Art therapy provides a dynamic and non-verbal medium for children to express emotions and navigate behavioural challenges. This case study explores the application of Effective-Based Art Therapy (EBART) in addressing the emotional and behavioural challenges of a 7-year-old female, diagnosed with aggression and behavioural issues. Through the art activity titled “What’s in the Heart?” artwork, featuring intricate symbols such as protective layers, a house with distinct doors, familial representations, and cosmic imagery, serves as a window into her inner emotional landscape. Layers symbolizing parental protection, the interplay of sun and moon signifying cosmic balance, and the use of rainbow colours reveal her nuanced emotional world. Structured semi-circles and radial patterns reflect her inward journey toward self-realization. Naming her artwork “ROCKS,” the client conveys her self-perception as resilient yet evolving. This report delves into the therapeutic interpretation of her artwork, situating findings within a literature-based context that supports art therapy’s efficacy for young children. The discussion highlights art therapy’s role in enhancing emotional regulation, familial attachment, and personal growth.

Keywords: art therapy, aggression, behavioural challenges, child psychology, emotional expression, familial attachment

Art therapy is an established psychological intervention for fostering self-expression and emotional regulation, particularly among children facing behavioural challenges. Malchiodi¹ emphasizes that art therapy transcends linguistic barriers, providing a safe space for children to externalize and process complex emotions. Aggression in children is often linked to unmet emotional needs and environmental stressors.² Utilizing creative modalities such as art can help identify and address these underlying issues.³ Effective-Based Art Therapy (EBART) offers a structured yet flexible framework that integrates emotional themes into therapeutic art practices.⁴

In this context, the “What’s in the Heart?” activity demonstrates how art becomes a mirror for her internal struggles and a tool for therapeutic intervention. The layers and figures in her drawing illustrate her attachment to her parents as sources of security, while cosmic symbols and rainbow colours showcase her emotional diversity and openness to growth.

Art therapy has long been recognized as a powerful tool for fostering emotional expression and regulation, especially among children grappling with behavioural challenges. According to Malchiodi,¹ art therapy surpasses verbal communication by creating a secure, nonjudgmental space where children can visually articulate their emotions, bypassing linguistic or developmental barriers. This makes it particularly effective for addressing aggression and other behavioural issues, which often stem from unmet emotional needs, familial conflicts, or environmental stressors.² By engaging in creative processes, children can externalize inner turmoil, gaining insight into their emotional world and fostering healing.

Effective-Based Art Therapy (EBART), as outlined by Moon,⁴ provides a structured yet adaptable framework that blends emotional themes into art-based interventions. This approach ensures that the therapeutic process remains tailored to the child’s unique needs while maintaining clear goals for emotional and behavioural growth. By integrating themes like family, security, and self-expression into art activities, EBART helps children navigate complex emotions and develop healthier coping mechanisms.

The “What’s in the Heart?” activity exemplifies how art can serve as both a diagnostic tool and a pathway for intervention. Through this activity, the child’s artwork becomes a vivid reflection of her internal struggles, desires, and emotional landscape. The visual elements—layers, colours, and symbols offer rich insights into her psyche. For instance:

Attachment to parents: The prominence of parental figures in the drawing underscores her deep emotional reliance on them as anchors of security and stability. This attachment may highlight a need for reassurance or a fear of separation, common among children dealing with behavioural challenges.

Cosmic symbols: The inclusion of celestial motifs like stars or moons suggests a yearning for connection, imagination, and a broader sense of belonging. These symbols may represent her subconscious exploration of larger emotional or existential questions.

Rainbow colores: The vibrant spectrum of hues in her artwork reveals her emotional diversity and capacity for resilience. Each colour could symbolize different emotional states—red for passion or frustration, blue for calmness or sadness, and yellow for joy or hope—indicating her openness to experiencing and expressing a wide range of feelings.

