Sunrise Report   2024

FRAMEWORK FOR DESCRIBING AND EVALUATING SCOPE OF PRACTICE AND/OR NEW LICENSURE PROPOSALS FOR POLICYMAKERS

Introduction

This framework is designed to aid policymakers in the objective analysis of legislative proposals relating to scope of practice changes for regulated health professions/occupations.

The framework was developed for the State of Minnesota by a core team of professional health care associations, health licensing boards, state legislators, and the Minnesota Department of Health, Office of Rural Health and Primary Care in partnership with the National Governors Association and the National Conference of State Legislatures. The core team remains interested in the use and applicability of this framework. Please send any feedback on the framework and examples of its use to: Nitika.moibi@state.mn.us. Thank you.

Using the Framework

The framework is organized into two parts:

• Part 1 (Summary and Details): This part is intended to summarize and organize key information about the scope of practice proposals to facilitate an objective review for legislators. It is intended to be completed by the author(s) of the proposed statutory change.

Part 1 includes two sections:

• Section I (Proposal Summary/Overview): This section is designed to provide an overview of the rationale for the proposal, including a summary (500-word count limit).

• Section II (Proposal Details): This section includes a series of structured questions capturing and organizing key information on the proposed change and its impact on dimensions important to analyzing such changes. Proposal author(s) may complete only those questions relevant/pertinent to the proposal (not all questions will be applicable in all situations).

• Part 2 (Legislator Review/Evaluation Tool): This part is meant to support legislators in the process of reviewing and evaluating the proposed legislative changes. It includes a series of open-ended questions designed to provoke critical review of key information. It is meant to be completed by the legislator(s) reviewing the proposal and serve as a quick reference.

Part 1

Section 1- Proposal Summary/ Overview

To be completed by proposal sponsor. (500 Word Count Limit)

1. State the profession/occupation that is the subject of the proposal.

Professional art therapists are seeking regulation by the state of Minnesota.

2. For existing professions, briefly describe the proposed statutory change or expansion and its intended outcomes, including a brief statement of importance. For currently unregulated or emerging professions, briefly describe the proposed scope of practice and/or other regulatory requirements.

Art therapists are seeking a distinct professional license with a scope of practice that accurately reflects the highly specialized clinical training and practice of art therapy, defined qualifications, and standards for practice to assure competent, safe, and ethical practice of art therapy. Regulation of the art therapy profession is sought to prevent public harm by persons claiming to practice art therapy without licensure and appropriate clinical training.

Art therapy is an integrative mental and behavioral health profession that enriches the lives of individuals, families, and communities through active art-making, creative processes, applied psychological theory, and human experience within a psychotherapeutic relationship.

Art therapists seek to engage a client’s mind, body, and spirit in ways that are distinct from verbal articulation alone. They use art therapy assessments and methods to create kinesthetic, sensory, perceptual, affective, symbolic, and creative opportunities that invite alternative modes of receptive and expressive communication, which can circumvent the limitations of language. Visual and symbolic expression give voice to experience and empower healing and transformation.

Art therapists work in diverse settings and with diverse client populations. Their functions and methods may differ depending on clinical orientation, the setting, and the client population served.  However, some art therapy functions may be considered basic to all practices of art therapy, including: 

• Using art therapy assessment methods to determine treatment goals and implement therapeutic art interventions to meet clients’ developmental, emotional, and mental needs;

• Creating safe, supportive, and non-judgmental environments for client art-making and evaluation; 

• Using treatment interventions that provide clients with opportunities for expression through the creative process; 

• Employing art media, the creative process, and the resulting artwork to assist clients in coping with and reducing psychiatric symptoms, enhancing neurological, cognitive, and verbal abilities, and promoting appropriate skills development.

• Engaging in case management, client psychoeducation, recordkeeping, and consultation with other professionals, as art therapists look beyond the surface-level symptoms and identify the “why” and the “how” behind behaviors and experiences. 

The objectives and functions of art therapy practice are described in more detail in the American Art Therapy Association’s Scope of Practice for Professional Art Therapy document (Attachment F) and the Art Therapy Credentials Board Ethical Principles for Art Therapists document (Attachment D).

Section 2 – Proposal Details

To be completed by the proposal sponsor. Please respond to applicable questions. A response is not required for questions which do not pertain to the profession/occupation (may indicate “not applicable” or leave the response area blank). Where applicable, please provide supporting evidence (including source of information and citations, where appropriate). Please note, this section has been designed to provide more detailed information about the proposal. Some overlap with the summary provided in Section 1 is expected.

A) Public Safety and Well-Being

1. Describe, using evidence to the extent possible, how the proposed scope and regulation may improve or may harm the health, safety, and welfare of the public?

Art therapists are mental health professionals who utilize their specific art therapy training to help children and adults with psychological, developmental, and behavioral challenges and/or disabilities find non-verbal ways to communicate emotions and find relief from pain. Art is an expressive tool, and art therapy recognizes the power of art and art-making to stimulate memories and reveal emotions.  Recent advancements in understanding the brain and its functions have increased public awareness of how the process of art-making can influence neural pathways and lead to improved physical and mental health. This has encouraged other licensed mental health practitioners (non-art therapists) to include art materials and art therapy methods within their practice without formal art therapy training and, often, with as little as basic continuing education courses or seminars in specific art therapy diagnostic tools. Art therapy is not regulated in Minnesota and almost anyone can represent themselves to the public as an art therapist or as having the training to practice art therapy. The primary potential for harm exists from individuals using art therapy methods without appropriate training.

Trained art therapists know how to appropriately respond to information communicated in and through a client’s artwork or creative process.   Understanding how art interacts with a client’s psychological disposition, and how to safely manage and interpret the reactions different art processes may evoke, are competencies that must be gained through substantial experiential learning that is unique to art therapy training. The use of art therapy carries risk of harm if applied beyond the training and competence of the practitioner.  Harm or potential for harm exists when practitioners lack specialized training to recognize mental health illness symptoms and features indicated in the process of art-making that suggest a patient or client may be at risk to harm themselves or others.

Researchers have warned mental health practitioners for several decades about potential ethical implications of using art in therapy. Writing in the Journal of Counseling & Development, Hammond and Gantt (1998), determined that untrained mental health practitioners have a likely lack of preparedness for powerful reactions often evoked by art and art materials, and uncertainty about how to use artistic processes to bring such reactions under control, to stress that no mental health professional should provide therapy services beyond his or her scope of practice. The authors cautioned that “other therapists challenge ethical and legal boundaries when they attempt to make an interpretation to the client or make a generalization about the meaning of the art to others.”

Despite these warnings, online listings by Psychology Today that identify therapists by different cities or regions in Minnesota include numerous licensed professionals who claim art therapy as a specialty or treatment approach without any indication of formal training or credentials. This means any person looking for someone who can apply art therapy interventions in mental health counseling cannot verify that the therapist they contact has appropriate or specialized training to provide art therapy with them. Unknowingly, many individual residents in Minnesota are put at risk when they have a mental health clinician conducting art therapy sessions.

Growing public awareness and interest in art therapy has encouraged increasing numbers of university-based and online programs claiming to provide certificate training, and even master’s degrees, in areas that appear very much like art therapy. Using titles such as “Arts in Medicine,” “Art for Healing,” or “Artists in Healthcare,” these programs claim to offer certification or “fully accredited” programs intending to appear as training in art therapy.  However, these programs typically require minimal on-site coursework, and often only online self-instruction. They do not include anything approaching the extensive graduate coursework, clinical training, supervised post-graduate practice, and national credentials required of professional art therapists. These programs do not provide adequate training for the safe and responsible practice of art therapy. Some of these programs, as well as publishers, also have sought to represent adult coloring books as involving “art therapy.” (A discussion and recent examples of programs misrepresenting training as art therapy is included in Attachment A, Public Risks from Untrained Practice of Art Therapy).

Individuals claiming training and certifications in methods or treatments intended to appear to the public as professional art therapy are opening health centers, advertising therapeutic services, and workshops in Minnesota and across the country.  

Examples are readily found on the internet and anecdotally from our members, including:

• Confusion in the marketplace: 

  • Psychology Today provides listings of mental health practitioners in Minnesota who offer “art therapy.” The number listed are numerous and only a handful can be confirmed as having art therapy master’s degrees and/or art therapy credentials. Some practitioners listed do not even have a master’s degrees. 4% of therapists listing art therapy as a specialty were verified to have proper education or credentials.

• Public risk recognized by other professionals: 

  • In the Twin Cities, it was reported to a clinical supervisor that an untrained therapist is conducting “art therapy” groups with their patients. In speaking with other licensed staff at this facility, namely a Social Worker and an Occupational Therapist, it was reported that, “After the clients come out of these [art therapy] sessions, we often have to pick up the pieces [of the emotionally distraught group participants].”  

• Contributing to the Misunderstanding of Art Therapy practices: 

  • A mental health practitioner inquired of Adler Graduate School of Psychology’s art therapy program director seeking art therapy students who may be interested in analyzing/interpreting children’s artwork for this practitioner who was hoping to discover the meaning of the artwork, noting the clients may have traumatic histories.

  • An in-home personal care assistant company inaccurately claims that their PCAs can include art therapy for seniors with their in-home services. Their website also inaccurately describes art therapy.

  • Radio station posted an article that misrepresents an art group and art show done with a recreation therapist as art therapy at an art center in St. Peters, MN. 

  • The University of Minnesota offers a “Healing Imagery” undergraduate course with the course description: “In this course, you will learn how imagery and imagery interventions are implemented for healing, and to promote health and well-being. You will experience a wide variety of imagery interventions in class and work on creating your own imagery interventions. The primary instructional strategies that will be utilized for this course include: experiential, discussions, readings, lecture and individual learning interventions.” The course is taught by an Advance Practice Nurse with no known art therapy training or experience and could create confusion for professionals and clients/patients as to what art therapy practice is and who is qualified to practice it.

  • CADI Waivers in MN allow for art therapy services to be reimbursed, but they inaccurately classify art therapy under Independent Life Skills Services. This creates confusion as it does not clearly identify art therapists as mental health professionals.

• Ethics Violation and False Advertising

  • A Registered Art Therapist testified that they were approached for advice from a professional who is not formally trained in art therapy practices and is attempting to practice art therapy ineffectively with their patients.

  • A therapy group practice in the Twin Cities lists that they offer both child and adolescent art therapy groups on their website, but none of their therapists list art therapy training in their bios. They have an open job listing for a play therapist, but not for an art therapist. 

  • Group therapy practice in Brooklyn Park states they offer art therapy for children and adolescents, but none of their staff have art therapy training or credentials.

  • An art educator advertises her art lessons for people with cognitive disabilities as “art therapy” classes that can be purchased online in St. Paul.

  • A Child Life department of a hospital inaccurately describes the training of a child life specialist as having training in art therapy.

  • A Twin Cities art educator claims she “blended Art Therapy Techniques with Fine Arts for her Master's Degree,” however her Master’s degree is not in art therapy. She advertises art therapy classes utilizing art therapy techniques as part of her curriculum.

  • A veteran women’s weekend event advertised offering art therapy, although the person offering the event does not have art therapy training or credentials.

These practitioners add to the public’s confusion about what art therapy involves and the level of training required for safe effective practice of art therapy. They also contribute to unnecessary delays in obtaining appropriate care, as well as additional expense, by consumers who have had to experiment with ineffective and potentially harmful treatments before learning about art therapy or identifying a qualified art therapist. These options, and most likely more, are being promoted to: Veterans, children, individuals with severe and persistent mental health, the elderly, individuals with disabilities, and trauma survivors.

(A list and recent examples of organizations misrepresenting art therapy is included in Attachment A: Public Risks from Untrained Practice of Art Therapy).

Art therapists begin therapy with the assumption that specific art therapy techniques, interventions, and/or materials might already be too powerful for specific client populations. Trained art therapists are able to use “graphic indicators” (such as content of the artwork, type of material used, the method in which materials are used, and positioning of images on a page) to assess risk, identify treatment needs, and support accuracy in diagnosis.  Individuals using art therapy methods and art materials in their mental health practice without appropriate or adequate clinical training pose significant risk to the emotional stability of their clients. Potential risks include misinterpreting or ignoring assessments the practitioner has not been clinically trained to diagnose or treat, or eliciting adverse responses from clients that they are not properly trained to interpret or treat. The potential for harm is magnified where a client has a vulnerable psychological predisposition.

2. Is there any research evidence that the proposed change(s) might have a risk to the public? Please cite.

No.

3. Will a regulatory entity/board have authority to discipline practitioners?

Yes.

4. Describe any proposed disciplinary measures to safeguard against unethical/unfit professionals. How can consumers access this information?

Lack of formal training and limited regulation of art therapy competencies carries substantial risk. The current state regulatory structure for art therapists does not lend itself to identifying and documenting serious complaints or disciplinary actions against art therapists.  Art therapists traditionally work towards and obtain the entry-level Registered Art Therapist (ATR) professional credential conferred by the Art Therapy Credentials Board (ATCB). Both the Art Therapy Credentials Board and The American Art Therapy Association have established ethical standards for practice of art therapy and requires adherence to these standards by all AATA members. (See Attachment D: Art Therapy Credentials Board Code of Ethics and Professional Practice document). This document defines and establishes principles of ethical behavior and conduct that apply to art therapists’ professional activities across a wide variety of contexts, including in person contacts and electronic transmissions including telephone, email, and internet.  

Art therapists must follow the profession’s strong Code of Ethics and Professional Practice required of them while working towards and after obtaining their credentials. However, compliance with the Ethics Principles is largely self-regulating.  The ATCB’s Ethics Committee is charged with educating credential holders about the ethical standards and their obligation to observe them.

The American Art Therapy Association and Art Therapy Credentials Board currently review complaints of unlicensed or unethical practice of art therapy either by art therapists who had not applied for licenses, or individuals claiming to be art therapists without appropriate training to qualify for licenses.  However, the disciplinary action is only applicable to the credential holder and does not impact their ability to practice within their state due to their other state-held license.  This carries risk of ongoing harm without additional state-based oversight.

In the absence of separate art therapy licenses in the majority of states, art therapists have, out of necessity, sought licensure in closely related mental health fields, particularly as mental health counselors and marriage and family therapists.  Disciplinary actions and complaints at the state level are generally not identified by the licensees’ background training or specialty and, thus, are indistinguishable from all others holding the same license. Even in several states that have provided art therapy licenses administered by composite mental health licensing boards, complaints and disciplinary actions are disclosed only by individual names or case numbers and do not identify specific licenses. In contrast, in the states that have administered an art therapist license with a separate art therapy licensing board or sub-committee of a related licensing board, the board provides details of complaints and disciplinary actions in meeting minutes.  The state licensing body is able to follow through with disciplinary action in a measurable and effective way.

The following describes the typical disciplinary measures used by the ATCB to address unethical behavior by credentialed professionals.  This process would be adopted by a state art therapy license, as would the Code of Ethics provided by the American Art Therapy Association and ATCB.

Following a disciplinary hearing and final determination by a Disciplinary Hearing Panel, the ATCB may deny, refuse to issue, revoke, suspend, or refuse to renew registration or certification of an art therapist for the following causes:

• Violation of the ATCB Standards of Ethics and Conduct

• Misrepresentation of the status of ATCB credentials

• Habitual use of alcohol or any drug or substance that impairs competent and objective performance

• Gross negligence in practice and professional work

• Limitation or sanction on practice of art therapy by a regulatory agency or board

• Conviction, or plea of guilty of a felony or any crime related to the practice of art therapy, professional qualifications, or public health and safety.

The ATCB Code of Ethics and Conduct provides for summary suspension of an art therapist’s credential for serious legal offences, including: 

• Capital offenses

• Sexual offenses involving a child victim

• Felony sexual offenses involving an adult victim who is a client 

• Multiple counts of felony sexual offenses involving any adult victim; 

• Homicide 1st degree

• Kidnapping

• Arson

• Homicide of lesser degrees

• Felony sexual offenses involving an adult victim who is not a client 

• Any felony or misdemeanor offenses potential physical harm to others and/or animals

• Felony or misdemeanor alcohol and drug offenses

Access, Cost, Quality, Care Transformation Implications

5. Describe how the proposed change(s) will affect the availability, accessibility, cost, delivery, and quality of health care.

Proposed regulation of Art Therapists will likely have the following impact on the supply of qualified mental health professionals in Minnesota:

• Licensure and regulation of Art Therapy will increase public awareness of Art Therapy and encourage growing numbers of students to enter Art Therapy graduate degree programs in Minnesota and nearby states.

• Licensure and regulation of Art Therapy will increase the supply of qualified Art Therapy practitioners in Minnesota by several means: first, by encouraging art therapists, including graduates of the Adler Graduate School of Psychology’s Art Therapy graduate degree program, to remain and practice in Minnesota, second by encouraging former graduates who have left Minnesota to gain licensure to return, and lastly by attracting Art Therapists from other states to relocate and practice in Minnesota.  (See Attachment B: CAAHEP Curriculum Competency Requirements for Educational Programs in Art Therapy)

• Art Therapy has been identified as a “Bright Outlook” occupation in the Occupational Information Network (O*NET) database of the U.S. Department of Labor. This indicates that the number of students pursuing careers in Art Therapy can be expected to grow significantly over the next decade. Since the addition of Art Therapy to O*NET, the field of Art Therapy has seen a dramatic increase in number of young people pursuing this career. 

• Licensure of qualified practitioners provides a reasonable, efficient and cost-effective approach for increasing the number of Art Therapists to help meet the growing need for trained mental health professionals across the state. 

Degree to which existing practitioners would be precluded: 

• Current licensed mental health professionals who use visual art or Art Therapy methods in their practice but lack the required academic master’s degree and supervised training in Art Therapy would not be precluded from continuing their practice, provided they do not describe their practice as Art Therapy or hold themselves out to the public as a licensed Art Therapist or infringe on the art therapist’s scope of practice. This does not prevent licensed mental health professionals from using art within their general scope of practice, but precludes them from using specific Art Therapy techniques in their practice.

• Credentialed Art Therapists with older master's degrees that do not meet specific education or supervised training requirements for licensure, but with prior years of professional practice of Art Therapy, would be able to obtain licensure under a recommended grandfather provision in the licensing legislation. 

• Only individuals who improperly claim to practice Art Therapy but lack qualifying training in Art Therapy or another licensed mental health profession would be precluded from practice.

6. Describe the unmet health care needs of the population (including health disparities) that can be served under this proposal and how the proposal will contribute to meeting these needs.

This proposal would allow art therapists, as a distinct field of licensed mental health professionals, to serve larger numbers of clients and be recognized as an independent practice of health care in the state of Minnesota. This proposal would allow for art therapists to work with groups of people who did not previously have access to art therapy in their communities. Additionally, since art is a visual and expressive tool, it is a valuable tool for working with individuals for whom language and verbal communication is often a barrier.  Examples include young children, individuals who have experienced significant trauma (including veterans, refugees, children involved in Child Protective Services), individuals for whom English is not a first language, individuals with Autism or other developmental delays involving limited use of verbal language, and elderly adults with dementia and related disorders.  In Minnesota, a significant number of citizens would benefit from art therapy services:

• As of 2019, Minnesota was home to 321,809 veterans, which is 6.4% of the state’s adult population.

