The Exploration of the Effects of Art Therapy on Individuals’ Psychological Recovery Mechanisms under the Chinese Cultural Context ()
1. Introduction
Arts therapies are defined by the clinical and evidence-based application of the arts in a therapeutic relationship that depends on experiential and action-oriented interventions (de Witte et al., 2020). These therapies—drama, art, music, and dance—are increasingly accessible to a wider range of clients as mental health practitioners recognize their capacity to foster connection and facilitate healing (Jones, 2020). Over time, art therapy has developed robustly in countries such as the United States (Junge, 2010), the United Kingdom (Waller, 1991), and Russia (Burno, 2006). In contrast, art therapy in China emerged during the 1990s (Ni & Hu, 2012) and is still in its early stage of cultural adaptation and methodological refinement.
In existing research on art therapy, although some scholars have examined the use of traditional Chinese art forms—such as calligraphy, flower-and-bird painting, and Mandala imagery—in therapeutic contexts (e.g., Fan & Zakaria, 2024; Zhang et al., 2021), these studies remain fragmented and are often limited to case-based applications or specific techniques. There is a lack of systematic theoretical integration, particularly in analyzing the interplay between culture, symbolism, and psychological healing within Chinese contexts. Additionally, few studies have effectively combined the aesthetic expressions in art therapy with cultural adaptation frameworks. This gap limits our understanding of how traditional Chinese art contributes to psychological recovery in culturally grounded ways. Yet despite these valuable contributions, there remains a lack of integrative frameworks to interpret the role of traditional Chinese arts in therapy.
To address these gaps, this study introduces an innovative framework—integrating the Expressive Therapies Continuum (ETC) (Hinz, 2019; Lusebrink et al., 2013) with Cultural Adaptation Theory (Chu et al., 2012; Sit et al., 2020), as well as a qualitative approach with in-depth interviews to explore how traditional Chinese art forms—such as calligraphy, ink painting, and flower-and-bird painting—function as therapeutic tools within expressive arts therapy to support psychological recovery in the Chinese cultural context. Specifically, it examines the emotional, cognitive, and symbolic impacts of these culturally embedded practices on individual healing processes, including self-awareness, trauma recovery, emotional regulation, and identity construction.
2. Literature Review
2.1. Arts Therapy in the World
The emergence and evolution of expressive arts therapy as a distinct, interdisciplinary field reflect its foundational role in integrating multiple artistic modalities into therapeutic practice. Providing the foundational framework for many of today’s interdisciplinary therapeutic approaches, Western expressive arts therapy originated early on—as the discipline established itself through the practice of art-oriented therapy. Expressive arts therapy is gaining recognition and expanding as a distinct field—one that, as Estrella (2023) explores, has evolved into a profession, separate from other creative arts therapies. Expressive arts therapy emerged as a distinct field in the 1970s—primarily in North America—in response to the growing demand for a more cohesive, cross-disciplinary method of integrating artistic modalities into therapeutic practice (Knill et al., 2005).
While expressive arts therapy has firmly established its roots and theoretical foundations in the West, an emerging body of scholarship is beginning to explore how these frameworks can be adapted to—and enriched by—culturally specific practices within non-Western contexts, particularly in China. Recent research underscores the culturally grounded therapeutic potential of traditional Chinese art forms—most notably calligraphy—when integrated into expressive arts therapy frameworks to facilitate emotional healing and interpersonal development across diverse populations. Demonstrating this potential, Nam (2020), blending elements of Chinese calligraphy with other artistic modalities, worked with adolescents in a school setting, employing the expressive therapies continuum (ETC) within a group therapy context. Drawing on the symbolic richness of traditional Chinese art, this approach illustrates how forms such as ink painting, calligraphy, and facial makeup function as multidimensional systems—engaging emotional, cognitive, and cultural layers within therapeutic experiences.
Moreover, shaped by indirect and hierarchical communication norms, the cultural dynamics of Chinese society significantly influence both the challenges and opportunities within therapeutic settings, especially those involving mistreated mothers and their children—often emerging from culturally embedded patterns of silence and deference. Lai (2011), modifying the expressive arts-based framework (EAT-MCR), tailored therapeutic strategies to strengthen mother-child bonds and assist survivors in navigating trauma stemming from domestic violence. Extending this culturally responsive paradigm, An (2025) concludes that art therapy—when grounded in Chinese cultural sensibilities—can markedly improve the emotional and social responsiveness of children with autism, reinforcing its applicability in therapeutic interventions across China.
While such culturally responsive adaptations have demonstrated promise in specific therapeutic contexts, other applications of symbolic art therapy in China—such as Mandala drawing—continue to encounter significant challenges due to inadequate cultural contextualization. Liu (2024) emphasizes that in the use of Mandala drawing therapy in China, art therapists often overlook the cultural specificity and the evolution of symbolic meanings across various cultural contexts while assessing the psychological states of the subjects, particularly when utilizing images as exotic symbols. To tackle this issue, Sue & Zane (1987) propose that cultural understanding and culture-aligned strategies should be associated with two fundamental processes—credibility and generosity.
2.2. The Model of Expressive Therapies Continuum (ETC)
The Expressive Therapies Continuum (ETC) offers a structured model for understanding how various levels of artistic engagement contribute to psychological healing. Within the ETC framework, different modes of information processing—kinesthetic/sensory, perceptual/affective, and cognitive/symbolic—are examined to guide therapeutic strategies. Among these, the third level, which encompasses cognitive and symbolic components, is particularly relevant for integrating traditional cultural practices such as Chinese calligraphy into therapy. This level was found to be most effectively supported through the incorporation of Chinese calligraphy elements (Nam, 2020).
Applications of the ETC in Chinese art therapy underline how cultural art forms can facilitate emotional regulation and symbolic expression. For example, Chinese flower-and-bird painting enables individuals to engage in visual and emotional expression through culturally significant imagery, promoting emotional regulation and psychological balance (Zhang et al., 2021). Similarly, Mandala art therapy provides a structured yet expressive outlet through which participants can explore archetypal imagery rooted in cultural traditions, supporting emotional clarity and self-awareness (Liu, 2024).
Beyond symbolic engagement, the physical dimension of art-making—especially in calligraphy—contributes significantly to therapeutic impact. The act of controlling a soft-tipped brush encourages attention to bodily movement and internal rhythms, helping individuals remain grounded in the present moment (Wu et al., 2023). Calligraphy thus becomes a vehicle for embodied self-regulation, linking motor activity with reflective awareness (Wu et al., 2023).