Together, these artistic elements form a tapestry that reflects her emotional complexity and readiness for growth. By analysing and discussing these symbols within the therapeutic setting, the child gains an opportunity to verbalize her feelings, develop self-awareness, and strengthen her emotional resilience. Moreover, the process of creating and interpreting her artwork encourages a sense of empowerment and agency, key components in addressing behavioural challenges.

The "What’s in the Heart?" activity not only reveals the child's inner world but also facilitates a collaborative journey between the therapist and the child. This partnership fosters trust and ensures that therapeutic interventions are grounded in the child’s lived experiences and emotional needs. By leveraging the power of art, this intervention paves the way for deeper emotional healing and behavioural transformation.

Soul Mandala Therapy is a creative and integrative therapeutic approach rooted in the use of mandalas circular, symmetrical designs often associated with harmony, balance, and inner peace. The concept of mandalas originates from ancient spiritual practices and is frequently linked to Carl Jung’s⁵ psychological theories, where mandalas symbolize the self and serve as a tool for exploring unconscious thoughts and emotions. In therapy, creating and interpreting mandalas helps individuals externalize inner conflicts, regulate emotions, and foster self-awareness.⁶

The role of mandalas in therapy

Mandalas provide a structured yet fluid medium that enables individuals, particularly children, to express their internal worlds without the constraints of language or traditional art forms. This is especially beneficial for addressing behavioural challenges like aggression or emotional dysregulation. The circular shape of mandalas naturally draws individuals toward a focal point, promoting mindfulness and grounding.⁷ Additionally, the repetitive patterns and symmetry inherent in mandalas facilitate a sense of order and stability, which can be particularly soothing for children dealing with chaotic emotions or environments.

Key elements of soul mandala therapy

Symbolism and archetypes

Mandalas often incorporate universal symbols and archetypes, which serve as a bridge between the conscious and subconscious mind. For example, cosmic symbols like stars or planets may represent hope, aspiration, or connection, while the use of colours conveys diverse emotional states. This aligns with Jung’s view that mandalas represent the psyche’s attempt to reconcile inner conflicts and achieve balance.⁵

Creative freedom and emotional safety

Mandala creation offers a safe, nonverbal outlet for individuals to explore their emotions. The emphasis on free choice of colours, shapes, and patterns encourages self-expression, helping individuals process and articulate feelings they might struggle to verbalize.⁸

Therapeutic insights

The completed mandala serves as a visual representation of the individual's emotional state. Therapists can interpret the symbolism, colours, and designs to understand the underlying issues contributing to behavioural challenges, such as aggression or anxiety.⁷

Research evidence on mandala-based interventions

Fincher⁶ underscores that mandala-making fosters self-regulation and emotional processing by engaging the creative brain’s ability to externalize and organize complex emotions.

Henderson et al.⁷ found that children participating in mandala-based art therapy reported reduced symptoms of anxiety and improved emotional expression, particularly in cases involving trauma or family stress.

Malchiodi⁸ highlights the effectiveness of art-based interventions in creating a nonverbal platform for children to address emotional and behavioural issues, noting that mandalas uniquely promote focus and emotional balance.

Soul mandala therapy in practice

In the context of the “What’s in the Heart?” activity, Soul Mandala Therapy becomes a mirror of the child's internal experiences:

Attachment and security

The mandala’s concentric layers reflect the child’s need for safety and security, symbolizing her reliance on familial relationships as emotional anchors.

Cosmic and universal themes

The inclusion of celestial imagery within the mandala showcases the child’s imaginative exploration and a potential desire for connection with a larger purpose or community.

Rainbow colores

The vibrant spectrum of colours used in the mandala indicates emotional diversity, resilience, and an openness to growth. Colores can also serve as emotional indicators—bright colours like yellow and green suggest optimism, while darker shades like blue or purple may indicate introspection or calmness.^9–15

Layers and protection

The client’s decision to outline her heart twice reflects a profound need for protection and security. These layers symbolize emotional boundaries, with each layer representing a vital source of safety and support. By identifying her father as the first protective layer and her mother as the second, the client demonstrates a strong attachment to her parents, indicating that she views them as her primary sources of stability and emotional reassurance. This layered depiction underscores the foundational role her family plays in fostering her sense of emotional safety and resilience.