• As of 2017, the number of adults age 65 and older in Minnesota reached 806,000, making up about 15 percent of the population. That population is projected to top 1.3 million in the next two decades, and more than one out of every five Minnesotans will be an older adult.

• As of 2018, 11.7% of Minnesota residents spoke a language other than English in the home.  The state’s population includes nearly 25% of all Hmong immigrants in the United States.  There are 58,800 people of Somali heritage living in Minnesota.  5.5% of Minnesota’s population identifies as Hispanic or Latino.

• As of 2018, the prevalence for Autism in Minnesota residents is one in 36, and the incidence for other neurodevelopmental disorders in children has also grown. 

• In 2018, 6,948 children were involved in Child Protective Services cases, with identified stressors including parental drug abuse, neglect, physical abuse, sexual abuse, and caregiver mental health issues.

• According to Mental Health America, Minnesota ranks 6th in prevalence of mental health concerns among the adult population.

Currently, credentialed art therapists work in a variety of clinic and private practice settings, but experience barriers to working in some settings specifically designed to help the above populations due to the lack of a state recognized license.  With a state art therapy license, the opportunity for job growth and the opportunity for expanded access to art therapy services would be greater.

7. Please describe whether the proposed scope includes provisions to encourage or require practitioners to serve underserved populations.

Art therapy by its nature is an avenue for serving underserved populations.  As a visual and expressive tool, art therapy provides access to healing for individuals for whom traditional talk therapy does not work.  Art therapy also lends itself to group and community healing because the active and sensory experience of art-making offers opportunities to externalize pain and turn negative experiences into tangible expressions of hope and healing. 

8. Describe how this proposal is intended to contribute to an evolving health care delivery and payment system (e.g. interprofessional and collaborative practice, innovations in technology, ensuring cultural agility and competence in the profession, value based payment etc.)

This proposal would include licensed art therapists in the field of mental health professionals who are able to provide telehealth sessions included in their billed services, something revealed to be crucial throughout the COVID-19 pandemic. Licensed art therapists will also have to take continuing education credits to maintain their licenses, and some of these courses will be regarding multiculturalism.

2. Regulation

   1. If the services or individuals are currently unregulated, what is the proposed form of credentialing/regulation (licensure, certification, registration, etc.)? State the rationale for the proposed form/level of regulation.i If there is a lesser degree of regulation available, state why it was not selected.ii

Minnesota Art Therapists along with the American Art Therapy Association (AATA) consider a separate clinical art therapy license (L.C.A.T.) to be the most appropriate level of regulation. Many art therapists in Minnesota are already licensed as either Marriage and Family Therapists (LMFT), Licensed Professional Counselors (LPC) or Licensed Professional Clinical Counselors (LPCC), Licensed Psychologists (LP) or Licensed Clinical Social Workers (LISCW).

Over the years, both the Minnesota Board of Psychology and Minnesota Board of Social Work have adopted changes in their statutes that have prevented any additional art therapists from pursuing or being grandfathered into these licenses. Additionally, the counseling professions’ continuing campaign to create a uniform identity for counselors based on CACREP program curriculum and degrees may serve to deny art therapist mental health counselor regulation if Minnesota adopts these standards in the future.

Minnesota is home to a wide range of mental health practitioners, all of whom can currently represent themselves as providing art therapy. The discrepancies in educational background inherent to this situation lend themselves to creating significant confusion in the marketplace as to what actually constitutes art therapy. The establishment of an art therapy license which offers title and practice protection for art therapists can dramatically reduce confusion and ensure that those purporting to offer art therapy services are of a uniform and sufficient educational background and training to render those services safely and effectively.

The State Advisory Council on Mental Health & Subcommittee: 2016 Report to the Governor and Legislature identified an increasing need for trained and experienced mental health professionals in Minnesota to provide early assessment and culturally relevant treatment services to both urban and rural underserved populations. Particularly: Children, adolescents and young adults experiencing behavioral problems and mental health conditions that impact school and family environments; and people struggling with addictions and co-occurring disorders. Additionally art therapist can serve military veterans, personnel and their families who may experience deployment/re-deployment, reintegration issues, traumatic brain injuries, military sexual trauma, and post-traumatic stress; the growing population of older adults suffering from dementia and physical ailments that lead to social isolation and caregiver stress; survivors of gun violence and human trafficking; cancer and other medical condition survivors and their families; adults with developmental disabilities. Art therapists are helping to meet this need in hospitals, clinics, reservations, schools, outpatient and senior communities, shelters, veteran’s centers, chemical health agencies and correctional facilities across Minnesota.

Without a separate clinical licensure in Minnesota for art therapists, it will be increasingly difficult to expand the use of innovative mental health services by appropriately trained professionals to reach and serve the growing mental health care needs of the residents of Minnesota.  

2. Describe if a regulatory entity/board currently exists or will be proposed. Does/will it have statutory authority to develop rules related to a changed/expanded scope or emerging profession, determine standards for education and training programs, assessment of practitioners’ competence levels?  If not, why not?iii

This legislation proposes the regulation of art therapists under the Minnesota Board of Marriage and Family Therapy by the addition of 2 professional members representing the art therapy profession and to establish reasonable standards regarding minimum requirements for licensure, leaving some space for board member discretion with regard to academic background in line with the other professions regulated under the board at present. This legislation proposes educational, practicum, and certification requirements for applicants, as follows: a graduate degree from a CAAHEP accredited institution or substantially similar academic background, the completion of 1000 hours of supervised practice, and receipt of a passing score from the ATCB board certification examination or substantially similar competency examination from a successor credentialing organization.   See Attachment C: A Sample “ATCB Agreement for Services to State Licensing Boards”.

3. Is there model legislation for the profession available at the national level? If so, from what organization? Which states have adopted it? Briefly describe any relevant implementation information.

Currently, 14 states and the District of Columbia have art therapy licenses: Connecticut has the Clinical Licensed Art Therapist (CLAT); Delaware has the Licensed Professional Art Therapist (LPAT) and Licensed Associate Art Therapist (LAAT); Kentucky has the Professional Art Therapy License (LPAT) and Professional Art Therapist Associate License (LPATA); Maryland has the Professional Clinical Art Therapy License (LPCAT) and Professional Graduate Art Therapy License (LGAT); Mississippi has the Professional Art Therapy License (LPAT); New Jersey has the Professional Art Therapy License (LPAT) and Licensed Associate Art Therapist (LAAT); New Mexico has the Professional Art Therapist License (LPAT); Oregon has the Licensed Art Therapist (LAT) and Licensed Certified Art Therapist (LCAT); Virginia has the Licensed Art Therapist (LAT) and Licensed Associate Art Therapist (LAAT); in Pennsylvania art therapy is defined in regulation as a qualifying “closely related field” for the professional counseling license (LPC); New York has the Creative Arts Therapist License (LCAT); Ohio has the Professional Art Therapist License (LPAT); Texas has a Professional Counselor with Specialization in Art Therapy License (LPC-AT); in the District of Columbia has the Licensed Professional Art Therapist (LPAT); in Utah, art therapists with clinical art therapy master’s degrees are recognized by the Utah Division of occupational and Professional Licensing as meeting the education requirements for the Associate Clinical Mental Health Counselor license; and Wisconsin has a Registered Art Therapist with License to Practice Psychotherapy.   See the full listing of licenses and credentialing bodies in Attachment E: State Licensing of Art Therapy.

4. Does the proposal overlap with the current scope of practice for other professions/practitioners? If so, describe the areas of overlap. (This question is not intended to imply that overlap between professions is negative.)

There is substantial overlap between the scope of practice of art therapists and other allied mental health care providers. Art therapy master’s level education shares a common foundation with other mental health professions in the study of human psychological development, theories of personality, group and family therapy, appraisal and evaluation, therapeutic knowledge and skills, and multicultural diversity competence.  However, it also requires training in studio art (drawing, painting, sculpture, etc.), the neurobiological implications of art-making, the creative process, and art therapy assessment methods. To qualify for admission, students must meet prerequisite requirements of college level training in psychology and studio art. Students must then complete a minimum of 66 to 75 credit hours (dependent upon specialization track) of graduate-level coursework, as well as 700 hours of supervised art therapy field experience. 

3. Education and Professional Supervision

   1. Describe the training, education, or experience that will be required for this professional based on this proposal, including plans for grandfathering in prior qualifications and/or experience where appropriate.

National requirements for professional entry into the practice of art therapy include, at minimum, a master's degree and extensive post-graduate clinical experience under the supervision of credentialed art therapists—a process which typically requires a minimum of four years.  Some art therapists also have a doctorate degree.  Because of the uniqueness of the study and practice of art therapy, practitioners must be trained within an approved art therapy master’s degree program recognized by the American Art Therapy Association, or equivalent mental health education programs approved by Art Therapy Credentials Board.  The Association has approved thirty-nine art therapy master’s degree programs at thirty-five accredited colleges and universities in twenty states, Canada, and the District of Columbia.

There is currently only one art therapy master’s degree program in Minnesota: The Adler Graduate School in Minnetonka.

Graduate program supervised experience includes a 100-hour practicum involving observation and practice in preparation for clinical internship practice. The internship requires a minimum of 600 supervised hours over at least two academic terms.  A minimum of 350 hours must involve working directly with clients providing art therapy services.  The remaining hours may be divided between experience with case review, record keeping, preparation, treatment team meetings, in-service conferences, and supervisor evaluations.

Art therapy master’s program training is distinct in its emphasis on imagery and art-making. Students are trained to understand the concepts of creativity and symbolism along with the science of imagery and of color, texture, and art media. This understanding of both art process and art products facilitates the therapeutic relationship to bring about healthy self-expression that can reduce symptoms and/or bring closure to clients. The art therapy curriculum includes course content based on two underlying theories: the Expressive Therapies Continuum which guides decision making processes in art therapy practice, and the premise that focused art making constitutes reflective practice and facilitates learning and resilience. The graduate curriculum also encourages students’ immersion in their own art practice, and art-based learning is integrated into all courses and clinical supervision.

Current program and curriculum standards for art therapy master’s programs were established in 2007 and continue to be administered by the American Art Therapy Association’s Educational Programs Approval Board (EPAB). The standards will continue to apply to programs with unexpired EPAB approval through a five-year transition to a new program of external accreditation through the Commission on Accreditation of Allied Health Education Programs (CAAHEP). 

Current EPAB art therapy program standards focus on nine core areas of coursework that all students must complete.  Core course areas include, but are not limited to:

• Theories of art therapy, counseling, and psychotherapy

• Ethics and standards of practice

• Assessment and evaluation

• Individual, group, and family art therapy techniques

• Human and creative development

• Multicultural issues

• Creativity, symbolism, metaphor

• Research methods

• Internship experiences in clinical, community, and/or other settings

As examples of how individual programs have structure coursework requirements to address these core areas and additional topics is demonstrated in the curriculum requirements for the Adler Graduate School’s art therapy master’s degree programs, which are provided as Attachment B: CAAHEP Educational Standards.

The CAAHEP Board formally approved the art therapy program standards and curriculum competency requirements prepared by the Accreditation Council for Art Therapy Education (ACATE) in 2016, and ACATE currently accredits 53 programs and is reviewing applications for accreditation from an additional art therapy programs around the country.

The new CAAHEP curriculum standards take an outcomes-based approach that focuses on competences that students must attain rather than core content and course requirements.  The standards divide and expand the nine core course areas in the EPAB standards to define seventeen curriculum content areas that must be included in each program’s curriculum.  These content areas are further broken down into 147 competency requirements that describe the knowledge, skills and behaviors students must attain for competent practice of art therapy. The CAAHEP curriculum competency requirements are included in Attachment B: CAAHEP Educational Standards.

Grandfathering would be based on applicants who have achieved both Art Therapy Registration & Board Certification and 4,000 hours of post-graduate supervised practice. 

2. Is the education program available, or what is the plan to make it available? Is accreditation or other approval available or proposed for the education program? If yes, by whom?

Yes, accreditation is proposed for the education program via ACATE (CAAHEP)

3. Do provisions exist or are they being proposed to ensure that practitioners maintain competency in the provision of services? iv  If so, please describe.

They must complete a minimum of 1000 hours of direct client art therapy services and receive a minimum of 100 hours of supervised practice. Practitioners whom receive the ATR-BC credential must maintain their credentials and complete 100 qualifying continuing education credits during the five-year certification cycle or re-take and pass the Art Therapy Credentials Board Examination (ATCBE), which is updated annually. A minimum of 6 CEC must be in the area of ethical professional practice.

4. Is there a recommended level/type of supervision for this practitioner—independent practice, practice needing formal agreements or delegated authority, supervised practice? If this practitioner will be supervised, state by whom, the level, extent, nature, terms of supervision.v

Any program graduate from an AATA approved program whom is granted the ATR-Provisional (ATR-P) credential must contract to participate in on-going supervision by an ATR-BC. They must complete a minimum of 1000 hours of direct client art therapy services and receive a minimum of 100 hours of supervision, of which 50% must be from an ATR-BC. The practitioner my also receive additional supervision in the workplace or independently from another board approved mental health practitioner (LMFT, LPCC, LP, or LICSW). The amount of experience and supervision required to achieve proposed licensure status in MN would be 4000 hours of experience with 200 hours of individual, dyad or group supervision by an approved supervisor.

4. Finance Issues – Reimbursement, Fiscal Impact to state, etc.

   1. Describe how and by whom will the new or expanded services be compensated (e.g., Medical Assistance, health plans, etc.)? What costs and what savings would accrue and to whom (patients, insurers, payers, employers)?

Compensation for Expanded Services

Art Therapy services are currently provided by an estimated 90 art therapists in MN and 39 art therapy students in Minnesota. Art therapists can currently receive remuneration from clients directly, through the state via Medical Assistance, or agencies through contract-for-services. Payment through insurance agencies is available to some art therapists who chose to also pursue licensure through a related body. A recent survey conducted by MNATA indicates that 32 art therapists have already completed their highest level of credentialing in art therapy as either a Registered Art Therapist or Board Certified Registered Art Therapist. Most (23) of these practicing art therapists have also completed the highest level of credentialing through a related body (LPCC, LMFT, LP), allowing third-party reimbursement. 

Based on the results of a recent survey by MNATA, we anticipate 90-130 art therapists will seek licensure as clinical art therapists during the first two years of the established license, with 30 each following year. We hope expanded services will allow all licensed clinical art therapists to receive payment through Medical Assistance. Other states have utilized a step-by-step legislative process to achieve insurance reimbursement for services, with only Maryland currently supported by the legislature to receive these expanded payments (Sagar, 2017). We hope to expand reimbursements for clinical art therapists to include insurance reimbursement in the future.

Costs/Savings

We expect that establishing a license for Clinical Art Therapy based on current rigorous educational and experiential standards in Minnesota will reduce the burden upon art therapists training in or transferring to Minnesota. Art therapists will be able to pursue their training with focus, less overall time required, and less cost. As a result, more qualified clinical art therapists will likely complete the license, resulting in adequate availability of clinical art therapists for the public. This type of consequence from creating a license is likely to decrease, stabilize, and equalize the cost of art therapy services to consumers.

By regulating art therapists under an already extant board, additional cost to the state can be minimized. Additionally, because art therapy is nationally credentialed, the state will not be required to offer any type of examination and can, rather, rely on an extant examination. 

Financial Impact on the State

Cost of a license. The cost of maintaining a licensing process for art therapy depends on the route taken to establish such a license. Details of this cost are provided in another section below.

Licensees will pay an annual fee for licensure, as well as possibly a separate fee for the application for licensure. This fee will be determined by calculating the staffing, meeting, administrative and other costs of having a license. Other states have estimated a proposed income of $30,000-60,000 from such a fee. Currently the cost of the application and license for art therapy in other states ranges from $100-$215, with Florida proposing a fee of $300-500 due to smaller numbers of applicants (Determining the Fiscal Impact of Florida Art Therapy Licensure Legislation).

Other similar boards charge the following annual fees for licensure fee in Minnesota: Behavioral Health and Therapy, LADC-$295, LPC/LPCC-$250 (with $150 application fee); Marriage and Family Therapy, $110 ($125 renewal fee); LICSW, 283.5 (with $48 app. fee); and Psychology, $500 (Minnesota Health-Related Biennial Report (MH-RBR), 2016). However, these boards service varying numbers of licenses. Between 2014 and 2016, the MN Board or Behavioral Health and Therapy issued 1649 new licenses and 5207 renewals, while the Board of Marriage and Family Therapy issued 674 new licenses and 4326 renewals (MH-RBR, 2016).

Income taxes. Increased availability of art therapists and use of art therapy by consumers will likely generate funds to the state of MN through income taxes paid. According to a survey conducted in 2013 (allpsychologycareers), across the US, art therapists earn between $30,000-80,000. Another estimate specific to Minnesotan art therapist suggests that salaries range from $35,000-65,000 (Crotti, 2010). In addition, clinical art therapists who are fully credentialed will provide supervision for supervisees. The Adler Graduate School in Minnetonka, MN currently provides a master’s level program for interested students. These opportunities related to the continuance of the profession also contribute to the state’s income through taxes, and future clinical art therapists.

Reciprocity. Art therapists with equivalent qualifications from other states will receive reciprocity in MN according to our bill. Art therapists from other states or countries with licenses specifically for Art Therapy will no longer be deterred from practicing in MN due to the added cost of pursuing an additional non-art therapy license just to receive third-party payments. Currently 14 states have art therapy licenses in the United States. In addition to art therapists coming from other states, they may come from other countries, like Alison Barnes, a MNATA member. She says, 

“As a Minnesotan that trained out of the country and moved home I found it incredibly difficult to enter the profession of art therapy or find related work without a license. I took a job that I was overqualified for. Even though I was able to start an art group for kids I was unable to offer art therapy services because the organization did not know how to account for that type of service. In Australia, I had met all of the requirements to become a qualified and practicing therapist in that country. If there was a system that allowed professionals of equivalent training reciprocity for their degree I would have been able to offer my services sooner which provide a much-needed form of therapy to those in need.”

Financial Impact on the Public

Current cost of art therapy. Current standards of credentialing for art therapists in MN results in variable fees to clients. A recent survey conducted by the MNATA indicates that the average number of clients served by post-graduate art therapists at 64 clients per week, or 3,328 client hours per year. About half of the art therapists surveyed worked part time, and half worked full time. Currently, the cost of art therapy services is variable due to the lack of consistency in provider qualifications, and due to a variety of payors. Payment per hour of individual therapy out-of-pocket averages $90, ranging from $35-150 with some providers offering a sliding scale fee, and can range from $70-135 through third-party reimbursement. Payments for group therapy may cost $25 out-of-pocket, with insurance reimbursement at $8-16 per hour. Payments also are different for contract-based group services where the art therapist earns a lump sum for a given time-frame with a variable number of clients attending the therapy session. In addition, art therapists are currently allowed to serve clients who qualify for a Community Access for Disabilities Inclusion (CADI) waiver (Muslik & Granger, 2016), suggesting that some MN art therapists may already provide services at low cost to the public. However, art therapists are not currently eligible for reimbursement for services through Medical Assistance (Department of Human Services, 2017).