Traditional Chinese art techniques, such as painting and calligraphy, reflect a synthesis of cognitive focus, physical coordination, and cultural immersion. Historically, Chinese calligraphy has been regarded as a pathway to introspection and symbolic thought. The aesthetic and mindful act of writing characters fosters self-reflection and emotional awareness, which aligns with the symbolic tier of the ETC. As Nam (2020) notes, calligraphy can activate cognitive-symbolic processing that integrates emotional and psychological insight, contributing to therapeutic transformation.
Finally, the creative process in art therapy provides broader psychological and social benefits by enabling non-verbal expression and strengthening interpersonal capacities. Art-making—particularly in culturally rooted forms like calligraphy—helps individuals process emotional conflicts, improve communication, and cultivate psychological wholeness (Luo, 2024; Xie, 2025). The embodied nature of this practice initiates a dialogue between internal experience and external form, supporting holistic recovery and cultural identity affirmation.
2.3. Cultural Adaptation Theory
Culturally adapted art therapy draws upon traditional Chinese art forms to enhance psychological relevance and therapeutic efficacy in local contexts. Chinese flower-and-bird painting, for instance, carries a rich cultural heritage and unique aesthetic expression, enabling individuals with depression to manage their emotions and alleviate symptoms by encountering beauty and expressing inner feelings (Zhang et al., 2021).
Although many Chinese individuals are introduced to calligraphy through early school-based literacy training, such instruction often emphasizes repetitive imitation with minimal space for creativity (Nam, 2020). In contrast, when applied therapeutically, Chinese calligraphy reveals distinct traits that generate multiple psychological benefits.
Effective cultural adaptation in art therapy also involves modifying symbolic content to resonate with local meanings. For example, Mandala therapy in China incorporates traditional symbols and indigenous belief systems to improve cultural fit and therapeutic effectiveness (Liu, 2024). Likewise, distinctions between the use of calligraphy for artistic training versus therapeutic intervention are essential. A shift from copying set phrases to composing individual words fosters greater creative agency, transforming the process into one of self-exploration and emotional acceptance (Nam, 2020).
Building on these insights, the study incorporates the Expressive Therapies Continuum (ETC) to investigate levels of emotional and symbolic processing and Cultural Adaptation Theory to explore how local meaning systems shape therapeutic engagement. These frameworks directly address emotional change, symbolic roles, identity construction, therapist-client cultural interaction, and the function of non-verbal expression—thereby bridging empirical gaps. Based on the above analysis, this study investigates the following five questions:
RQ1. What kinds of emotional and psychological changes have individuals experienced when going through Chinese culturally specific art therapy?
RQ2. What kinds of functional and symbolic roles does Chinese traditional art therapy play?
RQ3. How do patients express themselves, deal with trauma, and construct cultural identification with art therapy?
RQ4. In what ways do shared cultural backgrounds or symbolic practices between therapist and client influence therapeutic engagement and outcomes?
RQ5. How does non-verbal expression play a role in recovery?
3. Methodology
3.1. Research Design
This study employs a qualitative research design to explore how traditional Chinese art forms—such as calligraphy, ink painting, and flower-and-bird painting—contribute to psychological recovery within the context of expressive arts therapy. In-depth semi-structured interviews serve as the primary data collection method, allowing for the exploration of emotional regulation, trauma healing, identity construction, and symbolic meaning.
3.2. Researcher Reflexivity
The researcher is a Chinese national with academic training in psychology. This shared cultural background with participants facilitated rapport and encouraged open discussion of culturally embedded experiences. To mitigate potential bias, the researcher maintained reflexive notes throughout data collection and analysis, actively questioned personal assumptions, and engaged in member checking to ensure that interpretations accurately reflected participants’ intended meanings.
3.3. Pilot Study
In a pilot study, one participant was involved to evaluate their comprehension, ease, and clarity regarding the interview protocol, in order to inform the development of appropriate questions. Based on the pilot study, the wording has been modified for greater specificity, accompanied by relevant examples. The participant noted that the interpretation of “Chinese symbols” could be elaborated upon to ensure comprehension for all. Certain abstract inquiries like “Have you reconsidered your state of being?” have been clarified. Certain terms like “hope”, “meaning”, and “self-control” have been simplified to be more relatable and less formal for the participants. Regarding the comparison between Western therapy and Chinese therapy, there are more instances of Western examples given. In general, the questions in the interview protocol have been tailored to be more culturally specific and relatable.
3.4. Recruitment of Participants
Volunteer sampling is used in this research. Participants are recruited through an online social media platform named Red Note and a local art therapy association named International Expressive Arts Therapy Association—China Chapter. Eleven people responded to the recruitment post in rednote. One person comes from the recommendation of the local association.
3.5. Participants
Table 1. Basic information table of the interviewees.
Code |
Gender |
Age |
Occupation (Present) |
Time of Exposure to Art Therapy |
Interviewee 01 |
Female |
35 |
Psychotherapist |
2019 |
Interviewee 02 |
Female |
41 |
Art Therapist |
2019 |
Interviewee 03 |
Female |
N/A |
Art Therapist |
2021 |
Interviewee 04 |
Female |
21 |
New Media Editing Graduate |
N/A |
Interviewee 05 |
Female |
55 |
Art Therapist |
N/A |
Interviewee 06 |
Female |
26 |
Ph.D. student minoring in
Psychology |
N/A |
Interviewee 07 |
Male |
23 |
Recent Graduate |
2023 |
Interviewee 08 |
Female |
26 |
Research Assistant |
N/A |
Interviewee 09 |
Female |
28 |
Art Therapist; Psychological
Entrepreneurship Team Founder |
2020 |
Interviewee 10 |
Female |
In her 20s |
Freelance Literary and Artistic Creator |
N/A |
Interviewee 11 |
Male |
20 |
Student |
2024.4 |
Interviewee 12 |
Female |
27 |
Unemployed |
2020-2021 |
As Table 1 shows, a total of 12 people were interviewed, comprising ten females and two males, with ages ranging from 20 to 55. Their roles included psychotherapist, art therapist, student, research assistant, and freelancer, with art therapy occurring in the past few years, from 2019 to 2024.
The decision to interview 12 participants was guided by the principle of data saturation (Guest et al., 2006). In their analysis, they suggest that data saturation largely took place by the time they had examined twelve interviews. The concept of saturation, originating from grounded theory (Glaser & Strauss, 2017), relates to the categories of theory—rather than the data—that are being formed and appears when collecting additional data fails to generate novel theoretical insights or uncover new characteristics of fundamental theoretical categories of the study (Charmaz, 2006). Thus, the 12-person sample in this study was deemed sufficient to ensure theoretical completeness while preserving the depth and richness of qualitative inquiry.
After securing informed consent, the researcher proceeded to carry out semi-structured interviews. The duration of these sessions ranged from 40 minutes to 1 hour and 30 minutes. As a token of appreciation, each participant was compensated with 30 yuan. Audio recordings were made during all interviews, enabling the collection of qualitative data, and these recordings were later transcribed into text.
