides. Art therapy sessions can become a holding environment.
Transitional objects	Objects (like a blanket or toy) that help a child move from dependence to independence — in art therapy, this can be transitional images or materials.
True self vs. False self	The “true self” is authentic; the “false self” is a defensive adaptation. Art can help access and express the true self.
Play as healing	Creative play = essential for emotional development. Art = a symbolic form of play.

🧠 Why This Might Show Up on the Exam:

You may be asked which theoretical model focuses on transitional objects, holding environments, or self-development in relationships.
Or you may need to match a directive or response to a theory.

🔁 Back to Your Study Question:

❓ “Do I need to know who developed the theories?”
✅ Just enough to connect the theory to clinical application.
🚫 Don’t memorize dates or obscure names.

💡 Memorize These Pairs (High-Yield):

Theorist	Theory	Key Concept
Naumburg	Art Psychotherapy	Art = symbolic communication of the unconscious
Kramer	Art as Therapy	Artmaking itself is healing
Winnicott	Object Relations	Holding environment, transitional objects
Freud	Psychoanalysis	Unconscious drives, free association
Jung	Analytical psychology	Archetypes, mandalas, individuation
Rogers	Humanistic	Unconditional positive regard, client-led process
Bowlby	Attachment Theory	Secure base, early relationships
Rubin	Integrative	Blending approaches based on client need

🧠 Margaret Mahler’s Stages of Attachment

Theory: Separation–Individuation Process
Mahler focused on how infants develop a sense of self and separate emotionally from their caregivers.

Her theory is key in understanding attachment, autonomy, identity development, and what happens when this process is disrupted (e.g., in trauma or personality disorders).

🌱 Mahler’s Developmental Stages (Simplified for the ATCBE):

1. Normal Autistic Phase (Birth–1 month)

Infant is focused inward, unaware of external world.
This phase is now largely considered outdated, but it may still be referenced.

2. Symbiotic Phase (1–5 months)

Infant experiences no sense of self as separate from caregiver.
Caregiver and infant are one “emotional unit.”
Infant needs consistent, nurturing environment.

🌳 SEPARATION–INDIVIDUATION STAGE (5–24+ months)

➡️ This is Mahler’s core focus.

Subphases:

Subphase	Age	What’s Happening
Differentiation	~5–10 months	Baby begins to look outward and differentiate self from caregiver (e.g., looking around during feeding)
Practicing	~10–16 months	Baby begins walking → physically explores world, but still emotionally tied to caregiver (emotional “refueling”)
Rapprochement	~16–24 months	Toddler becomes more aware of separateness → seeks closeness, may show clinginess, anger, or mood swings
Object Constancy	~2–3 years	Child internalizes caregiver as a stable presence even when they’re not there → this is key to emotional regulation and identity

🧩 Why This Matters for Art Therapy:

These stages help explain:

Attachment behaviors
Emotional regulation challenges
Dependency vs. autonomy themes in art

You might see questions like:

“Which subphase involves alternating closeness and rejection of the caregiver?”
✅ Rapprochement

✅ Key Terms to Remember:

Separation–Individuation
Rapprochement
Object Constancy
Emotional refueling

🧠 Mnemonic to Remember the Core Four Subphases:

D.P.R.O. = "Don't Push Real Objects"

D = Differentiation
P = Practicing
R = Rapprochement
O = Object constancy

Theorist	Theory/Approach	Key Concepts	Art Therapy Relevance
Margaret Naumburg	Psychodynamic Art Therapy	Art reveals the unconscious; spontaneous image-making as expression of inner conflict	Therapist helps interpret symbolic content of the artwork
Edith Kramer	Art as Therapy	The process of art-making is the therapy; sublimation through creativity	Less emphasis on analysis, more on development through structured art experiences
D.W. Winnicott	Object Relations Theory	Holding environment, transitional objects, “good enough mother”	Art therapist provides emotional containment; materials may serve as transitional objects
Donald Kuspit	Aesthetic Psychoanalysis	Art as self-realization and integration of fragmented parts	Focuses on symbolic and aesthetic development through creative expression
Sigmund Freud	Classical Psychoanalysis	Unconscious conflict, repression, dreams, id/ego/superego	Art is a way to uncover and work through unconscious material
Carl Jung	Analytical Psychology	Archetypes, collective unconscious, individuation	Art reveals universal symbols; mandalas, dreams, and myths often explored in art therapy
Margaret Mahler	Separation-Individuation Theory	Normal stages of development: symbiosis → separation → individuation	Art can support boundary formation, identity development
Carl Rogers	Person-Centered Therapy	Unconditional positive regard, empathy, congruence	Emphasizes non-directive, client-led art making in a safe, supportive environment
Cathy Malchiodi	Trauma-Informed Art Therapy	Neuroscience + expressive arts to support trauma recovery	Use of safe, contained, sensory-based art experiences
Janie Rhyne	Gestalt Art Therapy	Here-and-now awareness, integration of self	Clients process artwork experientially, focusing on the present moment
Viktor Lowenfeld	Art Development Stages	Children’s art develops in predictable stages	Useful in assessment and age-appropriate interventions

Aspect	Sigmund Freud	D.W. Winnicott
Main Focus	Unconscious drives (especially sexual/aggressive); intrapsychic conflicts	Relational experiences, especially early caregiving
Key Theory	Psychoanalysis — Behavior is shaped by unconscious drives/conflict between id/ego/superego	Object Relations — The self develops through early relationships with primary caregivers (“objects”)
Therapeutic Tools	Interpretation of dreams, free association	Holding environment, transitional objects, play therapy
View of the Therapist	Neutral “blank slate” for projection	Emotionally attuned, responsive “good enough mother”
Relevance to Art Therapy	Understanding symbolic meaning and unconscious conflict in images	Creating a safe emotional container through the art process and therapist relationship

When you see a question about a theorist:

Is this about the process (Kramer)?
The symbolic meaning (Naumburg)?
The relationship (Winnicott)?
The inner world (Freud)?
The developmental stage (Mahler)?

That will help you eliminate wrong answers fast.

🔸 Separation–Individuation Theory (Margaret Mahler)

What it is: Describes how infants become separate from their caregivers.
Stages:

Normal Autistic Phase (birth–1 mo)
Symbiotic Phase (1–5 mo): Baby and caregiver are “one”
Differentiation (5–9 mo): Baby notices separateness
Practicing (9–16 mo): Explores world, comes back for safety
Rapprochement (15–24 mo): Clingy again; emotional push–pull
Object Constancy (2–3 yrs): Can feel connected even when caregiver isn’t there

In session: Use art to support identity, boundaries, and independence.

Developmental Stages of Art (Viktor Lowenfeld)

What it is: Children’s drawings evolve in stages:

Scribbling (2–4)
Preschematic (4–7): Stick figures, symbols
Schematic (7–9): Baseline drawings, clearer symbols
Realism (9–12): More realistic attempts

In session: Know what’s developmentally appropriate to assess and plan treatment.

Theorist	Approach	Key Terms	In Practice
Naumburg	Psychodynamic	Symbolism, unconscious, spontaneous art	Therapist helps interpret images
Kramer	Art as Therapy	Sublimation, structured art	Healing through artmaking itself
Winnicott	Object Relations	Holding environment, transitional object	Therapist = emotional container
Freud	Psychoanalysis	Id/ego/superego, defense mechanisms	Interpret unconscious through art
Jung	Analytical Psych	Archetypes, individuation	Explore symbols/mandalas
Mahler	Developmental	Separation–individuation	Support identity, boundaries
Rogers	Person-Centered	Empathy, congruence	Non-directive, client-led art
Rhyne	Gestalt	Here-and-now, dialogue with art	Awareness through image interaction
Malchiodi	Trauma-Informed	Safety, regulation, sensory-based	Structured, grounding art tasks
Lowenfeld	Art Development	Scribbling to realism	Assess developmental norms

LOWENFELD

Stage	Age Range	Characteristics	Therapeutic Considerations
1. Scribble Stage	~2–4 years	Random marks → controlled lines; kinesthetic enjoyment	Focus on sensory experience, freedom, and movement. No need for imagery.
2. Preschematic Stage	~4–7 years	First recognizable shapes (e.g. tadpole people); no spatial awareness	Use open-ended prompts. Explore identity, self-image, relationships. Expect symbolic distortions.
3. Schematic Stage	~7–9 years	Use of baseline, sky line; consistent symbols for objects (sun, house, etc.)	Ideal for structured tasks. Explore rules, emotions, family roles. Imagery becomes more intentional.
4. Dawning Realism	~9–12 years	Increasing detail; concern with accuracy and proportion; self-conscious	Be gentle with feedback. Help with frustration if realism doesn't match ability. Good time to explore self-esteem, peer issues.
5. Pseudo-Naturalistic	~12–14 years	Shading, perspective, realism attempts; critical of own work	Offer skill-building or symbolic art. Validate effort and support self-expression during identity formation.
6. Decision Stage	~14+ years	Individual style emerges or art drops off	Use abstract/symbolic work to explore existential themes, relationships, identity, and personal narrative.

