Art therapy vs psychotherapy: what is the difference? We compare talking therapy and creative methods by tools, focus, evidence and legal framework in Turkey.
"Should I make progress by talking, or by drawing?" Many people who are thinking of starting therapy and who see photos on social media of studios full of colourful pencils ask this question. Some think, "I find it hard to explain things, so drawing would suit me better"; others keep their distance from this approach, saying, "Drawing feels childish to me." In this article we look at frequently asked questions about art therapy vs psychotherapy: are they really separate things, what does research say, what is the legal framework in Turkey and, most importantly, are talking and creating alternatives to each other, or two tools on the same path?
Art Therapy vs Psychotherapy: What Is the Difference? The Short Answer
At first glance the two seem like opposing approaches: on one side, a room where you sit in an armchair and talk; on the other, paints and clay. Yet according to the founders of the field, art therapy is already a form of psychotherapy. So the real question is not "therapy or art?" but "is the main tool in therapy words, or creative materials?"
To sum up briefly:
- In talking psychotherapy, the main tool is conversation. Feelings, thoughts, relationships and experiences are put into words, explored together, and new perspectives are developed.
- In art-based therapy, the main tool is creative material: drawing, paint, clay, collage. The person first creates, and then the product is talked about. Sometimes there is very little talking, and the process of creating itself takes centre stage.
In both cases the essence of the work is the same: a safe relationship, a clear aim, an ethical framework and the person coming to understand themselves better. The difference lies in which tool is used more along the way. That is why dividing the two approaches into "the serious one" and "the fun one" is misleading.
How Does Talking Psychotherapy Work?
Psychotherapy is a process in which psychological difficulties are addressed using scientifically grounded methods, within a therapeutic relationship with a trained mental health professional. There are different schools of psychotherapy; cognitive behavioural therapy, schema therapy, psychodynamic therapy and acceptance and commitment therapy are some of them.
What talking therapies have in common is putting experience into words. In cognitive behavioural therapy, for example, the person learns to notice the thoughts that go through their mind in response to an event, to see how these thoughts affect their feelings and behaviour, and to develop more helpful alternatives. Work done between sessions helps the person carry what they have learned into daily life. If you are curious about this approach, you can read our article what is cognitive behavioural therapy.
The strength of talking therapies is that they have broad research support in many problem areas. Where they struggle is that some people, especially children or those who find it hard to name their feelings, have difficulty putting their experiences into words. Some people also describe events very fluently but without being in touch with their feelings as they speak, as if relating someone else's story. In situations like this, words can become a way of keeping feelings at a distance rather than approaching them. Adding creative tools to talking work can open a new door at exactly these points.
How Does Art-Based Therapy Work?
Art therapy took shape as a profession in the middle of the 20th century. In the United Kingdom, the painter Adrian Hill, having observed in a tuberculosis sanatorium that painting did patients good, is remembered as the first person to use the term "art therapy".
In the United States, two pioneers represent two different emphases in the field:
- Margaret Naumburg framed art therapy as a form of dynamic psychotherapy. The person was asked to draw spontaneously, and the drawing was then talked about through free association. Here, the drawing is a bridge to reaching words.
- Edith Kramer, on the other hand, emphasised the process of creating itself rather than the interpretation of the work. For her, making something, and giving a feeling form and order, was valuable in its own right.
These two outlooks also form the core of the art therapy vs psychotherapy debate. In Naumburg's approach, art serves talking; in Kramer's approach, creating is itself the healing process. Today many practitioners use both ends together. We described how art therapy works in general in more detail in our article what is art therapy.
Sometimes words open the door, and sometimes a drawing lights up the room where the words will be found.
Art Therapy vs Psychotherapy: A Comparison Under Five Headings
To see the difference more concretely, we can compare the two approaches under five headings.
1. The tool used
In talking therapy the tool is conversation; in art-based therapy it is materials such as drawing, clay and collage. There is talking in art-based work too, but it usually comes after creating and proceeds through the product.
2. The focus
Talking therapy usually carries out structured work on thoughts, beliefs, relationship patterns and behaviour. In art-based work, the focus is on the non-verbal expression of feeling, contact with the body and the senses, and the relationship formed with the product created. There is an important ethical principle here: the person does the interpreting. The practitioner does not impose "this drawing shows such-and-such"; meaning is discovered together.
3. Research support
Widely used talking approaches such as cognitive behavioural therapy have broad research support in many problem areas. In art therapy, the evidence is more limited. A systematic review published in 2015 found a significant positive change in symptoms in 10 of 15 randomised controlled trials in adults with non-psychotic mental health problems, but noted that the quality of the studies was generally low. Another review from 2018 likewise found the results promising but methodologically limited. For this reason, art-based approaches are usually considered in a supportive role alongside other methods.
4. Who might find it an easier starting point?
People who like to think by talking and who do not struggle to name their feelings may feel comfortable in talking therapy. For people who find it hard to put their feelings into words, who resist face-to-face conversation, or who open up more easily while doing something with their hands, creative materials can be a way in.