3.6. Thematic Analysis
Braun and Clarke’s (2013) thematic analysis was used to examine the data. In this analytical approach, there are six stages: (1) becoming acquainted with the data, (2) creating initial codes, (3) looking for themes, (4) assessing themes, (5) labeling themes, and (6) documenting themes. Based on these stages, the researcher systematically worked through the data to identify, analyze, and report patterns of meaning that emerged in relation to the participants’ experiences with Chinese culturally embedded art therapy.
In this study, the Expressive Therapies Continuum (ETC) and Cultural Adaptation Theory were incorporated as sensitizing frameworks during the initial coding stage. While codes were generated inductively from participants’ narratives, these two frameworks informed several a priori code categories—particularly those related to levels of emotional/symbolic processing (ETC) and culturally grounded adaptation mechanisms (Cultural Adaptation Theory). During the interpretation phase, both frameworks were also applied deductively to refine theme definitions and situate the findings within broader theoretical contexts.
To improve trustworthiness, this study utilized member checking, known as participant or respondent validation (Birt et al., 2016), as a technique. In addition, since an audit trail in qualitative research documents the processes undertaken and the manner in which researchers reach their conclusions (Carcary, 2020), this study employed an audit trail throughout the analytic process, maintaining detailed records of coding decisions, theme development, and reflective notes to ensure transparency and enable the research process to be reviewed and verified. These strategies strengthened the credibility and dependability of the thematic findings.
3.7. Ethical Considerations
This study adhered to strict ethical standards throughout the research process, ensuring that participants’ rights, dignity, and confidentiality were fully respected. All participants provided written informed consent that guaranteed any shared stories would be disclosed with complete confidentiality. All identifiable information was employed using ID names and by safeguarding participants from direct identifiers and indirect identifiers (Kapitan, 2017). In addition, data were securely stored on encrypted devices accessible only to the researcher.
As the study involved voluntary adult participants, posed minimal risk, and did not recruit from vulnerable populations, a formal institutional ethics review was not required under the applicable guidelines. Nonetheless, the research was conducted in accordance with recognized ethical principles for qualitative inquiry, including respect for autonomy, beneficence, and confidentiality.
4. Findings
4.1. Theme 1: Emotional Regulation and Psychological Recovery in Art Therapy
In the interview, multiple interviewees pointed out that art therapy has special effects on emotional regulation, especially when facing psychological problems such as stress, anxiety, and depression, etc.
4.1.1. Drawing and Emotional Release
Drawing is an effective method for emotional release. Participant 03 pointed out that art therapy, such as writing and drawing, provides an outlet for emotions, “Through writing about my experience, keeping an awareness journal, being aware of your mental state and how to adjust, I gradually recovered.” Participant 10 also pointed out that drawing can let go of negative emotions, “It is relaxing to draw whatever you want, such as in unrestricted, spontaneous, and theme-free ways...through drawing, you can express your inner thoughts, mindset, and let go of more emotions.”
One reason for drawing therapy to have effects on emotional regulation is that art has a relaxing effect in and of itself. Participant 09 described the underlying mechanisms, “The processes of drawing, music, and dancing relax your nerves. The content you draw about, and the way you dance, are the relative expressions.” Another reason for drawing therapy to have effects on emotional regulation is that drawing can release something repressed in your unconsciousness. As participant 03 noted, drawing can reflect people’s unconsciousness and mental state. She said, “Through drawing, one can express his spirit, his ultimate life ambition. Everyone expresses values and emotions differently through drawing, which is something that AI drawing cannot replace.”
Drawing therapy can help deal with negative emotions. Participant 05 noted that some people may feel even worse after drawing. The reason why they find it difficult is because the sad feelings are triggered. They unearthed the pain and sorrow repressed in their old world.” Drawing therapy can be used to improve family bonds. Participant 01 shared a project about the application of art therapy in improving mother-son and mother-daughter relationships and family violence, done by a student in Hong Kong SAR, “At first, the mother and her son or daughter did artwork separately, using their own ways to make connections through artwork. Initially, the drawings were only black and white, without showing many emotions and family bonds. Later, the drawings get increasingly colorful, and the bonds are formed more easily. Smiles and warmth can be seen throughout the creation processes.” Drawing therapy can also be applied in schools to track children’s mental states. Participant 12 shared a time when the police officers brought drawing therapy into a school. She described, “The whole class witnessed a violent conflict. We met them a week later, and put them into groups to draw together, such as one person drawing a sun, another helping with the color, which is theme-free drawing. This can make them relaxed, and the group drawing can help children develop a sense of cooperation.”
4.1.2. Emotional Awareness and Value Transformation
Art therapy facilitates self-reflection, emotional awareness, and behavioral change. Participant 09 noted that the process of artistic creation often involves introspection: “Through drawing, you might become aware of certain thinking patterns. When you observe the whole piece, you might start reflecting on various aspects.”
Participant 07 recalled a drawing therapy session related to exam pressure: “I found a place in the park, closed my eyes and focused on the distressing thoughts, then drew a shape. When I opened my eyes, it looked like a tree trunk, so I continued and turned it into a tree. To me, this tree represented the exam. Even though I failed this time, as long as I keep working, I can grow again like a tree. I didn’t draw the leaves, symbolizing that I hadn’t succeeded yet, but I believed they would grow. I interpreted it as: it’s okay to fail this time, and I’ll pass next time if I try hard enough.”
In addition to drawing, music therapy also supports emotional relief. Participant 10 shared a personal experience: “Before listening to music, I was agitated, distracted, and often overthinking. After listening for a while, the agitation faded, and my emotional state began to improve.” She described how the music’s rhythm impacted her emotional change: “After the first few bars—because it takes a moment to settle—the melodies gradually elevated my mood. I especially liked the chorus and some interludes. Even the intro was great.”
4.1.3. Therapeutic Outcomes and Individual Differences
Despite some participants stating that the effects of art therapy are moderate, such as Participant 06 who commented, “I think the effect is average, but not ineffective,” most acknowledged its positive role in providing emotional expression and a safe space.
However, art therapy demonstrates significant benefits for some respondents. Participant 09 noted improvements in participants with moderate anxiety and depression in her workshop: “They arrived tense and unwell, but through drawing therapy and the guidance of instructors, they left relaxed and happy. We had very engaging conversations, and you could feel the transformation in their emotional states.” She also shared a case involving medical workers: “Medical staff experience immense pressure. One person always frowned and had deep facial lines. But after using movement and music-based techniques in a session, they became joyful, asked to be photographed, and laughed freely. The contrast was striking.”