🛠️ HOW TO USE LOWENFELD IN CLINICAL PRACTICE

🔍 Assessment:

Ask: “Is this drawing typical for their age?”
If not, consider:

Emotional regression
Trauma (e.g., violent themes, missing body parts)
Cognitive or motor delays

Use art to track development over time

🎯 Treatment Planning:

Match materials and directives to the stage:

Scribble stage → sensory-rich, unstructured (e.g., finger paint)
Schematic → structured prompts (e.g., draw your family at dinner)
Dawning realism → gentle encouragement, narrative prompts
Adolescents → collage, metaphor, visual journaling

⚠️ RED FLAGS to Watch For in Assessment

Issue	Possible Indicator
Missing limbs/body parts	Trauma, dissociation, abuse
Very flat or chaotic space	Developmental delay, disorganization
Inappropriate for age	Emotional or cognitive delay
Regressive imagery	Stress, trauma, or unmet needs
Repeated violent images	Need to assess for aggression, exposure to violence

Concept	Founder	Key Idea	Example	ATCBE Tip
Classical Conditioning	Pavlov	Learn through association	Bell → Salivation	Know how triggers form; think trauma or sensory cues
Operant Conditioning	Skinner	Behavior shaped by consequences	Reward → More behavior	Know reinforcement types; used in behavioral plans
Stimulus–Response (S–R)	Watson	Behavior is a direct reaction	Loud noise → Flinch	Basis for behavioral theories
Theorist / Approach	Theory Name	Key Concepts	Example	ATCBE Exam Tips
Murray Bowen	Bowenian Family Therapy (Intergenerational)	- Differentiation of Self - Emotional Triangles - Multigenerational Transmission - Genograms	A teen’s anxiety is part of a triangle between mom, dad, and child.	Look for family history patterns, genogram use, or need for emotional distance with connection.
Salvador Minuchin	Structural Family Therapy	- Family structure - Subsystems (e.g. parental, sibling) - Boundaries (rigid, diffuse, clear) - Hierarchies	A parent and child are enmeshed; therapist realigns boundaries and roles.	Look for terms like realignment, enmeshment, disengagement, and restructuring roles.
Jay Haley / Cloe Madanes	Strategic Family Therapy	- Power and control - Directives (tasks) - Paradoxical interventions	Therapist tells teen to "keep arguing with your mom daily" → breaks pattern.	If the question mentions assigning a task or prescribing the symptom, it's strategic.
Virginia Satir	Experiential Family Therapy	- Communication stances - Self-esteem - Sculpting - Emotions in the here-and-now	Family members pose like statues to show emotional roles.	Choose Satir if focus is on emotions, self-worth, and expressiveness.
Carl Whitaker	Symbolic-Experiential Therapy	- Use of humor, confrontation - Therapist is actively involved - Focus on family creativity and symbolism	Therapist joins the family playfully and challenges absurd patterns.	Symbolism, play, and therapist joining the family system = Whitaker.
Michael White / David Epston	Narrative Therapy	- Externalizing the problem - Re-authoring stories - "The person is not the problem"	"Depression is trying to control you — how can we fight back?"	If the client is naming the problem or rewriting their story, it’s Narrative.
Steve de Shazer / Insoo Kim Berg	Solution-Focused Therapy	- Miracle question - Scaling questions - Exceptions to problems	"If your problem disappeared overnight, what would be different?"	Keywords: solution, exception, scaling, brief therapy, or future-focused.
Monica McGoldrick	Multicultural Family Therapy / Genogram Work	- Cultural legacy - Ethnicity, class, immigration - Family life cycle	Exploring how grief shows up in a Latinx family’s patterns of silence.	Choose this when question mentions culture, religion, race, or transitions across generations.

Freud psychosexual stages:

Oral- age 1

Anal- age 2

Phallic – ages 3-6

Latency- ages 6-11

Genital – age 11-12

Elements of design

-Line -Shape -Direction -Size -Texture -Color or Hue -Value or Tone

Principles of Design

-Balance -Gradation -Repetition -contrast -Harmony -Dominance -Form -Unity

Theorist / Approach	Key Concepts		Clinical/Art-Therapy Relevance		ATCBE Tip
Maria Salvini Palazzoli – Milan Systemic Family Therapy	Circular questioning; systemic patterns; focus on process not content		Use art-making to highlight and shift family feedback loops (e.g. drawing relational patterns)		Look for questions on reflecting interactions, interaction sequences
Harville Hendrix – Imago Relationship Therapy	Couples use childhood relationship models; aim to transform conflicts into healing		Use dyadic art activities, drawing “inner child” images		If question focuses on early relational templates or couples secondary art directive, think Imago
Hanna Kwiatkowska – Family Art Therapy	Art-based mapping of family roles and dynamics; joining children/adolescent world		Use family portrait prompts, sequencing lines of alliances/alliances in drawings		Choose when family art is used to map connectedness and discord
Elinor Landgarten – Family Art Therapy	Sensory, systems-based assessments; each family unit member draws same directive		Compare each member’s drawing of “family tree” or “family rules”		Relevant when directive is replicated across all family members
Deborah Linesch – Strategic/Experiential Family Art Therapy	Combines art, humor, paradox to shift family rigidity		Use art to disrupt patterns (e.g. each member draws inverse roles)		If rule- or structure-breaking art directive appears, think Linesch
Shirley Riley – Expressive Family Therapy	Focuses on narrative, ritual, and story within family art media		Art ritual prompts (e.g. joint collage of family story)		Use when question describes storytelling through art as healing process
Assessment Tool		Purpose / Method		Population / Use
APTIA (Art‑Based Assessment)		Client-directed imagery, metaphor, discussion of artwork		Adult/adolescents; narrative, emotional themes
APATA (American Psychiatric Art Therapy Association tools)		See art communication patterns, visual expression & psychosis		Psychiatric / inpatient populations
Family Drawings: e.g. (apples-and-family, etc.)		Evaluate family representation, alliances, roles		Children & adolescents in family therapy
DDS (Draw-a-Person Screening)		Projective personality indicators via figure drawing		Children/adolescents; developmental / emotional functioning
HFD (House–Tree–Person Test)		Symbolic assessment of self, home life, growth		Children/adolescents
Kinetic Family Drawing		Draw entire family doing activity; indicates roles, conflicts		Children 7–14; family dynamics
HTP (House–Tree–Person formal)		Scoring standardized for various features (e.g. shading, omissions)		Children & adolescents; screening / projective
DAS (Diagnostic Assessment of Art Skills)		Assess fine-motor and perceptual art skills		Children; developmental assessment
Silver Drawing Test		Drawings have identifiers graded for perceptual-motor integration		Children
PPAT (Person Picking an Apple from a Tree)		Structured directive to detect anxiety, aspiration, balance		Children / adolescents
FEATS (Formal Elements Art Therapy Scale)		Scored elements: line quality, color, space, etc. Correlates with overall functioning		Adolescents/adult assessments

ATCBE Tip: Know which are projective (HFD, KFD, House-Tree-Person, PPAT) versus skill-based (DAS, Silver).

🧠 B. Major Theoretical Approaches in Art Therapy

Cognitive — Focus on thought–emotion–behavior; visual journaling & reframing
Developmental — Combine Lowenfeld and Mahler for stages; use art to support stage transitions
Psychodynamic — Naumburg; art as unconscious expression; therapist interprets symbolism
Existential — Focus on meaning, choice, mortality; use art for exploring life themes
Humanistic — Rogers; client-centered, empathy, congruence; artmaking is client-led
Solution-Focused — Brief, goal-oriented art tasks, scaling, miracle questions
Kellogg Art Therapy Theory — Sensory-art developmental theory by Rhoda Kellogg; focus on child scribble progression & symbolic emergence

🔍 C. Child Developmental & Design Lists

Freud’s Psychosexual Stages: Oral → Anal → Phallic → Latency → Genital
Erikson’s Stages (Psychosocial):
Trust vs. Mistrust (0–1) → Autonomy vs. Shame (1–3) → Initiative vs. Guilt (3–6) → Industry vs. Inferiority (6–12) → Identity vs. Role Confusion (12–18) → Intimacy vs. Isolation (Young Adult) → Generativity vs. Stagnation (Adult) → Integrity vs. Despair (Older adult)
Piaget’s Cognitive Stages: Sensorimotor → Preoperational → Concrete Operational → Formal Operational

7 Elements of Design: Line, Shape, Value, Color, Texture, Space, Form
8 Principles of Design: Balance, Emphasis, Contrast, Movement, Pattern, Rhythm, Unity, Variety

🏁 Final Exam Prep Tips

Use the tables to rapidly recall theorist versus theory versus practical application.
Link assessment tools to age groups and purposes (e.g. projective vs. developmental).
Groups of theories (e.g. cognitive vs. existential vs. psychodynamic) will help eliminate answer choices quickly.
Know Erikson and Piaget for lifespan development.
Elements and principles of design can show up in material/process questions.

