What is art therapy for children and how can it help a child who can't name feelings? Read what happens in sessions, the limits of drawings and your role.
Imagine a six-year-old who answers "I don't know" to the question "Did something happen at school?", pushes their plate away at dinner and shuts themselves in their room, but that same evening draws a huge, pitch-black cloud on a sheet of paper. For the parents, this drawing is both worrying and something like a clue. Children cannot put their feelings into sentences the way adults do; they usually express them through play, movement and drawing. Art therapy for children is an approach that aims to use this natural way of expression within a safe relationship. In this article we explain why children turn to paint and clay instead of words, in which situations this kind of support might be considered, what happens in a session and, most importantly, what can and cannot be understood from a child's drawing.
What Is Art Therapy for Children?
Art therapy is the use of materials such as drawing, paint, clay, collage and the like within a therapeutic relationship for the purpose of psychological support. When working with children, this approach is often intertwined with play. For a child, playing with a lump of clay, painting a sheet of paper or placing figures in a sand tray is a way of showing what they cannot explain in words.
The aim here is not to make a beautiful picture or to teach the child to draw. The aim is to open up space for the child to reach their inner world at their own pace and in their own language. That is why there is no "right" or "wrong" picture in sessions; everything the child draws is accepted.
It is known that Edith Kramer, one of the pioneers of this field, taught art to refugee children in Prague in the 1930s. Kramer emphasised the value of the process of creating itself rather than the interpretation of the work. The experience she gained with children going through hard circumstances still nourishes one of the core intuitions of creative work with children today: while a child is making something, they are also giving shape to their own experience.
How it relates to play therapy
In psychological support with children, art materials, play dough and the sand tray are often natural parts of the playroom. That is why the line between art-based work with children and play therapy is not a sharp one. We explain in detail why play is so important for children in our article what is play therapy.
Why Do Children Choose Paint and Clay Instead of Words?
For adults, saying "I'm sad", "I'm angry" or "I'm scared" is relatively easy; even so, most of us struggle to name our feelings. For children, this is much harder. There are several reasons for this:
- Language is still developing. Young children have a limited vocabulary for feelings. "My tummy hurts" sometimes stands in for anxiety, sometimes for missing someone.
- Feelings are mixed. A child who both loves and is jealous of a newborn sibling does not know how to express these two feelings at the same time.
- Some experiences are wordless. Frightening events, or those experienced at a very young age, may remain in a child's memory more as images, sounds and bodily sensations than as words.
- Direct questions can create pressure. The question "Why did you do that?" pushes a child onto the defensive. Talking about a picture, by contrast, offers a more indirect and safer route.
At this point paint and clay give the child some distance. Instead of saying "I'm scared", the child can draw a picture in which a monster is locked in a cage. They can squash a clay figure and knead it again. This indirect form of expression can help the child make contact with a difficult feeling without being overwhelmed.
Sometimes a child does not tell you about a feeling, they act it out; an adult's job at that moment is to be able to stay beside them, calm and curious.
In Which Situations Might Art Therapy for Children Be Considered?
Creative methods are not specific to any particular diagnosis; they can be valuable mainly in situations where the child finds it hard to express themselves. Some situations families commonly encounter are:
- Children who cannot put their feelings into words, who often say "I don't know" or who withdraw
- Children going through big changes such as the birth of a sibling, parents separating, or a change of city or school
- Children grieving after an important loss, such as a grandparent or a pet
- Children whose sleep, eating or play patterns change after frightening events such as an earthquake, an accident or a hospital stay
- Children who have angry outbursts and struggle to regulate their emotions
- Children who are shy and hesitant to speak
This list is not a list of diagnoses. Each of these situations first calls for the child to be assessed as a whole. For some children art-based work will be suitable; for others, different approaches or a combination of approaches may be more appropriate.
Does every child like drawing?
No, and that is perfectly normal. Some children do not like getting messy with paint, some push the paper aside saying "I can't do it", and others prefer to move, build or tell stories. Art-based work does not mean pushing a child towards a particular material. For a child who does not want to draw, play dough, building blocks, puppets or the sand tray may be more inviting. What matters is that the child finds a way of expressing themselves that feels comfortable. A child rejecting a material is also valuable information; over time, as they feel safer, they may become more willing to try new materials.
What Happens in an Art Therapy Session for Children?
Each piece of work varies according to the child's age, needs and the stage of the process. Even so, it is possible to sketch a general framework.
Meeting the family first
Before starting work with the child, there is usually a meeting with the parents. The child's development, the family's observations, school life and recent changes are discussed. This meeting is an important starting point for understanding the child's world.
A safe space
The room the child enters offers them a range of options: pastels, felt-tip pens, watercolours, finger paint, play dough, clay, scissors and coloured paper, and sometimes a sand tray and miniature figures. The child largely decides which material to use and what to do with it.
The professional's role
The professional does not tell the child what to draw, correct the drawing or interrogate them with "What is this?" Instead, they watch what the child does and offer curious, non-interpretive observations: "You've used a lot of blue here", "This figure looks like it's running very fast." If the child wants to explain, they do; if not, nobody insists.