4.2. Theme 2: The Symbolic Significance of Traditional Chinese Cultural Elements in Art Therapy
In the interviews, several participants actively integrated imagery, rituals, and aesthetic elements from traditional Chinese culture into art therapy practices, imbuing the process with cultural identity and spiritual depth.
4.2.1. Tea Ceremony and Physical-Mental Grounding
The tea ceremony is a form of traditional Chinese art-based healing. Participant 02 specifically mentioned healing activities that combined tea culture and painting: “Including the entire tea ceremony healing activity, it’s very beautiful. You can wear modern Han-style clothing, recite poetry, paint lotus flowers, copy scriptures, light incense, and play traditional Chinese instruments like the Gu-Zheng or Gu-Qin.” She emphasized that this set of mind-body rituals was not merely an aesthetic practice but a process of “cultivating the mind,” enabling individuals to find “inner tranquility” within the atmosphere of traditional culture.
4.2.2. Calligraphy and Inner Cultivation
Calligraphy is a healing method deeply rooted in Chinese tradition. Participant 03 emphasized its role in therapeutic painting: “You can tell your mental state from your handwriting... Gradually your mind will settle, entering a flow state, and you begin to dialogue with yourself.” As a symbol of traditional culture, calligraphy in art therapy not only displays the beauty of ink and brushwork but also serves as a path of “focused stillness,” aiding emotional regulation and spiritual grounding. She mentioned that ancient scholars had always practiced this kind of artistic healing, such as Su Dongpo’s poetry, even though it was not labeled as therapy back then. Participant 02 also noted the meditative effects of traditional writing: “You can wear modern Han-style clothing, recite poetry, paint lotus flowers, copy scriptures, light incense, and play classical Chinese instruments like the guzheng or Gu-Qin. This process deeply cultivates the spirit.”
4.2.3. Mandalas and Eastern Spiritual Structure
Several participants mentioned combining mandala creation with Eastern philosophy, emphasizing the spiritual meaning of imagery. Participant 03 stated: “I used to draw mandalas for a while... They hold sacred meaning and structure, using patterns that combine visual dialects.” She further referenced Jungian theory, linking mandalas to “primitive cave paintings” and “Egyptian gods like Horus,” but emphasized that her mandala creation in Foshan had stronger “Chinese cultural and psychological integration.” For example, participants created mandalas based on their Chinese names to explore issues like “accepting the name given by parents” and “how to develop self-identity.”
4.2.4. Natural Imagery and Cultural Aesthetics
Many participants expressed that natural imagery is both effective and well-liked in art therapy. Participant 04 often used natural scenes in her paintings to reflect emotional states: “At first, the paintings were somewhat negative... Later, they focused more on landscapes.” She affirmed the symbolic meaning of green and natural scenes in traditional Chinese painting, such as “spring’s return to the earth” or “nourishing the heart through stillness,” which help regulate emotions and express hopes. Participant 10 mentioned her connection with nature through music therapy: “I used to go into nature. When I felt drained by certain events, nature would restore my energy, making me feel refreshed.” She described her most effective healing method: “For me, pure instrumental music works best—listening to it and to the sounds of nature.”
4.3. Theme 3: Art Therapy as a Pathway to Self-Exploration and Identity Construction
In the interviews for this study, multiple participants described art therapy as a process for deepening self-awareness and reconstructing personal identity. Practices such as drawing, writing, and mandala creation were repeatedly referred to as “bridges to inner dialogue”. Through these visual and symbolic forms of expression, participants were able to confront, understand, and accept their emotions and life experiences.
4.3.1. Self-Revelation and Acceptance in the Drawing Process
Drawing therapy can reveal one’s inner world and facilitate self-acceptance and identity integration, leading to profound healing experiences. Participant 05, an illustrator, admitted that she “once experienced tendencies toward depression and suicide,” but “after drawing for ten years, I drew myself back together.”
Participant 08 mentioned that nonverbal communication can uncover deeper insights, especially for those with verbal limitations. “Some groups of people may have language constraints—for example, they may find it difficult to express what they truly feel in words, or what they say may not fully reflect their inner state, leaving a gap. But through art therapy—whether drawing or sand tray work—they can, to some extent, express their true inner state.”
4.3.2. Writing and Symbolic Expression of the Subconscious
Participant 03 also emphasized the value of handwriting and drawing in expressing the subconscious: “When you write, your handwriting reveals your state… when you draw, the lines, the symbols, the colors you use reflect your personality traits, your preferences, your emotional state.” Through nonverbal means, individuals can concretize their inner experiences from the unconscious and gain access to the “real self”.
Participant 10 stated that sometimes she uses writing to express emotions: “If speaking is about venting emotions, expressing inner negativity, then speaking is more effective. It depends on the situation and what state you are in. Sometimes, after being alone for a long time, you want to find a trusted friend to discuss a deep topic; then you need language to express it.” Participant 04 mentioned that writing helps her express her current mood: “I will write a small paragraph next to my painting, draw a border, and write down what I wanted to say at that moment, what I wanted to say to myself.” She said this allows her to better express her state at that time.
4.3.3. Exploring Multiple Identities through Creation
Art can help explore different emotional expressions and social roles. Participant 04 discussed during the interview: “We draw some images from games, or our mood while playing, and even things about our current situation.” These drawings not only reflect her everyday psychological fluctuations but also her navigation and integration between multiple identities (student, job seeker, gamer). She further said: “Art has high freedom; it makes me aware that there is still much exploratory space.” Participant 03 also mentioned exploring social roles such as good wife, good mother, good daughter, noting that art therapy explores the constraints brought by these roles and provides an outlet for suppressed emotions, promoting self-recognition and acceptance.
People with certain identities or preferences are more adept at exploring their true selves through art therapy. Participant 04 stated that her identity as an art student determined how she relieves stress: “I am originally an art student, so my way to release stress might differ from others. I choose listening to music and drawing.” This way of working promotes her exploration within her own world: “I realized I’m still young, I can venture more, don’t hold myself back…there is much space for growth.”
4.4. Theme 4: The Role of Nonverbal Expression and Symbolic Cognition
Across interview materials, nonverbal forms of expression such as imagery, color, and shape—were described by many participants as the most healing aspect of art therapy.
4.4.1. Drawing as a Medium for Expression in Place of Language
In therapy, drawing serves as an effective medium for fostering expression and communication. Participant 08 emphasized in her art therapy practice: “They find it hard to articulate what’s in their hearts using words, but through drawing, they can present their true feelings more intuitively.”
The reason drawing is effective is that it reflects the inner world. Participant 03 stressed that images created in drawings reveal aspects of the unconscious: “There are many things you may not be able to express verbally, but once you draw them, they become visible…when you write, your handwriting shows your mental state, and when you draw, the lines, symbols, and colors all reflect your personality traits, preferences, and emotional states.”
