ATCBE Content Outline 2025

The Art Therapy Credentials Board Examination 2025

To be used on the ATCBE beginning 1 January 2025

Exam Purpose and Development

Art Therapy Credentials Board Examination (ATCBE) is a state-of-the-art professional examination that is developed by subject matter experts who are board-certified credentialed art therapists in conjunction with contracted psychometricians who are experts in creating professional examinations for mental health professions. The ATCBE is designed to assess the skill and ability of art therapy professionals who are seeking board certification or licensure in select states.

This content outline reflects the results of the most recent job analysis, which was administered in 2022. Over 1,000 credentialed art therapists completed the survey, which provided data on the current practice of art therapy, including major work behaviors and tasks, client populations, media/materials, diagnostic categories, ethical issues, and work settings.

Exam Format 

Examinees are given 3 hours and 30 minutes to complete 175 multiple-choice questions, including 150 scored items and 25 unscored (i.e., field items) on the ATCBE. The unscored items are distributed among the scored items in the same format and structure. Unscored items are used to evaluate new items for future use. A candidate’s score will be assessed as the number of correct responses out of the 150 scored items.

Exam Scoring

The passing score for the Art Therapy Credentials Board Examination (ATCBE) candidates is determined using the modified Angoff standard-setting method. This approach necessitates that Subject Matter Experts (SMEs) assess each question on the initial test form based on a new content outline to establish the passing score (cut score) for a Minimally Qualified Candidate. The passing/cut score obtained through standard-setting on the first test form is applied to other ATCBE test forms through statistical equating. Statistical equating adjusts the passing score up or down by accounting for the overall difficulty of each test form. Therefore, statistical equating ensures fairness to all candidates by associating the cut score on a test form with the overall difficulty level of the items on it. With this standard procedure for determining successful candidates on ATCBE, the passing scores will vary slightly for each ATCBE test form. The cut score for each exam form is unique to that exam. Thus, a candidate’s score on a previous exam does not count toward the cut score on a subsequent exam

Exam Content 

The examination items are written to reflect three different cognitive levels:

• Basic understanding (recall)
• Application (applying knowledge to a particular example)
• Mastery (analysis, synthesis, and evaluation)

For example, some questions require factual recall, while others require applying knowledge to a clinical scenario. As determined by the job analysis survey, the examination content is categorized into six major content areas, delineated below, along with their distribution across the ATCBE.

An attenuation study conducted by Prometric found that the exam could reduce from 175 scored questions to 150 with no impact on reliability. Beginning in January 2025, the Art Therapy Certification Board Examination (ATCBE) will include a total of 175 items with the following item distribution:

The following listing presents the knowledge, skills, and tasks under each domain of the Content Outline.

1. Theoretical Approaches (10%)
   Attachment Theory
   – Cognitive Behavioral Therapy (CBT) and other behavioral approaches (Acceptance and Commitment Therapy (ACT), Behavioral Therapy, Dialectical Behavior Therapy (DBT))
   – Developmental Approaches
   – Environmental/Ecotherapy Approaches
   – Expressive Therapies Continuum
   – Family Systems Theory
   – Feminist Theory/ Social Justice Approaches/Socially-engaged Practice
   – Humanistic Approaches (Adlerian, Existential, Gestalt, Spiritual/Transpersonal)
   – Motivational Interviewing (MI)/ Transtheoretical Model (TTM)/Stages of Change (SOC)
   – Psychodynamic Approaches (Psychoanalytic, Jungian, Internal Family Systems (IFS))
   – Positive Psychology
   – Solution-focused Therapy
   – Somatic Approaches
   – Systems Theory
   – Trauma-Informed Therapy

2. Facilitate Treatment (30%)
   – Adapt interventions to address clients’ communication/developmental level/learning styles and evolving treatment needs (maintain a physically safe environment regarding art materials – e.g., monitor sharps, select non-toxic materials)
   – Apply general interviewing skills (e.g., reflective statements, summarizing, session closure)
   – Collaborate with the client in formulating and modifying the treatment plan and goals
   – Conduct comprehensive intake and ongoing evaluations (conduct biopsychosocial evaluation, obtain demographic information and relevant history, assess the reason for referral/presenting problems, determine the current level of functioning and mental status).
   – Demonstrate empathy and validation
   – Document communications with clients and treatment team members
   – Establish a therapeutic relationship
   – Facilitate the creative process (knowledge of media and material use, select appropriate and safe media and material, utilize concepts of fine arts and art history, introduce the art therapy process, maintain an appropriate pace for art therapy, facilitate conclusion of the art therapy process within the session)
   – Manage group dynamics
   – Observe and process the art production and use of material (e.g., color, line, shading, perspective, symbols, material selection and use, metaphors, and respond appropriately to images that suggest violence or other risk factors)
   – Observe and respond to dynamics of the session (e.g., affect, behavior, verbal and nonverbal communication, and/or interpersonal interactions)
   – Promote client understanding of the art process and attainment of treatment goals
   – Provide crisis intervention
   – Refer to other treatment providers as needed
   – Routinely evaluate clients’ progress and the efficacy of the art therapy process
   – Understand current Diagnostic and Statistical Manual diagnoses
   – Use art therapy skills to facilitate expression and exploration of feelings, thoughts, and behaviors (e.g., witnessing, intention setting, art directives, encouraging reflection and connection of symbols to personal, cultural, and historic contexts)

