Art Therapy with People Living with Schizophrenia

Photo by Nicola POWYS on Unsplash

Art therapy can offer people living with schizophrenia a meaningful, stabilising and expressive space. The aim is not to interpret or challenge their internal experiences directly, but to gently support grounding, emotional regulation, identity, and connection.

Schizophrenia can involve disruptions in thinking, perception, sense of self, and relating to others. Art therapy provides a non-verbal, process-based way to access creativity and inner experience without pressure to “explain.” The therapist’s role is to create a safe, steady, and attuned environment where expression is welcomed and contained.

Core Principles for Art Therapists

1. Safety and Predictability

   • Consistent session times, structure, and pacing.

   • Clear beginnings and endings.

   • Avoid sudden changes in materials, prompts, or environment.

2. Grounding and Sensory Awareness

   • Encourage sensory-based art making: clay, collage, textured papers, repetitive mark-making.

   • Promote present-moment awareness rather than narrative processing of hallucinations or delusional themes.

3. Support a Strong Sense of Self

   • Focus on identity, strengths, choice, and authorship.

   • Reinforce personal style, preferences, and agency in art-making.

4. Non-Interpretive Stance

   • Avoid interpreting symbolic material as pathology.

   • Reflect form, colour, emotion, and relational qualities instead.

5. Relational Attunement

   • The therapeutic relationship is as important as the art itself.

   • The therapist’s presence should be calm, grounded, and patient.

     
     

Helpful Approaches and Techniques

Goal	Approach	Example
Grounding & calming	Sensory regulation through materials	Clay squeezing, slow brush strokes, working with warm or cool colors
Reducing overwhelm	Structured tasks with clear steps	Mandala-style circles, collage with pre-cut shapes, pattern repetition
Building self-identity	Personal storytelling through images	Life line drawing, personal symbols exploration, favourite objects drawing
Social connection	Gentle group art activities	Collaborative mural, shared materials with clear boundaries
Cognitive organisation	Art journaling / sequencing	Comic-strip storyboards, step-by-step image series creation

What to Avoid

• Overly abstract, chaotic, or unpredictable art tasks when the person is already feeling disorganized.

• Encouraging artwork that directly focuses on hallucinations, delusions, or frightening imagery (this can intensify distress or become reinforcing).

• Fast-paced, highly stimulating group sessions.

• Interpretation of artwork without request or consent.

Therapist Stance

CalmSteadyNon-judgmentalWarmRespectfully quietAllowing space

People living with schizophrenia often experience environments that are intrusive, overwhelming, or invalidating. The art therapy space should feel like the opposite: gentle, spacious, respectful, and grounding.

Example Session Arc (Simple and Safe Structure)

1. Opening grounding (breathing, hand warm-up, gentle stretching)

2. Choosing materials together (offering limited but meaningful choices)

3. Slow, repetitive or sensory art process

4. Reflection using descriptive language, not interpretation(“I notice you chose smooth textures today” rather than “You were feeling sad.”)

5. Clear closing ritual(cleaning brushes together, selecting one word for how they feel now, etc.)