Graduation Date


Document Type

Master's Thesis

Project Type

Mixed Methods

Degree Name

Master of Arts in Marriage and Family Therapy


Art Therapy

Program Director

Richard Carolan, PhD, ATR-BC

First Reader

Richard Carolan, PhD, ATR-BC

Second Reader

Lisa Hinz, PhD, ATR-BC


This study aimed to understand how artmaking experiences during assessment may influence the formation of the therapeutic alliance at the start of therapy. Rather than measuring therapeutic alliance directly, this study identified psychological safety as a vital component of the therapeutic relationship and an important topic of study via literature on attachment theory. Using a mixed-methods, repeated-measures design, this study compared artmaking experiences and feelings of psychological safety in response to two interventions––a Human Figure Drawing (HFD) assessment and an Expressive Therapies Continuum (ETC) assessment. Overall, qualitative data from semi-structured interviews and quantitative data from the Art-Based Intervention (ABI) questionnaire and an altered version of the Types of Positive Affect Scale (TPAS) showed that participants had a more positive artmaking experience and felt more psychologically safe during the ETC assessment compared to the HFD assessment. Aspects of the artmaking experience during the ETC assessment associated with safety were choice/freedom of expression and focus on the artmaking process, rather than the product. Some initial safety was also found in the direction given in the HFD instructions, but this seemed to be outweighed by negative experiences during artmaking, including feeling limited, self-critique, and concerns about expectations and judgement. The greater level of psychological safety experienced during the ETC assessment indicates that this type of art therapy assessment may be more beneficial in promoting the formation of the therapeutic alliance.

Keywords: art therapy, assessment, psychological safety, therapeutic alliance

IRB Number