“Purpose: The board has adopted regulations to establish qualifications for education, examination, and experience that will ensure minimal competency for issuance or renewal of licensure as an art therapist to protect the health and safety of clients or patients who receive art therapy services.”

“Issues: The primary advantage to the public is that the proposed amendments ensure competency and accountability”

The Regulations must empower these obligations by authoritatively, consistently administering the Standards of the Art Therapy Profession cited as required for licensure. Overall, the regs seem to set the appropriate standard for Art Therapist licensees, but defeat the purpose of the license through confounded standards that defer to unqualified practitioners, ‘certifying’ agencies, and ‘training’ programs.

1. The Art Therapy Credentials Board Code of Ethics, Conduct and Disciplinary Procedures shall be the standard for the Board to oversee the conduct of licensees because its ATR-P, ATR, and ATR-BC credentials are required for licensure.

The Proposed Regulations improperly accommodate licensees who do not maintain the ATR-BC credential, and, therefore, are not subject to the ATCB Code of Ethics. Furthermore, it is possible that a person could have been credentialed by the ATCB, but deemed ineligible through disciplinary action. And third, the teaching of a graduate course in Art Therapy, or having practiced Art Therapy, should not be qualifying factors for the license.

Section 18VAC115-90-120. Standards of practice parses out certain ethical obligations. It needs to set forth the licensee must not have criminal, no contender pleas, and obligate them to self-report any such violation unless Virginia law enforcement already supplies that information to the Board.

Mandatory reporting of abuse also needs to be incorporated into the Regs, unless elsewhere.

2. These Sections of the Regs are mutually incongruent:
   
   “18VAC115-90-40. Requirements for licensure.

In addition to the prerequisites set forth in 18VAC115-90-30:

1. Each applicant for licensure by examination as an art therapist shall submit to the board evidence of a current ATR-BC certification from the ATCB. (…) and:

c. Either:

(1) Current ATR-BC certification from the ATCB; or

(2) Documentation of passage of the examination of the ATCB and evidence of autonomous, clinical practice in art therapy, as defined in § 54.1-3500 of the Code of Virginia, for 24 of the last 60 months immediately preceding licensure application in Virginia. Clinical practice shall mean the rendering of direct clinical art therapy services, clinical supervision of clinical art therapy services, or teaching graduate-level courses in art therapy.”

3. The “minimum” Art Therapy Master’s degree empowers the ‘Standards of Practice’ among the Professions Licensed by the Board:

The only national standard for the “minimum” training and education “for entry-level practice of Art Therapy” to meet the State’s “Purpose” and “Issues” above requires an accredited Art Therapy, and no other, Master’s degree per the American Art Therapy Association.

 The Regs must consistently reflect this “minimum” training to support practitioners’ adherence to their separate Codes of Ethics which require: “a person shall only practice according to qualified training and qualified experience,” being the Art Therapy Master’s degree, or post-graduate equivalent Art Therapy degree unmentioned in the Regs.

Section 18VAC115-90-120. Standards of practice may ensure consumer protection by driving non-Art Therapists to the minimum education to practice Art Therapy, and their Codes of Ethics, specifically:

“A. The protection of the public health, safety, and welfare and the best interest of the public shall be the primary guides in determining the appropriate professional conduct of all persons whose activities are regulated by the board and

B. Each person licensed by the board shall:

2. Practice only within the boundaries of the licensee's competence, based on education, training, supervised experience, and appropriate professional experience, and represent education, training, and experience accurately to clients;

13. Advertise professional services fairly and accurately in a manner that is not false, misleading, or deceptive. Such as holding the “minimum” credential to practice Art Therapy.

Commentary: The Regs may follow suit of nearby states to incorporate the standards of the respective mental health licensees by stating “Art teaching is not Art Therapy;” “an individual may not practice, attempt to practice, or offer to practice Art Therapy unless licensed as an Art Therapist by the Board” to empower this section that already conveys “License required,” but which could be authoritatively stated “no person shall convey or tend to convey the person is trained or otherwise qualified to deliver Art Therapy services unless licensed by the Board and holding an Art Therapy Master’s degree.” This protects the public, comporting with the states and Virginia’s “Purpose” and “Issues” set forth above.

4. The Proposed Regs presuppose a standard no where in Art Therapists’ training or other states’ licensure -- that Art in Therapy “is a modality.”

The separate licensure of Art Therapists in Virginia settles, as legally unsupportable, that Art in Therapy is a “modality.”  The Definition of “Art Therapy” in Section 5.4.1-3500 Code of Virginia incorporated into the Regs makes anything Art+health, mental health, psychotherapy “Art Therapy” – now separately regulated by the Board as “Art Therapy”:

"Art therapy" means the integrated use of psychotherapeutic principles, visual art media, and the creative process in the assessment, treatment, and remediation of psychosocial, emotional, cognitive, physical, and developmental disorders in children, adolescents, adults, families, or groups.

