The Art Therapy-Projective Imagery Assessment (AT-PIA) was created at Eastern

Virginia Medical School in Norfolk, VA in 1973 by a group of art therapists. Since then, the AT-

PIA has had a few minor adjustments, such as name changes to the directives, to make it what it

is today. This assessment is intended for mental health settings of all age groups and is designed

to give information on things like developmental level, problem areas, strengths and defenses,

diagnoses, and an outlook on the potential the patient must engage productively in therapy. Since

it was designed and used in a hospital setting it was also meant to be compatible with other

psychological and psychiatric tests and evaluations and be laid out in a way that was legible and

familiar to these other professionals. The AT-PIA should take place in a private, distraction free

room, and the therapist notably should not sit directly across from the patient but instead side by

side or adjacent. Before the AT-PIA is administered the therapist should explain that the

drawings will he kept with them and the assessment will be documented, the total length of the

assessment is usually about one hour. There is also a series of standardized materials needed for

this assessment: 9x12 bogus paper (80lb) (grayish color), 20ct Crayola washable super tips felt

pens, 24ct Crayola colored pencils, 24ct Crayola crayons, 24ct Crayola portfolio oil pastels, 2

HB Drawing pencils, and 1 gum or vinyl eraser. The variety in materials allows for a few things,

color mixing, erasures, details, and the gray paper is so that the white materials show up. All the

materials are available throughout the duration of the assessment. It is important to ensure the art

materials are in good condition and care is taken in the way they are presented to the patient. In

mentioning that the therapist should take note of the patient’s behavior Deaver mentioned

something about music selection. This was not mentioned anywhere else in the chapter but from

this one might assume that music is allowed during the session when permissible.
 The AT-PIA is made up of a series of 6 drawings of a particular order which are all

included for specific reasons. The first is the Projective Scribble Drawing (PSD), which was

meant to test the patient’s functioning. The therapist gives the directive “Use one of these

materials to scribble freely on a piece of paper.” The second is Favorite Weather Drawing

(FWD), which is designed to look at the patient’s relationship with the environment, coping,

stress, affiliation vs loneliness, and safety. This is prompted with “Draw your favorite weather”.

This is followed “draw a person from head to toe. Try to draw a whole person not a cartoon or

stick figure”, for the Human Figure Drawing (HFD), which much like the draw a person test is

representative of sense of self in addition to developmental level and adjustment. The fourth

drawing is the Kinetic family drawing (KFD), the prompt given is “draw a picture of everyone in

your family doing something. Try to draw the people from head to toe, not cartoons or stick

people.” This test looks at their family relationships, sense of belongings, and attachment. Next

is the Reason for being here drawing (RBHD), “Draw a picture of why you are here [insert

location]”. This is supposed to be for reality testing, sense of responsibility or denial, or any

avoidance. Lastly, the series ends with Free choice drawing (FCD) prompted with “Using any of

these materials make one more drawing. This time you get to choose what to draw.” This is

placed at the end as less threatening way closure, it also tests creativity, anxiety, and ability yo

self-structure. If at any point the patient asks further questions the therapist should just say, “do

the best you can”. After each drawing is complete the therapist will also ask them to turn it

around and give it a title. During this point the therapist should also being subtly asking

questions or prompting verbal associations. There is no specific question list, so it is up the

therapist’s discretion. Observations should also be made about the patient’s behaviors,

interactions, verbal responses, and art process throughout the session, this should all be
considered during interpretation as well as the artwork, titles, and history. The therapist

autonomy in how they would like to interpret and can choose from the approaches that best align

with their theoretical orientation. The only thing that was mentioned was that most people use

Lowenfeld for development. The drawings are to be laid out from left to right in order, if one is

missing a blank paper should stand in its place. The therapist should look at the series as a whole

and make note of any patterns, regression, or progression throughout the series. There is a

standardized written report for the AT-PIA, it is designed to make it easy for other professionals

to understand. The report is organized by problem and not by drawing to limit the art therapist

from talking too much about the art. Instead, the themes are identified, and evidence is listed.

After the assessment is complete the patient may be asked to partake in a follow up and go over

the findings and goals for treatment.

It appears this assessment is meant to be non-threatening, for a few reasons. The

positioning of the therapist relative to the client, opportunity for music, and PSD and FCD at the

beginning and end. In addition to these I think the material choices also add to this. Gray paper is

less threatening than stark white, even if that wasn’t intended and assortment of materials makes

it seem less like a test, as just a pencil and paper would, and more fun, although it should be

taken into consideration that they could also be overwhelming. Overall, however, I believe the

creators intended to make it very approachable, this even extents to the report and how it as

designed to be approachable to other clinicians. In contrast, although I do like the material list, I

think in certain settings this is not the most accessible, I think this happens any time there’s a

longer list of very specific items. Most items are common in any setting but because of the

specificity of the paper, markers, and even oil pastels I think it might be difficult for underfunded

places to keep up with a fresh supply, especially since it is noted that they need to be in good
condition. Another thing I found interesting was how much of the interpretation was up to the

therapist’s discretion. I like that there’s not a specific question list, but I wish there were more

examples provided, at least there weren’t in this source. I also think it is cool how the therapist

can cater it to their theoretical framework and choose how to interpret however if it’s a

standardized assessment I almost want there to be more of a guideline in terms of what research

is relevant.