Throughout my professional work as an art therapist, I have developed and refined a Semi-Structured Art Therapy Assessment Tool (S.S.A.T.A.T). This tool was created in the early 2000s and outlined in my submitted dissertation when completing my MA in Art Therapy in 2007. At the time, I discovered that art therapy assessment tools were in use by therapists in the United States and Europe, but they were not part of my formal art therapy training years earlier.
The S.S.A.T.A.T. uses a combination of six different selected themes/tasks in the initial stages of therapy, enabling me as a clinician to gather information and gain insight into my client's world.
This understanding helps me identify the therapeutic needs and form a treatment plan, allowing the client to tell their story and have their voice heard. The initial images created from these themes/tasks form the backbone of the therapeutic process.
Throughout my practice, I have found that taking a directive approach in the initial stage of therapy can help clients feel safe. As Jean Goodwin (1982) stated, some children are so traumatized that the most important thing within the first few weeks of therapy may be to build up trust. The S.S.A.T.A.T can act as a holding and container, allowing the therapist to witness the pain/trauma without immediately exploring or processing it. This approach enables the clinician to examine resilience and maintain balance without retraumatizing the client. The trauma being witnessed may be sufficient, allowing work in the "here and now."
The therapist may choose to select individual themes or tasks, a combination of a few of the themes/tasks, or decide to use all of the themes or tasks from this Semi-Structured Art Therapy Assessment Tool for completion as part of the assessment plan.
If I had only one session to assess the client, I would use the theme/task, "The Island." The island can change, representing the client's current state and needs. It can very much depict where they are at present and what their needs might be.
Instruction given: Decorate your folder "Make it your own." Clients decorate a folder to make it their own. This task provides insight into the client's world, interests, and personality.
Instruction given: Draw your family, including extended family, friends, or neighbours who are close to them. Include any characteristics or features for those persons contained in the portrait. This task offers insight into the relationships within the family and the client's relationship with their family members.
Fig.1 Photograph of a client image. Family Portrait. Private collection.
Instruction given: Draw a timeline of your life, including important events, happy and sad times, and using colour to represent feelings. This task serves as a map of the client's life and story.
Instruction given: Draw your own island, including who and what you want on it. How do you get on and off and what is the sea like around your island? This task gives insight into the client's world and current needs.
Fig.2 Photograph of a client image. Island. Private collection.
Instruction given: Draw your feelings, representing the size and impact of each feeling in your life. Use colour to match the feeling. This task highlights the impact of traumatic events and emotions in the client's life.
Instruction given: Draw yourself as a flower, providing a self-representation and a means to compare with the family image.
Over the years, I have come to recognize the importance of these particular themes/tasks. I have compared them to some of the most frequently used art therapy assessments in the USA and Europe, such as the Human Figure Drawing Test (Koppitz, 1966), the Kinetic Family Drawings (Burns & Kaufman, 1970), and the Diagnostic Drawing Series (Cohen, Mills & Kijak, 1994).
My S.S.A.T.A.T. differs from these more rigid and structured assessments, as it allows clients more freedom to interpret instructions and express themselves. I am always amazed at how my clients interpret the S.S.A.T.A.T. and how different their responses to the themes/tasks can be.
Initially, art therapy assessment tools were projective drawing tests (Betts, 2012), which have since fallen out of favour due to their heavy reliance on interpretation. Standardized tools that focused on pictorial expression provided only snapshots of clients, and a more comprehensive approach was needed to capture the therapeutic and creative process (Kapitan, 2018).
New assessment models now incorporate essential elements of art therapy processes, such as the triangular relationship (Schaverien, 2000), and the creative process (Lusebrink, 2010; McNiff, 2012). Art therapy assessment is a growing research area driven by the need for research outcomes to satisfy funding providers (Miller, 2014).
A recent example of an innovative assessment tool is the Observation-Based Instrument for Assessment in Art Therapy with Traumatized Women (OBAS-ATT) (Jimenez, 2019). This mixed-methods instrument considers the artwork, creative process, therapeutic relationship, and specific areas related to trauma, anxiety, state of mind, resilience, self-esteem, empowerment, agency, body language, social skills, mentalization, and resilience.
