We talk to Art Psychotherapist Cate Smail about her experiences using creativity to treat mental health problems and her advice for those looking to go into the field.  


How did you begin to be interested in Art Therapy?

I originally trained as an artist. I became more interested in the way art can be used as a form of emotional expression through the voluntary work I was doing in the art room of a charity for the homeless. This encouraged me to find out more and I eventually ended up applying for the MA course in Art Therapy at Hertfordshire University.

In what way is Art a vehicle for Therapy?

Art therapy is a form of psychotherapy that uses art materials to help people to express how they are feeling. It’s especially helpful for those who find traditional talking therapies difficult. For example, children, who may not have an emotional language yet, or adults suffering with Post Traumatic Stress Disorder, who have witnessed terrible things and find it hard to talk about.

Cate Smail - art therapy 2

How did Art Therapy come into being?

In 1938, Adrian Hill discovered the profound effect that art-making had on his own health while recovering from TB in a sanatorium. He started up an art studio and recognised the therapeutic effects of producing art amongst traumatised soldiers and fellow TB suffers.

And have you had that experience too?

I find it helps people of all ages, but especially children. A child can draw or paint how they are feeling or use the sand tray to explore problems they might be experiencing. The therapist then works with them to help them understand their feelings and find ways of coping. The therapist does not make judgments, but facilitates the patient’s self-expression, as well as being an empathic witness to their story.

How long do you work with your clients?

It varies a lot. As in classic psychotherapy, with some people the work can last years, with others just a short time. For example in a school I might work with a child for just one term. It can depend on funding. The adults I work with are usually self-funding, whereas in schools there is a limited budget for therapy. I also work in a Health Centre where I’m funded by a local charity. The NHS used to be the main employer of art therapists, but this is changing due to cutbacks. Schools are increasingly becoming the main employers of Art Therapists, as it is especially useful for children when counselling hasn’t worked or the pupil hasn’t wanted to see a counsellor.

What qualities are needed in an Art Therapist?

It is important to be an artist first and foremost, as you need to understand how to use the art materials and have a sense of how it feels to express yourself through art. As with all forms of psychotherapy, you need to have an interest in psychology, and it helps if you are an empathic listener, and have a desire to help others.

Cate Smail - art therapy 5Who do you prefer working with?

I enjoy working with people of all ages. Children can be particularly interesting to work with, although it is often a challenge as they may use art materials in a non-conventional way, for example mixing everything together, pouring paint everywhere, or making ‘magic potions’ in the sink, which can get very messy. This chaos is often an expression of how they are feeling. The challenge can be finding out what’s going on and enabling the child to come to a better understanding of their situation.

Do you work with groups or one-to-one?

Both. A group is usually set up to work with those who are experiencing similar problems: for example children whose parents are going through divorce, or ‘young carers’, or people with eating disorders such as anorexia or bulimia. The group enables them to support each other and work through their problems together. Realising they are not alone with their problems can be very helpful.

Have you ever had a child that wouldn’t play? 

I’ve never had that experience. Usually children are very curious when they come into the art therapy room. There are lots of things to investigate, such as brightly coloured paints, gel pens, glitter and modelling clay, plus a sand tray with toys. Some are quite shy and will ask timidly if it’s okay to touch something, whilst others will just pull everything out and start playing straight away.

Can you work with everyone?

Not everyone responds to art therapy. Although previous experience and skill in art are not necessary, some people are very resistant to working with art materials, which is why it’s important to have an assessment session first to find out if we can work together.

Do you work with teenagers?

Yes. Teenagers find art therapy can provide a really helpful space to express themselves. At this stage, when life can be quite confusing and relationships with parents and peers can be complex and challenging, it is important to have an emotional outlet for difficult feelings. An example of an exercise I like to use with teenagers is the inside/outside box. On the outside of the box they stick images and words that express how they think others see them. Then on the inside of the box they put images and words that say how they really feel inside.

Where else do you work?

Cate Smail - art therapy 6I also work in a Care Home with the elderly, which is very rewarding, in particular with dementia patients. Many older adults are fearful of art-making, having been told at school that they couldn’t draw, so once they have been introduced to the creative possibilities, my elderly clients often experience the same joy as a child does when exploring paints and colours for the first time. The reward of their smile, their happiness, their creative expression in that moment is wonderful. Every age group has its own rewards.

Are there low points to the job?

The hardest thing is the suffering you see, especially with young children who have been abused.

Who helps you?

As with all therapy, the sessions are confidential. Therapists need to have supervision every week with a senior therapist. This provides a confidential space where they can reflect on their work, and receive advice and support. A therapist needs to be very resilient and able to cope with difficult events. For example, there can be child protection issues, or a mental health patient threatening suicide. You can’t help but take your work home with you. It’s easy to spend a lot of time worrying about patients in between sessions, which is why supervision is so important.

Do you miss being an artist?

I still do my own artwork in my spare time – what I have of it! In the summer I exhibit my work through my local artists group’s ‘Open Studios’ event. It helps that I have a deadline like that to help me focus on finishing some pieces for show. These events enable me to sell my pictures as well.

How do you relax?

I relax by making my own art and I enjoy visiting exhibitions. My favourite artists are Louise Bourgeois and Tracy Emin.

Cate Smail - studioWhat advice do you give to a young person who might consider this work?

I studied art therapy as a mature student, as do most people. The training is an MA course, so you need to study for your BA first. It’s best to choose a degree like Fine Art. It’s also essential to gain some experience in an area you are interested in before you apply (most universities require 1,500 hours), by working with children in schools or adults with mental health issues.

I wish I had known about art therapy as a career earlier in my life. I was originally working as a graphic designer. In order to get onto the MA course I needed to show that I had some relevant experience, so I went to India to teach art at The Future Hope orphanage in Kolkata. It was an amazing experience though quite a culture shock after working in Soho. The children were wonderful to work with, full of positive life and spirit.

What are your future plans?

I’d like to focus on expanding my company, ArtTherapy4all CIC, which aims to educate the wider community about the benefits of Art Therapy and provide low cost therapy for those who might otherwise be unable to afford it. We are also hoping to make a film about art therapy.

If you want to find out more about training, have a look at the British Association of Art Therapists’ website: http://www.baat.org/