Art Therapy and Art Psychotherapy: The Regulated Profession Behind the Word

Art therapy is a form of psychotherapy in which making an image is part of the therapeutic relationship rather than an activity alongside it, and in the United Kingdom it is delivered by practitioners holding one of two titles protected in law: art therapist and art psychotherapist. It is not an art class, artistic ability is irrelevant to it, and a craft afternoon run by a volunteer is not a weaker version of it but a different thing entirely.

I noticed how loose the word had become from a care home newsletter, which advertised art therapy every Wednesday. The Wednesday session was a lovely thing: a table, some acrylics, an activities coordinator who knew everybody’s name and which of them liked to be left alone. No assessment, no goals, no notes, no supervision, no registered practitioner. I have run the singing equivalent of that Wednesday for years and I would defend it, and it is not therapy, and the newsletter was not being dishonest. It was using a word that has stopped being policed anywhere except in law.

This page is the map of the regulated version. Where a claim about effect appears on this site it carries a tier (Tier 1 supported, Tier 2 promising but limited, Tier 3 practice and anecdote), explained on reading arts in health research.

Four protected titles, not three

In the UK, four arts therapy titles are protected by law and held on the Health and Care Professions Council register: art psychotherapist, art therapist, dramatherapist and music therapist. Using one of them without registration is a criminal offence.

You will very often read about “the three arts therapies”, including in material published by the sector itself. It is a small error with a specific consequence: art therapist and art psychotherapist are two separate protected titles covering one profession, and collapsing them loses the fact that a practitioner may lawfully be using either. In July 2026 the register listed 6,103 arts therapists in total across all four titles¹. That is a very small workforce, and it explains most of what people experience as patchy availability.

Registration means a postgraduate qualification, normally a masters with supervised clinical placements, plus continuing professional development and accountability to a regulator that can remove someone from the register. The professional body for the visual side is the British Association of Art Therapists, which maintains a members directory and publishes practice standards²; membership of it is not the same as registration, and both are worth checking. Routes into the profession, and how the UK and US systems differ, are on training as an art therapist.

Dramatherapy, the fourth title and the least known one

Dramatherapy is a registered arts therapy in exactly the same sense as the others, and most people have never heard of it.

It uses role, story, movement, improvisation and sometimes masks or puppets, with the same clinical scaffolding: assessment, goals, notes, supervision, discharge. In the UK it is offered mainly in mental health services, schools, learning disability services and forensic settings rather than in acute hospitals, and its professional body is the British Association of Dramatherapists³. Because dramatherapist is one of the four titles on the same register of 6,103 arts therapists¹, a dramatherapist is subject to exactly the same statutory regulation as a music therapist, which is not true of every practitioner who works with the arts in a health setting: dance movement psychotherapist, notably, is not a protected title at all. See dramatherapy and dramatherapy in mental health services.

How art therapy differs from an art class

The difference is not the materials, the room or the quality of the work. It is that in art therapy the image is part of a therapeutic relationship, and in an art class it is the point of the session.

An art therapist is not teaching technique and is not interpreting your painting back at you like a dream dictionary. They are working with what happens around the making: what gets chosen, what gets avoided, what is easier to put on paper than into a sentence, and what the two of you do with it afterwards. That is why artistic ability is beside the point, and why people who are good at art sometimes find it harder to begin than people who have not held a brush since school.

The practical differences are the five to check when something is offered to you or your relative: is there an assessment, are there written goals, does the practitioner have clinical supervision, are there notes, and is there a planned ending. A sixth check settles it on its own, and takes a minute: search the practitioner’s name on the HCPC register of 6,103 arts therapists¹. If they are not on it, whatever they are offering is not one of the four protected titles, and that is a fact about regulation rather than a judgement about their work. Two practices often filed alongside art therapy sit on the unregulated side of that line and are neither better nor worse for it: expressive writing and photovoice, covered on therapeutic writing and photography. Art therapy against an art class works through the distinction, and it is the same line drawn on music therapy against community music, dance movement psychotherapy and craft making and mental health. Both sides of that line help people. Only one is regulated, and a result proved about one does not transfer to the other.