Thus the development of art therapy assessment tools has evolved to incorporate more comprehensive and adaptable approaches, reflecting the complexity of the therapeutic process and the client-therapist relationship.
Several years later, I participated in a Body Mapping workshop (2014) led by Christine Lummis. We used a process diary, which provided me with valuable insight into my own process. Inspired by Lummis's idea, I incorporated a process diary and reflective questions into the S.S.A.T.A.T. to enhance the assessment experience. The reflective questions are samples or suggestions that can be tailored to individual clients.
Reflective questions: Focus on the client's reaction to art materials, feelings during the process. What’s the client communicating with their folder. Folder decoration gives insight into the client's world and interests.
Reflective questions: Explore the relationships within the family, the client's relationship with their family members, the characteristics and any surprises in the portrait. The Family Portrait offers insight into relationships within the family and the client's relationship with their family members.
Fig.3 Photograph of a client image. Exploring the relationship with family. Private Collection.
Reflective questions: Examine the client's feelings during the process, coping mechanisms, and potential gaps in their life story. The Life-line serves as a map of the client's life and story.
Reflective questions: Delve into the client's feelings about their island, its current state, and any desired changes. The Island provides insight into the client's world and current needs.
Reflective questions: Focus on the client's emotions during the process, the accuracy of the feelings' representation, and their size in relation to the client's life. The Feelings task highlights the impact of traumatic events and emotions in the client's life.
Fig.4 Photograph of a client image. Exploring feelings. Private collection.
Reflective questions: Explore the flower's characteristics, its environment, and its potential voice if it had one. The Flower serves as a self-representation and can be compared with the family image.
As a professional, I am continually learning and growing in my practice. The development and use of my Semi-Structured Art Therapy Assessment Tool have been an integral part of my journey as an art therapist.
It has not only helped me better understand my clients but also enabled me to create a safe space for them to express themselves and heal.
Art therapy assessment is a growing research area, with new assessment models taking into account essential elements of art therapy processes. My S.S.A.T.A.T. is just one example of how art therapists can develop tools that are adaptable, sensitive, and reflective of both the client's needs and the therapeutic relationship.
As I continue my practice and research, I am excited about the potential of art therapy assessment tools to contribute to the field and to support the clients I have the privilege of working with.
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Burns, R. C., & Kaufman, S. (1970). Kinetic Family Drawings. New York: Brunner/Mazel.
Cohen, B. M., Mills, A., & Kijak, A. K. (1994). An introduction to the diagnostic drawing series: A standardized tool for diagnostic and clinical use. Art Therapy, 11(2), 105–110. DOI: 10.1080/07421656.1994.
Goodwin, J. (1982). Use of drawings in evaluating children who may be incest victims. Children and Youth Services Review, 4(3), 269-278.
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Kapitan, L. (2018). Introduction to art therapy research (2nd ed.). Routledge.
Koppitz, E. M. (1966). Emotional indicators on human figure drawings of children: A validation study. Journal of Clinical Psychology, 22(3), 313–315. DOI: 10.1002/1097-4679
Lusebrink, V. B. (2010). Assessment and therapeutic application of the Expressive Therapies Continuum: Implications for brain structures and functions. Art Therapy: Journal of the American Art Therapy Association, 27(4), 168–177. DOI:10.1080/07421656.2010.10129380
McNiff, S. (2012). Art-based methods for art therapy assessments. In A. Gilroy, R. Tipple, & C. Brown (Eds.), Assessment in art therapy (pp. 66–80). Routledge.
Miller, C. (2014). Assessment and outcomes in the arts therapies: A person centred approach. Jessica Kingsley Publishers.
Schaverien, J. (2000). The triangular relationship and the aesthetic countertransference
in analytical art psychotherapy. In A. Gilroy & G. McNeilly (Eds.), The changing shape of art therapy (pp. 55–83). Jessica Kingsley Publishers.
Michelle Dunne PG Dip Art Therapy (2001) from CIT, CCAD, completed her MA in Art Therapy (2008) CIT, and has a Higher Diploma in Grief Therapy Counselling (Turning Point, Dublin), and an Advanced Diploma in Supervision (Middlesex University).