Cost of art therapy with a license. Clients may continue to experience some variability in cost of services, as clinical art therapists may continue to seek out direct pay and contract-for-services, with level of experience or specialized qualifications dictating cost. We hope that licensed clinical art therapists will expand their service to more clients who qualify for Medical Assistance. In the future, we hope to expand clinical art therapy services to include third-party reimbursement. When this change occurs, clientele will have access to services from clinical art therapists who can accept insurance reimbursement for services. The end result will be many more low-cost opportunities for clients.

Financial Impact on Employers

Employers of art therapists currently receiving third-party remuneration for art therapy services through another license will not experience any financial impact from this legislative change. Self-employed art therapists may experience an increase in income due to expanded clientele allowing them to take more clients who cannot afford to pay out-of-pocket (e.g., Medical Assistance, Insurance). 

Financial Impact on Insurers

Insurers of clients may see an increase in the number of clients who are requesting art therapy services, and thus a rise in overall payouts for mental health. However, since many art therapists already seek insurance reimbursement through alternative licenses, this increase is not likely to be drastic. 

2. Describe whether reimbursement is available for these services in other states? vi

Currently fifteen states, Connecticut, Delaware, Kentucky, Maryland, Mississippi, New Jersey, New Mexico, New York, Ohio, Oregon, Pennsylvania, Texas, Utah, Wisconsin, and Virginia, have a license for Art Therapy. Of these states, only Maryland currently supports art therapists with legislation that allows art therapists to be eligible for third party reimbursement. Many more states support art therapist reimbursement from Medicare or other such government-support programs.

3. What are the projected regulatory costs to the state government, and how does the proposal       include revenue to offset those costs?

Projected Regulatory Costs

At a state level, options exist for regulating art therapy licensing, including establishing a license through an existing board or agency (e.g., DHS), establishing a separate board, or utilizing a volunteer advisory committee to reduce cost. The cost of maintaining this regulation will be determined by which option is pursued for establishing the license for art therapy. Costs come from staffing, meetings, and administrative costs. Legal costs may also be incurred as complaints are investigated and addressed by the licensing body. A recent report from the Minnesota Health-Related Boards (Biennial Report, July 1, 2014-June 30, 2016) indicates that the following boards paid out the following amounts managing an average of roughly 4000 licenses: Behavioral Health and Therapy, $1,261,094; Marriage and Family Therapy, $661,302; Psychology, $1,578,771, and Social Work, $2,593,148. Additional cost may be implied if clinical art therapists wish to work with the Health Professionals Service Program.

The proposed cost incurred from staffing and meetings depend on how the license is established, especially whether it is established with an independent board, or through an existing agency or board from a related field. Typically, the overall cost is greatest when a distinct board is established, and least when a volunteer advisory committee administers the licenses (Pike, 2017; Sagar, 2014). The administrative cost of each application is likely to be less than $10 each (Sagar, 2014). We are proposing to utilize the existing MN Board of Marriage and Family Therapy. With this model, the cost of maintaining the board will be shared with existing marriage and family therapy applicants.

A national level organization, AATA, established in 1969, currently regulates standards of art therapy. This organization has established criteria for certification that meets the standards of other similar disciplines with licenses (e.g., LMFT, LPCC), including a national examination. A state licensure process in Minnesota would be able to coordinate with this organization to determine the eligibility of candidates.

Costs of administering the license could be additionally reduced by taking proactive steps to inform new applicants about the requirements for licensure directly (e.g., Hamilton & Nicol, 2017) and through the Adler Graduate School which currently hosts a Master’s level art therapy degree program.

4. Do you anticipate a state fiscal impact of the proposed bill?

☐No ☐ Yes

If, yes, describe briefly and complete table below to the extent possible:

We anticipate a rise in the number or art therapists and in the amount that art therapists are reimbursed for services overall, resulting in higher income taxes paid to the state of MN. 

In addition, more credentialed providers will be available to meet the growing demand for art therapy services. Recently, Sue Abderholden, Executive Director of the National Alliance on Mental Illness in Minnesota reported that "We already have a mental health workforce shortage in Minnesota… Nearly every county is deemed a workforce shortage area by the federal government and providers have a difficult time finding… therapists" (Zedchlik, 2017).

Fund (specify)

FY2017 FY2018

FY2019 FY2020

Expenditure

5. Workforce Impacts

   1. Describe what is known about the projected supply/how many individuals are expected to practice under the proposed scope?vii If possible, also note geographic availability of proposed providers/services. Cite any sources used.

The Art Therapy Credentials Board, ATCB, shows 89 currently credentialed art therapists in Minnesota and 6353 credentialed within the USA and Canada (ATCB, 2020). The Minnesota Chapter of the American Art Therapy Association had 79 members as of December 2023. Adler Graduate School’s Art Therapy program, which started in 2006, has graduated approximately 340 art therapy students as of December 2023, and had a near 100% job placement rate. They have a projected growth over the next five years anticipating 24-32 new art therapy students starting per year with a three-year program cycle. This projection suggests 120-160 new students gaining educational requirements to practice art therapy in the next 5-7 years. Gaining a separate art therapy licensure would also increase incoming trained therapists from other states. Many of the current art therapists in Minnesota received their master’s degrees in other states and either moved to Minnesota for a job or returned to their home state to work. 

Art therapists are located across many counties in Minnesota with the largest majority, 83% residing in the twin cities metro area (2020, ATCB). Based on demographic information provided from the Art Therapy Credentials Board, the MNATA Licensure Survey, and MNATA Membership lists, Art Therapists reside in the following counties: Anoka, Blue Earth, Beltrami, Carlton, Carver, Cook, Dakota, Douglas, Hennepin, Isanti, Itasca, Kandiyohi, Koochiching, Nicolette, Olmstead, Pennington, Ramsey, Rice, Scott, Sherburne, St Louis, Stearns, Washington, and Wright (ATCB, MNATA Survey, and MNATA Membership Lists).

2. Describe, with evidence where possible, how the new/modified proposal will impact the overall supply of the proposed services with the current/projected demand for these services.

By providing a separate licensure for Art Therapists, the art therapy profession will be received within the medical field, mental health field, and by the public with a more serious and legitimate tone. This action will increase potential for jobs across Minnesota at hospitals, mental health clinics, private practices, schools, shelters, non-profits, and more. 

6. Proposal Supporters/Opponents 

(Sponsor should understand and attempt to address the concerns of the opposition before submitting the document)

1. What organizations and groups have developed or reviewed the proposal?

At this time, the American Art Therapy Association (AATA), Adler Graduate School, and the Department of Health have reviewed this proposal. Minnesota Licensing Boards are aware of the development of the proposal.

2. Note any associations, organizations, boards, or groups representing the profession seeking regulation and the approximate number of members in each in Minnesota. Viii

Currently, the American Art Therapy Association with approximately 5000 members, with approximately 123 members representing the art therapy profession in Minnesota. The Art Therapy Credentials Board, provides national registrations and certifications for art therapists in the United States and Canada, with 5604 currently credentialed art therapists. Minnesota currently has 79 credentialed art therapists.

3. Please describe the anticipated or already documented position professional associations of the impacted professions (including opponents) will/have taken regarding the proposal.ix

The Minnesota Counseling Association (MnCA), Minnesota Association for Marriage and Family Therapy (MAMFT), and the Minnesota Chapter of the National Association for Social Workers (NASW-MN) support the proposed legislation.

4. State what actions have been undertaken to minimize or resolve any conflict or disagreement with those opposing/likely to oppose the proposal.x

Continued open communication with the above listed professional associations will prevent any conflict or disagreement regarding this proposed legislation.

5. What consumer and advocacy groups support/oppose the proposal and why?

N/A

7. Report to the Legislature

1. Please describe any plans to submit a report to the legislature describing the progress made in the implementation and the subsequent impacts (if measurable) of the scope of practice changes for regulated health professions/occupations. Describe the proposed report’s focus and timeline. Any proposed report schedule should provide sufficient time for the change to be implemented and for impacts to appear.

N/A

Part 2- Proposal Summary Notes

To be completed by legislators reviewing the proposal. This section serves as a companion to the information provided by authors (Part 1), and is designed for legislators to complete to serve as a guide/facilitate evaluation of proposed statutory changes.

Bill # (if introduced): Title: Author(s): 

Proposal Summary Notes:

Public Safety and Well Being

Review Notes:

Access, Cost, Quality, Care Transformation Implications

Review Notes:

Regulation

Review Notes:

Education and Professional Supervision

Review Notes:

Finance Issues – Reimbursement, fiscal impacts to state government, etc.

Review Notes:

Fiscal impact of the proposed bill:

☐No ☐YEs

Fund (specify)

FY2017 FY2018

FY2019 FY2020

Expenditure

If, yes, describe briefly:

Workforce Impacts

Review Notes:

Proposal Supporters and Opponents

Review Notes:

Reporting Requirements, if applicable:

Review Notes:

Other

Does the bill promote health equity?

Does the bill positively impact my constituents?

NOTES:

i Minnesota Health Occupation Review Program. Manual of Procedures for use by Occupations submitting proposals to the Minnesota Council of Health Boards. 2002. Available in hard copy upon request. See discussion on Credentialing Policy Guidelines – Part 4.

ii Minn Stat 214.002 Subd. 2. (3)

iii Federation of State Medical Boards. “Assessing Scope of Practice in Health Care Delivery: Critical Questions in assuring Public Access and Safety.” 2005

iv Federation of State Medical Boards. “Assessing Scope of Practice in Health Care Delivery: Critical Questions in assuring Public Access and Safety.” 2005

v Federation of State Medical Boards. “Assessing Scope of Practice in Health Care Delivery: Critical Questions in assuring Public Access and Safety.” 2005

vi Minnesota Health Occupation Review Program. Manual of Procedures for use by Occupations submitting proposals to the Minnesota Council of Health Boards. 2002. Available in hard copy upon request

vii Minnesota Health Occupation Review Program. Manual of Procedures for use by Occupations submitting proposals to the Minnesota Council of Health Boards. 2002. Available in hard copy upon request

viii Minnesota Health Occupation Review Program. Manual of Procedures for use by Occupations submitting proposals to the Minnesota Council of Health Boards. 2002. Available in hard copy upon request

9. Legislative Questionnaire for new or expanded regulation of health occupations. Submitted to the Minnesota Legislature by the Minnesota Advanced Practice Registered Nurse (APRN) in collaboration with the Minnesota Board of Nursing. January 29, 2014. This document includes more questions in addition to those required by Minn. Stat. 214.002. Only the new questions are included in the table.

10. Legislative Questionnaire for new or expanded regulation of health occupations. Submitted to the Minnesota Legislature by the Minnesota Advanced Practice Registered Nurse (APRN) in collaboration with the Minnesota Board of Nursing. January 29, 2014. This document includes more questions in addition to those required by Minn. Stat. 214.002. Only the new questions are included in the table.

Attachment A: Public Risks from Untrained Practice of Art Therapy

Art therapy recognizes the power of art and art-making to stimulate memories and reveal emotions.  Understanding how art interacts with a client’s psychological disposition, and how to safely manage and interpret the reactions different art processes may evoke, are competencies that must be gained through substantial experiential learning that is unique to art therapy master’s degree training.  The use of art as therapy thus carries risk of harm if applied beyond the competence of the practitioner.  

Recent advancements in understanding the brain and its functions have increased public awareness of how the process of art-making can influence neural pathways and lead to improved physical and mental health.  This has encouraged the creation of growing numbers of university-based and online programs claiming to provide certificate training, and even master’s degrees, in areas that appear very much like art therapy.  These programs typically require minimal on-sight coursework, and often only online self-instruction, that do not include anything approaching the master’s level coursework, clinical training, supervised practice and national credentials required of professional art therapists.  Individuals with this limited training are opening clinics and advertising therapeutic services and workshops in states across the country.  

These programs and practitioners add to the public’s misunderstanding of art therapy and the level of specialized education and clinical training required for safe, effective, and ethical practice of art therapy.  Recent examples of these programs include:

• Brandman University (part of the California based- Chapman University System) offers an Art4Healing certificate program directed to “counselors, teachers, therapists, medical professionals, artists and others interested in learning the Art4Healing method and using the exercises in their own work with children and adults suffering from abuse, illness, grief and stress.” The certificate program requires only 45 hours of on-site workshops at the University’s Art & Creativity for Healing studio.

• The University of Florida has initiated a Master of Arts in Arts in Medicine program which offers a fully on-line, 35-credit master’s degree program to train artists to work in hospital settings.  The University also offers a graduate certificate program in Arts in Public Health. 

• Montclair State University (NJ) has initiated a Graduate Certificate Program in Art and Health in cooperation with Atlantic Health System in response to what it describes as increasing demand among “medical professional interested in exploring ways that the arts can be used in comprehensive health care.” Certification involves only five 3-credit graduate-level courses, in which students meet in-person only at the start and end of each course. 

• Art & Creativity for Healing, Inc. provides certification for individuals to serve as facilitators to conduct workshops in the Art for Healing Method that are designed “to share art as a tool for self-expression and self-exploration.”  Facilitator training is provided through self-paced DVD programs in the Arts 4 Healing method that, for $1,200, “includes comprehensive training manuals and teaching method.”

• The London-based Renaissance Life Therapies advertizes “quality training courses” offered through its online Training Academy that have included a course in The Health Process of Art Therapy that it described as leading to a “fully accredited” art therapy diploma, and a four-part certificate program in Therapeutic Art.  The Academy’s courses have no age or prior education requirements and involve self-instruction through online lectures and a variety exercises and activities. The instructor is a cognitive behavioral therapist and advocate of coloring-in books for adults with no specialized training in art therapy.

• The Global Alliance for Arts & Health (GAAH) created a national Artists in Healthcare Certification program to attest for hospital administrators that artists who do artwork activities with patients in hospital and other healthcare have a minimal level of knowledge and competency to work in healthcare environments.  Certification involves passage of a national examination, with no specific training or prior experience in healthcare required to sit for the examination. 

Attachment B: CAAHEP Curriculum Competency Requirements for Educational Programs in Art Therapy

Preface:

The following learning outcomes, content areas and associated competency statements are adapted by the Accreditation Council for Art Therapy Education from the American Art Therapy Association Master’s Education Guidelines developed by the Association’s Education Standards Revision Task Force with input from art therapy educators, professionals, and students and approved by the AATA Board of Directors in 2015.

1. Student Learning Outcomes

Student learning outcomes highlight knowledge, skills and affective/behaviors critical to successful entry-level job performance of an Art Therapy program graduate. Achievement of learning outcomes upon completion of the program is demonstrated by a graduate’s knowledge and ability to: 

1. Understand the historical development of Art Therapy as a profession, Art Therapy theories and techniques, as a foundation for contemporary Art Therapy professional practice.

2. Distinguish among the therapeutic benefits of a variety of art processes and media, strategies and interventions, and their applicability to the treatment process for individuals, groups, and families.

3. Recognize that Art Therapy, from a multicultural perspective, takes into consideration the specific values, beliefs, and actions influenced by a client’s race, ethnicity, nationality, gender, religion, socioeconomic status, political views, sexual orientation, geographic region, physical capacity or disability, and historical or current experiences within the dominant culture.

4. Select culturally and developmentally appropriate assessment and evaluation methods and administer and interpret results to identify challenges, strengths, resilience, and resources for Art Therapy treatment planning.

5. Develop culturally appropriate, collaborative, and productive therapeutic relationships with clients.

6. Know federal and state laws and professional ethics as they apply to the practice of Art Therapy.

7. Recognize and respond appropriately to ethical and legal dilemmas using ethical decision-making models, supervision, and professional and legal consultation when necessary.

8. Recognize clients’ use of imagery, creativity, symbolism, and metaphor as a valuable means for communicating challenges and strengths and support clients’ use of art-making for promoting growth and well-being.

9. Recognize the legal, ethical, and cultural considerations necessary when conducting Art Therapy research.

10. Apply principles of human development, artistic and creative development, human sexuality, gender identity development, family life cycle, and psychopathology, to the assessment and treatment of clients.

11. Understand professional role and responsibility to engage in advocacy endeavors as they relate to involvement in professional organizations and advancement of the profession.

12. Continuously deepen self-understanding through personal growth experiences, reflective practice, and personal art-making to strengthen a personal connection to the creative process, assist in self-awareness, promote well-being, and guide professional practice.

13. Pursue professional development through supervision, accessing current Art Therapy literature, research, best practices, and continuing educational activities to inform clinical practice.

14. Recognize the impact of oppression, prejudice, discrimination, and privilege on access to mental health care, and develop responsive practices that include collaboration, empowerment, advocacy, and social justice action.

15. Understand the basic diagnostic process and the major categories and criteria of mental disorders, corresponding treatments, and commonly prescribed psychopharmacological medications.

Student preparation for the above learning outcomes should be incorporated throughout the program’s coursework, practicum, internship, student advisement, and any programmatic summative measures. 

2. Foundational Learning Content Areas

The following Foundational Learning content areas provide the basis for relevant learning outcomes in the core curriculum and must be met concurrently with the core curriculum or through prior coursework or demonstrated competency.

1. Studio art proficiency in 2- and 3-dimensional art media techniques and processes; and

Equivalency in non-academic studio art experience may be accepted

2. Foundational theories in psychology including developmental and abnormal psychology.

3. Core Curriculum Content Areas and Competencies

Student learning outcomes are supported by the following Core Curriculum areas which describe required curriculum content but do not refer to course titles or required courses.  The Core Curriculum content areas are more specifically delineated into competencies that allow programs to have goal defining minimum expectations to prepare entry-level Art Therapists. The following curriculum areas describe cognitive (knowledge), psychomotor (skills), and affective (behavior) competencies that art therapy students must develop through their coursework and which lead to overall student learning outcomes. 

Programs may combine content into a single course or distribute content over multiple courses as they develop curriculum to address program mission, goals, and outcomes. Attention to state licensing requirements also may assist in determining course structure and content. 

CONTENT AREA a: History and Theory of Art Therapy

The curriculum must provide students with the opportunity to integrate an understanding of the historical antecedents and ongoing conceptual development of the field, an overview of approaches and theory from related fields, the continuum of art therapy practice, and the development of Art Therapy as a distinct therapeutic profession.  The following knowledge, skills and behaviors must be developed for competency in the content area. 

Faculty members with instructional responsibility for this content should meet credentialing requirements as described in III.B.2.bof these Standards.

The following knowledge, skills and behaviors must be developed for competency in the content area.

Knowledge (K)

Skills (S)

Affective/Behavior (A)

1. 
   Identify major contributors and contributions that shaped the field of Art Therapy

2. Identify the relationship between art therapy approaches and theories from psychology, counseling, and related fields

3. Compare and contrast approaches to Art Therapy unique to the field:

1. Art psychotherapy

2. art-as-therapy

3. open studio and studio-based approaches

4. art-based clinical theories

5. community-based approaches

1. 
   Demonstrate how theory informs art therapy assessment and treatment planning

1. 
   Value the historical antecedents to current professional Art Therapy practice 

CONTENT AREA b: Professional Orientation, Ethical, and Legal Issues

The curriculum must provide students with the opportunity to develop a professional identity as an art therapist which integrates understanding of ethical, professional, and legally principled practices while performing roles and responsibilities in mental health and community-based settings. Additional areas of coverage include the importance of supervision, benefits of professional organizations and credentialing, collaboration, advocacy for the profession and advocacy for clients and their access to mental health services.

