As a result of international research in art therapies, they are increasingly being accepted as a health promoting practice (Stuckey and Nobel, 2010; Jensen and Bonde, 2018). Scientific evidence in this regard shows that these types of interventions positively influence both physical and psychological health, while improving social relationships (Stuckey and Nobel, 2010; Jensen and Bonde, 2018). In general terms, art therapy is a type of intervention that uses the creative process as a way to meet a therapeutic objective where different artistic disciplines can come together, as an instrument at the service of the healing process (Gacto and Gacto, 2012).

According to the Spanish Professional Association of Art Therapists, “Art therapy is a form of therapy that uses visual and artistic languages to facilitate the containment, exploration and resolution of conflicts. It is a healthcare profession, characterized by the use of artistic means and processes, to help contain and solve people’s emotional or psychological conflicts. In art therapy, the artistic creation process and the resulting objects act as intermediaries in the therapeutic relationship, allowing certain conflicting feelings or emotions to find complementary or alternative ways of expression to the word. The fields of application of art therapy extend to health, education and social assistance.”

On the other hand, the American Art Therapy Association (AATA) (American Art Therapy Association, 2021), defines art therapy as follows: “Art therapy provides the opportunity for non-verbal expression and communication, on the one hand, through involvement to solve emotional conflicts as well as to promote self-awareness and personal development.” It is about using art as a vehicle for psychotherapy, helping the individual to find a more compatible relationship between their inner and outer world.

Therefore, art therapy is understood to be a means by which an individual to know themselves, it requires an accompaniment of the person (in their process of inner growth) and a help for the person with social, educational, personal difficulties, through their artistic production, in such a way that the work carried out generates a process of transformation of the individual him or herself.

Different clinical guidelines of the National Institute for Health and Care Excellence (NICE) include art therapy as an indication with recommended evidence. Similarly, since the beginning of the 21st century, art therapy has been recognized in the Nursing Interventions Classification (NIC), as a Nursing intervention. Butcher et al. (2018), call it “Art Therapy” (4330), and it is defined as “the facilitation of communication through drawings or other forms of art.”

As complementary therapies, the different modalities of art therapy, among which are the visual arts, music therapy, dance therapy and drama therapy, are used to treat different psychological or cognitive behavioral disorders such as depression, stress, anxiety or neurological symptoms such as those caused by strokes (Wallace et al., 2004; Ozdemir and Akdemir, 2009; Hughes and da Silva, 2011; Eum and Yim, 2015; Sarid et al., 2017; Jang et al., 2018) or disorders derived from chronic diseases such as diabetes (Tang et al., 2021). These therapies provide benefits not only in the treatment or rehabilitation of the disease but also in the prevention of both certain disorders and the complications derived from them. Thus, different government agencies worldwide have drawn up evidence-based public policy documents that not only recognize the value of these interventions as alternative therapies, but also include their use in their recommendations (Galletly et al., 2016; Scottish Intercollegiate Guidelines Network, 2016; Sall et al., 2019).

In the specific case of the visual arts modality (drawing, illustration, painting, collage, photography and sculpture), art therapy not only prevails as a clinical intervention tool (Cheng et al., 2021; Hass-Cohen et al., 2021; Tang et al., 2021) but also as a diagnostic tool (Akhavan Tafti et al., 2021; Goldner et al., 2021; Grenimann Bauch and Bat Or, 2021), which gives it a versatile and innovative character, and which distinguishes it from the other art therapy modalities. Bearing in mind the above, and given the variety of studies and publications in this regard, it is of interest to have a more in-depth view of the scope and characteristics of the existing research; bibliometrics is the ideal instrument for this objective since by using bibliometric indicators, it is possible to evaluate scientific activity in any discipline or area of knowledge, and thus determine different basic categories that define who the producing people, institutions or countries are, how much they produce, what the impact of their publications is and how they collaborate with each other (Rodríguez Gutiérrez and Gómez Velasco, 2017).

After a thorough search of the literature, no research was found that involved a bibliometric study on scientific production in the visual arts modality within art therapy, therefore, this study could provide valuable information regarding the state of the question at hand in world research on the subject. Thus, the objective of the authors was to describe and contextualize international scientific production in the visual arts modality in the context of artistic therapies, to offer a broader and in-depth vision of the structure of this area of knowledge through a bibliometric analysis of the publications indexed in the core collection of the Web of Science (WoS), owned by Clarivate Analytics.

The analysis of scientific production, based on bibliometric parameters, is an essential tool for evaluating knowledge and determining the progress of disciplines and their fields. In the present case, given the specificity of the subject, this type of work provides useful information to understand the general properties of the state of knowledge about art therapy (Capilla-Díaz et al., 2020), since it offers a retrospective vision of the scientific production in the world based on the main bibliometric indicators.

Taking into account the annual progression of publications, a particular dynamic is observed with some periods of growth, alternating with others of regression. However, the increase in production from 2012 onward has shown a clear growth trend. This indicates that the topic has been gradually attracting the attention of professionals and researchers.

Regarding the geographical distribution of the publications, the results of the study are equivalent to those of a bibliometric study that analyzed the last 20 years of publications on music therapy (Li et al., 2021) since the 10 countries or regions that these authors identified as the main ones are among the twenty top producing countries in art therapy, with the United States heading the list in both cases.