House and family representations

The inclusion of a house within the heart, complete with distinct doors and windows, is a poignant representation of her personal space and emotional comfort zone. The “big door” and the “small door for the cat house” reflect her nuanced approach to emotional access suggesting that while some areas of her inner world are open and inviting, others are more private and selective. These details highlight her growing self-awareness and her ability to differentiate between various emotional boundaries, offering a glimpse into her complex emotional landscape.

Four hearts for family members

The smaller hearts representing her parents and grandparents further emphasize the centrality of familial relationships in her life. These symbols serve as anchors, reinforcing her emotional stability and sense of belonging. By incorporating these hearts into her artwork, the client expresses her reliance on the love and support provided by her family, which acts as a critical source of grounding during her developmental journey.

Use of rainbow colours

The use of the full spectrum of rainbow colours in her artwork signifies her emotional diversity and a willingness to explore the complexities of her feelings. Each colour represents a different facet of her emotional experience, suggesting a readiness to engage with both resolved and unresolved emotions. The vibrant palette symbolizes hope, balance, and the potential for emotional harmony, demonstrating her openness to personal growth and healing.

Structured semi-circle patterns

The radial movement of semi-circles, extending from the corners to the centre of her artwork, reflects a journey toward self-discovery and introspection. These patterns indicate an inward-seeking process, as the client navigates through layers of her inner world to reach a deeper understanding of herself. The structured design also highlights her efforts to bring order to her emotions, signifying a methodical and reflective approach to emotional regulation.

Title “ROCKS”

The title of the artwork, “ROCKS,” encapsulates her perception of herself as resilient and steadfast. Rocks, as a metaphor, symbolize strength, stability, and endurance. By choosing this title, the client conveys her belief in her ability to withstand challenges while remaining adaptable and open to transformation. This resilience is a cornerstone of her developing identity, reflecting both her struggles and her growth.

The findings align with existing literature emphasizing the role of art therapy in fostering emotional resilience and behavioural adjustment in children. Rubin et al.,³ suggest that art therapy facilitates the expression of unconscious emotions, while Moon⁴ highlights its role in developing coping mechanisms. The client’s artwork illustrates a complex interplay between her familial attachments, emotional vulnerabilities, and developmental growth. The use of protective layers, structured patterns, and symbolic representations underscores her evolving self-awareness and emotional regulation.

She use of cosmic imagery and rainbow colours indicates her understanding of balance and diversity within her emotional world. The integration of personal symbolism such as the title “ROCKS” demonstrates her developing resilience. These findings resonate with Malchiodi’s⁸ assertion that art therapy can enable children to reframe challenges and foster emotional healing.

The findings from this case study align closely with existing literature, which emphasizes the pivotal role of art therapy in fostering emotional resilience and promoting behavioural adjustment in children. Rubin et al.,³ suggest that art therapy provides a safe and creative outlet for expressing unconscious emotions that may otherwise remain inaccessible. This aligns with the client’s use of art to explore and externalize her complex emotional world. Similarly, Moon⁴ underscores art therapy’s contribution to developing coping mechanisms, a process evident in the client’s evolving ability to navigate her emotional landscape through artistic expression.

The client’s artwork reveals a multifaceted interplay between her familial attachments, emotional vulnerabilities, and developmental growth. The protective layers and structured patterns she employed signify a conscious effort to establish boundaries while seeking emotional balance and stability. These visual elements reflect her growing self-awareness and capacity for emotional regulation, offering a tangible representation of her psychological progress.

The use of cosmic imagery and rainbow colours further enriches the interpretation of her emotional state. These elements suggest an awareness of balance and diversity within her emotional experiences, symbolizing her acknowledgment of the multifaceted nature of her feelings. The vibrant and inclusive palette reflects her efforts to harmonize contrasting emotions, signalling emotional adaptability and a deeper understanding of her inner self.