Theorist	Theory / Model	Practical Application in Art Therapy
Sigmund Freud	Psychodynamic / Psychoanalytic	Explore unconscious material through symbols & imagery
Margaret Naumburg	Dynamically Oriented Art Therapy	Art = symbolic communication; used for free association
Edith Kramer	Art as Therapy	Artmaking itself is curative; less interpretation
Carl Rogers	Humanistic / Person-Centered	Client-led process; empathy and unconditional positive regard
Viktor Frankl	Existential Therapy	Search for meaning through creative process
Aaron Beck / Albert Ellis	Cognitive / Cognitive-Behavioral Therapy	Identify and change thought distortions via reframing in art
Erik Erikson	Psychosocial Development	Understand stage-specific challenges (e.g. identity vs. confusion)
Jean Piaget	Cognitive Development	Match directives to age/stage abilities
Rhoda Kellogg	Developmental Art Theory	Scribbling → Shapes → Diagrams → Pictorial stages
Hanna Kwiatkowska	Family Art Therapy	Family dynamics through joint artmaking
Salvador Minuchin	Structural Family Therapy	Subsystems, roles, boundaries in family drawings
Virginia Satir	Experiential Family Therapy	Express feelings, improve communication

Assessment Tool	Purpose / What it Measures	Best For	Type
HFD (House-Tree-Person)	Projective view of self, home, and environment	Children / Adolescents	Projective
KFD (Kinetic Family Drawing)	Family dynamics, role clarity, emotional tone	Children (7–14)	Projective / Relational
HTP (formal)	Adds scoring; assesses cognitive/emotional state	Clinical Populations	Standardized / Projective
PPAT	Problem-solving, developmental level, emotional tone	Children / Adolescents	Projective
FEATS	Formal scoring of visual elements	Teens / Adults	Standardized / Diagnostic
DAS	Visual-motor & perceptual skills	Children	Developmental / Skills
DDS	Figure drawing screening for psych diagnosis	Children / Teens	Projective
Silver Drawing Test	Drawing for visual-perceptual development	Children	Developmental
Family Drawing Series	Reveal family dynamics visually	All Ages	Projective / Relational
APTIA / APATA	Advanced narrative-based assessments	Teens / Adults (Psychiatric)	Narrative / Symbolic

Theoretical Group	Key Features	How to Recognize on the Test
Psychodynamic	Symbolism, unconscious, inner conflict	Dreamlike images, therapist interprets meaning
Cognitive	Thoughts → Feelings → Behavior	Reframing, thought bubbles, labeling distortions
Behavioral / CBT	Behavior modification, conditioning, rewards	Token systems, skill rehearsal
Humanistic	Empathy, growth, unconditional positive regard	Client-led, non-directive, validating
Existential	Meaning-making, choice, mortality	Themes of purpose, spiritual or philosophical tone
Developmental	Stages of growth in art or cognition	Use of scribble theory, matching tasks to age
Family Systems	Roles, structure, boundaries, alliances	Family trees, diagrams, drawing “who helps whom”
Solution-Focused	Brief therapy, future-focused, client strengths	Scaling, miracle question, finding exceptions

ERIKSON PSYCHOSOCIAL STAGES

Stage	Age Range	Conflict / Task
Trust vs. Mistrust	0–1 years	Can I trust the world?
Autonomy vs. Shame/Doubt	1–3 years	Independence vs. self-doubt
Initiative vs. Guilt	3–6 years	Assertiveness vs. overcontrol
Industry vs. Inferiority	6–12 years	Mastery of tasks vs. failure
Identity vs. Role Confusion	12–18 years	Who am I?
Intimacy vs. Isolation	Young Adult	Deep relationships vs. isolation
Generativity vs. Stagnation	Middle Adult	Contribution vs. self-focus
Integrity vs. Despair	Older Adult	Meaning in life or regret

PIAGET COGNITIVE DEVELOPMENT STAGES

Stage	Age Range	Main Features
Sensorimotor	0–2 years	Object permanence, sensory exploration
Preoperational	2–7 years	Symbolic thought, egocentrism, no logic
Concrete Operational	7–11 years	Logical thinking, conservation, classification
Formal Operational	12+ years	Abstract thought, hypothesis testing

Material	Therapeutic Use	Populations	Cautions / Notes
Adhesives	Used in collage; supports integration, control, and planning.	Kids, trauma survivors	Check for non-toxic; watch for allergic reactions.
Art Reproductions	Used for projection, discussion, and art appreciation.	All ages	Avoid copyrighted material; culturally sensitive use.
Ceramics	Grounding; sensorimotor regulation; emotional expression.	Teens, adults, trauma	May require kiln; can be messy or frustrating for some.
Collage Materials	Good for indirect expression; offers control & choice.	Children, trauma, dissociation	Pre-cut images may carry unconscious projections.
Crafts & Jewelry	Useful for identity formation, sequencing, symbolic meaning.	Adolescents, family work	May be too structured; avoid small pieces with young children.
Digital Art	Appeals to tech-savvy clients; non-messy, repeatable, identity play.	Adolescents, those with motor issues	Can be distancing if overused; assess tech literacy.
Drawing Materials	Fundamental for expression; control vs. spontaneity based on media type.	All ages	Pencil (controlled), charcoal/oil pastel (less controlled).
Found Objects	Use in assemblage; evokes memory, narrative, and meaning-making.	Adults, grief/loss clients	Must be safe, non-toxic, and meaningful to client.
Photography	Encourages perspective-taking, memory, narrative; can be used for self-portrait	Teens, adults, trauma	Consent if using images of others; digital manipulation.
Paint (wet media)	Encourages emotional release (especially fluid paints); less control.	Children, trauma, expressive work	Messy; may evoke anxiety in some; use smocks and safe paint.
Printmaking	Structured yet creative; supports repetition, planning, identity themes.	Adolescents, schools	Time-consuming; requires setup/cleanup.
Sculpture	3D expression of internal states; tactile processing; containment.	Trauma, children, sensory clients	Material safety; can trigger frustration if motor control is limited.
Textiles	Evokes comfort, sensory integration, and symbolic meaning (e.g. weaving).	Grief, trauma, older adults	Needle use or fiber shedding risks for certain clients.
Woodworking	Empowerment; mastery and control; sequencing and motor planning.	Adolescents, group work, addiction	Tools safety; not ideal for impulsive/aggressive clients.

