Following the murder of 19 children and two teachers at Robb Elementary School in Uvalde, Texas, on May 24, 2022, art therapist Wanda Montemayor spent a year driving the six-hour round trip between the town and her home in Austin.
By August of that year, Montemayor had launched “Tacos and Tiles” at Uvalde’s St. Henry’s church, where she invited survivors and community members to make mosaic fragments in community art therapy sessions. Over the course of months, Montemayor fired thousands of clay tiles designed by students, teachers, and families in Uvalde in her kiln, an initiative she dubbed the Uvalde Love Project. Her back-and-forth commutes to Uvalde culminated in a mosaic mural installed in town in August 2023, the result of a year of community clinical art therapy facilitated by her and a team of therapists.
While leading the tile sessions, Montemayor tracked participants’ distress levels, which she said decreased almost “universally” over the course of the meetings. Montemayor said she observed children who could not sleep alone finally sleep in their own beds.
“We didn’t say, ‘Tell us about the tragedy.’ It was more like: ‘What are you noticing in your body?’” Montemayor told Hyperallergic. She explained that the art-making sessions served as long-term therapeutic interventions to help regulate survivors’ nervous systems beyond the limits of talk therapy.
Montemayor is a registered art therapist in the state of Texas, a mental health profession that requires clinical counseling and technical art training yet is only considered a regulated mental health service in 15 states and Washington, DC, according to the American Art Therapy Association (AATA). Art therapy, according to four clinicians interviewed by Hyperallergic, combines art-making with observation and interaction from a trained clinician. It can be particularly effective, they said, in cases of trauma where individuals cannot fully articulate their feelings through words.
States like New York grant art therapy licenses, while others, like Texas, require these providers to obtain a mental health clinician license and separately register as art therapists. AATA advocates for licensure in all 50 states, which the organization says could make art therapy for the public and aspiring practitioners more financially feasible.
In Uvalde, survivors and community members wrote the names of the 21 individuals who died in the Robb Elementary shooting on the tiles. Other tiles featured hearts, butterflies, and animals. “The mural just happened because of the therapy, but the primary focus really was the therapy,” Montemayor said. “They had something to do together that kept them going.”
According to US Census data, about 80% of Uvalde residents self-identified as Hispanic. And yet, Montemayor said, the mental healthcare services offered by the state in the aftermath of the shooting were not bilingual. “It was all white people, [and] not in Spanish,” Montemayor said. “That’s not accessible.”
She started the project with little funding but later received grants to cover the $100,000 cost of the program from organizations including the David Rockefeller Fund and the National Endowment for the Arts. But the work is far from over, Montemayor noted, citing inadequate funding for effective mental healthcare for survivors.
While programs like the Uvalde Love Project are anecdotal examples of successful art therapy interventions where other methods might fail, providers across the country are fighting for wider recognition of the profession. In New York, where art therapists are licensed under the umbrella of “creative arts therapists,” advocates are now pushing for legislation that would allow them to bill Medicaid insurance plans directly for services so that they can work with populations covered by subsidized health plans.
After overwhelmingly passing the state senate earlier this year, a bill that would allow Licensed Creative Arts Therapists (LCATs) to bill Medicaid providers directly for art therapy services was delivered to Governor Kathy Hochul’s desk last week. Hochul will have until the end of this month to sign or reject the proposed legislation.
Marygrace Berberian, director of New York University’s Graduate Art Therapy Program, told Hyperallergic in an interview that in New York, when patients are admitted to an inpatient program, many of the providers they interact with are creative arts therapists.
But once patients are discharged, especially those who receive subsidized care, art therapy becomes difficult to access.
“Medicaid doesn’t cover art therapy on an outpatient basis,” Berberian said.
If Hochul signs the bill, art therapists in New York say they could reach broader populations.
“We can’t bill [medicaid] for services right now if we work within those systems,” Linda Turner, an art therapist in New York of 25 years and president of the LCAT Advocacy Coalition, told Hyperallergic. “This will enable us to expand our ability to work with the public.” Tuner said she works with doctors, lawyers, therapists, and artists in her private practice.
State Senator Samra Brouk, who sponsored the bill, said she backed it as a step to combat New York’s growing mental health crisis. “They’re the second-largest group of licensed mental health professionals in the state,” Brouk told Hyperallergic about LCATs in New York. “In the middle of a youth mental health crisis and all these other crises that we see with mental health, it only makes sense for us to remove barriers.”
Brouk added that previous legislation allowing mental health providers to bill Medicaid directly for outpatient services omitted creative arts therapists, an oversight she attributed to a lack of understanding about their work.
“We work a lot with trauma and survivors who maybe are struggling to find the words to be able to describe what they’ve endured,” Berberian said. “Art is an incredibly effective way to channel some of the angst that they’ve experienced.”
One possible obstacle to broadening access to the practice, Berberian said, has been a “cultural stigma against the arts.”
“The US has been very slow to understand that we can’t just rely on pharmaceuticals to help people manage their distress,” Berberian said.
Another misconception about art therapists, Turner said, is that “anyone can do it.”
“We are highly trained. We are highly skilled,” Turner said. “All of us who become creative arts therapists are artists … we know the materials, but we also know the mental health side.”
Los Angeles-based bilingual art therapist Nadia Paredes, president of the AATA, often employs the “emotional color palette” intervention technique, in which individuals use colored writing utensils to create marks that correspond to their emotions. Paredes demonstrated the practice to Hyperallergic, revealing a set of multi-colored scribbles she produced with various forces and speeds. The simple exercise, she said, allows clients to express emotions before they have too much time to overthink them.
“An image can be so much more than language can emanate,” Paredes said.