Boundaries and trust
The room has certain rules: nobody gets hurt, materials are not deliberately damaged, and the session has a beginning and an end. These boundaries help the child feel safe.
Closing and keeping the work
At the end of the session, time is set aside for closing so the child can calm down and return to daily life. The work produced belongs to the child; it is kept, photographed or shared only with parental permission and the child's own consent.
If you are curious about how the sand tray is used with children, you can also take a look at our article on sand tray therapy. A recent systematic review looking at children and adolescents in this area reported findings of benefit for emotion regulation and anxiety across 27 studies; however, it also stressed that the evidence base is weaker than for established therapies.
What Can a Child's Drawing Tell Us, and What Can't It?
This is the question families ask most often: "Does this drawing mean something?" The answer is both yes and no.
What it can tell us: A drawing is a doorway that opens up conversation with the child. It can show what the child is preoccupied with that day, which themes are going round in their mind, and what matters to them. But its meaning is discovered together with the child and over time.
What it can't tell us: A diagnosis cannot be made from a drawing. Scientific reviews are clear on this. A comprehensive review published in 2000 reported that, among projective tests, human figure drawings are among those with the most limited evidence of validity, and that for tools intended to detect child abuse from drawings, findings replicated by independent teams are almost non-existent. Another study published in 2013 showed that scores on the "Draw-a-Person" test are only weakly to moderately related to intelligence scales, and that the test should not be relied on to measure intelligence.
Many factors affect a child's drawing: their mood that day, how tired they are, their interests, the colours of the pens they happen to have, their drawing skills, even a cartoon they watched the day before. That is why interpretations such as "a child who uses black paint is depressed", "a figure without hands is a sign of abuse" or "a child who draws the sun in the corner has a problem with their father" are not valid. We discuss this topic in detail in our article on children's drawings analysis.
When an assessment of a child is needed, it draws on multiple sources: observation of the child, a meeting with the family, information from school where necessary, and standardised assessment tools are used together.
What Can Parents Do at Home?
Drawing with your child at home is a valuable way of bonding with them and making room for them to express their feelings. Bearing in mind that this is not therapy, but a shared activity that can do your child good, you can try the following:
- Make materials easy to reach. Keep paper, paints and play dough somewhere your child can get to them.
- Don't direct; accompany. Instead of saying "Draw a house", watch what your child wants to do.
- Describe instead of commenting. Observations such as "You've used lots of colours here" rather than "How lovely" leave room for your child to tell you more.
- Don't interrogate. Instead of "Who is this? Why is he crying?", ask "Would you like to tell me about it?" and respect a "no".
- Don't use drawings as a diagnostic tool. When you see a worrying drawing, rather than panicking, look at your child's general behaviour and daily life.
- Don't share drawings without permission. Ask your child before sharing their drawing on social media or in the family group chat.
Let's say a seven-year-old girl who recently lost her grandfather draws the same garden and a bench every day. This repetition may worry her family; but it may also be her way of working through her grief in her own language. Instead of saying "The same picture again?", sitting beside her and saying "This bench looks like a very important place" opens a door for her if she wants to talk.
When to Seek Professional Support, and How Is It Approached in Therapy?
Children struggle from time to time, and this is a natural part of development. However, in the following situations it may be helpful to speak to a child mental health professional:
- Unhappiness, withdrawal or constant restlessness lasting for weeks
- Marked, long-lasting changes in sleep, eating or toileting habits
- Refusing to go to school, or a marked drop in school performance
- Frequent, intense angry outbursts that are not appropriate for their age
- Being unable to recover months after a loss or a frightening event
- Self-harming behaviour or repeated talk about death
If thoughts of self-harm or suicide are involved, call 112 (emergency services) without delay. The other signs do not in themselves amount to a diagnosis; but they deserve to be assessed.
In child and play therapy, art materials, play dough and the sand tray can be used as tools that help the child express themselves. This work is carried out within an evidence-based framework suited to the child's age and needs, in collaboration with the family. Art-based approaches are supportive; where necessary, a child psychiatry assessment also becomes part of the process. Remember that a parent's involvement in the process is often as important as the child's own.
Frequently Asked Questions
Does my child need to be good at art?
No. In art-based work with children, the aim is not to make a beautiful picture but to express oneself. Scribbling, smearing paint or squashing clay is just as valuable as a drawing.
From what age can art-based work be done with children?
Creative work can be done with children of almost any age who can play with materials. With young children, sensory materials such as finger paint and play dough may be preferred; with older children, techniques such as collage or drawing a story. The method is chosen according to the child's developmental level.
Can I see the drawings my child makes in sessions?
The work a child produces is their own expression and is treated as confidential. Regular meetings about the process are held with parents; however, whether drawings are shown is handled with the child's age and consent in mind. This is usually discussed with the family at the start of the process.
My child's teacher looked at a drawing at school and became worried. What should I do?
First, stay calm and do not draw conclusions from a single drawing. Look at whether there has been any change in your child's general behaviour, sleep, appetite or friendships. If your concern continues, speaking to a professional who can assess your child as a whole is the healthiest way forward.
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Eda Erkan Alapala
Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.
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