Nonverbal creation in art therapy is often intuitive. Participant 06 noted that the drawing process feels relaxed and natural: “Some people find it hard to connect with their thoughts, but through nonverbal expression, they can use their bodies to explore—because the body and emotions always precede the brain and rational mind.” She emphasized the process of creation: “It’s not about whether I like a certain color or image; it’s that I created a new world through drawing. That act of creation is the key… sometimes, you don’t even need to talk about what you’ve gained. Just having fun during therapy is already a huge gain.”
Nonverbal expression varies from person to person; it works for some but not necessarily for everyone. Participant 02 noted: “It depends on the individual’s nature. Some people are more developed in the upper chakras, some in the lower. For those who value ideological or systematic thinking, verbal expression may be more suitable.” She elaborated on the personal benefits of nonverbal therapy: “I’m highly spiritual, and I need to nourish my higher self. As I said, when I was on medication, all my abilities were cut off. But after healing, my abilities became 3 to 10 times stronger—especially my connection to the higher self and the divine. I became my highest mode of healing.”
4.4.2. Symbolic Imagery and Psychological Projection
Symbolic expression is one of the core features of art therapy. Participant 07 shared an experience of creating a hybrid image of a pig and a lion: “I drew a pig and a lion… I might be a bit chubby, but if I had the willpower of a lion, I could still run fast.” This symbolic image both humorously referenced his self-perception and conveyed a desire for self-motivation and change—a typical case of cognitive transformation.
Participant 03 mentioned the psychological projection facilitated by OH cards: “Looking at OH card images can reflect your unconscious. It’s the same with drawing—sometimes, what you draw reveals parts of your subconscious.” Participant 12 also referred to OH cards’ projective and symbolic function: “People make up stories based on their current feelings or past experiences. You see an image and say whatever comes to mind, so it taps into the unconscious and memory blanks.”
Viewing others’ artworks also prompts self-projection. Participant 01 recalled: “I saw my colleague using a large white paper, layering many tape pieces and tangled strips of colored paper... I felt they must be emotionally chaotic and wounded. But that wasn’t their feeling at all.”
4.4.3. The Relationship between Color and Individual Emotion
Colors do not have fixed meanings but are shaped by personal experience. Participant 08 noted, “Color is just a personal choice; it doesn’t represent a fixed meaning… I had a client who used black to express joy.” This demonstrates that in art therapy, the therapist must respect each client’s symbolic system and avoid “predefined interpretations.” She added, “We assign emotional associations to colors, but everyone links color and emotion differently. I once met someone who asked me why red is red. I understood what he meant—if someone had told him as a child that red was called green, he would grow up believing red is green.”
Similarly, Participant 04 mentioned that her earlier paintings might have appeared more negative, but later works shifted toward landscapes, indicating emotional changes. Color and content variation reflected her internal state, recording psychological transformation via nonverbal expression.
4.4.4. Transformation and Meaning-Making through Drawing
Symbolic expressions are not limited to creation—it is also a process of constructing meaning. Participant 07 described a method: “Close your eyes and think about what’s bothering you, then draw something…when you open your eyes, observe the drawing and imagine what it means.” This technique helped her concretize abstract anxiety and reinterpret its meaning, leading to emotional release and cognitive integration.
Drawing promotes transformation from pain to healing. Participant 03 noted, “Through this self-exploration, I gradually found my own strength…you start letting go—letting go of unnecessary judgments from others.” Participant 07 said she used art therapy to cope with exam failure. Initially anxious, she later became calm and eventually free of pressure. “Even though I wasn’t exactly cheerful, there were no negative emotions or stress anymore. It just didn’t feel like a big deal anymore.”
Art therapy not only promotes self-understanding but also evokes understanding when appreciating others’ works. Participant 01 shared her experience of making friends in a therapy group through artwork: “The theme was the idealized self. I became friends with someone who said only one thing—his piece was called ‘Tree,’ and he said, ‘In reality, I cannot become a tree.’ I burst into tears.”
Art therapy can also enhance parent–child understanding. Participant 08 shared the case of a girl whose trust in her mother improved through art therapy: “At first, she didn’t trust her mom—she sat with the therapist instead, isolated. The whole course lasted seven or eight years. Eventually, she built trust with her mom. In the last session, she held her mother’s hand with her left hand and the therapist’s with her right. That showed me it’s possible for drawing to repair family issues—trust can be rebuilt, relationships improved, and everyone ends up happy.” Because artworks are preserved and revisited during therapeutic review, both therapist and client can recall the progression—from mistrust to trust—clearly.
4.5. Theme 5: Cultural Resonance and Disjunction in the
Therapeutic Relationship
As a form of cross-cultural psychological practice, art therapy inevitably encounters issues of localization and cultural tension when introduced into local contexts.
4.5.1. Suppression of Expression in East Asian Culture and the
Unblocking Function of Art
East Asian cultural contexts may contribute to a lower level of acceptance and recognition of art therapy. Participant 08 explicitly stated: “In East Asian cultural backgrounds, whether children or adults, they might not have received any art training while growing up. They may feel hesitant about artistic expression... Promotion is relatively difficult.” This shyness and suppression of emotional expression often make it difficult for clients to open up in verbal psychotherapy. Art therapy, by offering a more symbolic and less explicit expressive form, can partially relieve the psychological defenses caused by cultural barriers.
Sometimes, art therapy groups do not explicitly highlight cultural differences. Participant 01 noted that facilitators would assess gender ratios and geographical diversity, but “no one puts cultural differences directly on the table.” She added, “I’ve never felt any cultural gap in my own experience—even with teachers from Russia or Greece.”
The limitations of the East Asian educational system also impact art therapy. Participant 03 reflected: “In our current college entrance exam system, sketching, quick drawing, and color are required subjects. When I was in high school, I found sketching quite stifling—it had to be very precise, always in grayscale, which felt oppressive.” She criticized this as a narrow selection method that fails to recognize creativity: “Everything is about whether the form is accurate, whether the structure is correct. It’s mechanical. Most students entering art academies are screened through this system, and many creative individuals are excluded, which is unfortunate.”
4.5.2. “Emotional Temperature” and Cultural Reconstruction in
Therapeutic Relationships
In art therapy, the therapeutic relationship plays a pivotal role, and one’s ability to turn inward often depends on the setting and the facilitator. Participant 02 emphasized: “If the group lacks discipline and structure, it’s hard to focus on the inner world. Everyone present influences each other. At the beginning, when you don’t yet have inner stability, the facilitator’s guidance is critical. The key is whether you trust the therapist—whether their energy can stabilize your inner core. If you want to fully enter the healing space, then both the environment and the therapist are essential.” She also mentioned the role of tools: “Some use breath, others painting or tea. With the support of such tools, it becomes easier to enter the therapeutic process.”