Population	Key Considerations	Therapeutic Focus	Effective Art Approaches / Media	Exam Tip
General Population	Broad needs; may include stress, life transitions, or preventative care.	Expression, self-discovery, resilience.	Drawing, painting, open-ended prompts.	Match treatment to developmental stage and presenting issue.
Grief / Loss / Bereavement	May be complicated, delayed, or disenfranchised grief.	Meaning-making, honoring loss, containment.	Memory boxes, collage, timelines, symbols.	Use media that facilitates expression of absence and connection.
LGBTQIAA	Identity, stigma, discrimination, safety, validation.	Empowerment, identity affirmation, safe space.	Identity-based prompts, self-portrait, collage, mixed media.	Use inclusive, affirming language; avoid assumptions.
Dual Diagnosis (MI + Substance Use)	High complexity; relapse risk, trauma, emotional dysregulation.	Self-regulation, insight, coping, identity building.	Simple, structured art tasks; grounding materials like clay or marker.	Choose structured activities that avoid emotional flooding.
BIPOC (Black, Indigenous, People of Color)	Historical/generational trauma, cultural values, racism.	Empowerment, cultural resilience, identity, safety.	Narrative art, ancestral imagery, culturally relevant symbols.	Honor cultural context—don’t universalize trauma or experience.
Multicultural Families	Acculturation stress, generational conflict, differing worldviews.	Communication, roles, cultural validation.	Family mandalas, role-based drawings, genograms with art.	Don’t assume shared meaning across family members—clarify.
Adoption	Attachment, identity, loss, unknowns about origins.	Integration of story, identity development, trust.	Lifebook projects, storybooks, container-making.	Explore themes of belonging, but pace based on attachment readiness.
Intimate Partner Violence (IPV)	Trauma, shame, safety concerns, disempowerment.	Safety, boundaries, expression, re-empowerment.	Protective imagery, mask making, safe container imagery.	Avoid unstructured or emotionally flooding media early on.
Military / Veterans	Hypervigilance, PTSD, moral injury, family disruption.	Re-integration, trust, trauma processing, identity.	Narrative art, mask making, sculpture (externalizing trauma).	Use structure and containment first—build toward trauma content.
Religious / Spiritual	May be a source of strength or internalized conflict/shame.	Explore beliefs, values, spiritual resilience or injury.	Mandalas, ritual-based imagery, spiritual symbols.	Be respectful, client-led, and aware of belief-related taboos.
Immigrants / Refugees	Trauma, loss of homeland, cultural displacement.	Identity, safety, belonging, cultural expression.	Mapping, journey images, flag or cultural symbol creation.	Use visual narrative to externalize story; use interpreters as needed.
Housing Insecurity / Homelessness	Instability, trauma, lack of access, survival focus.	Safety, grounding, strengths, hope.	Portable materials, collage, container making, resource mapping.	Prioritize accessibility and empowerment; avoid re-traumatization.

ATCBE Tips by Theme

Cultural humility is essential — never assume shared experience even within a cultural group.
Match media to regulation needs: safe, contained media for trauma/disempowerment.
Consider accessibility: some populations need portable, low-cost, or non-triggering materials.
Be ready to adapt communication styles, especially with multicultural, trauma-affected, or youth clients.
In questions, look for responses that emphasize client agency, identity, and cultural awareness.

Context	Key Considerations	Art Therapy Goals	Common Interventions	ATCBE Exam Tips
Couples	Power dynamics, attachment, communication, conflict cycles, emotional safety.	Improve communication, rebuild trust, externalize conflict, explore emotional patterns.	Joint drawing, relationship timeline, two-sided dialogue images, container work.	Avoid "taking sides"; focus on relational patterns, not individual blame.
Education (Schools, learning environments)	Developmental needs, peer influence, learning styles, behavior regulation, IEPs.	Emotional regulation, identity formation, social skills, self-expression.	Visual journals, art games, safe place imagery, self-portraits.	Be aware of mandated reporting, FERPA, and integrating art into educational goals.
Families	Roles, structure, alliances, intergenerational patterns, cultural expectations.	Improve communication, clarify roles, strengthen connection, process trauma or transition.	Family sculpture, genograms, shared drawing, family mandala.	Use systems thinking: examine interaction patterns, not isolated behavior.
Groups	Group dynamics, safety, inclusion, cohesion, boundaries, peer modeling.	Build social connection, reduce isolation, learn from others, collective expression.	Group mural, sequential drawing, role-based art, shared prompts.	Focus on group process (cohesion, norms, safety) as much as content. Observe how members respond to others' work.
Individuals	Age, diagnosis, trauma history, goals, motivation, cultural context.	Insight, emotional regulation, self-expression, integration, goal setting.	Media exploration, personal symbols, timelines, narrative art.	Match media to need: calming for trauma, expressive for repression. Watch for over-interpretation—stay client-led.
Systems / Organizations	Policies, culture, roles, team dynamics, burnout, communication barriers.	Clarify mission, improve morale, enhance communication, address systemic issues.	Organizational mandalas, value-based collage, metaphor drawing (e.g., “your team as an ecosystem”).	Think macro: You’re addressing culture, communication, and interpersonal systems, not clinical issues.

🔍 ATCBE Strategy Reminders:

Always align the intervention with the structure: e.g., couple = dyadic, group = relational, family = systemic.
For schools, know the difference between clinical vs. educational goals.
Be cautious about confidentiality in groups and families: clarify limits early.
Use non-verbal communication to support clients who may struggle with spoken language (esp. children, trauma, multicultural).
When addressing organizations, interventions should support systems-level change, not individual therapy.

Would you like visual diagrams, a cheat sheet, or practice questions next?

FERPA stands for the Family Educational Rights and Privacy Act — a U.S. federal law that protects the privacy of student education records.

🔍 Key Points About FERPA:

Topic	Details
Purpose	To give parents and eligible students rights to access and control the disclosure of educational records.
Who It Applies To	Any school that receives federal funding (e.g., public schools, many private institutions).
Rights Given by FERPA	1. Right to access student records. 2. Right to request correction of inaccurate records. 3. Right to control disclosure of personally identifiable information (PII) from records.
When Students Control Their Own Records	At age 18 or when they enter a postsecondary institution (college/university), rights transfer from parents to the student (called an “eligible student”).
When Records Can Be Shared Without Consent	- School officials with legitimate educational interest - Other schools where the student is transferring - Financial aid purposes - Health/safety emergencies - Court orders or law enforcement subpoenas (under strict rules)

🎨 FERPA & Art Therapists in Schools

If you're practicing art therapy in a school, FERPA affects:

Artworks created in therapy: If stored with identifiable info (name, notes), they’re part of the educational record.
Sharing artwork: Cannot be displayed or discussed without written consent if it includes identifiable info.
Collaborating with teachers or staff: You can share relevant info only if they have a legitimate educational interest.

🧠 ATCBE Test Tip:

If you’re working in a school setting:

Protect student artwork as confidential under FERPA.
Get written consent from guardians or students (if 18+) to display or share art.
Be able to differentiate between FERPA and HIPAA (FERPA covers schools; HIPAA covers medical records).

Would you like a comparison between FERPA vs. HIPAA next?

Here’s a quick comparison between FERPA and HIPAA, especially helpful for the ATCBE exam, where you need to know which privacy law applies in different settings.

📊 FERPA vs. HIPAA: Quick Reference Table

Feature	FERPA (Family Educational Rights and Privacy Act)	HIPAA (Health Insurance Portability and Accountability Act)
Main Focus	Privacy of education records	Privacy of health information (medical/mental health)
Applies To	Schools that receive federal funding (K–12, colleges)	Health care providers, insurance companies, and clearinghouses
Covers	Student education records, including counseling/art therapy notes kept by school staff	Protected health information (PHI) — diagnoses, treatment, billing, etc.
Examples	Report cards, IEPs, therapy notes (if stored by school), student artwork with identifiers	Medical records, psychotherapy notes, lab results, billing info
Who Has Rights?	Parents (until student turns 18 or enters college), then students	The patient or their legal representative
When Consent is Needed to Share	Before sharing educational info outside of school staff	Before sharing health info outside of care team
When Consent is NOT Needed	- Health/safety emergency - School officials with legitimate interest	- Emergency situations - Public health or legal requirements
Which Law Applies in Schools?	FERPA always applies to student records in schools	HIPAA does NOT apply to school records covered by FERPA

🎨 In Art Therapy Settings:

Setting	Law That Applies	Why It Matters
Public School (K–12)	FERPA	Student records, including artwork and therapy notes, are protected under FERPA if stored by school.
Private Practice / Clinic	HIPAA	Therapist must protect PHI and follow HIPAA’s privacy rules.
College Counseling Center	FERPA or HIPAA (depends on funding and structure)	If the college gets federal funding and therapy is tied to education, FERPA applies. If clinic is separate, HIPAA may apply.

✅ ATCBE Exam Tips:

If you’re working in a school, assume FERPA applies.
If you're in private practice or a medical setting, it’s HIPAA.
Be aware of what records are considered “educational” and when you need written consent to share them.
FERPA > HIPAA in school settings.