Faculty members with instructional responsibility for this content must meet credentialing requirements as described in III.B.2.b of these Standards.  

The following knowledge, skills and behaviors must be developed for competency in the content area. 

Knowledge (K)

Skills (S)

Affective/Behavior (A)

1. 
   Define the professional role and function of an Art Therapist

2. Recognize the  ethical principles for practice of the American Art Therapy Association and the Art Therapy Credentials Board, as well as those of related fields (e.g., American Counseling Association)

3. Describe the purpose and goals of supervision, including models, practices, and processes

4. Define the role and process of professional Art Therapists advocating on behalf of the profession

5. Identify professional organizations and membership benefits, activities, services to members, and current issues

6. Summarize roles and responsibilities as members of interdisciplinary community outreach and emergency management response teams

7. Describe how ethical principles guide the use of technology in professional practice (i.e., electronic records, professional and social networking, and distance therapy and supervision)

1. 
   Demonstrate how to apply decision-making models and  legal principles to ethical dilemmas

2)   Demonstrate how to complete professional documentation required in clinical mental health settings such as treatment plans and progress notes

3)   Practice conducting a job search, resume writing and professional interviewing skills to prepare for the transition from student role to professional practice

1. 
   Acknowledge the value of developing a strong professional Art Therapist identity founded in ethical practice

2. Recognize the importance and impact of professional credentialing (e.g., Registration, Board Certification, and Licensure) and the effects of public policy on these issues

3. Value advocacy processes necessary to address barriers that block access and equity to mental health and related services for patients/clients

4. Recognize the need for collaboration and consultation within and among organizations, including interagency and inter-organizational collaboration

5. Recognize the impact of personal and professional development through supervision, self-care practices appropriate to the Art Therapist professional role, and continuing education

CONTENT AREA c: Materials and Techniques of Art Therapy Practice

The curriculum must provide students with the opportunity to integrate understanding of the safety, psychological properties, and ethical and cultural implication of art-making processes and materials selections in order to design art therapy strategies which address therapeutic goals.

Faculty members with instructional responsibility for this content must meet credentialing requirements as described in III. B.2.b of these Standards.  

The following knowledge, skills and behaviors must be developed for competency in the content area. 

Knowledge (K)

Skills (S)

Affective/Behavior (A)

1)   Describe theory of specific properties and effects of art processes and materials informed by current research such as Expressive Therapies Continuum

2)   Identify toxic materials, safety issues with select populations, allergic reactions.

3)   Identify requirements for  studio set-up and maintenance

4)   Identify resources and programs for using technology as it relates to creating artwork

5)   Identify ethical and safe storage methods for client artwork 

1)   Develop therapeutic goals and art-based intervention strategies based on the therapeutic effect of art making, including benefits, limitations and contraindications of art materials

2)   Develop strategies to effectively manage resistance to creative expression

3)   Demonstrate understanding of therapeutic utility and psychological properties of a wide range of art processes and materials (i.e., traditional materials, recyclable materials, crafts) in the selection of processes and materials for delivery of art therapy services

4)   Adapt tools and materials for clients with disabilities

1)  Incorporate ethical and cultural considerations in materials selection and therapeutic applications

2)   Formulate the potential value of and contraindications for public display of client artwork

3)   Evaluate the potential appropriateness of various venues for display of artwork

CONTENT AREA d: Creativity, Symbolism, and Metaphor

The curriculum must provide students with the opportunity to apply knowledge of creativity, symbolism, metaphor, and artistic language to the practice of Art Therapy. Such applications include work with individuals, groups, families and/or communities of diverse cultures.

Faculty members with instructional responsibility for this content must meet credentialing requirements as described in III. B.2.b of these Standards.  

The following knowledge, skills and behaviors must be developed for competency in the content area. 

Knowledge (K)

Skills (S)

Affective/Behavior (A)

1)  Describe theories and models of creativity

2)  Describe theories and models for understanding symbolism, metaphor, and artistic language

1)   Apply understanding of artistic language, symbolism, metaphoric properties of media and meaning across cultures and within a diverse society

2)   Practice skills for developing awareness and insight into art processes and images

1)   Demonstrate belief in the value of using art-making as a method for exploring personal symbolic language

2)   Recognize the need for awareness of and sensitivity to cultural elements which may impact a client’s participation, choice of materials and creation of imagery 

3)   Value  the benefits of student/therapist reflective art-making to inform clinical practice

CONTENT AREA e: Group Work

The curriculum must provide students with the opportunity to integrate theory, processes, and dynamics of group work to form and facilitate ethically and culturally responsive art therapy groups that have been designed with a clear purpose and goals for the population served. Principles of group dynamics, therapeutic factors, member roles and behaviors, leadership styles and approaches, selection criteria, art-based communication and short- and long-term group process will be reviewed.  

Faculty members with instructional responsibility for this content must meet credentialing requirements as described in III. B.2.b of these Standards.  

The following knowledge, skills and behaviors must be developed for competency in the content area. 

Knowledge (K)

Skills (S)

Affective/Behavior (A)

1)  Describe the theoretical foundations of group work with an emphasis on group art therapy

2)  Explain dynamics associated with group process and development

3)  List therapeutic factors and how they influence group development and effectiveness

4)  Identify types of groups and formats

1)  Develop approaches to forming groups, including recruiting, screening, and selecting members

2)  Demonstrate characteristics, skills, and functions of an effective group leader

3)  Consider purpose, goals, population characteristics,. when designing art therapy groups in a variety of settings

4)   Facilitate ethical and culturally responsive group practices, including informed approaches for designing and facilitating diverse groups

1)   Incorporate critical thinking skills and defend rational of art processes and media selection for the group therapy context

2)   Evaluate the experience of art-making on group development and effectiveness

3)   Recognize the value of participating in a group and engaging in group process, group stages, and group dynamics 

CONTENT AREA f: Art Therapy Assessments

The curriculum must provide students with the opportunity to become familiar with a variety of specific art therapy instruments and procedures used in appraisal and evaluation.  Additional areas of coverage include the selection of assessments with clients/patients as the basis for treatment planning, establishing treatment effects, evaluating assessment validity and reliability, documentation of assessment results and ethical, cultural, and legal considerations in their use.

Faculty members with instructional responsibility for this content must meet credentialing requirements as described in III. B.2.b of these Standards.  

The following knowledge, skills and behaviors must be developed for competency in the content area. 

Knowledge (K)

Skills (S)

Affective/Behavior (A)

1)   Discuss definitions and purpose of Art Therapy assessments

2)   Describe historical development of Art Therapy assessments and current assessments and applications

3)   Compare and contrast terminology used in Art Therapy assessments such as, but not limited to, tests and assessments that are standardized, non-standardized, norm-referenced, criterion-referenced, group and individual testing and assessment, behavioral observations, and symptom checklists

1)   Differentiate between assessment and testing, and appropriate applications of each

2)   Demonstrate the ability to administer and apply appropriate Art Therapy assessments

3)  Present purposes of summative and formative assessment in art therapy practice and research

4)   Assess purposes of Art Therapy assessments to establish treatment goals

5)  Cite methods to determine validity and reliability of Art Therapy assessments

6)   Execute methods to interpret data from Art Therapy assessments

1)   Display ethical, cultural, and legal considerations when selecting, conducting, and interpreting art therapy and related mental health fields’ assessments

2)    Incorporate critical thinking skills when determining the role of assessment in diagnosis and diagnosing in the field of Art Therapy  

CONTENT AREA g: Thesis or Culminating Project

The curriculum must provide student with the opportunity to integrate knowledge with regard to the profession of Art Therapy, including literature in the field, through a culminating project which may include, but is not limited to, thesis or other extensive, in-depth project. Use of established research methods (e.g., quantitative, qualitative, mixed methods, arts-based), innovative methods of inquiry, clinical practice, or a synthesis of clinically-based personal and professional growth (e.g., service learning, designing a program, designing a “tool kit” for Art Therapists) may be included in keeping with the program mission and goals, along with established education standards. 

Faculty members with instructional responsibility for this content must meet credentialing requirements as described in III. B.2.b of these Standards.  

The following knowledge, skills and behaviors  must be developed for competency in the content area

Knowledge (K)

Skills (S)

Affective/Behavior (A)

1)   Organize research on the literature in the field as the basis for an extensive thesis or culminating project

1)  Create an in-depth study of one aspect of Art Therapy or an integration of knowledge and clinical skill in Art Therapy

2)  Complete a thesis or culminating project based on established research methods (e.g., quantitative, qualitative, mixed methods, arts-based), innovative methods of inquiry, clinical practice, or a synthesis of clinically-based personal and professional growth (e.g., service learning, designing a program, designing a “tool kit” for art therapists)

1)   Participate in opportunities and support for sharing thesis or culminating project outcomes in a public forum (e.g., thesis presentations, written article for publication, submission of grant application)

CONTENT AREA h: Human Growth and Development

The curriculum must provide students with the opportunity to integrate stages of human growth and development in assessment and treatment of typical and atypical client and patient populations. Additional areas of coverage contextual/ecological factors that impact these groups, recognition that development exists along a continuum and the feasibility of health across the lifespan 

Faculty members with instructional responsibility for content related to developmental stages in artwork must meet credentialing requirements as described in III.B.2.b of these Standards.  

Content other than that specified above may be taught by Art Therapy Faculty or Related Professions Faculty.

The following knowledge, skills and behaviors must be developed for competency in the content area. 

Knowledge (K)

Skills (S)

Affective/Behavior (A)

1)   Compare and contrast theories of individual and family development across the lifespan, including, but not limited to typical and atypical cognition, personality, human sexuality, moral and creative capacities

2)   Examine theoretical and biopsychosocial roots of developmental crises, trauma, disabilities, addictions, and exceptionality on development across the lifespan

1)   Assess developmental stages in artwork, including typical, atypical, and exceptional characteristics for all age groups

2)   Integrate contextual/ ecological factors bearing on human development such as cultural identities, spiritual, systemic within and outside family nucleus, physical, neurological, biological, and physiological

1)   Justify methods of advancing wellness and actualization of potential, coping capacity, creativity, and optimal development throughout life

CONTENT AREA i: Helping Relationships and Applications

The curriculum must provide students with the opportunity to review the therapeutic benefits of art processes and media, strategies and interventions, and culturally-appropriate, collaborative, and productive applications to the treatment process.  Additional areas of coverage include the importance of and processes for the therapist’s own responsive art-making to reflect on treatment, evaluate progress and build self-awareness. 

Content related to art therapist’s characteristics that promote the therapeutic process, utilization of art materials and processes within the context of building the therapeutic relationship, implications for incorporating one’s own art making into session, trauma-focused art therapy approaches, sensory-based art therapy interventions and development of a personal approach to the practice of art therapy must by taught by faculty members who meet credentialing requirements as described in III. B.2.b of these Standards. 

Content other than that specified above may be taught by Art Therapy Faculty or Related Professions Faculty.

The following knowledge, skills and behaviors must be developed for competency in the content area. 

Knowledge (K)

Skills (S)

Affective/Behavior (A)

1)   Identify evidence-based strategies and clinically-grounded approaches for assessment and treatment

2)   Describe approaches to crisis intervention

3)   Describe trauma-focused art therapy interventions

4)   Describe theories, assessment, and treatment of addictive behaviors and disorders

5)   Review  therapeutic process (relationship building; mid-phase; termination)

6)   Identify theories of effective programs in various settings including strategies for program development and evaluation 

7)   Understand a systems approach (family, community, political)

1)  Utilize art materials and processes within the context of building the therapeutic relationship

2)  Perform interviewing skills

3)  Demonstrate case conceptualization skills

4)  Formulate treatment planning/goal setting

5)  Identify the steps of  suicide risk assessment

6)  Develop  relevant sensory-based art therapy  interventions

7)   Integrate evaluation of treatment

8)   Provide examples of referral processes and accessing community resources  

9)   Plan clinical interventions for the treatment of children, adolescents, adults, couples, and families in a variety of settings including inpatient, outpatient, partial treatment, aftercare

1)   Recognize and display a professional commitment to Art Therapist characteristics that promote  the therapeutic process

2)   Respond to clinical and ethical implications for incorporating one’s own art-making process in a session to develop therapeutic rapport, facilitate creative expression, and promote the therapeutic process 

3)   Value the development of a personal approach to the practice of Art Therapy

4)   Acknowledge transference and counter-transference

5)   Value consultation, collaboration and inter-professional teamwork

CONTENT AREA j: Psychopathology and Diagnosis

The curriculum must provide students with the opportunity to identify major categories of mental illness using the DSM and/or the ICD, engage in the diagnostic process, understand possible art-based indicators of mental disorders, review commonly prescribed psychopharmacological medications, and to recognize the effects that culture, society, and crisis have on individuals with mental illness. Additional areas of coverage include ongoing conceptual developments in neuroscience. 

Content related to the applications of neuroscience theory and research to art therapy practice and also content related to art-based indicators of mental disorders/psychopathology in patient/client artwork must be taught by faculty members who meet credentialing requirements as described in III. B.2.b of these Standards.  

Content other than that specified above may be taught by Art Therapy Faculty or Related Professions Faculty.

The following knowledge, skills and behaviors must be developed for competency in the content area. 

Knowledge (K)

Skills (S)

Affective/Behavior (A)

1)   Identify major categories and criteria of mental disorders according to the current Diagnostic and Statistical Manual (DSM) and/or the International Classification of Diseases (ICD)

2)   Understand potential for substance use disorders to mimic and/or co-occur with a variety of neurological, medical, and psychological disorders

3)   Describe basic classifications, indications and contraindications among commonly prescribed psychopharmacological medications for appropriate referral and consultation

4)   Understand neuroscience theory as applied to art therapy interventions

1)  Apply use of the diagnostic process  in treatment planning 

2)  Exhibit a basic understanding of art-based indicators of mental disorders/ psychopathology in patient/client artwork

3)  Demonstrate understanding of basic diagnostic process, including differential diagnosis

4)  Demonstrate use of behavioral observations as indicators of mental disorders

5   Describe applications of neuroscience theory and research to art therapy practice

1)   Value cultural factors impacting the diagnostic process and concepts of health/illness

2)   Critique use of diagnostic categories in treatment and intervention

3)   Display sensitivity to the prevalence of mental illness and impact on individuals and society

4)   Display sensitivity when considering the impact of crisis on individuals with mental health diagnoses

CONTENT AREA k: Psychological and Counseling Theories

The curriculum must provide students with the opportunity to understand major psychological and counseling theories and applications to practice. 

This content may be fully taught by Related Professions Faculty.

The following knowledge, skills and behaviors must be developed for competency in the content area. 

Knowledge (K)

Skills (S)

Affective/Behavior (A)

1)   Describe basic tenets of psychotherapy and counseling theories (including psychodynamic, humanistic, cognitive-behavioral, systemic)

1)   Apply theory to practice through case analysis or critique of clinical scenarios

1)   Recognize the implications of applying theoretical foundations to therapeutic practice

CONTENT AREA l: Appraisal and Evaluation 

The curriculum must provide students with the opportunity to select culturally and developmentally appropriate assessment and evaluation methods and administer and interpret results to identify individual or familial challenges, strengths, resilience, and resources for art therapy treatment planning.

This content may be fully taught by Related Professions Faculty.

The following knowledge, skills and behaviors must be developed for competency in the content area. 

Knowledge (K)

Skills (S)

Affective/Behavior (A)

1)   Understand historical perspectives of assessment procedures in treatment

2)   Describe concepts of standardized and non-standardized testing and assessment throughout treatment process (intake, treatment planning, diagnoses, termination)

3)   Demonstrate knowledge of rudimentary statistical concepts related to assessment and testing 

4)   Understand procedures for identifying/reporting suspected abuse

1)  Apply risk assessment strategies and tools (danger to self, others)

2)  Display skills for conducting bio-psychosocial assessment, mental status exam, and substance abuse disorder assessments

3)  Recognize cultural, social, and co-occurring issues that affect assessment outcomes 

1)   Value culturally and developmentally appropriate assessment tools and applications to utilization and interpretation of results 

CONTENT AREA m: Research

The curriculum must provide students with the opportunity to understand the purposes, methods, and ethical, legal, and cultural considerations of research and demonstrate the necessary skills to design and conduct a research study. Additional areas of coverage include the use of research to assess effectiveness of mental health and art therapy services by becoming an informed consumer of art therapy research.

Content specific to art-based research methodologies as related to art therapy must be taught by faculty members who meet credentialing requirements as described in III. B.2.b of these Standards.  

Content other than that specified above may be taught by Art Therapy Faculty or Related Professions Faculty.

The following knowledge, skills and behaviors must be developed for competency in the content area. 

Knowledge (K)

Skills (S)

Affective/Behavior (A)

1)   Recognize foundational purposes of research with emphasis on applications to the field

2)   Define research methodologies (e.g., quantitative, qualitative, mixed-methods) and research design formats used in the field

3)   Describe art-based research methodologies as related to art therapy

4)   Understand concepts of validity and reliability and applications to selection and application of assessments and tests

1)   Apply methods used to conduct a review and critique of the literature on a topic of interest

2)   Perform basic steps required to design and conduct a research study

3)   Demonstrate basic statistical concepts such as scales of measurement, measures of central tendency, variability, distribution of data, and relationships among data as applied in research studies

1)   Recognize ethical and legal considerations used to design, conduct, interpret, and report research

2)    Recognize cultural considerations used when conducting, interpreting, and reporting research

CONTENT AREA n: Cultural and Social Issues

The curriculum must provide students with the opportunity to understand the relevance of cultural competence to strategies for working with diverse communities, understanding of privilege and oppression and reflective thinking in regards to the therapist’s own attitudes and beliefs.  

Content related to the role of the arts in social justice, advocacy and conflict resolution and also an overview of AATA’s Multicultural and Diversity Competencies must be taught by faculty members who meet credentialing requirements as described in III.B.2.b of these Standards.  

Content other than that specified above may be taught by Art Therapy Faculty or Related Professions Faculty.

The following knowledge, skills and behaviors must be developed for competency in the content area. 

Knowledge (K)

Skills (S)

Affective/Behavior (A)

1)  Identify research addressing characteristics of help-seeking behaviors of diverse cultural and social groups and implications for responsive practice

2)  Demonstrate an understanding of current issues and trends in a multicultural society

3)  Describe cultural and social diversity theories and competency models including AATA’s Multicultural and Diversity Competencies

1)  Plan strategies for identifying the impact of oppression and privilege on individuals and groups and eliminating barriers, prejudices, intentional and unintentional oppression, and discrimination

2)  Make use of experiential learning activities (e.g., cultural genogram) designed to explore and develop student cultural and social self-awareness including self-assessment of attitudes, beliefs, and acculturative experiences

3)  Apply cultural and social diversity theories and competency models to an understanding of identity development, empowerment, collaboration, advocacy, and social justice

1)  Value strategies for collaborating with and advocating for wellness within diverse communities

2)   Display a professional commitment to AATA’s Multicultural and Diversity competencies 

3)   Justify the role of arts in social justice, advocacy, and conflict resolution

4)   Contrast connections of student cultural and social self-awareness to their view of others, including their cultural assumptions and biases

CONTENT AREA o: Studio Art

The curriculum must provide students with the opportunity to maintain contact with the discipline of art making, to continuously engage in a personal creative process, and to expand knowledge and skills via ongoing explorations of media potentials. Additional areas of coverage include an understanding personal symbolic language and integrative thinking in regards to intellectual, emotional, artistic, and interpersonal knowledge. 