Participant 12 underscored the importance of emotional resonance with the therapist: “Even if the technique is there, if the therapist feels emotionally cold or indifferent to me, then no matter how advanced the method is, I can’t immerse myself in the experience.” She recalled a positive art therapy session in which the therapist “closely observed each of us as we worked on our art cards... I felt that he was genuinely attentive... He came across as a very kind and gentle middle-aged man.”
In many cases, emotional transformation in art therapy is not merely a technical outcome, but one facilitated by cultural symbols such as images, colors, and modes of interaction. In families or cultures lacking verbal communication habits, art offers a “third space” where emotional expression can occur safely and gently. Participant 01 shared a group case involving mother-child dyads from a background of domestic violence. Initially, “their interactions were minimal…the paintings were all gray.” However, after eight weeks of art activities, “the images became more colorful…and their connections grew smoother.” Even without overt verbal expressions of care, the artistic process enabled them to “silently support each other,” rebuilding their emotional bond with “warmth”.
Finding resonance with a therapist may depend on personal affinity. Participant 03 noted, “Sometimes you feel a strong connection with someone, and that allows them to guide you to a deeper level. But if you feel out of sync or don’t like the person, you won’t want to listen.” She added that shared religious beliefs may also influence therapeutic outcomes: “If there’s a strong conflict in belief systems, the effect may be weaker.”
In some cases, deeper resonance may occur among group members rather than with the therapist. Participant 06 noted that therapists often wear “social masks” due to their professional roles and thus may not show their authentic selves. “I may resonate more with fellow participants, especially if we share similar traumas. The comfort and encouragement among peers are significant.”
The cultural background of the therapist may also influence therapeutic outcomes. Participant 08 explained that therapists who share the client’s background can create stronger resonance. For example, “My instructor was from Hong Kong of China, educated partly in the West, and earned a master’s degree in the UK. His clients were mostly foreigners, so he could better relate to children and special populations from Western backgrounds.”
4.6. Theme 6: Personal Transformation and Mechanisms of Change in the Therapeutic Process
In the practice of art therapy, multiple participants experienced not only short-term emotional release but also long-term transformations in cognition, behavior, and even self-identity.
4.6.1. Visualization and Relief of Emotional Trajectories
Art therapy helps participants identify and ease their emotional patterns, facilitating psychological adjustment. Participant 05, an illustrator, observed emotional symbols in children’s drawings while teaching them, reflecting on her own healing journey: “Through the children’s drawings, I realized I could understand their emotions because I had once healed myself through creation.”
Participant 10 described how music helped regulate her emotions: “After listening to a few songs, I felt emotionally soothed. Immersed in the beauty of art, I began to see the good in life again and naturally felt more love for it.” Participant 11 also recalled how music lifted him from emotional lows: “I started off feeling depressed and irritable, even angry. But as I listened to music, my emotions rose until I found a solution. The process ended with emotional calm and resolution.”
Participant 12 reflected on the power of sand play therapy: “It doesn’t rely on language. It brings our inner thoughts and confusion into the open... He (the interpreter) was so sharp. I realized what I hadn’t said out loud had already been expressed in the sand tray... I wondered how someone could describe my feelings so accurately.”
4.6.2. Cognitive Reconstruction and Behavioral Shifts
Art therapy can reconstruct cognitive patterns and lead to behavioral change. Participant 07 observed, “At first, I felt I couldn’t do anything right. Now, I work more logically, and my mindset has become much calmer... I feel like nothing is impossible now.” This illustrates that art therapy extends beyond emotional regulation; it prompts individuals to reorganize their lifestyle and develop adaptive strategies. She added, “If someone just tells you something, you may forget it immediately... but through art therapy, I realized it by myself.” This highlights the central role of self-realization in the therapeutic mechanism.
Participant 02 stated, “When I began practicing self-healing, it was a revolutionary shift. I went from confronting my emotions, to reconciling with them, to discovering a powerful and courageous version of myself that could overcome the weak one.” She emphasized that everyone has blind spots in life, including therapists, and that ongoing healing is necessary for personal evolution. She quoted an ancient Chinese saying: “Remove bad habits, transform temperament, and return to true nature.” She likened the therapeutic process to the peeling of petals—shedding acquired patterns, recognizing deep-seated traits, and ultimately living out one’s true nature.
4.6.3. Identity and Life Integration
Art therapy also supports self-growth and the integration of life experiences and identity. Participant 05, an experienced illustrator, reflected on a decade of transformation through drawing: “I once had suicidal thoughts... but after ten years of drawing, I healed myself.” She added, “At first I drew very dark things...but later, the colors became increasingly vibrant.” For her, art was not just a means of expression, but a way to transmute trauma, activate inner resources, and integrate the self.
Participant 03 discussed her identity shift: “Through art therapy, I evolved from a regular art teacher to someone who educates and heals—‘education’ in both teaching and emotional transformation. It’s like upgrading from version 1.0 to 2.0.” She believed being an art therapist carries deeper meaning and leads to personal growth. Participant 09 emphasized that art therapists see this work as a life-oriented profession: “We respect the life of each client and teach them self-healing methods, instead of making them overly dependent on us.”
4.6.4. Symbolic Translation: From Fear to Awareness
Fear often surfaces through symbols in art therapy. These symbolic expressions allow clients to process and relieve overwhelming emotions. Participant 05 shared an example: a client drew a mother pig with piglets in a slaughterhouse, saying, “I think my family could kill me anytime.” Gradually, with guidance, the client recognized his defensive overreaction—“My family actually doesn’t mean harm.” In this case, symbolic drawing became a medium for making the unconscious conscious, adjusting cognition, and shifting emotional responses.
This client also portrayed his family members as animals—himself as a pig, his father and brother as monkeys, his father again as a bird, his mother as a giraffe, and his sister as a mouse. The therapist asked, “Which of these animals could really kill or eat a pig?” The client laughed. By realizing the symbolic meaning, his fear lessened. He soon brought his mother to therapy, and with the therapist facilitating, he opened up and reconciled with her. They hugged, and he smiled again. Once paranoid and depressed, he became more open and emotionally connected.
4.7. Theme 7: Limitations of Art Therapy and Suggestions for
Improvement
In China, the experience and depth of workshops led by local facilitators are often insufficient, with a lack of progressive design in therapeutic activities. Participant 01 pointed out, “Domestic workshops often operate under the banner of art therapy, but they merely follow a routine. For example, drawing a certain theme—after finishing, the facilitators don’t really know how to deepen the process through art as a medium. They lack the skills. In dance therapy, after dancing, they don’t know how to connect it with psychology or how to foster connection and meaningful experience in the group. Domestic facilitators simply can’t achieve that. For instance, three games may be played, but these games are disconnected. Even if they all belong to drama therapy, there’s no depth.”