What happens in a session, and what happens to the work

Sessions are quieter and less directed than most people imagine, and the artwork normally stays with the service rather than going home.

There is usually a consistent room, a consistent time, a range of materials laid out, and a great deal of latitude about whether you make anything at all. In a clinical setting the images form part of the record of the work and are stored confidentially, which is worth asking about at the outset: who sees them, where they are kept, and what happens to them at the end. Where the person in the room is a child, or an adult who cannot give informed consent, those questions get considerably harder and are covered on consent and safeguarding in arts in health and art therapy for children. What happens in an art therapy session describes the shape of the hour itself.

Why this page quotes no effect size

There is no effect size on this page, and that is a decision rather than an oversight.

On this site an efficacy claim has to arrive with five things beside it: the effect size, the confidence interval, the certainty rating, the sample size and the year. A pillar page that summarised the art therapy literature in a sentence would either have to leave those out or pick one condition and pretend it stood for the rest. So the numbers live on the condition pages, where each one can be set out properly with its tier: art therapy for psychosis, art therapy for trauma and PTSD, art therapy during cancer treatment and art therapy for children.

Two things follow from that, and they pull in opposite directions.

The first is that the absence of a headline number here is not a verdict. Tier 3 means the question has not been answered properly, not that the answer is no. Arts therapies are hard to blind, the funding runs in short cycles, the outcomes people care about are difficult to measure, and the sector’s money goes into delivery rather than trials. Plenty of work that people find genuinely valuable sits at Tier 3 and may move up when somebody finally runs the study.

The second is that a large literature is not the same as a strong one. The WHO Europe scoping review mapped over 900 publications, made up of 200 plus reviews and 700 plus individual studies, with the reviews themselves covering over 3,000 studies⁴. Note how those counts nest: the 3,000 are inside the reviews, which are inside the 900, and presenting them side by side inflates the field several times over. That review maps a literature rather than pooling it, so it carries no tier and supports no claim about effect at all. It tells you the field has been studied. It does not tell you what was found.

The US credentials, and the number that is not published here

In the United States the credentials to know are ATR-P (provisional), ATR (registered), ATR-BC (board certified) and ATCS (certified supervisor), awarded by the Art Therapy Credentials Board, which runs a public verification tool for checking an individual⁵.

No count of US art therapy credential holders appears anywhere on this site, and the reason is instructive rather than merely cautious. The board publishes two different, undated and unreconciled figures on its own website, and its own annual reports do not support either. Its 2021 report states a total of 6,235 active credential holders, but 6,235 is the Total row, which includes applications and retired credentials; the Active rows sum to 4,955⁶. Its 2020 report states 8,226, where the rows sum to 8,053 and the Active rows to 7,150⁷. Active ATR falls from 3,165 in 2020 to 1,861 in 2021 with no explanation offered. And the credentials stack: one person can hold ATR, ATR-BC and ATCS at once, so none of these tables counts people in the first place.

If a US scale figure is genuinely needed, the American Art Therapy Association reports more than 4,200 members worldwide in its 2024 Annual Impact Report⁸. That is association membership, not credentials, and AATA is a different organisation from ATCB. Labelled that way it is usable. Presented as a headcount of American art therapists it is not.

Costs, and the fee figure that does not exist

No private fee figure for art therapy appears on this site, because the profession’s own UK body publishes its fee guidance to members only².

That is a plain statement about what is available, and it has a practical implication: any BAAT attributed fee you encounter has come from somewhere else and acquired the attribution along the way. Individual practitioners set their own rates and will quote them on request, which is the only source worth relying on.

Where art therapy comes through the NHS, a hospice, a school, a local authority or a charity, it is normally free to the person receiving it. With 6,103 arts therapists registered across all four titles¹, the constraint is almost always whether a post exists in your area rather than what it would cost. If nothing clinical is available, the community route is a different offer rather than a lesser one: see arts on prescription and how to get referred to an arts scheme.

Nothing on this page is a reason to change anything about anyone’s treatment, and no arts intervention substitutes for one.