The Difference Between Art Therapy and Expressive Arts Therapy (And Why It Matters for Your Licensure)
Art therapy is a distinct licensed clinical profession requiring a master's degree in art therapy specifically. Expressive arts therapy is an intermodal, multimodal approach that integrates multiple creative modalities and can be practiced by licensed clinicians who pursue additional training and credentialing, such as the Registered Expressive Arts Therapist (REAT) credential.
If you've been Googling "expressive arts therapy" and wondering whether you need to go back to school for a whole new degree, you don't. But the distinction between these two fields matters for your scope of practice, your credentialing pathway, and what you're legally allowed to call yourself with clients. Let's get into it.
Are Art Therapy and Expressive Arts Therapy the Same Thing?
No. Art therapy is a separate licensed profession with its own degree pathway, board certification (ATR-BC), and scope of practice. Expressive arts therapy is an integrative approach that spans multiple modalities and is built into the existing scope of a licensed clinician's practice through additional training.
This confusion comes up constantly, and it makes sense. Both fields use creativity. Both show up in clinical settings. Both have the word "therapy" in the name. But structurally, they are completely different tracks.
What does an art therapist's training actually look like?
Art therapy has its own graduate-level credentialing pathway administered by the Art Therapy Credentials Board (ATCB). To become a Registered Art Therapist (ATR), a clinician must first obtain the provisional credential (ATR-P) while completing post-graduate supervised experience. The full ATR requires 1,000 hours of direct client contact and 100 hours of supervision, with at least 50 of those supervision hours under a Board Certified Art Therapist (ATR-BC) (ATCB, 2026). From there, ATRs can pursue board certification by passing an additional examination.
Art therapy training is grounded in visual art as the primary therapeutic modality. It is a single-discipline specialty, not a multimodal one. In some states, art therapy carries its own separate license entirely, distinct from an LMFT or LPC.
What does an expressive arts therapist's training look like?
Expressive arts therapy is multimodal by design, weaving together music, movement, visual art, poetry, drama, and other creative forms as vehicles for healing. As Degges-White and Davis describe it, modalities such as "music, movement, drawing, painting, poetry, meditation, and imagery can all become potential vehicles for communication within the expressive arts" (Degges-White & Davis, 2017, Chap. 1).
The REAT credential is granted by IEATA and has multiple pathways depending on your degree. For clinicians holding a master's in counseling, social work, marriage and family therapy, psychology, or a related mental health discipline, the pathway requires completing training through an IEATA-recognized expressive arts therapy institute, plus 1,000 direct client hours of supervised clinical experience and at least 50 hours of individual supervised sessions (IEATA, n.d.). Your clinical license is the foundation. The REAT sits on top of it.
I pursued a counseling psychology program with a specialization in expressive arts therapy, led by practitioner-scholars who were active REATs. They were invaluable in clarifying the distinction between obtaining a state board license and pursuing a national or international credential, because those are genuinely different processes that run in parallel.
Navigating that parallel process required advocating for myself. Because my clinical training site didn't have a REAT on staff, I arranged for outside supervision with a registered expressive arts therapist in addition to my on-site clinical supervision. I specifically prioritized finding a supervisor who was eligible to supervise in California so our hours would count toward both my state license and the REAT credential. Essentially, I received double the supervision. At this stage of the field, there are so few REATs at clinical training sites that this kind of arrangement is common, and I hope Metaphor becomes a space where aspiring REATs can access supervision for both processes in one place.
Why Does This Distinction Matter for Your License?
Practicing art therapy without an art therapy credential constitutes scope of practice violations in many states. Expressive arts therapy, by contrast, is practiced within the frame of your existing license when you have appropriate training, making the REAT a credential that extends your scope ethically rather than replacing it.
This isn't a technicality. It's the difference between operating legally and putting your license at risk.
Can an LMFT or LPC use expressive arts in sessions legally?
Yes. Your LMFT or LPC is what authorizes you to practice therapy. You can incorporate creative and arts-based tools within that scope. But there's a meaningful difference between using a creative tool and practicing expressive arts therapy with clinical intentionality. Degges-White and Davis are clear that "counselors using expressive art therapies need to be familiar with the modality they are using through training" and that "pursuing training in a modality prepares a counselor with knowledge of the modality and the skills necessary to facilitate that expressive art" (2017, Chap. 11). Supervision with a REAT is how you build that competency the right way.
What happens if you call yourself an "art therapist" without the credential?
In many states, "art therapist" is a protected title tied to specific licensure. Using it without the credential can constitute misrepresentation to clients and exposure to licensing board action.
What most therapists don't realize is that the same principle applies during the REAT credentialing process itself. Even while I was actively pursuing my REAT credential, I could not call myself an expressive arts therapist. I told clients I incorporated expressive arts approaches and that I was working under the supervision of a registered expressive arts therapist. I addressed this explicitly in my informed consent. This is also why proper training matters at a clinical level: expressive arts approaches "bypass spoken language and the mind's normal regulation of material and may result in unexpected disclosure of emotional and raw material" (Degges-White & Davis, 2017, Chap. 11), and clients deserve to know what they're entering into.