This content may be fully taught by Related Professions Faculty.

The following knowledge, skills and behaviors must be developed for competency in the content area. 

Knowledge (K)

Skills (S)

Affective/Behavior (A)

1)   Identify methods and venues for displaying artwork

1)    Incorporate knowledge and skills about art materials and processes

2)    Demonstrate personal, hands-on contact with the discipline of art making

3)    Recognize personal symbolic language  (student recognition of their own imagery as opposed to client imagery)  

1)    Display connections to a personal creative process and artist identity

CONTENT AREA p: Specializations

The curriculum must provide students with the opportunity to apply one or more areas of treatment specialization with specific clinical populations, settings, and interventions that recognize their unique characteristics.

Content specific to art therapy theory and practice must be taught by faculty members who meet credentialing requirements as described in III. B.2.b of these Standards.  

Content other than that specified above may be taught by Art Therapy Faculty or Related Professions Faculty.

The following knowledge, skills and behaviors must be developed for competency in the content area. 

Knowledge (K)

Skills (S)

Affective/Behavior (A)

1)   Demonstrate advanced knowledge of a well-defined, specialized area of clinical or community-based practice    

1)   Describe in-depth experience with specific patient/client populations, practice settings and methods of interventions

1)   Display cultural competence in consideration of unique characteristics of specific populations and settings

CONTENT AREA q: Career Development

The curriculum should provide students with the opportunity to understand knowledge and skills considered essential in enabling individuals and organizations to positively affect career development and aptitude. Additional areas of coverage include methods of assessment and strategies to facilitate career development with diverse clients. The content is recommended if required for certification or state licensure, but is not required for all programs.

This content may be fully taught by Related Professions Faculty.

The following knowledge, skills and behaviors must be developed for competency in the content area. 

Knowledge (K)

Skills (S)

Affective/Behavior (A)

1)   Define theories and models of career planning and decision-making

2)   Understand assessment tools and techniques, including art therapy assessments, relevant to career development

1)    Apply information/resources available to support client choice

2)    Use approaches for assessing the relationship between career development and client match in terms of lifestyle, life roles and mental health factors

1)   Value multicultural and ethical strategies for facilitating career and educational planning and development with diverse clients

4.  Clinical Education Experiences 

a.   The curriculum must include clinical education experiences that provide students with opportunities to practice the cognitive, psychomotor, and affective/behavior competencies that Art Therapy students must develop through their coursework and which lead to overall student learning outcomes. 

Clinical education experience should allow students opportunities to practice with varied client populations and practice settings.

b.   Clinical education experiences must include an Art Therapy practicum involving observation and clinical practice of Art Therapy in regular consultation with a site supervisor and faculty supervisor, and a clinical internship working with clients under direct supervision of a qualified site supervisor and faculty supervisor in an appropriate setting. 

c.   Clinical education experiences must provide students with both individual and group supervision.

d.   The structure and duration of clinical education experiences must meet educational program clinical experience requirements for credentialing and entry level practice as an Art Therapist.

Attachment C: Sample ATCB Agreement for services to State Licensing Boards

AGREEMENT BETWEEN

THE ART THERAPY CREDENTIALS BOARD

AND

THE STATE BOARD

This AGREEMENT is made by and between the Art Therapy Credentials Board, Inc.

(ATCB), a nonprofit corporation located at 7 Terrace Way, Greensboro, NC 27403, and the State Board (State Board), located at (collectively referred to as the Parties).

Inconsideration of the mutual promises and covenants contained herein, and for other good and valuable consideration, the mutual receipt and sufficiency of which are hereby acknowledged, the Parties agree as follows:

1. PURPOSE

The purpose of this Agreement is to set forth the terms and conditions by which the ATCB will administer the Art Therapy Credentials Board Examination (ATCBE)for the State Board to eligible candidates in connection with licensing laws and regulations specified for the State of __________.

2. EFFECTIVE DATE/AGREEMENT TERM/AGREEMENT RENEWAL

1. Agreement Term. This Agreement is effective when executed by all Parties, and all required approvals have been granted (Effective Date). The term of this Agreement begins on the Effective Date through December 31, 2016, and will remain in full force and effect unless terminated by either Party. All services will be completed during this term.

2. Agreement Renewal. This Agreement may be renewed by agreement of both Parties in writing, and subject to the required approvals by an authorized representative of each Party.

3. ATCB RESPONSIBILITIES

Pursuant to this Agreement, the ATCB will provide the following services:

1. ATCBE Test Administrations. The ATCB or its authorized testing partner will provide a paper/pencil administration of the ATCBE each year on the date established by the ATCB for the national paper/pencil examination administration. The ATCBE will be administered by the ATCB’s authorized testing partner through a computerized administration, at testing sites throughout the United States, during three testing windows each year, at approximate three-month intervals, not including the paper/pencil administration date. 

2. ATCBE Test Sites. The ATCB will establish an annual ATCBE paper/pencil examination administration site at an ATCB-selected location. The ATCB’s Computer-based Test (CBT) administration partner will maintain the locations for the CBT administrations of the ATCBE. The test sites will be designed to provide candidates with a high-quality testing experience. Sites will be operated to convey a professional image, and will provide an appropriate and secure testing environment. Sites will comply with all Federal, State, and local laws regarding the use of public buildings, to ensure accessibility required by the Americans with Disabilities Act (ADA), and to accommodate candidates with disabilities on an individual basis. The ATCB in consultation with its testing partners, will evaluate candidate volume, and if appropriate, will add sites and administration dates.

3. Candidate Registration. The ATCB will register all approved Examination candidates who submit a complete application form and pay the appropriate testing fee. The ATCBE will be administered only to eligible licensure candidates who have received test eligibility approval from the State Board.

4. Test Scheduling Process and Candidate Information. The ATCB will provide a candidate examination scheduling process for use by eligible ATCBE candidates, including test scheduling information. The ATCB or its testing partner will provide directions to the testing site. Candidate access to test scheduling will be based upon the licensure candidate eligibility information provided by the State Board. The ATCB will prepare materials to inform candidates of ATCBE testing procedures. These materials shall include, but not be limited to, information containing examination schedules, fees, procedures, reservations, and test preparation.

5. Test Proctors. The ATCB or its testing partner will select and reimburse qualified test administration proctors for each administration of the ATCBE.

6. Test Scoring. The ATCB will make all necessary arrangements to score each ATCBE test administration in a timely manner. The candidate will be notified of examination results within six (6) weeks of testing. 

7. Candidate Retesting. Eligible candidates who fail the ATCBE will be permitted to retake the Examination once every three (3) months, but no more than three (3) times in a twelve (12) month period, unless specifically authorized otherwise by the State Board. A candidate must submit an Examination registration form and payment by the deadline for each ATCBE administration as specified on the registration form.

8. Test Score Report to State Board. The ATCB will provide to the State Board a composite report for each Examination identifying: each candidate who has taken the ATCBE during the previous paper/pencil test administration or following the close of each CBT testing window through which      state licensure candidates tested; each candidate’s individual score; and, an analysis of candidate scores for the total and each subsection of the ATCBE. The analysis will include the following information: the number of candidates; the total number of items on the Examination; the range of scores; the highest and lowest scores; and, the mean and the standard deviation for each subsection and the total score.

9. Notification of Changes. The ATCB will notify the State Board in the event of any relocation of the ATCB national office, or change in the CBT partner.

4. STATE BOARD RESPONSIBILITIES

Pursuant to this Agreement, the State Board will assume the following responsibilities:

1. State Laws and Regulations. The State Board will be responsible for transmitting to the ATCB in a timely manner all applicable laws and regulations of the State of pertaining to, or otherwise affecting, the administration of the ATCBE, or affecting the ATCB's responsibilities and obligations under this Agreement.

2. Test Eligibility. The State Board will be solely responsible for determining the eligibility of each licensure candidate for the ATCBE, and for communicating such eligibility or ineligibility determinations to licensure candidates and the ATCB in a timely manner.

3. Test Passing Score Determination. The State Board will use the National Minimum Criterion Score for each form of the ATCBE, as determined by the ATCB, in order to determine whether a candidate has passed the Examination.

4. Candidate Examination Fees. The State Board will instruct all eligible candidates to pay all ATCBE registration fees directly to the ATCB, in the form of checks, money orders, VISA, MasterCard, or American Express, payable to the ATCB as specified on the Examination registration form provided by the ATCB. Eligible candidates will also be instructed by the State Board to forward such payments with a completed Examination registration form to the ATCB.

5. ESL Candidate Fees. If applicable, the State Board will require eligible candidates who communicate in English as a second language (ESL candidates) to pay an additional sixty-dollar ($60) Examination fee to ATCB for extra or extended testing time.

6. Information to be Distributed by State Board. The State Board will distribute ATCBE examination registration forms to all eligible ATCBE candidates for licensure in _________. The State Board will be responsible for the distribution of score reports and related correspondence directly to licensure candidates, including notices of state licensure.

7. Notification of Eligibility Determinations. The State Board will notify the ATCB national office staff of the names and addresses of all candidates eligible to sit for the ATCBE, and will identify: each candidate who requires special examination accommodations (physical or learning disability accommodations); and, the specific nature of the required accommodation(s).

8. Compliance with ATCB Policies. The State Board will require that all ATCBE candidates agree to accept, and comply with, ATCB test administration policies, rules, and procedures related to candidate conduct during the administration of the ATCBE.

9. Test Confidentiality. The State Board will be responsible for maintaining the confidentiality and security of all ATCBE and related materials should they come into possession of the State Board and/or its representatives. The State Board will not duplicate or reproduce the Examinations or the ATCBE materials in any manner, media, or form, including, but not limited to, answer sheets, ATCBE questions, and other Examination documents, unless specifically directed by the ATCB to do so in writing.

5. JOINT PARTY RESPONSIBILITIES

1. ADA Compliance. As required, the State Board and the ATCB will be responsible for compliance with any applicable Federal, State, and local laws, including but not limited to the Federal Americans with Disabilities Act (ADA). The State Board will consult with the ATCB regarding licensure eligibility determinations and applicable ADA requirements. The ATCB will be responsible for ATCBE testing accommodation costs to appropriate licensure candidates with respect to extra or extended time, readers, scribes, and paper and pencil administrations of the Examination. Other costs associated with ADA accommodations will be reviewed and determined on a case-by-case basis between the State Board and the ATCB. Both Parties to this Agreement acknowledge and recognize that it is essential that the ATCBE be maintained and administered under secure conditions, and that certain accommodations requested by candidates may alter the ability of the Examination to test minimum competencies (validity issues). Therefore, the Partieswill consult with one another in determining reasonable testing accommodations under the ADA. In the event the ATCB determines that an accommodation request is not reasonable because of security and/or validity issues, and should the matter be contested by the candidate, the ATCB will provide professional advice and consultation to the State Board in support of such decisions.

VI. CONFIDENTIALITY/INTELLECTUAL PROPERTY OWNERSHIP

1. Confidentiality. The Parties will protect the confidentiality and security of the ATCBE and related ATCB materials in all formats, and will expressly prohibit any and all candidates, attorneys, members of the public, and other unauthorized persons from reviewing any version of the ATCBE and the answer keys to the Examination.

2. Intellectual Property Ownership. The ATCB owns all rights, title, and interest in, or related to, the Art Therapy Credentials Board Examination (ATCBE)including all copyright, trademark, and other proprietary rights referenced in this Agreement or otherwise created and owned by the ATCB. The State Board agrees that no property or proprietary rights relating to the Examination are granted to the State Board by this Agreement or otherwise.

3. Examination Confidentiality Requirements. The ATCB and the State Board agree that no Examination information or materials will be released without the agreement of both Parties, and subject to an appropriate Court Order and confidentiality agreement approved by the ATCB.

7. HOLD HARMLESS/INDEMNIFICATION

The ATCB agrees to indemnify and hold harmless the State Board, its designated representatives, agents, and employees from any and all liability, loss, damage, cost, or expense, including reasonable counsel fees and expenses, paid, or incurred by reason of the ATCB's breach of any of the obligations, covenants, representations, or terms contained in this Agreement, or otherwise by reason of the ATCB's conduct. This indemnification does not extend to a claim that results from: the State Board's negligence or unlawful act; or, an action by the ATCB taken in reasonable reliance upon an instruction or direction given by an authorized person acting on behalf of the State Board related to this Agreement.

8. TERMINATION

1. This Agreement may be terminated by either of the Parties hereto for noncompliance by the other Party. A Party intending to terminate for noncompliance by the other Party will provide written notice to the other Party at least thirty (30) days prior to the intended date of termination. Such notice will include the reasons for the termination. By such termination, neither Party may nullify obligations already incurred for performance or failure to perform prior to the date of termination. Regardless of termination or expiration of this Agreement, the provisions of Section VI will survive the termination or expiration.

2. This Agreement may be terminated in the event that Federal or State laws or other requirements should be amended or judicially interpreted so as to render continued fulfillment of this Agreement, on the part of either Party, unreasonable or impossible. If the Parties should be unable to agree upon amendment which would therefore be needed to enable the substantial continuation of the services contemplated herein, then the Parties will be discharged from any further obligations created under the term of this Agreement, except for the equitable settlement of the respective accrued interests or obligations as of the date of termination.

3. This Agreement may be terminated by either of the Parties for any reason by one hundred and eighty (180) days prior written notice to the other Party.

9. GENERAL PROVISIONS

1. Applicable Law. The construction, interpretation, and enforcement of this Agreement will be governed by the laws of the State of.

2. Agreement Dispute Resolution. Any questions related to the interpretation of this Agreement will be settled through discussion between the Parties in good faith. If such questions are not settled between the Parties, the Agreement will be terminated immediately.

3. Independent Contractor. In the performance of this Agreement, the Parties hereto agree that ATCB, and any agents and employees of ATCB, will act in the capacity of an independent contractor and not as officers, employees, or agents of the State Board.

4. Notices. All notices arising out of, or from, the provision of this Agreement will beIN writing and given to the Parties either by regular mail, electronic mail, facsimile, or delivery in person, and addressed to the Parties as follows:

State Board

The Art Therapy Credentials Board, Inc.

c/o Name, Executive Director

7 Terrace Way

Greensboro, NC 27403

5. Entire Agreement. This Agreement represents the entire agreement and understanding of the Parties with respect to the subject matter hereof and supersedes any prior or contemporaneous discussions, representations, or agreements, oral or written, of the Parties regarding this subject matter. This Agreement will not be modified except by further writing signed by both Parties.

6. Severability. If any provision contained in this Agreement is determined by a court of competent jurisdiction, or an arbitration tribunal, to be invalid or unenforceable, said determination will not affect the validity and enforceability of the remaining provisions hereof. The Parties represent that they are not aware that any provision of the Agreement is invalid or unenforceable.

7. Waiver. No waiver by either Party, whether express or implied, of any right or obligation set forth in this Agreement, or any breach or default, will constitute a continuing waiver of that or any other right, obligation, breach, or default.

8. Force Majeure. Neither the ATCB, nor its affiliated organizations, nor the State Board, will be responsible for delays or failures in performance due to acts beyond and outside of their respective control. Such acts will include, but are not limited to: acts of God, strikes, lockouts, riots, acts of war, epidemics, governmental regulations superimposed after the fact, fire, failure by public or private carrier, communication line failure, earthquakes, or other disasters. However, both Parties have the responsibility to cure any failures to perform or other breach of this Agreement as soon as practical and reasonable following the ending or correction of the delay or failure.

9. Paragraph Headings. The paragraph headings and numbers in this Agreement are for convenience only and will not be deemed to affect in any way the language of the provisions to which they refer.

IN WITNESS WHEREOF, the undersigned, hereby certifying that they are authorized to do so, have executed this Agreement on behalf of the Parties on the dates indicated below.

EXECUTED IN DUPLICATE ON THE DATES INDICATED

The Art Therapy Credentials Board, Inc. (ATCB)

By: _____________________________________

Mary Ellen McAlevey

President, ATCB

Date: ___________________________________

State Board

By: _____________________________________

Board Administrator

Date: ___________________________________

Attachment D: Art Therapy Credentials Board Code of Ethics, Conduct, and Disciplinary Procedures (2016)

PREAMBLE

The Art Therapy Credentials Board (ATCB) is a nonprofit organization that seeks to protect the public by issuing registration, board certification, and clinical supervisor credentials to practitioners in the field of art therapy who meet certain established standards. The Board is national in scope and includes academicians, practitioners, supervisors, and a public member who work to establish rigorous standards that have a basis in real world practice.
The ATCB art therapy registration, board certification, and clinical supervisor credentials, hereinafter sometimes referred to as credentials, are offered to art therapists from a wide variety of practice disciplines, who meet specific professional standards for the practice of art therapy.

The Code of Ethics, Conduct, and Disciplinary Procedures is designed to provide art therapists and credential applicants with a set of Ethical Standards (Part I, Section 1) to guide them in the practice of art therapy, as well as Standards of Conduct (Part I, Section 2) to which every credentialed art therapist and credential applicant must adhere. The ATCB may decline to grant, withhold, suspend, or revoke the credentials of any person who fails to adhere to the Standards of Ethics and Conduct (Part I, Section 3). Credentialed art therapists and credential applicants are expected to comply with ATCB Standards of Ethics and Conduct.

The ATCB does not guarantee the job performance of any credential holder or applicant. The ATCB does not express an opinion regarding the competence of any registered or board certified art therapist or art therapy certified supervisor. Rather, registration, board certification or super-visor certification offered through an ATCB program constitutes recognition by the ATCB that, to its best knowledge, an art therapist or applicant meets and adheres to minimum academic preparation, professional experience, continuing education, and professional standards set by the ATCB.

I. CODE OF ETHICS AND CONDUCT

1. General Ethical Standards

The Art Therapy Credentials Board endorses the following general ethical principles, which shall guide the conduct of all art therapists who seek to obtain or maintain credentials under the authority of the ATCB.