Personal symbolism, such as the title “ROCKS,” provides additional insight into her psychological framework. The title represents a metaphorical anchor, demonstrating her developing resilience and ability to face challenges with fortitude. This aligns with Malchiodi’s⁸ assertion that art therapy offers children an opportunity to reframe their difficulties, thereby fostering emotional healing and growth. By assigning symbolic meaning to her artwork, the client has taken an important step in recontextualizing her struggles and reinforcing her psychological resources.

These findings emphasize the transformative potential of art therapy in helping children navigate their emotional and behavioural challenges. By engaging in a structured yet flexible creative process, children can externalize their inner conflicts, make sense of their experiences, and develop healthier coping mechanisms. This case also highlights the importance of integrating personal symbolism and creative freedom into therapeutic interventions, allowing children to build emotional resilience in a way that feels authentic and meaningful to them.

Future research should further explore the implications of such findings in broader clinical contexts. Investigating how specific elements of art therapy, such as the use of symbolism, colour, and structured patterns, contribute to emotional resilience could deepen our understanding of its mechanisms. Additionally, studies on diverse populations and varying therapeutic settings could provide valuable insights into tailoring art therapy approaches to meet the unique needs of individual clients.^16–26

The “What’s in the Heart?” activity exemplifies how EBART can effectively address aggression and behavioural challenges in children. Her artwork reveals her reliance on familial support, emotional exploration, and intrinsic resilience. This case underscores the therapeutic potential of art therapy in promoting emotional regulation, personal growth, and familial attachment. Further research is warranted to explore the scalability of EBART in diverse clinical contexts.

Soul Mandala Therapy offers a holistic framework for addressing emotional and behavioural challenges, particularly in children. By engaging with the therapeutic process, children can externalize their inner struggles in a structured yet flexible format, gain insight into their emotions, and develop healthier coping mechanisms. This approach’s emphasis on creativity, mindfulness, and symbolism makes it a valuable tool for therapists working with children facing aggression, anxiety, or other behavioural concerns.

The “What’s in the Heart?” activity exemplifies the efficacy of Expressive Behavioural and Reflective Art Therapy (EBART) in addressing aggression and behavioural challenges in children. This activity serves as a window into the child’s emotional world, highlighting their reliance on familial support, capacity for emotional exploration, and intrinsic resilience. Such revelations underscore the therapeutic potential of art therapy in fostering emotional regulation, promoting personal growth, and strengthening familial bonds.

This case also highlights the broader applicability of art therapy techniques like EBART in clinical settings. By providing a creative and non-verbal outlet, these methods empower children to externalize their inner struggles, allowing them to process and understand their emotions within a structured yet flexible framework. Through this process, children can uncover healthier ways of coping with their challenges, leading to long-term emotional and behavioural improvements.

Soul Mandala Therapy, another complementary approach, provides a holistic framework for addressing emotional and behavioural challenges, particularly in children. By engaging in this form of therapy, children connect with mindfulness and creativity, using symbolic imagery to represent their inner experiences. This process not only facilitates emotional exploration but also promotes self-awareness and resilience.

The emphasis on creativity, mindfulness, and symbolism makes both EBART and Soul Mandala Therapy powerful tools for therapists working with children facing a range of concerns, from aggression and anxiety to other behavioural issues. These therapies encourage children to take ownership of their healing journey by fostering emotional insight and strengthening their ability to manage life’s difficulties effectively.

Further research is essential to explore the scalability of EBART and Soul Mandala Therapy across diverse clinical contexts. Investigations could assess their effectiveness in various cultural and demographic settings, as well as with different age groups and psychological conditions. Expanding this research will help establish evidence-based guidelines and enable therapists to integrate these approaches more broadly into their practices, benefiting a larger population of children and families.^27–32

None.

None.

The authors declare that there are no conflicts of interest.

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