Setting	Definition	Key Features & Art Therapy Considerations
a. Community Mental Health	Local clinics offering low-cost or sliding-scale therapy	- Diverse clients (SES, culture)- Often trauma, severe mental illness- Collaboration with case managers- Emphasis on accessibility, social justice
b. Corrections	Jails, prisons, or juvenile justice facilities	- Structured, secure environment- Issues of control, trust, trauma- Confidentiality is limited- Group art therapy common- Ethics: boundaries and safety paramount
c. Inpatient Psychiatric Setting	Hospital-based short-term psychiatric care	- Acute mental health crises- Severe diagnoses (psychosis, suicidality)- Short stays = rapid assessment & stabilization- Art therapy = containment, expression, safety
d. Intensive Outpatient Program (IOP)	Structured part-time care (e.g. 3–5 days/week)	- Step down from inpatient or PHP- Group-focused- Common for mood, substance use- Art therapy supports identity, reflection, coping
e. Medical Setting	Hospitals, outpatient clinics, palliative/hospice care	- Works with patients with medical illnesses- Common: oncology, chronic illness, pain- Focus: quality of life, expression, end-of-life care- HIPAA applies, often short sessions
f. Older Adult Care Setting	Nursing homes, assisted living, memory care units	- Dementia, grief, cognitive decline- Emphasis on sensory-based media- Process > product- May integrate reminiscence & life review themes
g. Open Studio/Art Studio	Community-based, non-clinical or low-barrier art therapy setting	- Focus on creativity and autonomy- Therapist as facilitator, not director- Great for trauma, identity exploration, recovery- Emphasis on process and empowerment
h. Partial Hospitalization Program (PHP)	Day treatment, 5+ hours/day, 5 days/week	- More intensive than IOP- Group-focused- Common diagnoses: eating disorders, mood, PTSD- Therapist must balance structure and expression
i. Private Practice/Outpatient	Individual or group therapy in a private setting	- Flexible, client-led- Longer-term therapy- Commonly used for anxiety, depression, life transitions- Ethics: clear contracts, HIPAA, informed consent
j. Residential Care	Live-in treatment, often long-term or rehab	- Adolescents, trauma, substance use, eating disorders- 24/7 care—art therapy is one part of integrated team- Strong boundaries and structure needed- Art therapy helps with internalization, safety
k. School-Based Setting	Public or private K–12 schools	- Often under FERPA, not HIPAA- Common issues: bullying, IEPs, trauma, ADHD- Art can support emotional regulation and communication- Must navigate confidentiality with minors and parents
l. Telehealth	Online sessions (individual or group)	- Requires clear informed consent and tech boundaries- Must be licensed in client’s state- Limitations in material access and nonverbal cues- Use adaptable media (e.g., drawing, collage, digital tools)

✅ ATCBE Study Tips

Know how the setting impacts confidentiality laws:

FERPA = schools
HIPAA = hospitals, clinics, private practice

Expect questions comparing inpatient vs. outpatient vs. PHP/IOP.
Telehealth: Know the ethical issues (licensure across states, tech limitations, informed consent).
Open studio vs. clinical art therapy: Open studio is non-directive, often community-based and not diagnostic.

Theory	Core Ideas	Art Therapy Applications	ATCBE Tip
Attachment Theory	Early bonds with caregivers shape emotion regulation & relationships	Use art to explore relational dynamics, repair insecure attachment	Think: inner child, trust-building, family art genograms
CBT / ACT / DBT	Thoughts affect feelings/behaviors (CBT); values-based action (ACT); emotional regulation (DBT)	Use cognitive distortions worksheets, emotion-regulation art (DBT chain analysis), mindfulness-based collage	Choose when the question involves skill-building or thinking errors
Developmental Approaches	Development unfolds in stages (Piaget, Erikson); mismatch = problems	Match materials to age (e.g., sensory play for early stages, narrative work for teens)	Know Piaget/Erikson stages and age-appropriate media
Ecotherapy / Environmental Approaches	Connection to nature promotes wellness	Natural materials, eco-art, land art, outdoor sessions	Watch for questions involving grief, climate anxiety, or sensory grounding
Expressive Therapies Continuum (ETC)	A framework for understanding media use: Kinesthetic → Sensory → Perceptual → Affective → Cognitive → Symbolic → Creative	Guides media selection; e.g., clay = sensory/kinesthetic; narrative collage = symbolic	Key ATCBE model—know the media levels and how to choose them
Family Systems Theory	Individuals are embedded in family systems; problems reflect system dysfunction	Family art assessments, joint drawings, genograms	Watch for questions about dynamics, triangulation, boundaries
Feminist / Social Justice	Power, identity, intersectionality, advocacy in therapy	Identity-based work (zines, protest art, altars), addressing oppression through art	Use when question involves advocacy, equity, community work
Humanistic (Adlerian, Gestalt, Existential, Transpersonal)	People are capable of growth; focus on meaning, potential, agency	Spontaneous art, process-focused sessions, client-led exploration	Use with open-ended prompts, dreams, spirituality, grief, or self-exploration
Motivational Interviewing / SOC / TTM	People move through stages of change; therapy should match stage	Timeline art, decision art, values collage; affirm ambivalence	Useful for substance use, ambivalence, goal setting
Psychodynamic (Psychoanalytic, Jungian, IFS)	Unconscious processes shape behavior; symbols reveal deeper meaning	Mandalas (Jung), active imagination, parts work (IFS), dreamwork	Use with symbolism, transference, inner conflict
Positive Psychology	Focus on strengths, resilience, meaning, flow, gratitude	Gratitude journaling, legacy projects, strength-based self-portraits	Use when promoting well-being, hope, or celebrating strengths
Solution-Focused Therapy	Focus on what works, solutions not problems, future-oriented	Best hopes drawing, miracle question art, strength-based art	Use when question emphasizes future goals, not insight
Somatic Approaches	Trauma and emotion live in the body; movement/art help release	Body maps, movement-based art, sensory integration	Choose for trauma, dissociation, grounding
Systems Theory	Everything is interconnected; change in one part affects the whole	Sociograms, network mapping, role art	Applies to communities, organizations, families
Trauma-Informed Therapy	Prioritizes safety, empowerment, trust, choice, and collaboration	Controlled, sensory-safe materials; trauma narratives only when appropriate	Key ATCBE focus—match interventions to stability level; avoid retraumatization

Top 5 to Know for ATCBE

ETC (Expressive Therapies Continuum)
Attachment Theory
CBT / DBT
Developmental Models (Erikson/Piaget)
Trauma-Informed Care

Levels of the ETC

The ETC is organized into 4 main levels, sometimes with sublevels, that represent different ways people process information and express themselves through art:

Kinesthetic/Sensory Level

Kinesthetic: Focus on movement and physical activity (e.g., large arm movements, messy play).
Sensory: Focus on the tactile and sensory experience (e.g., touching, feeling textures).
Use: Good for clients who need grounding, regulation, or to work through trauma via body connection.

Perceptual/Affective Level

Perceptual: Involves form, structure, and visual-spatial relationships (e.g., drawing shapes, organizing elements).
Affective: Related to emotions and feelings, often expressed through color, texture, and intensity.
Use: Helps clients explore emotions or organize thoughts visually.

Cognitive/Symbolic Level

Cognitive: Involves thinking, problem-solving, planning, and reflection (e.g., creating detailed drawings, symbolic images).
Symbolic: Using images to represent ideas, feelings, or experiences (e.g., metaphors, storytelling through art).
Use: Supports clients who are ready to make meaning from their experience and gain insight.

Creative Level

The integration of all levels where the client uses art freely for self-expression, healing, and transformation.
Encourages personal meaning, self-awareness, and therapeutic growth.

Why is ETC Important?

It helps tailor art therapy interventions to the client’s current needs.
Supports assessment by observing which level the client uses most.
Guides therapists in choosing media and techniques to promote healing and engagement.
Encourages movement through the levels for growth (e.g., from sensory grounding to cognitive insight).

Quick Tips for Exam:

Know the four levels and what they represent.
Understand how different art materials might fit each level (e.g., clay = kinesthetic/sensory; detailed drawing = cognitive).
Recognize the ETC is both a model for assessment and intervention.
Be able to explain how the ETC supports clients’ emotional, sensory, and cognitive processing.