Some therapists and workshops have technical deficiencies and lack responsibility. Participant 09 observed, “Sometimes a participant’s trauma is triggered during therapy, but the therapist doesn’t help them process it, leaving them in worse condition and misunderstanding what art therapy is. Maybe the therapist didn’t have the capability to handle it. Many people use art as a gimmick, without truly understanding it. It’s like they ‘kill’ someone in the session but don’t have the ability to ‘bury’ them.” She added, “People often misunderstand art therapy. They think as long as participants release emotions, that’s enough. But without proper closure, participants may drift into another realm or get lost in fantasy.” She believed the issue stems from therapists’ backgrounds. “Especially in China, backgrounds are diverse—many come from traditional arts without a psychology base, so what they offer is mere emotional release.” She recommended that, “Art therapy should not stop at expression and release—it also needs transformation and elevation, allowing participants to take something meaningful with them.”
China’s art therapy system needs restructuring, standardization, and systematization. Participant 02 said, “I hope we can open a growth camp in Shenzhen for more children, helping them learn rather than making them feel sick. I also hope to organize this content into a system, presenting it through various media so people can try different methods like a buffet—choose what works best, and use it to heal and grow.” She added that growth takes time and long-term companionship to truly change the effects of the original family, behavioral habits, thinking patterns, and even karmic forces or spiritual elements, “the higher self, the higher dimension, and integration with oneself. Since every person is a unique being, we hope to have schools and formal systems for that.” She emphasized that art therapy should be tailored to the individual, just like education.
Some participants hope that art therapy recipients will not be labeled. Participant 04 said, “I hope researchers treat us like regular people, not as problematic individuals. Don’t use overly targeted methods—help us relax instead of doing everything with a fixed agenda.” She wanted art therapy to be seen as an activity or interest, not a medical solution or problem-solving tool.
The effectiveness of art therapy in China remains limited. Participant 06 stated that for her, art therapy did not have much therapeutic effect. “Most sessions I’ve attended barely achieved real therapeutic impact.” The process emphasized form over substance, lacked goal-oriented therapeutic design, and often had no clear treatment objective. “The facilitator and group mostly had fun, more like a game than therapy. But I do not entirely blame the facilitator—group dynamics do matter. So, the activities I joined did not directly address trauma or pain. For example, people might paint on each other or play games, ending up in a joyful mood. That is not necessarily bad, but in terms of effectiveness, it is more of a first-time experience than actual healing. I even feel the sessions were more like art performances. I suspect the design prioritized aesthetics, but from a participant’s view, I did not feel genuinely healed. And I believe the activities I attended were among the better ones in China—still, they were average.”
Art therapy in China currently lacks depth. Participant 06 further noted, “I’ve attended many—from schools to commercial events to institutes like the Chinese Academy of Sciences—but whether music or drawing therapy, none had a significant effect on me. I couldn’t tell if what I drew truly reflected my deepest emotions or whether it was therapeutic.”
Compared with Western countries, the understanding of art therapy in East Asia is limited. Participant 08 noted that, due to East Asian cultural norms, people are often hesitant to engage in expressive art forms, and the concept of therapy is less widespread than in the West. “They first need to recognize the need for therapy, then choose from among many types of therapy the one that suits them.” She offered a suggestion: “We shouldn’t make art therapy seem too lofty. We can extract a few elements and simplify them into forms accessible to everyone.” She again compared East and West in terms of artistic atmosphere: “Western countries are often immersed in artistic environments, so they’re more open to art therapy. But in East Asian cultural contexts, acceptance is much harder.”
5. Discussions and Conclusions
5.1. Summarization of the Findings
The study found that in the context of native Chinese culture, art therapy has significant effects on participants’ emotions and psychological state. Not only does the creation process of drawing, calligraphy, Mandala, and others provide a safe emotional outlet, but it also helps them gradually change from anxiety and depression to a state of internal calmness and self-acceptance.
The findings answer all the questions at the end of the literature review. In terms of RQ1 and RQ2, Chinese culturally specific art therapy has significant effects on individuals’ emotional and psychological experiences. It plays important functional and symbolic roles. Chinese art therapy, culturally specific, has a localized symbolic framework, strengthened emotional ties during therapy, and broadened its cultural scope. The research revealed that numerous participants incorporated imagery, rituals, and aesthetic components from traditional Chinese culture into art therapy. It is in the environment of Chinese traditional culture that people can “nurture the mind” and discover “inner peace.” Chinese art therapy acts as a means of “concentrated calm,” assisting in emotional control and spiritual stability; it assists in managing emotions and conveying optimism. Chinese painting, for example, is neither intense nor rigid; it allows for the expression of emotions—especially through the use of soft and bright colors, which can soothe individuals experiencing anxiety from deep internal struggles and help alleviate stress.
In terms of RQ3, art therapy significantly influences emotional regulation, particularly when dealing with psychological issues like stress, anxiety, and depression, offering a form of expression and release that is non-verbal and free from judgment. It also has an impact on self-reflection, emotional awareness, and behavioral change. Participants described art therapy as a process for deepening self-awareness and reconstructing personal identity. Practices such as drawing, writing, and mandala creation were repeatedly referred to as “bridges to inner dialogue.” Through these visual and symbolic forms of expression, participants were able to confront, understand, and accept their emotions and life experiences.
In terms of RQ4, therapeutic connections, cultural identity, regular forms of expression, and emotional communication methods greatly impact the therapy process. Numerous participants emphasized that the effectiveness of art therapy relies on the technique used, as well as its ability to connect with the client’s cultural background or address their feelings of cultural disconnection.
In terms of RQ5, non-verbal expressions like imagery, color, and shape not only circumvent the constraints of verbal thought but also promote emotional and cognitive integration at a subconscious level. Not only do these forms of expression transcend the constraints of verbal reasoning, but they also promote emotional and cognitive integration within the subconscious. By means of symbolic creation, participants could express internal experiences and forge routes toward self-awareness and psychological change.
5.2. Compared with Previous Research
5.2.1. Similarities
The present study denotes how drawing—and other expressive activities—helped participants release repressed emotions and achieve psychological relief. This finding of the present study resonates with and aligns with Zhang et al. (2021), who argued that traditional Chinese flower-and-bird painting enabled individuals with depression to experience emotional release and inner peace—achieved through aesthetic immersion and symbolic expression. Likewise, Wu et al. (2023) emphasized how the act of brush control in Chinese calligraphy cultivated present-moment awareness and emotional regulation through embodied engagement—mirroring participants’ descriptions of drawing as a soothing, sensory-based process.