1.1 Responsibility to Clients
1.1.1 Art therapists shall advance the welfare of all clients, respect the rights of those persons seeking their assistance, and make reasonable efforts to ensure that their services are used appropriately.
1.1.2 Art therapists will not discriminate against or refuse professional services to individuals or groups based on age, gender, gender identity, gender expression, sexual orientation, ethnicity, race, national origin, culture, marital/partnership status, language preference, socioeconomic
status, citizenship or immigration status, disability, religion/spirituality, or any other basis.
1.1.3 At the outset of the client-therapist relationship, art therapists must discuss and explain to clients the rights, roles, expectations, and limitations of the art therapy process.
1.1.4 Art therapists respect the rights of clients to make decisions and assist them in understanding the consequences of these decisions. Art therapists advise their clients that decisions on whether to follow treatment recommendations are the responsibility of the client. It is the professional responsibility of the art therapist to avoid ambiguity in the therapeutic relationship and to ensure clarity of roles at all times.
1.1.5 Art therapists continue a therapeutic relationship only so long as they believe that the client is benefiting from the relationship. It is unethical to maintain a professional or therapeutic relationship for the sole purpose of financial remuneration to the art therapist or when it becomes reasonably clear that the relationship or therapy is not in the best interest of the client.
1.1.6 Art therapists must not engage in therapy practices or procedures that are beyond their scope of practice, experience, training, and education.
1.1.7 Art therapists must not abandon or neglect clients receiving services. If art therapists are unable to continue to provide professional help, they must assist the client in making reasonable alternative arrangements for continuation of services.
1.1.8 Art therapists shall ensure regular contact with clients and prompt rescheduling of missed sessions. 
1.1.9 Art therapists shall make all attempts to ensure there are procedures in place or follow recommendations for a “professional will” that suggests the handling of client documentation and art, if applicable, in the event of their unexpected death or inability to continue practice. Art therapists shall recognize the harm it may cause if clients are unable to access services in such a situation and identify individuals who can assist clients with obtaining services and with appropriate transfer of records. These written procedures shall be provided to the client.
1.1.10 Art therapists shall provide clients with contact information for the Art Therapy Credentials Board.
1.1.11 Art therapists are familiar with state requirements and limitations for consent for treatment. When providing services to minors or persons unable to give voluntary consent, art therapists seek the assent of clients and/or guardians to services, and include them in decision making as much as possible. Art therapists recognize the need to balance the ethical rights of clients to make choices, their capacity to give consent or assent to receive services, and parental or familial legal rights and responsibilities to protect these clients and make decisions on their behalf.
1.1.12 Art therapists should obtain qualified medical or psychological consultation for cases when such evaluation and/or administration of medication is required. Art therapists must not provide services other than art therapy unless certified or licensed to provide such other services.
1.1.13 Practitioners of art therapy must conform to relevant federal, provincial, state, and local statutes and ordinances that pertain to the provision of independent mental health practice. Laws vary based upon the location of the practice. It is the sole responsibility of the independent practitioner to conform to these laws. Art therapists shall be knowledgeable about statutes and/or laws that pertain to art therapy and mental health practice in any jurisdiction (state, province, country) in which they practice.
1.1.14 Art therapists must seek to provide a safe, private, and functional environment in which to offer art therapy services. This includes, but is not limited to: proper ventilation, adequate lighting, access to water supply, knowledge of hazards or toxicity of art materials and the effort needed to safeguard the health of clients, storage space for client artworks and secured areas for any hazardous materials, monitored use of sharps, allowance for privacy and confidentiality, and compliance with any other health and safety requirements according to state and federal agencies that regulate comparable businesses.

1.2 Professional Competence and Integrity
1.2.1. Art therapists must maintain high standards of professional competence and integrity.
1.2.2 Art therapists must keep informed and updated with regard to developments in the field which relate to their practice by engaging in educational activities and clinical experiences. Additionally, art therapists shall seek regular consultation and/or supervision with fellow qualified professionals.
1.2.3 Art therapists shall assess, treat, or advise only in those cases in which they are competent as determined by their education, training, and experience.
1.2.4 Art therapists shall develop and improve multicultural competence through ongoing education and training. Art therapists shall use practices in accordance with the client’s or group’s age, gender, gender identity, gender expression, sexual orientation, ethnicity, race, national origin, culture, marital/partnership status, language preference, socioeconomic status, immigration/citizenship status, disability, religion/spirituality, or any other identity factor.
1.2.5 Art therapists shall communicate in ways that are both developmentally and culturally sensitive and appropriate. When clients and/or art therapists have difficulty understanding each other’s language, art therapists shall attempt to locate necessary translation/interpretation services.
1.2.6 Art therapists will obtain client’s written consent to communicate with other health care providers for the purpose of collaborating on
client treatment.
1.2.7 Art therapists, because of their potential to influence and alter the lives of others, must exercise special care when making public their professional recommendations and opinions through testimony or other public statements.
1.2.8 Art therapists must seek appropriate professional consultation or assistance for their
personal problems or conflicts that may impair or affect work performance or clinical judgment.
1.2.9 Art therapists must not distort or misuse their clinical and research findings.
1.2.10 Art therapists shall file a complaint with the ATCB when they have reason to believe that another art therapist is or has been engaged in conduct that violates the law or the Standards of Ethics and Conduct contained in this Code. This does not apply when the belief is based upon information obtained in the course of a therapeutic relationship with a client and voluntary, written authorization for disclosure of the information has not been obtained; however, this does not relieve an art therapist from the duty to file any reports required by law.
1.2.11 Art therapists shall notify the ATCB of any disciplinary sanctions imposed upon themselves or another art therapist by another professional credentialing agency or organization, when such sanctions come to their attention.
1.2.12 Art therapists shall not knowingly make false, improper, or frivolous ethics or legal complaints against colleagues or other art therapists.

1.3 Responsibility to Students and Supervisees
1.3.1 Art therapists must instruct their students using accurate, current, and scholarly information and at all times foster the professional growth of students and advisees.
1.3.2 Art therapists as teachers, supervisors, and researchers must maintain high standards of scholarship and present accurate information.
1.3.3 Art therapists must not permit students, employees, or supervisees to perform or to represent themselves as competent to perform professional services beyond their education, training, experience, or competence, including multicultural and diversity competence.
1.3.4 Art therapists who act as supervisors are responsible for maintaining the quality of their supervision skills and obtaining consultation or supervision for their work as supervisors whenever appropriate.
1.3.5 Art therapists are aware of their influential position with respect to students and supervisees, and they avoid exploiting the trust and dependency of such persons. Art therapists, therefore, shall not engage in a therapeutic relationship with their students or supervisees.
1.3.6 Art therapists do not condone or engage in sexual harassment, which is defined as unwelcome comments, gestures, or physical contact of a sexual nature.
1.3.7 Art therapists who offer and/or provide supervision must:
1.3.7.1 Ensure that they have proper training and supervised experience, contemporary continuing education and/or graduate training in clinical supervision;
1.3.7.2 Ensure that supervisees are informed of the supervisor’s credentials and professional status as well as all conditions of supervision as defined/outlined by the supervisor’s practice, agency, group, or organization;
1.3.7.3 Ensure that supervisees are aware of the current ethical standards related to their professional practice, including the ATCB Code of Ethics, Conduct, and Disciplinary Procedures;
1.3.7.4 Ensure regular contact with supervisees and prompt rescheduling of missed supervision sessions;
1.3.7.5 Provide supervisees with adequate feedback and evaluation throughout the supervision process;
1.3.7.6 Ensure that supervisees inform their clients of their professional status, the name and contact information of their supervisors, and obtain informed consent from their clients for sharing disguised client information and artwork or reproductions as necessary with their supervisors;
1.3.7.7 Ensure that supervisees obtain client consent to share client artwork or reproductions in supervision;
1.3.7.8 Establish procedures with their supervisees for handling crisis situations.
1.3.9 Art therapy supervisors shall provide supervisees with a professional disclosure statement that advises supervisees of the supervisor’s affirmation of adherence to this Code of Ethics, Con-duct, and Disciplinary Procedures, and instructions regarding how the supervisee should address any dissatisfaction with the supervision process including how to file a complaint with the ATCB, the ATCB’s address, telephone number, and email address.

1.4 Responsibility to Research Participants
1.4.1 Art therapists who are researchers must respect the dignity and protect the welfare of participants in research.
1.4.2 Researchers must be aware of and comply with federal, provincial, state, and local laws and regulations, agency regulations, institutional review boards, and professional standards governing the conduct of research.
1.4.3 Researchers must make careful examinations of ethical acceptability in planning studies. To the extent that services to research participants may be compromised by participation in research, investigators must seek the ethical advice of qualified professionals not directly involved in the investigation and observe safeguards to protect the rights of research participants.
1.4.4 Researchers requesting potential participants’ involvement in research must inform them of all risks and aspects of the research that might reasonably be expected to influence willingness to participate, and must obtain a written acknowledgment of informed consent, reflecting an understanding of the said risks and aspects of the research, signed by the participant or, where appropriate, by the participant’s parent or legal guardian. Researchers must be especially sensitive to the possibility of diminished consent when participants are also receiving clinical services, have impairments which limit understanding and/or communication, or when participants are children.
1.4.5 Researchers must respect participants’ freedom to decline participation in or to withdraw from a research study at any time. This principle requires thoughtful consideration when investigators or other members of the research team are in positions of authority or influence over participants. Art therapists, therefore, must avoid relationships with research participants outside the scope of the research.
1.4.6 Art therapists must treat information obtained about research participants during the course of the research protocol as confidential unless the participants have previously and reasonably authorized in writing that their confidential information may be used. When there is a risk that others, including family members, may obtain access to such information, this risk, together with the plan for protecting confidentiality, must be explained to the participants as part of the above stated procedure for obtaining a written informed consent.

1.5 Responsibility to the Profession
1.5.1 Art therapists must respect the rights and responsibilities of professional colleagues and should participate in activities that advance the goals of art therapy.
1.5.2 Art therapists must adhere to the ATCB standards of the profession when acting as members or employees of third-party organizations.
1.5.3 Art therapists must attribute publication credit to those who have contributed to a publication in proportion to their contributions and in accordance with customary professional publication practices.
1.5.4 Art therapists who author books or other materials that are published or distributed must cite persons to whom credit for original ideas is due.
1.5.5 Art therapists who author books or other materials published or distributed by a third party must take reasonable precautions to ensure that the third party promotes and advertises the materials accurately and factually.
1.5.6 Art therapists are encouraged, whenever possible, to recognize a responsibility to partictipate in activities that contribute to a better community and society, including devoting a portion of their professional activity to services for which there is little or no financial return.
1.5.7 Art therapists are encouraged, whenever possible, to assist and be involved in developing laws and regulations pertaining to the field of art therapy that serve the public interest and in changing such laws and regulations that are not in the public interest.
1.5.8 Art therapists are encouraged, whenever possible, to promote public understanding of the principles and the profession of art therapy through presentations to general audiences, mental health professionals, and students. In making such presentations, art therapists shall accurately convey to the audience members or students the expected competence and qualifications that will result from the presentations, as well as, the differences between the presentation and formal studies in art therapy.
1.5.9 Art therapists must cooperate with any ethics investigation by any professional organization or government agency, and must truthfully represent and disclose facts to such organizations or agencies when requested or when necessary to preserve the integrity of the art therapy profession.
1.5.10 Art therapists should endeavor to ensure that the benefits and limitations are correctly conveyed by any institution or agency of which they are employees.
1.5.11 Art therapists are accountable at all times for their behavior. They must be aware that all actions and behaviors of the art therapist reflect on professional integrity and, when inappropriate, can damage the public trust in the art therapy profession. To protect public confidence in the art therapy profession, art therapists avoid behavior that is clearly in violation of accepted moral and legal standards.

2. Standards of Conduct

The Art Therapy Credentials Board prescribes the following standards of conduct, which shall guide the conduct of all art therapists who seek to obtain or maintain credentials under the authority of the ATCB.

2.1 Confidentiality
2.1.1 Art therapists shall inform clients of the purpose and limitations of confidentiality.
2.1.2 Art therapists shall respect and protect confidential information obtained from clients, including, but not limited to, all verbal and/or artistic expression occurring within the client-therapist relationship.
2.1.3 Art therapists shall protect the confidentiality of the client-therapist relationship in all matters.
2.1.4 Art therapists shall not disclose confidential information without the client’s explicit written consent unless mandated by law or a court order. In these cases, confidences may be disclosed only as legally and reasonably necessary in the course of that action. All disclosures of information shall be documented in the client’s file, including the identity of the recipient, the basis upon which the information was disclosed, and a description of the information disclosed.
2.1.5 If there is reason to believe that the client or others are in immediate, serious danger to health or life, any such disclosure shall be made consistent with state and federal laws that pertain to the protection and welfare of the client or others. Art therapists strive to disclose information in a way that ensures respect for the client and integrity for the therapeutic relationship.
2.1.6 In the event that art therapists believe it is in the interest of a client to disclose confidential information, they shall seek and obtain written authorization from the client or the client’s legal guardian, before making any disclosures, unless such disclosure is required by law.
2.1.7 For the purpose of collecting information on harm caused to clients or possible violations of ATCB rules and its Code of Ethics, Conduct, and Disciplinary Procedures by art therapists or those falsely claiming to have an ATCB credential, art therapists may disclose such information without the client’s explicit written consent if the information is disguised so that the identity of the client is fully protected.
2.1.8 Art therapists shall maintain client treatment records for a reasonable period of time consistent with federal and state laws, agency regulations and sound clinical practice. Records shall be stored or disposed of in ways that maintain client confidentiality.
2.1.9 Whenever possible, a photographic representation should be maintained, in accordance with the provisions set forth in 2.2.2 of this document on consent to photograph, for all work created by the client that is relevant to document the therapy if maintaining the original artwork would be difficult.
2.1.10 When the client is a minor, any and all disclosure or consent shall be made to or obtained from the parent or legal guardian of the client, except where otherwise provided by state law. Care shall be taken to preserve confidentiality with the minor client and to refrain from disclosure of information to the parent or guardian that might adversely affect the treatment of the client, except where otherwise provided by state law or when necessary to protect the health, welfare, or safety of the minor client.
2.1.11 Client confidentiality must be maintained when clients are involved in research, according to Part I, Section 1.4 of this code of practice.
2.1.12 Independent practitioners of art therapy must sign and issue a written professional disclosure statement to a client upon the establishment of a professional relationship. Such disclosure statement must include, but need not be limited to, the following information: education, training, experience, professional affiliations, credentials, fee structure, payment schedule, session scheduling arrangements, information pertaining to the limits of confidentiality and the duty to report. The name, address, and telephone number of the ATCB should be written in this document along with the following statement, “The ATCB oversees the ethical practice of art therapists and may be contacted with client concerns.” It is suggested that a copy of the statement be retained in the client’s file.

2.2 Use and Reproduction of Client Art Expression and Therapy Sessions
2.2.1 Art therapists shall take into consideration the benefits and potential negative impact of photographing, videotaping, using other means to duplicate, and/or display and/or broadcast client artwork with the client’s best interest in mind. Art therapists shall provide to the client and/or parent or legal guardian clear warnings about the art therapist’s inability to protect against the use, misuse, and republication of the art product and/or session by others once it is displayed or posted.
2.2.2 Art therapists shall not make or permit any public use or reproduction of a client’s art therapy sessions, including verbalization and art expression, without express written consent of the client or the client’s parent or legal guardian.
2.2.3 Art therapists shall obtain written informed consent from a client, or when applicable, a parent or legal guardian, before photographing the client’s art expressions, making video or audio recordings, otherwise duplicating, or permitting third-party observation of art therapy sessions.
2.2.4 Art therapists shall use clinical materials in teaching, writing, electronic formats and
public presentations only if a written authorization has been previously obtained from the client, client’s parent, or legal guardian.
2.2.5 Art therapists shall obtain written, informed consent from a client or, when appropriate, the client’s parent or legal guardian, before
displaying the client’s art in galleries, healthcare facilities, schools, the Internet or other places.
2.2.6 Only the client, parent or legal guardian may give signed consent for use of client’s art or information from sessions and treatment, and only for the specific uses, and in the specific communication formats, designated in the consent. Once consent has been granted, art therapists shall ensure that appropriate steps are taken to protect client identity and disguise any part of the notes, art expression or audio or video recording that reveals client identity unless the client, parent or legal guardian specifically designates in the signed consent that the client’s identity may be revealed. The signed consent form shall include conspicuous language that explains the potential that imagery and information displayed or used in any form may not be able to be permanently removed if consent is later revoked.

2.3 Professional Relationships
2.3.1 Art therapists shall not engage in any relationship, including through social media, with current or former clients, students, interns, trainees, supervisees, employees, or colleagues that is exploitative by its nature or effect.
2.3.2 Art therapists shall make their best efforts to avoid, if it is reasonably possible to do so, entering into non-therapeutic or non-professional relationships with current or former clients, students, interns, trainees, supervisees, employees, or colleagues or any family members or other persons known to have a close personal relationship with such individuals such as spouses, children, or close friends.
2.3.3 In the event that the nature of any such relationship is questioned, the burden of proof shall be on the art therapist to prove that a non-therapeutic or non-professional relationship with current or former clients, students, interns, trainees, supervisees, employees, or colleagues is not exploitative or harmful to any such individuals.
2.3.4 Exploitative relationships with clients include, but are not limited to, borrowing money from or loaning money to a client, hiring a client, engaging in a business venture with a client, engaging in a romantic relationship with a client, or engaging in sexual intimacy with a client.
2.3.5 Art therapists shall take appropriate professional precautions to ensure that their judgment is not impaired, that no exploitation occurs, and that all conduct is undertaken solely in the client’s best interest.
2.3.6 Art therapists shall not use their professional relationships with clients to further their own interests.
2.3.7 Art therapists shall be aware of their influential position with respect to students and supervisees, and they shall avoid exploiting the trust and dependency of such persons. Art therapists, therefore, shall not provide therapy to students or supervisees contemporaneously with the student/supervisee relationship.
2.3.8 Art therapists must not knowingly misuse, or allow others to misuse, their influence when engaging in personal, social, organizational, electioneering or lobbying activities.
2.3.9 Art therapists do not condone or engage in sexual harassment, which is defined as unwelcome comments, gestures, or physical contact of a sexual nature.
2.3.10 Art therapists shall be aware of and take into account the traditions and practices of other professions with which they work and cooperate fully with them.
2.3.11 Art therapists who have a private practice, but who are also employed in an agency or group practice must abide by and inform clients of the agency’s or group practice’s policies regarding self-referral.
2.3.12 Any data derived from a client relationship and subsequently used in training or research shall be so disguised in such a way that the client’s identity is fully protected. Any data which cannot be so disguised may be used only as expressly authorized by the client’s informed and voluntary consent.

2.4 Financial Arrangements
2.4.1 Independent practitioners of art therapy shall seek to ensure that financial arrangements with clients, third party payers, and supervisees are understandable and conform to accepted professional practices.
2.4.2 If a client wishes to access insurance coverage for art therapy services out of state, art therapists shall advise clients that it is the client’s responsibility to confirm coverage before beginning services.
2.4.3 Art therapists must not offer or accept payment for referrals.
2.4.4 Art therapists must not exploit their clients financially.
2.4.5 Art therapists must represent facts truthfully to clients, third party payers, and supervisees regarding services rendered and the charges thereof.
2.4.6 Art therapists who intend to use collection agencies or take legal measure to collect fees from clients who do not pay for services as agreed upon must first inform clients in writing of such intended actions and offer clients the opportunity to make payment.
2.4.7 Art therapists may barter only if the relationship is not exploitive or harmful and does not place the art therapist in an unfair advantage, if the client requests it, and if such arrangements are an accepted practice among professionals within the community. Art therapists should consider the cultural implications of bartering and discuss relevant concerns with clients and document such agreements in a clear written contract.
2.4.8 Art therapists shall not accept gifts from clients except in cases when it is culturally appropriate or therapeutically relevant to the specific client. Prior to acceptance, art therapists shall consider the value of the gift and discuss the gift-giving with the client. The art therapist shall document the matter, including all consideration and the client discussion in the client’s record.