ETC Level	Materials Associated	When to Apply	How It May Show Up on Test
Kinesthetic	Large paint brushes, clay, finger paint, movement-based materials, heavy tools (rolling pins, large brushes)	Clients needing physical engagement, grounding, sensory-motor activation, or to release tension or anxiety	Scenario: Client needing to release trauma through movement; Choose kinesthetic activities
Sensory	Textured paper, sand, fabric, finger paint, textured objects, watercolors	Clients who need tactile stimulation, sensory regulation, calming, or exploring physical sensations	Question about sensory regulation or calming techniques via art materials
Perceptual	Drawing pencils, markers, collage materials, stamps, stencils	Clients working on structure, visual-spatial organization, and reality testing	Identify interventions focused on structure, boundaries, or perception organization
Affective	Bright colors, soft pastels, bold materials, expressive brush strokes	Clients exploring emotions, expressing feelings, or working through emotional blocks	Question on facilitating emotional expression through art choices
Cognitive	Detailed drawing tools, mixed media for planning, paper, collage, writing/drawing combination	Clients ready for problem-solving, planning, and reflection	Scenario requiring cognitive insight or structured problem-solving in art therapy
Symbolic	Symbolic images, metaphoric materials, collage, storytelling art	Clients working on meaning-making, symbolism, metaphors, and narrative	Question about using symbolism to facilitate client insight or storytelling
Creative	Open choice of materials allowing freedom	Clients integrating all levels for self-expression and growth	Test may ask about promoting integration and personal meaning through free creative art

Task	What You Need to Know	Exam Tips/Examples
Adapt interventions	Adjust activities to client's developmental, communication level, and learning style; ensure safety (non-toxic, no sharps)	Question about selecting safe materials or modifying interventions for kids, elderly, or clients with disabilities
Apply interviewing skills	Use reflective listening, summarizing, and effective session closure techniques	Identify examples of good interviewing skills in scenarios or choose best closing statement
Collaborate on treatment plan/goals	Work with clients to create and adjust goals and plans based on their evolving needs	Question on client-centered planning or modifying goals during treatment
Conduct intake and evaluations	Complete biopsychosocial assessments, gather history, mental status, referral reasons, functioning levels	Scenario on what to assess during intake or ongoing evaluation
Demonstrate empathy and validation	Show understanding, respect feelings, and acknowledge client experiences	Recognize empathic responses vs. invalidating statements
Document communications	Accurately record client interactions, progress notes, and team communications	Choose best documentation practice or identify errors in progress notes
Establish therapeutic relationship	Build rapport, trust, and safety with clients	Recognize techniques that foster strong therapeutic alliance
Facilitate creative process	Know media/materials, art history concepts, introduce and pace art therapy, close sessions effectively	Scenario about choosing materials or ending session art process
Manage group dynamics	Facilitate balanced participation, resolve conflicts, observe interactions	Identify group management strategies or responses to group conflict
Observe/process art production	Note use of color, line, symbols, metaphors, and respond to risk indicators (violence, self-harm)	Question on interpreting artwork elements or appropriate clinician response
Observe/respond to session dynamics	Monitor affect, behaviors, verbal/nonverbal cues, and interpersonal interactions	Pick up on nonverbal cues and their clinical implications
Promote client understanding	Help clients see how art connects to feelings, thoughts, and goals	Example question about facilitating client insight or reflection
Provide crisis intervention	Recognize crises, provide immediate support, and safety	Scenario requiring crisis response or referral
Refer to other providers	Know when to connect clients to additional medical, mental health, or social services	Question about appropriate referrals or coordination of care
Evaluate client progress	Regularly review treatment effectiveness and modify as needed	Recognize signs of progress or need for treatment change
Understand DSM diagnoses	Be familiar with common mental health diagnoses and how they relate to treatment planning	Identify diagnoses relevant to case examples
Use art therapy skills for expression	Use witnessing, intention setting, directives, and connecting symbols with personal and cultural meaning	Choose best directive or interpretation that encourages exploration and expression
Material Type	Examples of Non-Toxic Options	Notes
Paints	Tempera, water-based acrylics labeled “non-toxic”	Avoid solvent-based or oil-based paints
Markers & Pens	Water-based markers (Crayola, Prang)	Avoid permanent markers with solvents
Glue/Adhesives	White school glue (PVA), glue sticks labeled “non-toxic”	Avoid industrial glues or strong adhesives
Clay & Modeling Materials	Air-dry clay (non-toxic), natural modeling clay	Avoid polymer clays with unknown safety
Crayons & Colored Pencils	Standard crayons (Crayola), colored pencils labeled non-toxic	Avoid oil pastels or soft pastels that contain heavy metals
Paper & Cardstock	Acid-free paper, construction paper	Generally safe
Pastels	Soft pastels labeled non-toxic	Avoid oil pastels with solvents
Other materials	Fabric, yarn, natural materials (feathers, leaves)	Be mindful of allergies

Assessment	Purpose/Focus	Notes
Belief Art Therapy Assessment (BATA)	Explore client beliefs and values through art	Used for insight into personal meaning
Bird’s Nest Drawing (BND)	Assess emotional state and relational themes	Often used with children
Bridge Drawing	Explore conflict resolution and problem-solving	Symbolic representation of overcoming obstacles
Cognitive Art Therapy Assessment (CATA)	Evaluate cognitive functioning via art	Links cognitive abilities and artistic expression
Diagnostic Drawing Series (DDS)	Series of drawings to assess emotional, cognitive, and psychological status	Standardized with scoring system
Draw-A-Person-In-The-Rain (DAP)	Assesses emotional vulnerability and stress	Rain symbolizes stressors, DAP for self-image
Draw-A-Story (DAS)	Narrative drawing to reveal unconscious material	Client tells a story about their drawing
Face Stimulus Assessment (FSA)	Explore identity and emotional state via face drawings	Helps access feelings about self and others
Formal Elements Art Therapy Scale (FEATS)	Quantitative measure of formal elements in drawings	Assesses factors like color, line, space, energy
Kinetic Drawings:	(KFD, K-H-T-P, KSD) Family, House-Tree-Person, School drawings	Reveal family dynamics, self-perception, and social functioning
Family Art Evaluation	Assess family relationships and dynamics	Often involves joint family drawings
Levick Emotional and Cognitive Evaluation and Assessment Method (LECATA)	Evaluates emotional and cognitive integration	Comprehensive, includes analysis of art and verbal responses
Mandala Assessment Research Instrument (MARI)	Mandala drawing assessment focused on emotional states	Uses symbolism and structure of mandalas
Person Picking an Apple from a Tree (PPAT)	Analyzes motivation, goal setting, and self-efficacy	Symbolic action drawing
Road Drawing	Explore life journey, challenges, and future goals	Metaphor for life’s path
Silver Drawing Test (SDT)	Used mainly with children to assess trauma, stress, and emotional status	Uses storytelling about drawings

How this might show up on the exam:

Identify which assessment fits a particular clinical situation.
Example: “Which art-based assessment is best for evaluating family dynamics?” → Kinetic Family Drawing or Family Art Evaluation.
Describe how to administer and interpret a specific test.
Example: “What does the presence of heavy rain in a DAP drawing indicate?”
Write or evaluate a brief report based on assessment results.
Know the strengths and limitations of specific assessments.

Quick tips:

Think about client goals before choosing an assessment.
Pay attention to both art product and process.
Link observations to psychological constructs (e.g., anxiety, trauma, family dynamics).
Be familiar with standardized vs. non-standardized assessments.
Always consider client comfort and cultural factors in administration.

Standardized Art Therapy Assessments

(Standardized means they have a specific administration protocol, scoring system, and norms for interpretation.)

Diagnostic Drawing Series (DDS)
Formal Elements Art Therapy Scale (FEATS)
Levick Emotional and Cognitive Evaluation and Assessment Method (LECATA)
Mandala Assessment Research Instrument (MARI)
Silver Drawing Test (SDT)
Cognitive Art Therapy Assessment (CATA)

Non-Standardized Art Therapy Assessments

(Non-standardized assessments are more flexible, qualitative, and interpretive without formal scoring.)

Belief Art Therapy Assessment (BATA)
Bird’s Nest Drawing (BND)
Bridge Drawing
Draw-A-Person-In-The-Rain (DAP)
Draw-A-Story (DAS)
Face Stimulus Assessment (FSA)
Kinetic Drawings:

Kinetic Family Drawing (KFD)
Kinetic House-Tree-Person (K-H-T-P)
Kinetic School Drawing (KSD)

Family Art Evaluation
Person Picking an Apple from a Tree (PPAT)
Road Drawing

Absolutely! Here’s a breakdown of the Kinetic Family Drawing (KFD), Kinetic House-Tree-Person (K-H-T-P), and Kinetic School Drawing (KSD)—all related but with key differences:

1. Kinetic Family Drawing (KFD)

What it is: A drawing assessment where the client is asked to draw their family members doing something (an action).
Purpose: To explore family dynamics, roles, relationships, and feelings about family members. The “kinetic” (movement/action) part helps reveal how the client perceives interactions and energy within the family.
Focus: Family relationships, emotional atmosphere, conflicts, and alliances.
How it’s used: Art therapists analyze positioning, size, actions, omissions, emotions in figures, and spatial relationships to understand family functioning and the client’s role in it.

2. Kinetic House-Tree-Person (K-H-T-P)

What it is: An extension of the traditional House-Tree-Person drawing where the client is asked to draw these three elements engaged in action or movement.
Purpose: To gain insight into the client’s self-image (person), home life and security (house), and growth or inner feelings (tree), with the added dimension of activity/interaction.
Focus: Psychological state, personal identity, family and home environment, emotional well-being. The kinetic aspect adds context to how the client perceives these core elements “in motion.”
How it’s used: The drawings are interpreted by looking at what actions are depicted, emotional tone, use of space, and details in the drawings.