A high degree of dispersion is observed at the journal level, fulfilling Bradford’s Law, since the scientific production in art therapy presents a highly unequal distribution given that a large number of articles are concentrated in a small population of journals, while the rest of the articles are scattered over a large number of journals. On the other hand, it seems logical that the main sources in this area, Arts in Psychotherapy, Frontiers in Psychology and Art Therapy, would be the journals chosen by the authors to publish their research, considering that they are specialized journals in art therapy. In the case of Frontiers in Psychology, although it is not specific to this area of research, it does belong to the field of psychology, one of the two domains identified in the present study as being main domains. This result is also similar to that of Li et al. (2021), mentioned above, where the authors found that the leading journals in the field were specialized in music therapy and where one of the main domains was also psychology.

Although two of the four most productive institutions were from the United States, it should be noted that the leading institution in this field is an Israeli university. Most of the institutions had a low performance in the scientific production on art therapy.

The most cited articles have a main interest in addressing symptoms with a psychological component such as anxiety, fatigue, emotional anguish or fear, during the course of serious diseases such as cancer, as well as psychiatric diseases such as schizophrenia or depression. In general, there is a clear line of research that refers to mental health. In addition, the different scientific domains present different citation practices, which for reasons of normalization of the bibliometric indicators are not comparable (González and González, 2016). Therefore, based on the results of this analysis it seems that, in general terms, the research in art therapy may not have an impact maturation speed of more than 5 years. This is probably due to the fact that as an area of research, it is still being development.

Regarding authorship, the most notable result is the high transience of the authors, which also points to the low level of development in research in the area of art therapy.

Art therapy is applied to a wide spectrum of health problems, through a wide variety of artistic modalities. In the last decade of the twentieth century, interventions took place in hospital and institutional settings, in hospitalized or inpatients, and according to the studies analyzed, they were mainly aimed at children. The first outpatient experiences in art therapy appeared in 2000, when it started diversifying out of the health field into educational settings and began to be used as a preventive therapy, applied to healthy people (Robertson, 2001; Swan-Foster et al., 2003), and for diagnostic purposes, with drawing or photography being incorporated into the assessment instruments (Hays and Lyons, 1981; Kim et al., 2011; Darewych, 2013). Experiences of combined therapies integrating two or more types of artistic therapies into psychological and/or pharmacological therapy have been described. As of 2006, with the development of information technology and the internet, the virtual environment and tools in digital format started to gain momentum as a means of artistic therapy. This development in art therapy has been growing stronger since 2010, with the improvement of mobile terminals, applications for digital tablets and mobile phones.

There are no established research lines concerning the thematic variability identified in the analyzed publications. However, the scientific community seems to have been directing its research efforts toward issues related to the improvement of physical symptoms and the psychological well-being in patients with oncological pathologies. Furthermore, there are numerous studies focused on the cognitive behavioral intervention of patients with psychiatric diseases such as schizophrenia or degenerative diseases such as dementias, especially Alzheimer’s. Finally, drawing, painting and photography are the most recurrent visual arts modalities.

The only information used in the study was retrieved from the core WoS collection. As a quantitative approach was the fundamental approach used in the development of the study, this could lead to a certain bias in the analysis of the results since the qualitative component of the publications in this research area was not taken into account.

The bibliometric approach is a good methodology to map the scientific development of the domain in terms of findings and gaps in research. A systematic review would be necessary to detail the available scientific evidence on the efficacy-effectiveness and efficiency of this type of intervention.

To the best of the authors’ knowledge, this is the first study to describe the evolution of the domain through the development of its lines of research.

This work did not find the previous existence of any bibliometric analysis on the international scientific production in art therapy. The present study shows that the number of publications on the subject has multiplied substantially over the last decade. The results here are similar to those obtained in a similar study (Li et al., 2021) which evaluated the growth of music therapy research over the last 20 years.

The bibliographic data retrieved from the databases of the core WoS collection are analyzed by applying this retrospective, exploratory, descriptive and cross-sectional study, with a bibliometric approach.

In the 63 years between 1958 and April 2021, a total of 563 works on art therapy in the visual arts were found, indexed in the databases selected for the sample of this study, with psychology and rehabilitation being the main domains research.

In addition, the ability of art to broaden personal horizons means that these disciplines are able to transcend the individual aspects present in the disease (Marxen, 2011), bestowing on artistic therapies a polyvalent, multifaceted, multidisciplinary and conceivable character regardless of the application environment, the means and objectives of intervention, as described in this work.

In sum, through the proposed analysis, the authors conclude that, despite verifying a substantial growth in the number of publications on the subject during the last decade, the interest of researchers in visual arts as therapy continues to grow and progress.

The findings may provide useful information for art therapy (visual arts) researchers to identify new research directions and topics.

The datasets analyzed during the current study are available from the corresponding author on reasonable request.

All authors certify that they have participated sufficiently in the work to take public responsibility for the content, including participation in the concept, design, analysis, writing, or revision of the manuscript. LC-P and NR: conception and design of the study, acquisition of data and analysis, and interpretation of data. NR, MN, and JR: drafting the manuscript. MN and JR: revising the manuscript critically for important intellectual content. LC-P, NR, MN, and JR: approval of the version of the manuscript to be published.

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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