2.5 Advertising
2.5.1 Art therapists shall provide sufficient and appropriate information about their professional services to help the layperson make an informed decision about contracting for those services.
2.5.2 Art therapists must accurately represent their competence, education, earned credentials, training, and experience relevant to their professional practice.
2.5.3 Art therapists must ensure that all advertisements and publications, whether in print,
directories, announcement cards, newspapers, radio, television, electronic format such as the Internet, or any other media, are formulated to accurately convey, in a professional manner, information that is necessary for the public to make an informed, knowledgeable decision.
2.5.4 Art therapists must not use names or designations for their practices that are likely to confuse and/or mislead the public concerning the identity, responsibility, source, and status of those under whom they are practicing, and must not hold themselves out as being partners or associates of a firm if they are not.
2.5.5 Art therapists must not use any professional identification (such as a business card, office sign, letterhead, or telephone or association directory listing) if it includes a statement or claim that is false, fraudulent, misleading or deceptive. A statement is false, fraudulent, misleading or deceptive if it: fails to state any material fact necessary to keep the statement from being misleading; is intended to, or likely to, create an unjustified expectation; or contains a material misrepresentation of fact.
2.5.6 Art therapists must correct, whenever possible, false, misleading, or inaccurate information and representations made by others concerning the art therapist’s qualifications, services, or products.
2.5.7 Art therapists must make certain that the qualifications of persons in their employ are represented in a manner that is not false, misleading, or deceptive.
2.5.8 Art therapists may represent themselves as specializing within a limited area of art therapy only if they have the education, training, and experience that meet recognized professional standards to practice in that specialty area.

2.6 Measurement and Evaluation
2.6.1 Art therapists shall use or interpret only the specific assessment instruments for which they have the required education and supervised experience.
2.6.2 Art therapists must provide instrument specific orientation or information to an examinee prior to and following the administration of assessment instruments or techniques so that the results may be placed in proper perspective with other relevant factors. The purpose of testing and the explicit use of the results must be made known to an examinee prior to testing.
2.6.3 In selecting assessment instruments or techniques for use in a given situation or with a particular client, art therapists must carefully evaluate the specific theoretical bases and characteristics, validity, reliability and appropriateness of each instrument.
2.6.4 When making statements to the public about assessment instruments or techniques, art therapists must provide accurate information and avoid false claims or misconceptions concerning the instrument’s reliability and validity.
2.6.5 Art therapists must follow all directions and researched procedures for selection, administration and interpretation of all evaluation instruments and use them only within proper contexts.
2.6.6 Art therapists must be cautious when interpreting the results of instruments that possess insufficient technical data, and must explicitly state to examinees the specific limitations and purposes for the use of such instruments.
2.6.7 Art therapists must proceed with caution when attempting to evaluate and interpret performance of any person who cannot be appropriately compared to the norms for the instrument.
2.6.8 Because prior coaching or dissemination of assessment instruments can invalidate test results, art therapists are professionally obligated to maintain test security.
2.6.9 Art therapists must consider psychometric limitations when selecting and using an instrument, and must be cognizant of the limitations when interpreting the results. When tests are used to classify clients, art therapists must ensure that periodic review and/or retesting are conducted to prevent client stereotyping.
2.6.10 Art therapists recognize that test results may become obsolete, and avoid the misuse of obsolete data.
2.6.11 Art therapists must not appropriate, reproduce, or modify published assessment instruments or parts thereof without acknowledgement and permission from the publisher, except as permitted by the fair educational use provisions of the U.S. copyright law.
2.6.12 Art therapists who develop assessment instruments for the purpose of measuring personal characteristics, diagnosing, or other clinical uses shall provide test users with a description of the benefits and limitations of the instrument, appropriate use, interpretation, and information on the importance of basing decisions on multiple sources rather than a single source.

2.7 Documentation
Art therapists must maintain records that:
2.7.1 Are in compliance with federal, provincial, state, and local regulations and any licensure requirements governing the provision of art therapy services for the location in which the art therapy services are provided.
2.7.2 Are in compliance with the standards, policies and requirements at the art therapist’s place of employment.
2.7.3 Include essential content from communication with/by the client via electronic means.

2.8 Termination of Services
2.8.1 Art therapists shall terminate art therapy when the client has attained stated goals and objectives or fails to benefit from art therapy services.
2.8.2 Art therapists must communicate the termination of art therapy services to the client, client’s parent or legal guardian.

2.9 Electronic Means
2.9.1 Art therapists must inform clients of the benefits, risks, and limitations of using information technology applications in the therapeutic process and in business/billing procedures. Such technologies include but are not limited to computer hardware and software, faxing, telephones, the Internet, online assessment instruments, and other technological procedures and devices. Art therapists shall utilize encryption standards within Internet communications and/or take such precautions to reasonably ensure the confidentiality of information transmitted, as in 2.9.5.6.
2.9.2 When art therapists are providing technology-assisted distance art therapy services, the art therapist shall make a reasonable effort to determine that clients are intellectually, emotionally, and physically capable of using the application and that the application is appropriate for the needs of clients.
2.9.3 Art therapists must ensure that the use of technology in the therapeutic relationship does not violate the laws of any federal, provincial, state, local, or international entity and observe all relevant statutes.
2.9.4 Art therapists shall seek business, legal, and technical assistance when using technology applications for the purpose of providing art therapy services, particularly when the use of such applications crosses provincial, state lines or international boundaries.
2.9.5 As part of the process of establishing informed consent, art therapists shall do the following:
2.9.5.1 Inform clients of issues related to the difficulty of maintaining the confidentiality of electronically transmitted communications, and the difficulty in removing any information or imagery that has been posted electronically if consent is later revoked.
2.9.5.2 Inform clients of all colleagues, supervisors, and employees (including Information Technology [IT] administrators) who might have authorized access to electronic transmissions.
2.9.5.3 Inform clients that, due to the nature of technology assisted art therapy, unauthorized persons may have access to information/art products that clients may share in the therapeutic process.
2.9.5.4 Inform clients of pertinent legal rights and limitations governing the practice of a profession across state/provincial lines or international boundaries.
2.9.5.5 Inform clients that Internet sites and e-mail communications will be encrypted but that there are limitations to the ability of encryption software to help ensure confidentiality.
2.9.5.6 When the use of encryption is not possible, art therapists notify clients of this fact and limit electronic transmissions to general communications that are not client specific.
2.9.5.7 Inform clients if and for how long archival storage of transaction records are maintained.
2.9.5.8 Discuss the possibility of technology failure and alternate methods of service delivery.
2.9.5.9 Inform clients of emergency procedures, such as calling 911 or a local crisis hotline, when the art therapist is not available.
2.9.5.10 Discuss time zone differences, and cultural or language differences that might impact service delivery.
2.9.5.11 If a client wishes to access insurance coverage for technology-assisted distance art therapy services, art therapists shall advise clients that it is the client’s responsibility to confirm coverage before beginning services.
2.9.5.12 Inform clients that communication will be included in client documentation as mentioned in 2.7.3.
2.9.6 Art therapists maintaining sites on the Internet shall do the following:
2.9.6.1 Regularly check that electronic links are working and professionally appropriate.
2.9.6.2 Provide electronic links to the ATCB and other relevant state, provincial, and or international licensure and professional certification boards to protect consumer rights and facilitate addressing ethical concerns.
2.9.6.3 Strive to provide a site that is accessible to persons with disabilities

2.10 Social Media
2.10.1 Art therapists who maintain social media sites shall clearly distinguish between their personal and professional profiles by tailoring information specific to those uses and modifying who can access each site.
2.10.2 Art therapists do not disclose or display confidential information through social media.

3. Eligibility for Credentials

As a condition of eligibility for and continued maintenance or renewal of any ATCB credential, each applicant, registrant, certificant, or certified supervisor agrees to the following:

3.1 Compliance with ATCB Standards, Policies and Procedures
3.1.1 No person is eligible to apply for or main-tain credentials unless in compliance with all ATCB eligibility criteria as stated in the ATR, ATR-BC, and ATCS applications, as well as all other ATCB rules and standards, policies and procedures, including, but not limited to, those stated herein, and including timely payment of fees and any other requirements for renewal of credentials.
3.1.2 Each applicant, registrant, or certificant bears the burden for showing and maintaining compliance at all times. The ATCB may deny, decline to renew, revoke, or otherwise act upon credentials when an applicant, registrant, or certificant is not in compliance with all ATCB stan-dards, policies, and procedures.

3.2 Complete Application
3.2.1 The ATCB may make administrative requests for additional information to supplement or complete any application for credentials or for renewal of existing credentials. An applicant must truthfully complete and sign an application in the form provided by the ATCB, must provide the required fees, and must provide additional information as requested.
3.2.2 The applicant, registrant, or certificant must provide written notification to the ATCB within 60 days of occurrence of any change in name, address, telephone number, and any other facts bearing on eligibility for credentials, including but not limited to: filing of any civil or criminal charge, indictment or litigation involving the applicant, registrant, or certificant; disposition of any civil or criminal charge, indictment or litigation involving the applicant, registrant, or certificant, including but not limited to, dismissal, entry of a judgment, conviction, plea of guilty, plea of nolo contendere, or disciplinary action by a licensing board or professional organization.
3.2.3 An applicant, registrant, or certificant will provide information requested by the Ethics Officer.
3.2.4 An applicant, registrant, or certificant must not make and must correct immediately any statement concerning his or her status that is or becomes inaccurate, untrue, or misleading.
3.2.5 All references to “days” in ATCB standards, policies and procedures shall mean calendar days. Communications required by the ATCB shall be transmitted by certified mail, return receipt requested, or other verifiable method of delivery.
3.2.6 The applicant, registrant, or certificant shall provide the ATCB with documentation of compliance with ATCB requirements as requested by the ATCB through its President or Executive Director.

3.3 Property of ATCB and Eligibility Determination
3.3.1 All examinations, certificates, and registration or certification cards of the ATCB, the name Art Therapy Credentials Board, all marks and terms of credentials, and all abbreviations relating thereto, are all the exclusive property of the ATCB and may not be used in any way without the express prior written consent of the ATCB.
3.3.2 ATCB applicants, registrants, or certificants who share, use, or alter ATCB examinations, certificates, and registration or certification cards of the ATCB, the name Art Therapy Credentials Board, all marks and terms of credentials, and all abbreviations relating thereto, are subject to disciplinary sanctions that may include but are not limited to denial, declined renewal, or revocation of ATCB credentials and may be subject to civil or criminal prosecution.
3.3.3 In case of suspension, limitation, relinquishment, or revocation of ATCB credentials, or as otherwise requested by the ATCB, a person previously holding an ATCB credential shall immediately relinquish, refrain from using, and correct at his or her expense any and all outdated or otherwise inaccurate business cards, stationery, advertisements, or other use of any certificate, logo, emblem, and the ATCB name and related abbreviations.

3.4 Pending Criminal or Administrative Proceedings
3.4.1 An applicant, registrant, or certificant shall provide written notification to the ATCB of the filing in any court of any information, complaint, or indictment charge of a felony or with a crime related to the practice of art therapy or the public health and safety, or the filing of any charge or action before a state or federal regulatory agency or judicial body directly relating to the practice of art therapy or related professions, or to a matter described in Part I, Section 4.1. Such notification shall be within 60 days of the filing of such charge or action, and shall provide written documentation of the resolution of such charge within 60 days of resolution.

3.5 Criminal Convictions
3.5.1 Applicants who meet all criteria as delineated in the current ATCB credential applications and who have not had sanctions imposed by the ATCB or other governmental authority, insurance carrier, professional organization, or credentialing board, or been convicted of a serious criminal offense, or been listed on a governmental abuse

registry will be considered eligible for an ATCB credential upon submission of all application materials and fees. All other applicants will be subject to review by the ATCB and demonstration of their fitness to practice art therapy and that they do not pose a risk to the public.

II. DISCIPLINARY PROCEDURES

4. Standards Of Conduct: Discipline Process

4.1 Grounds For Discipline
4.1.1 The ATCB may deny or revoke credentials or otherwise take action with regard to credentials or an application for credentials under the following circumstances:
4.1.1.1 Failure to observe and comply with the Standards of Ethics and Conduct stated herein;
4.1.1.2 Failure to meet and maintain eligibility for ATCB credentials;
4.1.1.3 Irregularity in connection with any ATCB examination;
4.1.1.4 Failure to pay fees required by the ATCB;
4.1.1.5 Unauthorized possession of, use of, or access to ATCB examinations, certificates, registration or certification cards, logos, the name Art Therapy Credentials Board, all marks and terms of credentials, and all abbreviations relating thereto, and any variations thereof, and any other ATCB documents and materials;
4.1.1.6 Obtaining, maintaining, or attempting to obtain or maintain credentials by a false or misleading statement, failure to make a required statement, fraud, or deceit in an application, reapplication, or any other communication to the ATCB;
4.1.1.7 Misrepresentation of status of ATCB credentials;
4.1.1.8 Failure to provide any written information required by the ATCB;
Failure to cooperate with the ATCB or anybody established or convened by the ATCB at any point from the inception of an ethical or disciplinary complaint through the completion of all proceedings regarding that complaint;
4.1.1.10 Habitual use of alcohol, any drug or any substance, or any physical or mental condition, which impairs competent and objective professional performance;
4.1.1.11 Gross negligence in the practice of art therapy or other related professional work; including, but not limited to, sexual relationships with clients, and sexual, physical, social, or financial exploitation;
4.1.1.12 Limitation or sanction (including but not limited to discipline, revocation, or suspension by a regulatory board or professional organization) in a field relevant to the practice of art therapy;
4.1.1.13 ?The conviction of, or plea of guilty or plea of nolo contendere to, (i) any felony or (ii) any crime related to the practice of art therapy, the therapist’s professional qualifications, or public health and safety. Convictions of this nature include but are not limited to those involving rape, sexual abuse of a patient or vulnerable person, actual or threatened use of a weapon or violence, and the prohibited sale, distribution or use of a controlled substance;
4.1.1.14 Failure to update information in a timely manner, including any violation referred to in this section, to the ATCB;
4.1.1.15 Failure to maintain confidentiality as required in the Standards of Ethics and Conduct, by any ATCB policy or procedure, or as otherwise required by law; or
4.1.1.16 Other violation of an ATCB standard, policy, or procedure stated herein or as stated in the ATCB candidate brochure or other material provided to applicants, registrants, or certificants.

4.2 Release of Information
4.2.1 Each applicant, registrant, and certificant agrees to cooperate promptly and fully in any
review of eligibility or credential status, including submitting such documents and information deemed necessary to confirm the information in an application.
4.2.2 The individual applicant, registrant, or certificant agrees that the ATCB and its officers, directors, committee members, employees, ethics officers, and agents, may communicate any and all information relating to an ATCB application, registration or certification, and review thereof, and any imposed public disciplinary sanctions to state and federal authorities, licensing boards, and employers, and may communicate any imposed public disciplinary sanctions and the status of
a registrant’s or certificant’s credential to the public.

4.3 Waiver
4.3.1 An applicant, registrant, or certificant releases, discharges, exonerates, indemnifies, and holds harmless the ATCB, its officers, directors, committee members, employees, ethics officers, and agents, and any other persons from and against all claims, damages, losses, and expenses, including reasonable attorneys’ fees, for actions of the ATCB arising out of applicant’s application for or participation in the ATCB registration and/or certification programs and use of ATCB trademarks or other references to the ATCB registration and/or certification programs, including but not limited to the furnishing or inspection of documents, records, and other information and any investigation and review of applications or credentials by the ATCB.

4.4 Reconsideration of Eligibility and Reinstatement of Credentials
4.4.1 If eligibility or credentials are denied, revoked, or suspended for a violation of the Standards of Ethics and Conduct, eligibility for credentials may be reconsidered by the Board of Directors, upon application, on the following basis:
4.4.1.1 In the event of a felony conviction, no earlier than five years from and after the exhaustion of appeals, completion of sentence by final release from confinement, probationary or parole status, or satisfaction of fine imposed, whichever is later;
4.4.1.2 In any other event, at any time following imposition of sanctions, at the sole discretion of the Board of Directors.
4.4.2 In addition to other facts required by the ATCB, such an applicant must fully set forth the circumstances of the decision denying, revoking, or suspending eligibility or credentials as well
as all relevant facts and circumstances since the decision.
4.4.3 The applicant bears the burden of demonstrating by clear and convincing evidence of rehabilitation and absence of danger to others.

4.5 Deadlines
4.5.1 The ATCB requires its applicants, registrants, and certificants to meet all deadlines imposed by the ATCB, especially in regard to submission of fees, renewal or recertification applications, required evidence of continuing education, and sitting for its examinations. On rare occasions, circumstances beyond the control of the applicant, registrant or certificant, or other extraordinary conditions may render it difficult, if not impossible, to meet ATCB deadlines.
4.5.2 An applicant, registrant, or certificant who wishes to appeal a missed deadline must transmit a written explanation and make a request for a reasonable extension of the missed deadline along with the appropriate fees with full relevant supporting documentation, to the ATCB Executive Director, to the attention of the ATCB National Office.
4.5.3 The Board of Directors shall determine at the next meeting of the Board, in its sole discretion and on a case-by-case basis, what, if any, recourse will be afforded based on the circumstances described and the overall impact on the profession of art therapy. No other procedures shall be afforded for failure to meet ATCB deadlines.
4.5.4 The ATCB shall make every effort to follow the time requirements set forth in this document. However, the ATCB’s failure to meet a time requirement shall not prohibit the final resolution of any ethics matter.

5. DISCIPLINARY PROCEDURES

5.1 Appointment of Disciplinary Hearing Panel
5.1.1 The ATCB Board of Directors may authorize an Ethics Officer and a Disciplinary Hearing Panel to investigate or consider alleged violations of the Standards of Ethics and Conduct contained in this Code or any other ATCB standard, policy or procedure. The ATCB Board of Directors shall appoint the chair of the Disciplinary Hearing Panel.
5.1.2 The Disciplinary Hearing Panel shall be composed of three members, including the chair. The membership of the Disciplinary Hearing Panel shall be drawn from ATCB registrants and certificants, except that one member of the Disciplinary Hearing Panel shall be a public member who shall not be an ATCB registrant or certificant.
5.1.3 The initial appointments to the Disciplinary Hearing Panel shall be for terms of three years as determined by the ATCB Board of Directors. Thereafter, a panel member’s term of office on the panel shall run for three years and may be renewed. Once a member of the Disciplinary Hearing Panel begins to participate in the review of a matter, the panel member shall remain part of the Disciplinary Hearing Panel for that particular matter even if the review extends beyond the expiration of his or her term.
5.1.4 A Disciplinary Hearing Panel member may not serve simultaneously as Ethics Officer and may not serve on any matter wherein an actual or apparent conflict of interest or the Panel Member’s impartiality might reasonably be questioned.
5.1.5 When a party to a matter before the Disciplinary Hearing Panel requests that a member of the panel, other than the chair, self-recuse, a final decision on the issue of recusal shall be made by the chair, subject to review as hereinafter provided. In the event a request is made that the chair self-recuse, the decision shall be made by the ATCB President, subject to review as hereinafter provided.
5.1.6 Panel action shall be determined by majority vote.
5.1.7 When a Panel member is unavailable to serve by resignation, disqualification, or other circumstance, the President of the ATCB shall designate another registrant or certificant, or public member, if applicable, to serve as an interim member for a particular matter or for the duration of the panel member’s unexpired term whichever is appropriate.