Moreover, the present study revealed participants’ engagement with natural imagery as a means of accessing—and reconfiguring—their inner world; this aligns with Liu’s (2024) focus on the culturally specific interpretation of symbols. Additionally, the present study echoes findings from Tong et al. (2021) and Qiu et al. (2017), both of whom noted that art therapy can enhance interpersonal relationships and improve overall social functioning.
5.2.2. Divergences and Innovations
Several distinctions also emerge when compared with previous research. First, the findings of the present study delve more deeply into how art therapy engages with trauma exposure and recovery, including the risks of triggering unresolved wounds if therapists lack appropriate training (e.g., Participant 09’s critique). Earlier studies, such as Tong et al. (2021), emphasized therapeutic benefits but did not address potential harm or the necessity for trauma-informed care.
Second, the findings of the present study provide detailed, first-person narratives about how art therapy fosters value clarification, behavioral transformation, and life integration—domains largely underexplored in prior work. The shift from “venting” to “reconstruction” suggests that art therapy’s efficacy lies not only in catharsis, but also in meaning-making and long-term identity evolution.
Finally, the findings of the present study highlight the sociocultural challenges of implementing art therapy in China, including constraints from East Asian expression norms, a lack of professional standards, and a misinterpretation of art therapy as merely an artistic activity. These findings address a gap in earlier empirical studies, many of which presupposed the effectiveness of art therapy without critically examining its local adaptation and delivery.
5.3. Contribution of This Study
This study advances the field by synthesizing the Expressive Therapies Continuum (ETC) with Cultural Adaptation Theory, using them both as a priori sensitizing concepts in the coding process and as interpretive lenses in the thematic analysis. This dual application offered a nuanced framework for understanding psychological healing within a Chinese cultural context. Whereas the ETC delineates the multilayered processes of affective, sensory, cognitive, and symbolic engagement inherent in art-making, Cultural Adaptation Theory situates these mechanisms within indigenous epistemologies and socio-emotional norms. Their convergence elucidates how participants navigated emotional distress, fostered introspection, and negotiated identity through culturally embedded modalities—namely, calligraphy, Mandala design, and tea ceremony rituals in art therapy on individuals’ psychological recovery.
5.4. Limitations and Directions for Future Research
Despite the theoretical construction and empirical exploration achieved in this study, several remaining limitations—both methodological and contextual—should be addressed in future research:
First, the sample size is relatively limited—the participants primarily consist of middle-aged and young women, whose educational backgrounds are concentrated in fields such as art, psychology, and education. This gender imbalance (ten female participants and two male participants) and the predominance of participants with prior exposure to art-related disciplines may have shaped the ways in which they engaged with and interpreted art therapy. Such homogeneity potentially amplifies perspectives aligned with creative or expressive predispositions, while underrepresenting the experiences of men, individuals from non-art backgrounds, or those with little prior familiarity with creative practices. Consequently, the transferability of the findings to broader populations—particularly those with different gender compositions, occupational profiles, or cultural exposure to art—is constrained. Future research should purposefully recruit a more diverse sample in terms of gender, educational specialization, and prior engagement with art, in order to capture a wider range of therapeutic experiences and meanings.
Second, although this research primarily employed qualitative interviews—emphasizing subjective experience and cultural interpretation—it lacked quantifiable assessments of intervention outcomes. While the interview data offered rich insights into symbolic meanings and healing mechanisms, judgments regarding the intensity and sustainability of therapeutic effects still require longitudinal follow-up—as well as integration with mixed-methods approaches. This gap calls for triangulated research designs in subsequent studies.
Finally, although the study illuminated the role of traditional Chinese cultural elements, it never systematically compared the therapeutic differences among distinct cultural symbols. For instance: Do calligraphy and mandalas differ in their mechanisms for emotional regulation, self-exploration, or identity formation? Which symbols are particularly well suited to address specific psychological difficulties? Future research should aim to refine the classification and comparison of cultural art forms—while also exploring their therapeutic mechanisms across a range of psychological themes and populations.
Appendix
The full interview protocol (i.e. In-depth Interview Guide)
A. Basic Information and Background Introduction (Warm-up Questions)
1. Please briefly introduce yourself (e.g. age, occupation, gender).
B. Art Therapy Contact
2. How did you first learn about art therapy? What made you decide to try it?
3. What type of art therapy did you participate in? What traditional Chinese art elements were used (e.g., calligraphy, ink painting, facial painting, etc.)?
C. Motivation and Expectation
4. Have you ever used other forms of therapy? If so, how has art therapy compared to other forms of therapy you’ve previously received? Why?
D. Treatment Process and Psychological Experience
5. Can you recall a specific treatment experience? Please describe how you used it and your reaction.
6. During the treatment process, did you experience any emotional changes? What were your specific feelings?
7. Was there a moment in your treatment process that you found particularly meaningful? Why?
E. The Role of Cultural Elements (The Role of Chinese Cultural Symbols)
8. you think there are therapeutic Chinese elements in art, such as calligraphy and painting? If so, what impact have these traditional Chinese elements had on your emotions or psychology?
9. Have you ever been exposed to Western art therapy? If so, what are the similarities and differences between Chinese art therapy and Western art therapy?
F. Current Focus on Art Therapy and Identity (Self-Expression and Identity)
10. During treatment, have you rethought your role in life? Do you feel you have changed in any way?
11. Talk about the changes after treatment. Do you feel that art therapy has helped you rediscover your cultural background or identity in some way? For example, has there been a single session where you saw a part of yourself that you had overlooked, or regained a sense of belonging?
G. Non-verbal & Symbolic Communication
12. Have you ever been exposed to non-verbal artistic expressions in therapy, such as colors, shapes, fonts, or images? What do you think of them?
13. Do you think non-verbal artistic expression can help you with therapeutic tasks, such as regulating emotions, more easily than verbal expression? Why?
H. Therapist and Culture Interaction (Therapeutic Relationship and Cultural Resonance)
14. Are there any therapists who are compatible with art therapy? Are there any cultural resonances or barriers you encounter when interacting with therapists?
15. Do you feel your therapist understands your cultural background? How does this understand impact the treatment process?
I. Recovery & Change
16. After completing art therapy, have you noticed any changes in your sense of hope for the future, meaning in life, or control over your life? If so, could you share two examples?
17. If you could sum up your greatest takeaway from art therapy in one word or sentence, what would it be?
J. Conclusion and Suggestions (Closing)
18. If a friend of yours were experiencing psychological problems, would you recommend art therapy to them? Why?
19. Which art forms or cultural elements do you think are more suitable for future art therapy?