Credentials and Professional Identity

Some might describe my art therapy class cohort as rowdy but I like to think that we were, well, passionate. There was this one time when we attended a required colloquium on professional credentials. The assembled speakers, all art therapists, described their experiences and rationale for obtaining U.S. national and state (regional) credentials beyond those offered by the Art Therapy Credentials Board (ATCB; www.atcb.org). One spoke about counseling, another on teaching, and a third on a related field that escapes my memory. What I do remember are the pointed questions my classmates and I raised on just wanting to be art therapists. After all, we would have pursued different graduate training had we wanted to be some other kind of helping professional. In the final years of the 1990s, licensure was not yet widespread and plenty of us could work without it—and, indeed, several of us did (and still do). After we graduated and settled on our professional paths, some have continued to work only with art therapy credentials, some pursued credentials in other fields, and some worked as artists.

Credentialing as an indication of professional competence is an important but thorny process. National bodies furnish registrations and certifications to set standards for a profession. Governmental agencies issue licenses (in the U.S.) or registration (in the U.K. and other countries) to regulate a profession. Private institutes award certifications for specialized practices. The relationships between national bodies and local agencies in the U.S. are particularly fraught given the somewhat unique federal republic government structure in which each individual state and jurisdiction dictates its own rules.

In the U.S., art therapy credentials are in a state of transition as national ATCB credentials (registration and board-certified) are no longer the only indication of competence due to state licenses. There have been many conversations and arguments on art therapy credentials—far too many to repeat here. What is sometimes missing is a broad review of credentials across the mental health professions that reveals tensions of expectations, professional identity, and development. For context, social workers and psychologists began licensure efforts in 1945 and counselors in 1976, but it took each profession 30-40 years for licenses to be enacted in every state. In contrast, art therapists pursued licensure as marriage and family therapists in California in 1979 and as independent art therapists in New Mexico in 1993. As of this writing, 10 states and Washington DC have independent art therapy licenses, five include art therapists in other licenses, three have official recognition, and 12 states are actively pursuing legislation for licensure (AATA, 2022).

First, credentials yield a range of competing interests. Credentials offer clients assurance of practitioner competence. For professions, credentials define scope of practice and qualifications as means to homogenize practitioners in a common field. For governmental agencies, credentials protect their citizens and determine access to health benefits.

Second, mental health practitioners sometimes have to navigate a range of overlapping and contradictory policies across states. Individuals who practice in one state may find different regulations in another, even for the same profession. In other cases, practitioners trained in one field may have to utilize a license of another one. For example, masters-level psychologists in the U.S. might be licensed as counselors because psychology licensure requires a doctorate (Lawson, 2016). However, this has an impact on the psychologist’s professional identity, counselors’ definition of proficiency, and client confusion (Campbell et al., 2018). Furthermore, the presence of a license does not prevent similar but unregulated treatments—such as differences between therapists and life coaches (Aboujaoude, 2020).

Third, although many mental health professions in the U.S. begin with national guidelines and credentials, they ultimately succumb to state licenses. For example, the national credentials in social work (NASW, 2022) and counseling (NBCC, 2022) became voluntary when individuals were able to practice solely with a license (Bradley, 1995). Counselors Weinrach and Thomas (1993) advocated for abandoning the national credential due to costs and redundancy associated with holding multiple credentials. As a result, national credentialling agencies re-invented themselves as simply providers of an examination or verifiers of qualifications to support license portability (acquiring a license in another state due to holding a license in another state) or monitor inter-state compacts (an individual licensed in a member state can practice in all others) (Bohecker & Eissenstat, 2020).

Art therapists in the U.S. are familiar with all three of these aforementioned experiences. The many changes have caused practitioners to traverse the ever-changing national and state regulatory landscape. For example, historic loyalty to national credentials might conflict with the necessity of a license, which will impact the ATCB. Given the diversity in art therapy’s interdisciplinary roots and applications, as well as its newness to licensure advocacy, it is unsurprising that art therapists are caught up in both frustrations of just wanting to work and excitement over receiving long overdue professional recognition. Another look at the three tensions uncovers dynamic opportunities to identify collaborative partnerships across stakeholders, broaden concepts of professional identity as inclusive of a range of credentials, and acknowledge the evolution of professional signifiers. My classmates and I could not appreciate these intricacies back when we were in training, although we, and colleagues since, have experienced them along our career trajectories. What has remained true, however, is that no matter which denotations follow our names, we are all bound by our shared dedication to art therapy.

In This Issue

Movement between an art therapy core identity and range within the profession is well represented in this issue of the journal. The authors demonstrate how security in professional identity and advancement come about from various sources. These include: cultural responsiveness, art material interactions, and research findings.

Ensuring that art therapy is responsive to client cultural values and needs is paramount to good services. Kai Ying Huang’s qualitative study uncovered the ways that Taiwanese art therapists who were trained in the U.S. integrated their practices to meet their clients’ expectations, values, and contexts. Paola Luzzatto, Letisia Ruzibuka, Mary Njau, Anitha Makoye, and Jessie Mbwambo described how they designed a substance use recovery program specific to Tanzania that is based in storytelling. Rachel Brandoff reflects on racist messages conveyed in art materials and how an anti-racist stance can counter harm.

Interactions with art making, the one distinctive element that separates art therapy from other mental health professionals, builds professional identities. Frances Smokowski’s cover art speaks to the ways in which many people turn to art for healing and restoration but also to how art making can lead to changes. Abbe Miller’s art-based research investigated an often overlooked, but crucial, aspect of art making—the interim period when seemingly little is happening in creative work.

Formal research underscores professional tenets and expands applications. Christina Blomdahl, Suzanne Guregård, Marie Rusner, and Helle Wijk demonstrated the immediate and long-term impacts of standardized art therapy for alleviating depression. Leslie A. Becerra, Elizabeth M. Hill, and Kristen M. Abraham identified specific ways self-portraits, mandalas, and free drawings decrease anxiety. When taken together, the assembled articles, reports, and viewpoints ensure that whatever credentials define art therapy practice, there will continue to be animating forces propelling new directions.