Graduation Date

2025

Document Type

Master's Thesis

Project Type

Mixed Methods

Degree Name

Master of Arts in Marriage and Family Therapy

Program

Art Therapy

Program Director

Richard Carolan, ATR-BC, EdD

First Reader

Victoria Dobbins, PhD, LMFT, ATR-BC

Second Reader

Erin Partridge, PhD, ATR-BC

Abstract

This mixed methods, randomized, single-session study tested whether integrating text-to-image generations into Solution-Focused Brief Art Therapy alters therapeutic rapport and short-term outcomes relative to traditional artmaking materials. Participants were assigned by coin flip to create using either a text-to-image generator or convention media (23 per group), completing immediate and three-day follow-ups. Alliance was measured using DREAM (Dimensions of Regard, Empathy, and Authenticity Metric), and problems were rated pre/post; groups did not differ significantly on DREAM total or facets, and both modalities produced reliable pre-to-post reductions in problem severity. At the same time, process differences were pronounced: the AI condition showed substantially higher medium resistance and markedly impaired multitasking during artmaking. Multitasking ability followed an inverted-U relation with distress reduction—moderate ability corresponded to the largest gains—and correlated positively with several DREAM dimensions (overall rapport, unconditional positive regard, empathic understanding). Together, these findings indicate that text-to-image generation can materially shift the creative process without degrading immediate alliance or symptomatic improvement in this brief format, suggesting cautious, evidence-led integration: to use AI when it demonstrably supports access, engagement, or fit with therapeutic goals, and to revert to tactile media when attentional load or process disruption threatens rapport or efficacy.

IRB Number

11264

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