What can art therapy in addiction treatment offer, and where are its limits? Read about the place of creative methods in treatment and how relatives can help.
When someone close to you begins treatment for alcohol or drug addiction, you have many questions: How will the process work, how can I help, and what else is done in treatment? Sometimes your relative comes home one day with a drawing on a sheet of paper or a collage made in a group session, and you wonder what it means. Art therapy in addiction treatment is a topic heard about more often in recent years, yet it is often misunderstood. In this article we look calmly and realistically at what place creative methods can have in addiction treatment, what they can offer, where they fall short, and how you, as a relative, can offer support during this process.
How Does Addiction Treatment Work? The Basic Framework
To understand the place of arts-based work, it helps first to know the general framework of addiction treatment. Addiction is a many-sided problem that affects a person's body, thoughts, emotions, relationships and daily life. For this reason, its treatment is usually many-sided too.
The core components of treatment may include:
- Medical assessment and monitoring: Especially with alcohol and some substances, stopping use can carry physical risks. That is why it is important for the process to be carried out under a doctor's supervision. In Turkey, state addiction treatment centres known as AMATEM also provide services in this area.
- Psychotherapy: Approaches such as cognitive behavioural therapy (CBT) help the person notice the thoughts and situations that lead to use, develop skills to cope with cravings and make plans to prevent relapse.
- Supporting motivation: Talking about the person's ambivalence about change and helping them find their own reasons is an important part of the process.
- Support from family and loved ones: Addiction affects not only the individual but the whole family. It is important that relatives are also informed and receive support.
- Restructuring daily life: Work, sleep patterns, social relationships and free time can be decisive in sustaining recovery.
Arts-based work can play a supportive role within this framework. It never takes the place of medical treatment or psychotherapy.
What Can Art Therapy in Addiction Treatment Offer?
Many people struggling with addiction find it hard to name and express their emotions. Shame, guilt, anger, loneliness and a sense of emptiness are often experienced all at once. For a long time, alcohol or drugs may have become a way of coping with these emotions. When use stops, these emotions can surface in a rawer and more intense form.
Creative tools such as drawing, collage, clay or music can help in several different ways at this point:
- Expressing what cannot be said: Drawing themes such as "me before and after using" or "the moment the craving comes" can make visible experiences the person finds hard to talk about.
- Making shame shareable: Expressing an experience that is hard to describe directly through a picture or a symbol can ease the feeling of shame a little.
- Seeing the craving from the outside: Drawing the urge to use as a wave, a storm or a character can help the person notice that the craving is an experience that comes and goes.
- Filling free time meaningfully: The gap left by stopping use is one of the hardest parts of recovery. A creative pursuit can fill part of that gap with a healthy activity.
- A sense of achievement and making something: Completing something from start to finish can make a small but valuable contribution to rebuilding self-confidence.
Imagine a man in his late thirties who has been drinking for a long time. In the first weeks of treatment, when he is asked in a group session to draw "his future", he is left with a blank sheet. The following week he draws only a small window. A few weeks later, a table appears in front of the window, and a glass of tea on the table. These drawings are not "proof" of his recovery; but they can be a moving expression of the fact that, over time, he has begun to open up a space of hope for himself.
Art does not treat addiction; but it can make room for the emotions, and the hope, that have been left in addiction's shadow.
Creative Work in a Group Setting
In addiction treatment, creative work is often carried out in groups. A group setting can make it easier for a person to realise they are not alone, to learn from others' experiences and to share their own.
Some examples of work that can be done in a group:
- A shared board: Each group member draws or finds an image of something that gives them strength in their recovery. These are brought together on a shared board.
- Mask work: The person draws or writes the face they show to the world on the outside of a mask, and what they experience inside on the inner side. This exercise can be a starting point for talking about hidden emotions.
- Road map: The person draws what they have been through, from the past to the present, and where they want to go in the future, as a road. Obstacles and sources of support along the road are also marked.
Certain principles matter if this kind of work is to be safe: no one is forced to share, the work produced belongs to the participants and is not shown outside the group without their permission, and comments are made in supportive rather than critical language. You can find more detail on how group-based creative work operates in our article on group art therapy.
Art Therapy in Addiction Treatment: Research and Realistic Expectations
It is important to keep expectations about art therapy in addiction treatment realistic. Research on arts-based approaches is generally promising but limited. A review of art therapy in adults, for example, reported promising results in different areas such as cancer, mental health problems, trauma and prison settings, but stressed that the studies were methodologically limited.
The situation is similar in the field of addiction. It is thought that creative methods may support engagement with treatment, emotional expression and bonding within a group; but strong evidence clearly showing their effect on the outcomes of addiction treatment is limited. The common problems of research in this area are also known: small samples, the impossibility of blinding, short follow-up periods and measures based on people's own reports.
For this reason, the healthiest way to think of arts-based work is this: not the core of treatment, but a layer that supports the core. For some people, this layer can make it easier to engage with the process and express their emotions; for others, different routes of support may be more suitable.