What Is the REAT, and How Does It Fit Into This Picture?
The Registered Expressive Arts Therapist (REAT) is a post-licensure credential granted by the International Expressive Arts Therapy Association (IEATA). It recognizes licensed clinicians who have completed advanced training in multimodal expressive arts practice, and it sits on top of an existing clinical license rather than replacing it.
What does REAT training actually involve?
The REAT is built around three core competencies: expressive arts therapy training, general therapy knowledge, and active arts practice. Applicants must complete training across at least three of four areas, including individual expressive arts therapy process, group process, application of intermodal approaches, and various approaches to practice, with a minimum of 25 hours of coursework per category (IEATA, n.d.). The full credential also requires 1,000 direct client hours and 50 hours of supervised sessions post-graduation.
The personal arts practice requirement is something many clinicians don't anticipate. You aren't just learning how to facilitate creative work with clients. You're expected to maintain an ongoing relationship with your own artmaking. That requirement changes the nature of the credential, and honestly, of the clinician.
Is REAT supervision different from regular clinical supervision?
Yes, significantly. REAT supervision addresses both clinical skill development and the ethical integration of expressive arts modalities into practice, and it's meant to be provided by someone who is themselves an active practitioner in the field.
I began my REAT credentialing process after graduating and continuing through my associateship. I met with my supervisor for 50 individual sessions biweekly. Even after completing the required 1,000 clinical hours and 50 supervision hours, I continued the supervision relationship until my REAT credential was formally approved.
What surprised me most was how integrating the perspectives of two supervisors simultaneously deepened my clinical thinking. I viewed cases through multiple theoretical lenses at once, between group supervision and individual expressive arts supervision. In my experience, it made me a sharper clinician and improved my ability to conceptualize cases and translate what I was observing into different frameworks. That's not something I expected going in, and it's one of the things I find myself telling therapists who are early in the process.
How Do You Know Which Path Is Right for You?
If you want to specialize solely in visual art as a clinical treatment modality and build a practice specifically around art therapy, pursue an art therapy master's degree and the ATR pathway. If you're a licensed clinician who wants to integrate creative modalities into your existing practice in a flexible, multimodal way, the REAT pathway is the better fit.
What if you already use creative tools in sessions — does that mean you're practicing art therapy?
Not necessarily. Using a creative tool with a client is different from holding yourself out as an art therapist or claiming a credential you don't have. The ethical question isn't whether you used something creative. It's whether you have the training to facilitate the clinical process that might emerge. Ethical counselors, as Degges-White and Davis put it, should "experience an expressive art modality before inviting a client to participate" (2017, Chap. 11). That preparation is the baseline, not the ceiling.
Where do most licensed therapists start when they're exploring expressive arts?
Usually with continuing education, a workshop, or a training intensive. The REAT supervision relationship is often what bridges initial curiosity into ethically grounded, clinically integrated practice.
Something I didn't fully anticipate before starting REAT supervision was how accessible expressive arts integration could actually be. I began my clinical career during the COVID-19 pandemic, working entirely through telehealth. I felt the constraints of that setting acutely. My supervisor helped me think outside the box, exploring how to use what was available through Zoom, leaning into modalities that don't require physical art supplies, and discovering somatic interventions that work well in small spaces. That reframe changed how I think about expressive arts entirely. It isn't dependent on having a studio or a supply cabinet. The creative process travels.
If you're a licensed therapist who's been incorporating creative tools and wondering whether REAT supervision is the right next step, you can learn more about working together here.
References
Art Therapy Credentials Board. (2026). 2026 registration standards for ATR.https://atcb.org/registered-art-therapist-lp/2026-atr-credential-requirements/
Degges-White, S., & Davis, N. L. (Eds.). (2017). Integrating the expressive arts into counseling practice: Theory-based interventions. Springer.
International Expressive Arts Therapy Association. (n.d.). Standards and requirements of REAT: Registered expressive arts therapist.https://www.ieata.org/reat-standards-requirements/
Author Bio
Jasmine McMeeking, LMFT, REAT is a Licensed Marriage and Family Therapist and Registered Expressive Arts Therapist (REAT) specializing in couples therapy, relational healing, and expressive arts supervision for licensed clinicians. Jasmine works with queer partnerships, interracial couples, and non-traditional relationship structures navigating major life transitions — and with therapists who are ready to bring more of the whole person into their clinical work.
At Stanza, Jae offers individual and couples therapy grounded in Emotionally Focused Couples Therapy (EFCT) and expressive arts approaches, alongside REAT supervision for licensed therapists integrating creative modalities into their practice.
Jasmine's work is liberation-focused, deliberately unpolished, and built on the belief that healing happens through genuine human connection, not performance.