Therefore, the findings of the 2018 Report that are feathered throughout the Regs were unsupportable then, and are unsupportable now based on every standard in America for the Art Therapy profession and the practice of Art Therapy. The Regs must align the licensure law with the national standards (it also sets forth) to correct the disinformation that preceded the enactment of the license:

“Background. In 2018, the Board of Health Professions assembled a regulatory research committee that conducted a study titled "Study into the Need to Regulate Art Therapists in the Commonwealth of Virginia" on behalf of the Virginia Art Therapy Association.³ The major findings of the study are:

1. Art therapy is an integrative mental health and human services profession. Art therapists are educated in psychotherapeutic principles as specifically trained in the use of art media to provide counseling to individuals, families and groups.

2. Art therapy is categorically different than "art in therapy." Art in therapy is a therapeutic modality leveraging the creative process as a growth-producing experience.”

Comporting with the separate licensure of Counselors and Art Therapists in Virginia, in 2009, the American Counseling Association and the American Art Therapy Association established a national standard that Art Therapy “is a separate and distinct” profession from Counseling.

The Regs need to reflect this and certainly not make way for modality-practice of a separately-regulated, advance-practice healthcare profession (US Department of Labor Standard Occupational Classification O*NET: “Art Therapist,” “Healthcare Occupation,” “extensive preparation necessary.” Once a mental health profession attains licensure, it is no longer a free-for-all icebreaker “modality.” Art-in-Therapy, by every standard, is “Art Therapy.” Those presenting otherwise are attempting unqualified practice, or unethically supporting it. Modality practice defeats consumer protection obligations and oppresses the Art Therapist workforce.

To further support the license as separate, the Definitions in Virginia Code Section 5.4.1-3500 separately define the other disciplines licensed by the Board: “Practice of counseling,” “Practice of marriage and family therapy,” and “practice of substance abuse treatment.”

The separate practice of “Art Therapy” is empowered by the separate accredited Art Therapy Master’s degree, also required for licensure. The Regs need to authoritatively communicate the actual qualifying standards of the Art Therapy profession (simply: Art Therapy Master’s degree plus ATCB credential).

5. The ATCB standards of the profession also need to be implemented in the approved supervisor section, set forth as a supervisor holding the ATR-BC or ATCS credential.

This recognizes that non-credential holders cannot comply with their Codes of Ethics to provide clinical supervision unless they have the “minimum” training and demonstrated competency attained in a Master’s program in Art Therapy (AATA). These are 2 national standards the Regs must adopt.

6. The continuing competency standards propose unrelated or substandard ‘training’ and ‘certification’ for the “Art Therapy” profession.

As a consumer protection obligation, the Regs must reconcile that Art Therapists, and the profession overall, are facing unprecedented, unqualified, competing, and diminishing ‘training,’ ‘certification,’ and ‘ethics’ that controvert the national standards adopted in the license. This confuses the public, who are led to believe a workshop “certificate” equates with the 8-year-earned ATR-BC credential required for licensure. Where, throughout America, “Art Therapy” is the name of the regulated profession and occupation, as in Virginia Code corresponding to the Regs, it would be helpful if the CEUs were ones related to the license – that are offered by accepted national certifying entities with legal presence in Virginia.

For example, the IEAT is not a domestic entity and is widely involved with issuing ‘certificates’ in Art Therapy that confuse the public. Those holding the REAT credential must take 1 hour per certification cycle to maintain that credential. Thus, relying on the IEAT for Art Therapists’ continuing education is not a substantially similar standard. Other proposed CUE purveyors seem unrelated to the profession and the license. It would seem more appropriate if the CEU standards of the ATCB were simply adopted, to assure apples-to-apples, particularly, since the licensee would be sing the approved continuing training to maintain the ATCB credential.

The sections of the regs that seem to defeat the “Purpose” and “Issues” of the Regs as set forth above are:

“18VAC115-90-90. Continuing competency activity criteria.

A. Hours of continuing competency activity for an art therapist shall be approved if the hours meet the continued education requirements for recertification as an ATR-BC.

B. Additionally, continuing competency activity for an art therapist shall be approved if the activities are workshops, seminars, conferences, or courses in the behavioral health field offered by an individual or organization that has been certified or approved by one of the following:

6. The Commission on Rehabilitation Counselor Certification;

10. A national behavioral health organization or certification body;

15. The International Expressive Arts Therapy Association

Related Commentary for CEUs: 18VAC115-90-120. Standards of practice.

“12. Use only in connection with the licensee's practice as a mental health professional those educational and professional degrees or titles that (i) have been earned at a college or university accredited by an accrediting agency recognized by the U.S. Department of Education, (ii) are credentials granted by a national certifying agency, and (iii) are art therapy in nature”

As a consumer protection and advertising issue, non-Art Therapists can earn the non-domestic REAT (Registered Expressive Arts Therapist) ‘credential’ in as few as 15 hours, I believe. The Regs should omit Section 12 above to protect licensees and clearly communicate the only domestic standard, adopted via the “Art Therapist” license, being the LPAT and LAAT credentials.

Overall, it is disappointing to see the Proposed Regs accommodate persons who do not meet the “minimum” training or the ATCB credentials to qualify for the credentials. I look forward to the simple revisions to implement the actual standards of the Art Therapy profession, without functional or administrative revision. Thank you for your work.

Jennifer August, LPAT (Delaware), LCPAT (Maryland), ATR-BC          Dated: 1/24/25