The Place of Creative Pursuits in Recovery
Recovery is not a process that ends on the day treatment finishes. For many people the real challenge begins after returning to daily life: the old circle of friends, familiar places, intensely stressful days and especially evenings spent alone can revive the urge to use. In this period it is important for the person to have concrete options they can turn to when cravings rise.
A creative pursuit can be part of such a list of options. In a relapse prevention plan, for example, the things to do "on evenings when cravings rise" might include calling a supportive person, going for a walk and spending half an hour drawing. The aim here is not to suppress the craving but for the person to keep busy with something that does not harm them while waiting for it to pass. Many people describe how a craving rises like a wave and then subsides, and how it becomes easier to ride out the wave when their hands and attention are occupied with something else during that time.
Another contribution of a creative pursuit concerns a person's identity. Someone who has lived with addiction for a long time may begin to see themselves only as "an addict". Learning to play an instrument, joining a handicraft workshop or starting to draw again can help the person remember other sides of themselves too. These small steps can offer points to hold on to on a long recovery journey full of ups and downs.
How Can You Support Them as a Relative?
Being the relative of someone in addiction treatment is an exhausting, worrying and at times isolating experience. While supporting your loved one through this process, it is important not to neglect yourself. We discuss the effects of addiction on the family in detail in our article on being the relative of someone with addiction.
If your relative is taking part in arts-based work as part of treatment:
- Be curious, but don't push. You can ask, "What did you do today?"; but if they do not want to show or talk about their work, respect that choice.
- Don't interpret. Rather than looking at a drawing they bring home and commenting, "This is very dark, are you feeling bad again?", make room for them to tell you about it if they wish: "Would you like to tell me about this drawing?"
- Don't belittle it. Remarks such as "So you're going to get better by drawing pictures?" can weaken your relative's commitment to the process. This work is not the whole of treatment, but it can be a valuable part of it.
- Support creative pursuits. If, after treatment, your relative wants to continue with a pursuit such as drawing, music or handicrafts, making room for it can help them fill their free time in a healthy way.
- Get support for yourself too. The exhaustion, anger, guilt and hopelessness experienced by relatives of people with addiction are entirely understandable. You too can seek support from a professional to cope with these emotions.
Let us consider an example: a mother whose teenage son is being treated for substance use becomes worried when she sees the drawing he brings home at the weekend, a single yellow line on a black background. Instead of asking, "Are you feeling bad again?", she asks, "What does this line mean?". Her son pauses for a moment and says, "That's me, trying to make my way through the darkness." This short conversation reveals a meaning far more hopeful than his mother had imagined.
Many families in Turkey may see addiction as "shameful" or a "family secret" and try to hide it from relatives and neighbours. This can leave both the person with addiction and the family isolated. Remembering that addiction is not a weakness of character but a health problem that needs treatment can make it easier to put support in place of shame.
When Should You Seek Professional Support?
Addiction is a health problem that requires professional support. If you notice the following signs in someone close to you or in yourself, it is important to see a professional:
- If attempts to cut down or stop using alcohol or substances keep failing
- If use is causing marked problems at work, at school, in the family or with health
- If physical symptoms such as trembling, sweating or restlessness appear when trying to stop
- If use is leading to debt, lying or serious ruptures in relationships
- If the urge to start using again grows stronger after treatment
In the case of emergency symptoms such as confusion, seizures or difficulty breathing, or if thoughts of self-harm or ending one's life are present, call 112 (emergency services) without delay.
How Is Addiction Addressed in Therapy?
In addiction, psychotherapy is an important part of recovery when carried out alongside medical follow-up. In the cognitive behavioural therapy approach, the person identifies the triggers that lead to use (particular places, people, emotions or times of day), develops alternative behaviours they can use when faced with these triggers, and prepares a plan against a possible relapse. Talking about the person's ambivalence about change and clarifying their own values and goals are also part of the process.
From the perspective of schema therapy, early life experiences that may lie behind addiction, unmet emotional needs and the person's deep beliefs about themselves can be addressed. In this process, drawing, writing or other creative tools can be used in a supportive way according to the person's needs.
If you are wondering when alcohol use becomes a problem, you can read our article on alcohol addiction. For people with a relative who has an addiction, individual therapy can help them carry their own burden and set healthy boundaries; the treatment of the addiction itself, however, should always be planned together with a medical assessment.
Frequently Asked Questions
Can art therapy treat addiction on its own?
No. Arts-based work is a supportive approach that can be used in addiction treatment together with medical follow-up and psychotherapy. It should not be seen as a treatment method on its own.
My relative doesn't enjoy drawing. Is that a problem?
No. Creative methods may not suit everyone equally. For some people, talking, exercise, walking or other pursuits may be more suitable. What matters is that the person finds the routes of support that suit them.
Would it be right for me to ask to see the drawings my relative makes in treatment?
The work produced belongs to your relative. They decide whether or not they want to show it. You can gently express your curiosity; but insisting may damage their safe space.
Should creative pursuits continue after treatment ends?
If the person wants them to, yes. Pursuits such as drawing, music or handicrafts can help fill free time meaningfully and build structure into daily life. They do not, however, replace regular follow-up and, where needed, therapy.
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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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