3. Administer and Evaluate Art Therapy and Art-Based Assessments (15%)
   – Determine the need for, select, and administer the appropriate art therapy and art-based assessment (linked to client goals)
   – Write and evaluate art therapy and art-based assessment reports
   – Understand and administer art therapy and art-based assessments
   1. Belief Art Therapy Assessment (BATA)
   2. Bird’s Nest Drawing (BND)
   3. Bridge Drawing
   4. Cognitive Art Therapy Assessment (CATA)
   5. Diagnostic Drawing Series (DDS)
   6. Draw-A-Person-In-The-Rain (DAP)
   7. Draw-A-Story (DAS)
   8. Face Stimulus Assessment (FSA)
   9. Formal Elements Art Therapy Scale (FEATS)
   10. Kinetic drawings (Kinetic-Family-Drawing (KFD), Kinetic-House-Tree-Person (K-H-T-P), Kinetic-School-Drawing (KSD))
   11. Family Art Evaluation
   12. Levick Emotional and Cognitive Evaluation and Assessment Method (LECATA)
   13. Mandala Assessment Research Instrument (MARI)
   14. Person Picking an Apple from a Tree (PPAT)
   15. Road Drawing
   16. Silver Drawing Test (SDT)

4. Professional Practice and Ethical Responsibilities (25%)
   – Abide by the ATCB Code of Ethics, Practice and Disciplinary Procedures
   – Comply with the Health Insurance Portability and Accountability Act (HIPAA)
   – Discuss confidentiality/privacy, fee structure, and storage/retention of artwork
   – Document art therapy products (label/photograph/store)
   – Document supervision sessions
   – Engage in Cultural Responsiveness (e.g., engage in activism, engage in personal art making, participate in continuing education/training, participate in peer consultation and supervision)
   – Evaluate risk of harm to self and/or others (duty to warn)
   – Knowledge of supervision models
   – Provide guidance on ethical research practices
   – Provide supervision and consultation
   – Review and obtain informed consent and release of information forms
   – Seek supervision and consultation
   – Set up a secure teleconference for therapy sessions and supervision
   – Use technology for data management (e.g., progress notes, records, billing, storage of art products)
   – Utilize appropriate electronic methods of communication with clients
   – Utilize reflective art-making processes

5. Professional Development and Research (10%)
   – Gather, review, and interpret research literature and apply to practice (Learn new techniques or media relevant to client population/setting, pursue additional resources when necessary, research best practices for client needs)
   – Prepare research for publication
   – Provide guidance on ethical research practice
   – Understand and conduct qualitative research (interviews, focus groups, etc.)
   – Understand and conduct quantitative research (experimental designs, developing or distributing measures, distributing surveys)

6. Administrative Functions and Program Management (10%)
   – Conduct programmatic needs assessments/program evaluation (prepare for external program accreditation review and audit, prepare necessary reports for agencies/collaborating professionals/funding sources
   – Consult with other agencies/organizations (maintain knowledge of community resources and referral sources)
   – Ensure that universal precautions are utilized in the work environment (e.g., body fluids)
   – Learn new techniques or media relevant to the client population/setting
   – Orchestrate programming that supports the work setting (e.g., fundraising, shows, exhibitions, weekly schedules)
   – Organize non-art therapy activities for clients (e.g., field trips, other enrichment activities)
   – Participate in administrative meetings, case presentations, and clinical team meetings
   – Provide appropriate physical space (e.g., proper ventilation, lighting, and access to water)
   – Provide community outreach, staff training and in-services

Examination Preparation Guidance

As part of the 2022 Job Analysis, art therapists were asked to respond to survey questions seeking to understand better the practice of art therapy, including descriptions of their client populations, media/materials utilized, and work environments. The most highly endorsed responses are provided below to assist examinees in their examination preparation, as these areas will be represented in the examination content. Please note: The examination content is not limited to the areas below but will primarily cover the most reflective aspects of art therapy practice.