Anne (pseudonym*) is a teenage girl with a diagnosis of Attention Deficit Hyperactivity Disorder. She shows difficulties in her self-esteem and has been supported through play therapy. She was referred to art therapy as she was observed to be unmotivated and reserved in expressing her feelings, sometimes presenting challenging attitudes.

The objective of the art therapy programme with Anne was to provide a safe space for her to experience relaxation and emotional regulation; hopefully to empower her self-esteem through self-expression.

At the beginning of art therapy, Anne showed little response to the art therapist and the art directives. As observed, however, she elicited her interests when she was given choices of visual tools (such as picture cards) and sensory materials even though there was not much verbal exchange.
Fig. 1
Sensory-based directives were introduced to provide Anne opportunities to experience a sense of agency and self-control.
Different sensory mediums were explored with Anne and she was willing to try.

Figure 1 shows her painting with rollers. Initially, she wanted to represent a seascape, but was overwhelmed with the changes caused by the fluid medium and felt that she made mistakes easily.

The art therapist gave affirmation to her feelings and supported her by jointly looking at the image, and exploring possibilities to reflect and perceive the changes.

As she continued the sensorimotor process layering colours on the emerging images, Anne felt much relaxed and enjoyed in the present moment, letting the image unfold by itself as she saw a “galaxy” (Fig. 2) and was contented with the outcome. 

Artmaking provided Anne a safe and holding space to share about her feelings, hopes and struggles for which she found hard to express through other means.

“Through art expressions, she shared that bright colours represented happiness and dark colours represented anger or sadness."

In her painting “Nowhere” (Fig. 3), she released her difficult feelings through her colour choice and the action of smearing, covering up, and erasing.

Fig. 2
Fig. 3
Fig. 4

When art therapy came to a close, Anne became more open, focused, and engaged with the creative process. She initiated to create a final artwork with rainbow colours running fluidly on the paper (Fig. 4).

Overall, art therapy provided Anne with opportunities to connect with her emotions, express and regulate herself, and communicate with others.

Sensorimotor explorations and painting process helped her to gain self-awareness, regulate her emotions through relaxation, letting go, and resorting to creative resolutions. The artmaking process provided a holding space for her to
express difficult emotions. Through the therapeutic relationship and mastery of skills, she gained self-confidence and increased self-esteem, especially in relating to another.