3. Kinetic School Drawing (KSD)

What it is: A drawing where the client is asked to depict a school setting with figures engaged in activity, such as students or teachers doing something in the school environment.
Purpose: To explore feelings, attitudes, and experiences related to school, peers, authority figures, and learning. It can reveal social dynamics, stressors, or comfort in school settings.
Focus: School-related experiences, peer relationships, academic self-concept, authority and social interaction.
How it’s used: Therapists examine the depicted activities, interactions, and emotional content to understand the client’s view and feelings about school.

Assessment	Subject(s) Drawn	Focus of Assessment	Key Feature
Kinetic Family Drawing (KFD)	Family members in action	Family relationships and dynamics	Family members depicted doing activities
Kinetic House-Tree-Person (K-H-T-P)	House, tree, person in action	Self-image, home life, growth, emotions	Core symbols drawn in motion
Kinetic School Drawing (KSD)	School setting with people in action	School experiences, peer and authority relations	School environment and interactions depicted

Let me know if you want tips on interpreting specific elements or common themes!

1. Kinetic Family Drawing (KFD)

What it is: A drawing assessment where the client is asked to draw their family members doing something (an action).
Purpose: To explore family dynamics, roles, relationships, and feelings about family members. The “kinetic” (movement/action) part helps reveal how the client perceives interactions and energy within the family.
Focus: Family relationships, emotional atmosphere, conflicts, and alliances.
How it’s used: Art therapists analyze positioning, size, actions, omissions, emotions in figures, and spatial relationships to understand family functioning and the client’s role in it.

2. Kinetic House-Tree-Person (K-H-T-P)

What it is: An extension of the traditional House-Tree-Person drawing where the client is asked to draw these three elements engaged in action or movement.
Purpose: To gain insight into the client’s self-image (person), home life and security (house), and growth or inner feelings (tree), with the added dimension of activity/interaction.
Focus: Psychological state, personal identity, family and home environment, emotional well-being. The kinetic aspect adds context to how the client perceives these core elements “in motion.”
How it’s used: The drawings are interpreted by looking at what actions are depicted, emotional tone, use of space, and details in the drawings.

3. Kinetic School Drawing (KSD)

What it is: A drawing where the client is asked to depict a school setting with figures engaged in activity, such as students or teachers doing something in the school environment.
Purpose: To explore feelings, attitudes, and experiences related to school, peers, authority figures, and learning. It can reveal social dynamics, stressors, or comfort in school settings.
Focus: School-related experiences, peer relationships, academic self-concept, authority and social interaction.
How it’s used: Therapists examine the depicted activities, interactions, and emotional content to understand the client’s view and feelings about school.

Family Art Evaluation

What it is: A broad term for using various family-related art tasks to assess family dynamics, roles, communication patterns, and emotional relationships within the family unit.
How it works: The family members might create art together or separately, such as drawing, painting, or collage, often focusing on their family or relationships. The therapist observes interactions, collaboration, conflicts, and how family members express themselves through art.
Purpose: To evaluate how family members relate to each other, express emotions, and communicate, plus how they negotiate roles and conflicts.
Use in clinical settings: Helpful when you want to observe family interactions live through the art-making process as well as analyze the art product itself. It’s especially useful in family therapy where multiple members participate.

Kinetic Family Drawing (KFD)

A specific standardized drawing task where one individual draws the family members in action.
Primarily used for individual clients to express their perceptions of family dynamics and roles through symbolic representation in a drawing.

When to choose which?

Clinical Situation	Best Assessment Choice	Why?
Evaluating family dynamics through one client’s perception	Kinetic Family Drawing (KFD)	Focuses on individual’s view of family relationships and roles via drawing family members in action
Evaluating family dynamics through multiple family members interacting or expressing themselves	Family Art Evaluation	Involves actual family participation, observing interaction patterns during art-making, and assessing family relationships as a system

Supervision

1. Know Different Supervision Models

Supervision in art therapy means a more experienced therapist or supervisor guides, supports, and evaluates your clinical work. There are several common supervision models you should know:

Developmental Model: Supervisory support adjusts based on the therapist’s level of experience and skills. New therapists need more direction; advanced therapists get more autonomy.
Psychodynamic Model: Focuses on the therapist’s unconscious processes, feelings about clients, and relational dynamics in therapy.
Integrative Model: Combines different approaches and tailors supervision based on the therapist’s needs, the client population, and clinical context.
Reflective Model: Emphasizes self-reflection, helping therapists think critically about their practice and personal reactions.
Task-Oriented Model: Focuses on specific clinical tasks, skills development, and problem-solving.

Summary of

ATCB Code governing Standards of Practice, Eligibility for and Regulation of Credentials, and Disciplinary Procedures

The Art Therapy Credentials Board (ATCB) is a nonprofit organization responsible for issuing credentials to art therapists who meet specific standards. These credentials are granted to protect the public and ensure that art therapists practice within a set of established professional standards.

Here are the key points to remember for your exam:

Purpose of the ATCB:

Protects the public by certifying qualified art therapists.
Sets standards for art therapy practice.
Provides several credentials to art therapists from various practice disciplines.

Board of Directors:

Composed of academicians, practitioners, supervisors, and public members.
Develops and maintains the standards for practice based on real-world needs.

The Code:

Governs Standards of Practice, Eligibility for Credentials, and Regulatory/Disciplinary Procedures.
Applies to all credentialed art therapists and those applying for credentials.
Includes rules that all ATCB credential holders must follow, regardless of other professional affiliations.

Disciplinary Actions:

If an art therapist does not follow the Code or Standards of Practice, the ATCB can take actions such as:

Withholding, suspending, revoking, or declining credentials.
Placing the individual on probation.

ATCB's Role:

Does not guarantee job performance or express opinions about an art therapist's competence.
Credentials only indicate that the individual has met the minimum academic, professional experience, and continuing education requirements.

🔹 1.1 Intent and Application of the Code

The Code has three main components:

Standards of Practice
Eligibility and Regulation of Credentials
Disciplinary Procedures

It outlines the professional and ethical expectations for anyone seeking, holding, or maintaining ATCB credentials.
Every credentialed or aspiring art therapist must follow it.
Ignorance of the Code is not a valid excuse for violating it.
Violations can result in disciplinary actions (e.g., probation, suspension, revocation of credentials).

🔹 1.2 Scope of the Code

Applies to all professional activities, including:

Therapy sessions
Supervision
Consultation
Training
Research
Editorial or peer-review work

Applies across all settings and formats, including:

In-person
Phone
Email
Text
Video calls, etc.

Therapists must also follow:

All federal, state, local, tribal, and international laws
Agency and institutional review board regulations
Other applicable professional standards

ATCB does not guarantee that following its Code will automatically ensure compliance with other organizations or legal bodies.
ATCB may share credential and disciplinary info with:

Licensing boards
Government agencies
Credentialing organizations
Professional associations

🔹 1.3 Key Definitions You Should Know

Art Therapist
Anyone who has applied for, holds, or is trying to maintain ATCB credentials.

Client
Recipient of art therapy services.

Confidential
Any information—spoken, written, or artistic—shared by or about a client during therapy.

Conflict of Interest
When an art therapist’s objectivity is or may be compromised due to personal, financial, or professional relationships.

Crisis Situation
When someone experiences something they feel is unmanageable using their current coping skills.

Legally Authorized Representative
Someone legally allowed to consent on behalf of another (e.g., a guardian for a minor or incapacitated person).

Dual Relationships
When an art therapist has more than one role with a client (e.g., therapist + friend, or therapist + business partner), or is involved with someone close to the client.

Reasonable/Reasonableness
What an average, competent art therapist would typically do under similar circumstances.

Reasonable Cause
Enough factual evidence or observation to believe something is likely true.

Social Media
Websites/apps that allow users to share content or connect online (e.g., Instagram, Facebook, LinkedIn).

✅ What to Focus on for the Test:

Know the 3 components of the Code and its application across all settings.
Be clear on definitions like dual relationships, conflicts of interest, and crisis situations.
Understand compliance with laws and limits of ATCB's authority.
Remember that violations have consequences, and you can’t claim you didn’t know the rules.

🔹 2.1 Conduct of Art Therapists

Scope of Practice:

Only practice within your education, training, and experience.
Correct any false or misleading claims about your qualifications.

Conflicts & Dual Relationships:

Avoid conflicts of interest and dual relationships unless:

They’re unavoidable, limited, and with informed consent.
Take action to reduce harm if dual relationships become problematic.