5. Training and legal framework
In Turkey, a separate postgraduate programme under the name "art therapy" does not appear to be widespread, and the field seems to be still developing academically; many certificate and workshop programmes are offered by private institutions. There does not seem to be a separate, legally defined professional title for "art therapist"; it is necessary to follow current legislation on this. In psychology, the definition of "clinical psychologist" was added to Law No. 1219 by an amendment made in 2011; the Turkish Psychological Association, meanwhile, is calling for a comprehensive law on the profession.
Using Both Together: Talking and Creating Side by Side
In real life these two approaches are often not separated by sharp lines. Creative tools can be used in talking therapies too, and talking is indispensable in art-based work.
A few examples:
- In cognitive behavioural therapy, a person may be asked to show the intensity of a feeling with colours, to draw an anxiety-provoking situation like the panels of a comic strip, or to bring a scene in their mind to life through imagery exercises.
- When working with children, play, drawing and clay are natural means of communication. In child-centred play therapy, the child tells of their inner world in their own language through toys and materials. We described this approach in our article what is play therapy.
- In work on grief or trauma, expressing a memory that cannot be put into words first as a shape or a colour can help the person move on to talking through that expression later.
Imagine a young person preparing for the university entrance exam who is under intense pressure because of their family's expectations. In sessions they cannot get beyond saying, "I don't know, it's just like that." When asked to show this pressure in a drawing, they draw a small figure in the middle of the page, surrounded by books piled on top of one another and speech bubbles. Looking at the drawing, they say for the first time, "Everyone is saying something, but nobody is asking me." This sentence becomes the real starting point for the talking work. Here the drawing did not replace therapy; it cleared the way for conversation.
This example also sums up the most practical answer to the question of art therapy vs psychotherapy: most of the time the issue is not "which one" but "which tool at which moment".
Common Misconceptions About Art Therapy vs Psychotherapy
Some stock ideas often heard on this subject can lead people to stay away from an approach that might suit them, or to develop unrealistic expectations of it.
"Art therapy is only for children." Creative materials are a natural tool when working with children, but they are also used in work with adults, adolescents and older people. Many adults feel a certain shyness from not having picked up paints since their school years; this shyness usually eases after the first few attempts.
"A professional who looks at my drawing will figure out my personality." In art-based work, a drawing is not a test or an X-ray. No firm conclusions about personality, diagnosis or past experiences can be drawn from a single drawing. Meaning is discovered by talking together with the person who made the product.
"Therapy done by talking is more serious; therapy done through drawing is lighter." Creative methods are not light or superficial; on the contrary, they can sometimes open up unexpectedly powerful feelings. That is why they require a safe framework, a slow pace and a careful close.
"Colouring at home does the same job." Colouring on your own, keeping a journal or joining a workshop are valuable forms of self-care and can support your mood. However, without a therapeutic relationship, a clear aim and an ethical framework, these activities are not therapy.
Setting these beliefs aside makes it easier to see the two approaches not as rivals but as tools that can complement each other.
Which Approach Might Suit Whom?
There is no hard-and-fast rule, and it would not be right to make this decision just by reading an article. Still, the following general observations may offer some guidance:
- If there is a specific problem area, such as panic attacks, obsessive thoughts or depression, the approaches with the strongest research support are generally taken as the basis. Creative methods can be added to this process as support.
- When working with young children, play and art materials are natural means of communication suited to the child's developmental level.
- For adults who find it hard to name their feelings, creative tools can be a bridge that clears the way for talking work.
- For someone who says, "Drawing isn't for me", talking work may be a more comfortable start. Creative tools are never compulsory.
In the first meetings, the person's needs, expectations and the forms of expression they feel comfortable with are discussed with the professional, and a road map is drawn up accordingly. Colouring on your own, keeping a journal or listening to music are valuable self-care activities; but they are not therapy.
When Should You Seek Professional Support?
Whatever tool is used, it may help to speak with a mental health professional in the following situations:
- Sadness, anxiety or anger has lasted for weeks and is affecting your daily life
- There are marked changes in your sleep, appetite or energy
- The same problems keep recurring in your relationships
- You are finding it hard to recover after a loss or a traumatic event
- You don't know what you are feeling, but you sense that something is not right
Individual therapy is grounded in cognitive behavioural therapy, and creative tools such as drawing and imagery can also be used where needed. Clinical Psychologist Eda Erkan Alapala is not an art therapist; however, especially when working with children, she uses tools such as play and drawing within the framework of her training in play therapy and child and adolescent psychotherapy. If you are having thoughts of harming yourself, call 112 (emergency services) without delay.
Frequently Asked Questions
Is art therapy a type of psychotherapy?
According to the founders of the field, yes; art therapy is defined as a form of psychotherapy in which creative materials are used within a therapeutic relationship. However, drawing or colouring activities done in a workshop do not count as therapy.
Is talking therapy or art therapy more effective?
Talking approaches such as cognitive behavioural therapy have broader research support in many problem areas. Findings for art-based approaches are promising but more limited; this is why they are generally considered supportive.
What happens if I don't want to draw in therapy?
Nothing at all. Creative tools are an invitation, not an obligation. The work follows the form of expression the person feels comfortable with.
Can the two approaches be used together in the same process?
Yes, they are often used together. For example, drawing may be suggested at a difficult moment in a talking therapy, or work that begins with a drawing may deepen through conversation.
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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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