5.2 Submission of Allegations
5.2.1 Any person concerned about a possible violation of the ATCB Standards of Ethics and Conduct, or other ATCB standard, policy or procedure, may initiate a written grievance, in as much detail and specificity as possible, including identifying the person(s) alleged to be involved and the facts concerning the alleged conduct. The written grievance should be accompanied by all available documentation. The grievance should be addressed to the Executive Director. A person initiating a grievance shall be referred to as the complainant.
5.2.2 The written grievance must identify by name, address, and telephone number of the complainant making the information known to the ATCB, and others who may have knowledge of the facts and circumstances concerning the alleged conduct. The ATCB may provide for the submission of grievances on forms to be supplied by the Executive Director.
5.2.3 The Executive Director shall forward the grievance to the Public Member of the ATCB Board of Directors (the “Public Member”) for further action. The Public Member may initiate grievances that shall be handled in the manner provided hereinafter for the review and determination of all grievances.
5.2.4 The Public Member shall review the allegations and supporting information and make a determination of the merits of the allegations, after such further inquiry as considered appropriate, and after consultation with ATCB legal counsel as needed.
5.2.5 The Public Member may direct the ATCB Executive Director to assist with factual investigations or with administrative matters related to the initial review of allegations.
5.2.6 If the Public Member determines that the allegations are frivolous or fail to state a violation of the Standards of Ethics and Conduct, or that the ATCB lacks jurisdiction over the grievance or the person(s) complained about, the ATCB shall not take further action and shall notify the complainant.
5.2.7 If the Public Member determines that probable cause may exist to deny eligibility for credential or that probable cause exists of a failure to comply with the Standards of Ethics and Conduct or any other ATCB policy or procedure, the Public Member shall forward in writing all details of the allegations to one of the Ethics Officers.
5.2.8 The Ethics Officer shall review the allegations and supporting information provided and may make such further inquiry, as deemed appropriate.
5.2.9 The Ethics Officer may seek the assistance of the Executive Director to research precedents in the ATCB’s files, as reasonably determined to be necessary in making a determination regarding probable cause of a violation of the Standards of Ethics and Conduct, any other ATCB policy or procedure, or other misconduct. The Ethics Officer may direct the ATCB Executive Director to assist with factual investigations or with administrative matters related to the review of allegations.
5.2.10 If the Ethics Officer concurs that probable cause may exist to deny eligibility or that probable cause exists of a failure to comply with the Standards of Ethics and Conduct or any other ATCB policy or procedure, the Ethics Officer shall transmit written notification containing the allegations and findings to the full Disciplinary Hearing Panel, the complainant and the applicant, certificant or registrant. All written notices to the applicant, registrant or certificant shall be sent by certified mail, return receipt requested, to their addresses listed in the ATCB records. However if the Ethics Officer, in agreement with the Public Member, determines that the probable violation(s) are minor or technical in nature and have neither caused nor presented a danger of serious harm to a client or the public, the Ethics Officer may choose to resolve the complaint by the issuance of an advisory letter to the registrant or certificant setting out the identified probable violations and recommendations on corrective or preventative measures that should be implemented by the registrant or certificant in the future. All such advisory letters shall be maintained as part of the registrant’s or certificant’s file and may be taken into consideration of the sanctions to be assessed in connection with any future complaints brought against the registrant or certificant. Advisory letters shall not be made public.
5.2.11 If the Ethics Officer determines that probable cause does not exist to deny eligibility or that that probable cause does not exist of a failure to comply with the Standards of Ethics and Conduct or any other ATCB policy or procedure, or that the ATCB lacks jurisdiction over the complaint or the person(s) against whom the complaint was made, the Ethics Officer shall direct ATCB to take no further action and shall notify in writing the Board, the applicant, registrant, or certificant, and complainant, if any.
5.2.12 If upon referral of a grievance from the Public Member the Ethics Officer determines that reasonable cause exists that a registrant or certificant has had a license or certification revoked or suspended or has been charged, indicted, placed on deferred adjudication, community supervision, probation, or convicted of an offense listed below or determines that there is a serious concern for the protection and safety of the public, the Ethics Officer shall present to the Disciplinary Hearing Panel a recommendation for summary suspension of the registrant’s or certificant’s registration or certification. If approved by a majority vote of the Disciplinary Hearing Panel, the Ethics Officer shall notify the registrant or certificant in writing by certified mail, return receipt requested, of the summary suspension at the registrant’s or certificant’s address listed in the ATCB records. The suspension shall be effective three (3) days after the date of mailing.
Summary suspension shall be considered for all serious offenses including but not limited to the following:
(A) capital offenses;
(B) sexual offenses involving a child victim;
(C) felony sexual offenses involving an adult victim who is a client (one or more counts);
(D) multiple counts of felony sexual offenses involving any adult victim;
(E) homicide 1st degree;
(F) kidnapping;
(G) arson;
(H) homicide of lesser degrees;
(I) felony sexual offenses involving an adult victim who is not a client (single count);
(J) attempting to commit listed crimes;
(K) any felony or misdemeanor offenses potential physical harm to others and/or animals;
(L) felony or misdemeanor alcohol and drug offenses;
(M) all other felony offenses not listed.
A registration or certification summarily suspended shall remain suspended until final resolution of all criminal charges and a final decision of all complaints by the ATCB.
5.2.13 The ability of a complainant to withdraw a complaint shall be governed by the following standards:
(A) The complaint may be withdrawn in the initial stage of the examination by the Public Member Director; however, the Public Member Director or the ATCB reserves the right to refile the complaint if, in his or her judgment, there is concern for the protection of the public.
(B) Once the complaint has moved to an Ethics Officer for review, it cannot be withdrawn; however, the complainant cannot be forced to assist further.

5.3 Procedures of the Disciplinary HearingPanel
5.3.1 Upon receipt of notice from the Ethics Officer containing a statement of the complaint allegations and the finding(s) that probable cause may exist to deny eligibility for credential or question compliance with the Standards of Conduct or any other ATCB policy or procedure, the applicant, registrant, or certificant shall have thirty (30) days after receipt of the notice to notify the Ethics Officer in writing that the applicant, registrant, or certificant disputes the allegations of the complaint and to request review by written submissions to the Disciplinary Hearing Panel, a telephone conference with the Disciplinary Hearing Panel, or an in-person hearing (held at a time and place to be determined by the panel), with the respondent bearing the respondent’s own ex-penses for such hearing.
5.3.2 If the applicant, registrant, or certificant (respondent) does not contest the allegations of the complaint, the respondent may still request review by written submissions to the Disciplinary Hearing Panel, a telephone conference with the Disciplinary Hearing Panel, or an in-person hearing (held at a time and place to be determined by the panel), with the applicant, registrant, or certificant bearing the respondent’s own expenses for such hearing, concerning the appropriate sanction(s) to be applied in the case.
5.3.3 If the applicant, registrant, or certificant does not submit a written statement contesting
the allegations or notify the board of a request for review by written submission, telephone conference or in-person hearing as set forth in this paragraph, then the Disciplinary Hearing Panel shall render a decision based on the evidence available and apply sanctions as it deems appropriate.
5.3.4 If the applicant, registrant, or certificant requests a review, telephone conference, or hearing, the following procedures shall apply:
5.3.4.1 The Ethics Officer shall forward the allegations and any written statement from the applicant, registrant, or certificant to the Disciplinary Hearing Panel, and shall present the allegations and any substantiating evidence, examine and cross-examine witnesses, and otherwise present the matter during any hearing of the Disciplinary Hearing Panel.
5.3.4.2 The Disciplinary Hearing Panel shall then schedule a written review, or telephone or in-person hearing as requested by the applicant, registrant, or certificant, allowing for an adequate period of time for preparation, and shall send by certified mail, return receipt requested, a notice to the applicant, registrant, or certificant and the complainant. The notice shall include a statement of the standards allegedly violated, the procedures to be followed, and the date for submission of materials for written review, or the time and place of any hearing, as determined by the Disciplinary Hearing Panel. The applicant, registrant, or certifi-cant and the complainant may request a change in the date of any hearing for good cause, which shall not unreasonably be denied.
5.3.4.3 The Disciplinary Hearing Panel shall maintain a verbatim audio, video, or written transcript of any telephone or in-person hearing.
5.3.4.4 During any proceeding before the Disciplinary Hearing Panel, all parties may consult with and be represented by counsel at their own expense. At any hearing, all parties or their counsel may make opening statements, present relevant documents or other evidence and relevant testimony, examine and cross-examine witnesses under oath, make closing statements, and present written briefs as scheduled by the Disciplinary Hearing Panel.
5.3.4.5 The Disciplinary Hearing Panel shall determine all evidentiary and procedural matters relating to any hearing or written review. Formal rules of evidence shall not apply. Relevant evidence may be admitted. The chair, subject to the majority vote of the full panel, shall determine disputed questions regarding procedures or the admission of evidence. All decisions shall be made on the record.
5.3.4.6 The burden shall be upon the ATCB to demonstrate a violation by preponderance of the evidence.
5.3.4.7 Whenever there is a reasonable concern that the mental or behavioral abilities of the applicant, registrant, or certificant may be impaired, calling into question the ability to competently, safely and professionally provide art therapy services, the respondent may be required to undergo a mental or behavioral health examination at the respondent’s own expense. The report of such an examination shall become part of the evidence considered.
5.3.4.8 The Disciplinary Hearing Panel shall issue a written decision following any telephone or in-person hearing or written review and any submission of briefs. The decision shall contain findings of fact, a finding as to the truth of the allegations, and any sanctions applied. It shall be mailed by certified mail, return receipt requested, to the applicant, registrant, or certificant and complainant.
5.3.4.9 If the Disciplinary Hearing Panel finds that the allegations have not been proven by a preponderance of the evidence, no further action shall be taken, and the applicant, registrant, or certificant, and the complainant, if any, shall be notified by certified mail.
5.3.4.10 If the Disciplinary Hearing Panel finds that the allegations have been proven by a preponderance of the evidence it shall assess one or more appropriate public sanctions as set forth below:
(1) deny, refuse to issue, or refuse to renew a registration or certification;
(2) revoke or suspend a registration or certification;
(3) probate a suspension of a registration or certification;
(4) issue a reprimand.
(5) publish the rule violation and the sanction imposed;
(6) require mandatory remediation through specific education, treatment, and/or supervision;
(7) require that the registrant or certificant take appropriate corrective action(s);
(8) provide referral or notice to governmental bodies of any final determination made by the ATCB; or
(9) other corrective action.
The Disciplinary Hearing Panel will determine the length of the probation or suspension. If the Disciplinary Hearing Panel probates the suspension of a registration or certification, it may require the registrant or certificant to:
(1) report regularly to the Ethics Officer on matters that are conditions of the probation;
(2) limit practice to the areas prescribed by the Disciplinary Hearing Panel; or
(3) complete additional educational requirements, as required by the Disciplinary Hearing Panel to address the areas of concern that are the basis of the probation.
(4) provide periodic progress reports from the registrant’s or certificant’s health care providers.
(5) provide periodic supervision reports from the registrant’s or certificant’s supervisor.
All public sanctions shall be listed on the ATCB’s website and accessible to the general public and/or published in the ATCB’s official publication.
5.3.4.11 An individual whose registration or certification is revoked is not eligible to apply for a registration or certification for a minimum of three years after the date of revocation. The ATCB may consider the findings that resulted in revocation and any other relevant facts in determining whether to deny the application if an otherwise complete and sufficient application for a registration, or certification is submitted after three years have elapsed since revocation.
5.3.4.12 A voluntary surrender of a registration or certification accepted by the ATCB in response to a grievance or complaint shall be deemed to be an admission to the alleged violations and may be considered as such by the Disciplinary Hearing Panel in rendering its decision.

5.4 Appeal Procedures
5.4.1 If the decision rendered by the Disciplinary Hearing Panel is not favorable to the applicant, registrant, or certificant (respondent), the respondent may appeal the decision to the ATCB Board of Appeals by submitting to the Executive Director a written appeal statement within thirty (30) days following receipt of the decision of the Disciplinary Hearing Panel. The Disciplinary Hearing Panel shall grant any reasonable requests for extensions.
5.4.2 The Disciplinary Hearing Panel may file a written response to the appeal with the Executive Director.
5.4.3 The Executive Director shall immediately forward any appeal documents to the ATCB Board of Appeals.
5.4.4 The ATCB Board of Appeals by majority vote shall render a decision on the record without further hearing, although written briefs may be submitted on a schedule reasonably determined by the Board of Appeals. On matters on which the ATCB Public Member has initiated a complaint or performed the initial review, the Public Member shall not be part of the ATCB Board of Appeals.
5.4.5 The decision of the ATCB Board of Appeals shall be rendered in writing following receipt and review of briefs. The decision shall contain findings of fact, findings as to the truth of the allegations, and any sanctions applied and the decision shall be final.
5.4.6 The decision of the ATCB Board of Appeals shall be communicated to the applicant, registrant, or certificant by certified mail, return receipt requested. The complainant, if any, shall be notified of the Board of Appeals’ final decision.

5.5 Bias, Prejudice, Impartiality
5.5.1 At all times during the ATCB’s handling of any matter, the ATCB shall extend impartial review. If at any time during the ATCB’s review of a matter an applicant, registrant, certificant, or any other person identifies a situation where the judgment of a reviewer may be biased or prejudiced or impartiality may be compromised (including employment with a competing organization), such person shall immediately report such matter to the Executive Director or President of the ATCB.
5.5.2 In matters where impartiality may be compromised, the reviewer shall self-recuse.

Attachment E: State Licensing of Art Therapists (as of December 2023)

I. States Enacting Art Therapist Licenses

Delaware: Licensed Professional Art Therapist (LPAT) and Licensed Associate Art Therapist (LAAT) issued by the Board of Mental Health and Chemical Dependency Professionals.

Kentucky:  Professional Art Therapy License (LPAT) issued by the Kentucky Board of Licensure for Professional Art Therapists, which is attached to the Office of Occupations and Professions of the Kentucky Public Protection Cabinet.

Maryland:  Professional Clinical Art Therapy License (LPCAT) issued by the State Board of  Professional Counselors and Therapists.

Mississippi: Professional Art Therapy License (LPAT) issued by the Mississippi State Board of Health with a 3-member Professional Art Therapy Advisory Council.

New Jersey: Professional Art Therapy License (LPAT) issued by a five-member Art Therapy Advisory Committee under the State Board of Marriage and Family Therapy Examiners.

New Mexico: Professional Art Therapist License (LPAT) issued by the Counseling and Therapy Practice Board under the Boards and Commissions Division of the New Mexico Regulation & Licensing Department. 

Ohio: Licensed Professional Art Therapist (LPAT) issued by The Ohio Counselor Social Worker Marriage and Family Therapist Board (CSWMFT).

Oregon: Licensed Art Therapist (LAT) and Licensed Certified Art Therapist (LCAT) issued by the Health Licensing Office of the Oregon Health Authority.

Virginia: Licensed Art Therapist (LAT) and Licensed Associate Art Therapist (LAAT) issued by the Board of Marriage and Family Therapy.

District of Columbia: Licensed Professional Art Therapist (LPAT) issued by the Board of Professional Counseling.

II. States Licensing Art Therapist under Related Licenses:

New York: Creative Arts Therapist License (LCAT) issued by the Office of the Professions of the New York State Education Department.

Pennsylvania: Art therapy defined in regulation as a qualifying “closely related field” for the professional counseling license issued by the State Board of Social Work, Marriage and Family Therapists and Professional Counselors under the Pennsylvania State Secretary of State. 

Texas:  Professional Counselor with Specialization in Art Therapy License (LPC-AT) issued by the Texas State Board of Examiners of Professional Counselors.

Utah: Art therapists with clinical art therapy master’s degrees recognized by the Utah Division of Occupational and Professional Licensing as meeting the education requirements for the Associate Clinical Mental Health Counselor license.  

Wisconsin: Registered Art Therapist with License to Practice Psychotherapy issued by the Wisconsin Department of Safety and Professional Services to qualifying art therapists with board certification by the Art Therapy Credentials Board (ATCB).

III. States Recognizing Art Therapists for purposes of State Hiring or Title Protection (July 2017):

Arizona: State law authorizes the State Department of Health Services to contract for mental health and behavioral health services of Certified Art Therapists; defines Art Therapy for purposes of state law and provides title protection for credentialed art therapists.  

Connecticut: Art therapy is defined in State law for purposes of qualifying who may provide art therapy services to the public and restricting use of the title “art therapist” to persons holding national art therapy credentials.   

Louisiana: State hiring regulations recognize credentialed art therapists as qualified school art therapists in public schools and eligible providers of therapeutic and rehabilitative activities in hospitals that provide psychiatric services. 

Attachment F: Scope of Practice for Professional Art Therapy 

The scope of practice of a licensed professional art therapist includes, but is not limited to: 

(a) The use of psychotherapeutic principles, art media, and the creative process to assist individuals, families, or groups in:

(1) Increasing awareness of self and others;

(2) Coping with symptoms, stress, and traumatic experiences;

(3) Enhancing cognitive abilities; and

(4) Identifying and assessing clients’ needs in order to implement therapeutic intervention to meet developmental, behavioral, psychological, and emotional needs.

(b) The application of art therapy principles and methods in the diagnosis, prevention, treatment, and amelioration of psychological problems and emotional or psychological conditions that include, but are not limited to:

(1) Clinical appraisal and treatment during individual, couples, family or group sessions which provide opportunities for engagement through the creative process; 

(2) Using the process and products of art creation to tap into client’s inner fears, conflicts and core issues with the goal of improving physical, psychological and emotional functioning and well-being; and

(3) Using art therapy assessments to determine treatment goals and implement therapeutic art interventions which meet developmental, psychological, and emotional needs; an

(c) The employment of art media, the creative process and the resulting artwork to assist clients to:

(1) Reduce psychiatric symptoms of depression, anxiety, posttraumatic stress, and attachment disorders;

(2) Enhance neurological, cognitive, and verbal abilities, develop social skills, aid sensory impairments, and move developmental capabilities forward in specific areas;

(3) Cope with symptoms of stress, anxiety, traumatic experiences and grief;

(4) Explore feelings, gain insight into behaviors, and reconcile emotional conflicts;

(5) Improve or restore functioning and a sense of personal well-being;

(6) Increase coping skills, self-esteem, awareness of self and empathy for others;

(7) Healthy channeling of anger and guilt; and

(8) Improve school performance, family functioning and parent/child relationship. 

American Art Therapy Association (2014)