Changes over time in therapeutic and art therapy working alliances in simulated art therapy sessions

Inbal Argaman Ben David, Michal Bat Or, Dafna Regev, Sharon Snir

Research output: Contribution to journalArticlepeer-review


This pilot study examines fluctuations in the strengths of the art therapy working alliance and the therapeutic working alliance over time in simulated art therapy sessions. Participants were 53 female graduate students of art therapy (Age range 23–57), who assumed the role of creators/clients in simulated art therapy sessions, and filled out the two questionnaires (n = 44 at time 1, n = 29 at time 2, n = 36 at time 3). Repeated measures of the two alliances were obtained in three time points during the simulation from only 19 participants. Findings revealed a distinct difference in the patterns of change between the two alliances: while the strength of the therapeutic alliance increased linearly during the course of the simulation, the strength of the art therapy working alliance decreased in the middle of the simulation and increased at its end. The main factor that was found as significantly decreasing at time point 2 was the Art Task factor. Significant associations between the two alliances were found at each of the three time points. Results shed light on the complex nature of art therapy, in which the ‘simulated client’ may experience fluctuations in her/his trust levels in the art medium during the art therapy simulation process, while the collaborative relationship with the ‘simulated therapist’ may get stronger. Results, implications and limitations are discussed.

Original languageEnglish
Article number101804
JournalArts in Psychotherapy
StatePublished - Sep 2021

Bibliographical note

Publisher Copyright:
© 2021 Elsevier Ltd


  • Art therapy
  • Simulated art therapy
  • Therapeutic alliance
  • Triangular relationship
  • Working alliance
  • Working alliance inventory-short-revised

ASJC Scopus subject areas

  • Health Professions (miscellaneous)
  • Clinical Psychology
  • Psychiatry and Mental health


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