Discrimination & Harassment:

Never discriminate based on personal characteristics or identity.
Avoid unprofessional, harassing, or hostile behavior.

Personal Relationships:

No romantic/sexual relationships with:

Current clients, supervisees, students, research participants.
Former clients or supervisees until 5 years after the relationship ends and with documented closure.

Therapist Impairment:

Do not practice if impaired (e.g., mental health, substance abuse).
Seek help or consult if personal issues affect your work.

Termination of Therapy:

End therapy if the client has reached goals, is no longer benefiting, or discontinues therapy.

Participation in Investigations:

Make reasonable efforts to participate in ATCB and legal investigations.
You may invoke your Constitutional right against self-incrimination.

🔹 2.2 Responsibility to Clients

Client-Centered Care:

Always act in the client’s best interest.
Use the client’s preferred name and pronouns.

Informed Consent:
Clients must be informed of:

Therapist’s qualifications
Fees and payment options
Goals and limitations of therapy
Confidentiality (limits and scope)
Supervision and use of other professionals
How their art may be used (must have written consent)

Multi-client Scenarios:

Clarify roles and confidentiality when treating more than one person in a relational unit (e.g., couples, families).

Missed Sessions & Continuity of Care:

Make reasonable efforts to maintain contact and reschedule.

Referrals:

Refer clients when you cannot meet their needs.

🔹 2.3 Therapy Records & Record Retention

Record Keeping:

Keep clear, detailed, legible notes and comply with legal and professional standards.

Record Storage:

Store/dispose of records safely and confidentially.
Create a succession plan in case of your unexpected death or incapacity.

Access to Records:

Clients have a right to access their records, unless limited to protect someone’s well-being.

🔹 2.4 Client/Patient Artwork

Client Art as Confidential Property:

Store it securely and treat it as part of the clinical record.
Don’t display or share it without written consent.
Retain or dispose of it per regulations and sound clinical practice.

🔹 2.5 Practice Environment

Create a safe, functional, and compliant therapy space for all clients and settings.

🔹 2.6 Electronic/Virtual/Remote Therapy

Use only HIPAA-compliant platforms.
Inform clients about:

Risks, benefits, and limitations of virtual services.
Encryption limits and potential confidentiality issues.
Technology failure plans and insurance coverage responsibility.
Third-party access to communications.

🔹 2.7 Financial Obligations to Clients

Transparent Billing:

Only bill for services rendered.
Clarify financial responsibility and insurance coverage before therapy starts.
Provide written fee explanations if requested.

🔹 2.8 Responsibility to Students, Employees, and Supervisees

Promote growth, ethics, and competence.
Do not allow them to:

Misrepresent qualifications.
Practice beyond their training.

Provide:

Accurate supervision, evaluations, and feedback.
Crisis procedures and informed consent for supervision.

Supervision must be within the art therapist’s competence and training.

🔹 2.9 Confidential Information

Protect confidentiality at all times.
Disclosure allowed only if:

Client consents.
Required by law or court order.
To prevent serious harm or crime.

Even after therapy ends, confidentiality must be maintained.
Only share minimum necessary information.

🔹 2.10 Data Privacy

Secure storage of records and data.
Disguise client identity in training/research unless consented.

🔹 2.11 Websites and Social Media

Separate professional and personal profiles.
Professional sites must:

Be safe and accessible.
Link to the ATCB and licensing boards.
Reflect ethical conduct.

🔹 2.12 Advertising

Be truthful and accurate.
Do not use misleading, false, or exaggerated claims in:

Business cards
Websites
Directories
Promotional materials

📝 What to Focus on for the Exam

Know ethical boundaries around dual relationships, consent, documentation, and virtual care.
Understand rules around client confidentiality, especially regarding artwork.
Memorize the 5-year waiting period for relationships with former clients/supervisees.
Know your responsibilities for:

Recordkeeping
Client communication
Technology use
Supervision and advertising

🔹 3.1 Compliance with ATCB Standards

You must follow all ATCB rules and policies to obtain or maintain credentials.
All credential-related actions (e.g., applications, renewals, updates) must be done through the MyATCB portal.
You must update your contact info within 30 days of any change.
The ATCB can suspend, deny, revoke, or decline credentials if you:

Fail to meet eligibility
Commit fraud or misrepresentation
Provide false information
Are involved in criminal or legal action
Are disciplined by another licensing body or professional organization

🔹 3.2 Application Process

Applicants must:

Be truthful and complete in applications
Disclose any:

Criminal history (past or pending)
Professional complaints or misconduct (past or pending)
Litigation related to professional conduct (past or pending)

Provide explanations and documentation
Notify the ATCB of final dispositions within 60 days

🔹 3.3 Annual Maintenance (Renewal)

Credential year = July 1 to June 30
Renewal begins April 1
Failure to complete renewal = Inactive status
Must disclose:

Any new legal, criminal, or professional complaints
Any pending or past disciplinary or litigation matters

Grace period: 30 days (ends July 30)
After grace period = credential becomes inactive
You may:

Appeal to the Board of Appeals
Choose temporary inactive status or relinquish credentials
To reinstate, you must:

Complete the application
Be in full compliance with all policies (Sections 3.1–3.2)

🔹 3.4 Five-Year Recertification

Board Certification must be recertified every 5 years
Failure to recertify = loss of board certification
A 90-day extension may be available
You may appeal to the BOA

🔹 3.5 New Complaints or Legal Proceedings

You must disclose any new:

Criminal charges or convictions
Administrative or professional complaints
Professional misconduct litigation

Disclosures must be made within 60 days
Provide supporting documentation
You must report the final outcome within 60 days

🔹 3.6 Use of ATCB Credentials

ATCB exams, logos, credentials, seals, etc., are ATCB property
You cannot use them without permission
Unauthorized use may lead to:

Disciplinary action
Legal consequences

If your credentials are inactive, suspended, revoked, or relinquished, you must stop using all ATCB identifiers immediately

📝 Focus Areas for the Test:

Know disclosure timelines (typically 60 days).
Understand when and how credentials can be revoked or suspended.
Be familiar with renewal dates, recertification timelines, and MyATCB portal usage.
Understand the proper use and protection of ATCB-owned materials and credentials.

🔹 4.1 Professional Conduct

Art therapists must:

Be honest, accurate, objective, and fair in all professional work.
Avoid behavior that is deceptive, misleading, or fraudulent.
Refrain from any conduct that harms the profession or public trust.

Misuse of credentials (e.g., false claims) is prohibited.

🔹 4.2 Professional Boundaries

Must maintain clear and ethical boundaries with clients, supervisees, and others.
Avoid dual relationships that could impair judgment or lead to exploitation.

E.g., romantic, financial, or familial entanglements.

Avoid sexual relationships with current or former clients and supervisees.

🔹 4.3 Competence

Only provide services in areas where you're qualified by education, training, or experience.
Seek supervision or consultation when working in unfamiliar areas.
Stay current through continuing education.

🔹 4.4 Assessment and Evaluation

Assessments must be used appropriately, respecting:

Cultural, linguistic, and developmental differences.

Must be qualified to administer and interpret any tools used.

🔹 4.5 Confidentiality

Keep all client information confidential, including:

Verbal communication
Artworks
Digital and written records

Disclose only with:

Informed consent
Or when legally required (e.g., risk of harm, court order)

🔹 4.6 Client Welfare

Always act in the best interest of the client.
Take steps to ensure:

Client safety, especially in crisis situations.
Continuity of care, including referral or termination plans.

🔹 4.7 Cultural Competence

Must demonstrate sensitivity to cultural and individual diversity.
Avoid imposing your own values or beliefs on clients.

🔹 4.8 Use of Technology and Social Media

Maintain professionalism in electronic communication (email, text, video).
Use secure platforms to protect confidentiality.
Avoid engaging clients through personal social media.

🔹 4.9 Record Keeping

Maintain accurate, timely, and secure records of sessions.
Keep records in accordance with:

Legal, ethical, and agency requirements

🔹 4.10 Termination and Referral

Terminate services only when:

Client no longer needs them
Continued service is not in the client’s best interest

Provide referrals or transitions as needed.

📝 Summary for the Test:

Focus on knowing:

What constitutes ethical behavior and misconduct
The importance of clear boundaries, confidentiality, and client welfare
When to seek supervision or consultation
Proper use of technology and records
The difference between appropriate and inappropriate dual relationships
Handling termination, referrals, and crisis situations

Mission

The mission of the Art Therapy Credentials Board (ATCB) is to protect the public by establishing and upholding the highest standards for competent practice of art therapy through the credentialing and certification process.