How Art Therapy Can Reduce Anxiety and Build Self-Acceptance
Anxiety is one of the most common mental health challenges today, yet many individuals continue to struggle even after engaging in traditional treatments such as cognitive-behavioral therapy (CBT) or medication. While these approaches are highly effective for many, they do not work for everyone particularly for individuals who find it difficult to express or process emotions through words alone.
My doctoral dissertation, Enhancing Self-Acceptance and Reducing Anxiety through Tree Ring Self-Portraits in Art Therapy, explores an alternative, evidence-based approach that integrates art therapy, narrative meaning-making, and symbolic self-expression.
This research introduces a novel intervention called the Tree Ring Self-Portrait, designed to help individuals visually map their life experiences and develop a more compassionate, integrated relationship with themselves.
Why Self-Acceptance Matters in Anxiety Treatment
A growing body of research shows that low self-acceptance is strongly associated with higher levels of anxiety, emotional distress, and self-critical thinking. Conversely, individuals who develop greater self-acceptance tend to experience improved emotional regulation and resilience.
Traditional therapies often focus on reducing symptoms, but symptom reduction alone does not always lead to deeper psychological change. This study focuses on self-acceptance as a core mechanism of healing, rather than simply targeting anxiety symptoms.
What Is the Tree Ring Self-Portrait?
The Tree Ring Self-Portrait is a symbolic, non-traditional form of self-portraiture. Instead of drawing a literal image of oneself, individuals create concentric rings, similar to the rings of a tree, to represent different phases of their life.
Each ring may include:
A felt sense of that time in your life
Life experiences (positive and difficult)
Emotional states
Significant events or transitions
Personal growth and resilience
This approach allows clients to externalize their internal experiences in a safe, structured, and non-threatening way, particularly for those who struggle with verbal expression or feel uncomfortable with traditional self-portraiture.
Key Findings from the Research
This mixed-methods study included 20 adult participants and integrated both quantitative measures and qualitative analysis to provide a comprehensive understanding of the intervention’s impact on anxiety and self-acceptance. By combining standardized assessments with participant narratives and artwork interpretation, the study was able to capture not only whether change occurred, but how that change was experienced and understood.
Significant Reduction in Anxiety
Participants demonstrated a statistically significant decrease in anxiety symptoms following completion of the Tree Ring Self-Portrait intervention, as measured by the Generalized Anxiety Disorder–7 (GAD-7). Mean anxiety scores decreased from 14.05 (SD = 4.78), indicating moderate anxiety, to 8.95 (SD = 3.78), reflecting a shift toward the mild range. This change was statistically significant, t(19) = 8.29, p < .001, with a large effect size (d = 1.85), suggesting a robust treatment effect.
These findings indicate that even within a brief, three-session intervention, participants experienced meaningful reductions in anxiety severity. Importantly, qualitative data further supported these results, with participants describing decreased emotional intensity, reduced overwhelm, and an increased ability to observe anxious thoughts without becoming consumed by them.
Significant Increase in Self-Acceptance
In addition to reductions in anxiety, participants showed a statistically significant increase in unconditional self-acceptance, as measured by the Unconditional Self-Acceptance Questionnaire (USAQ). Mean scores increased from 78.95 (SD = 11.08) to 91.65 (SD = 11.94), t(19) = −6.78, p < .001, with a large effect size (d = 1.52), indicating substantial improvement.
This increase reflects more than a reduction in distress; it suggests a fundamental shift in how participants relate to themselves. Qualitative findings revealed that participants moved toward greater self-compassion, reduced self-criticism, and an increased ability to accept both positive and difficult life experiences as part of a cohesive identity. Statements such as “I realized I liked myself more than I thought” and “I don’t 100% regret it because it was an experience” illustrate this shift toward a more integrated and nonjudgmental self-view.
Integration of Findings
Taken together, these results suggest that the intervention does not simply reduce symptoms, but facilitates deeper psychological change. The simultaneous decrease in anxiety and increase in self-acceptance supports the interpretation that self-acceptance may play a central role in emotional regulation and anxiety reduction. By helping participants reframe their life experiences within a broader, more compassionate narrative, the Tree Ring Self-Portrait appears to support both immediate symptom relief and longer-term shifts in self-perception.
The Connection Between Self-Acceptance and Anxiety
A central finding of this study was the identification of a moderate inverse relationship between self-acceptance and anxiety, such that increases in self-acceptance were associated with corresponding decreases in anxiety (r = −.51, p = .02).
This relationship is clinically meaningful because it shifts how we understand change in anxiety treatment. Rather than viewing self-acceptance as a secondary benefit that emerges after symptoms improve, these findings suggest that self-acceptance may actively contribute to the reduction of anxiety itself.
From a psychological perspective, anxiety is often maintained by patterns of self-criticism, avoidance, and rigid cognitive evaluation. Individuals who struggle with anxiety frequently report persistent negative self-appraisal, difficulty tolerating internal experiences, and a tendency to become overwhelmed by thoughts and emotions. In contrast, self-acceptance involves a nonjudgmental acknowledgment of one’s experiences, including perceived flaws, past difficulties, and emotional states, without equating them with personal failure or inadequacy.
As participants in this study developed greater self-acceptance, qualitative data indicated several parallel shifts:
Increased ability to tolerate distress without escalation
Reduced identification with negative thoughts
Greater capacity to hold both positive and difficult experiences simultaneously
Movement from self-criticism toward self-compassion and understanding
These changes align with contemporary models of emotional regulation, which emphasize that anxiety is often intensified not only by the presence of distressing thoughts and feelings, but by how individuals relate to those internal experiences. When individuals adopt a more accepting stance, anxious thoughts may still arise, but they are less likely to dominate attention or trigger secondary cycles of rumination and avoidance.
Importantly, this finding is further supported by the distinction between static and dynamic relationships observed in the data. While self-acceptance and anxiety were not significantly correlated at single time points, their changes over time were significantly related, suggesting that it is the process of increasing self-acceptance that is linked to reductions in anxiety.
Taken together, these results support the interpretation that self-acceptance functions as a mechanism of change within the intervention. By facilitating a more compassionate and integrated relationship with the self, the Tree Ring Self-Portrait may reduce the internal conditions that sustain anxiety, thereby promoting both emotional regulation and psychological resilience.
What Happens During the Process?
Qualitative findings revealed a powerful emotional and psychological shift across participants:
Before the intervention, individuals often described:
Emotional overwhelm
Persistent negative thinking
Somatic distress
Feelings of fear, disconnection, or instability
After completing the artwork and reflection process, participants reported:
Reduced emotional intensity
Greater ability to observe thoughts without being overwhelmed
Increased grounding and stability
Greater self-compassion and acceptance
Participants frequently described seeing their lives differently, not as a series of disconnected or painful events, but as a cohesive and meaningful narrative.
Why Art Therapy Works Differently
Art therapy engages what is often called the “language of emotions”—using color, shape, and symbolism to express experiences that may be difficult to put into words.
In this study, participants:
Assigned personal meaning to colors, shapes, and symbols
Used visual structure to organize life experiences
Externalized difficult emotions in a contained and manageable way
This process creates psychological distance, allowing individuals to explore anxiety and trauma without becoming overwhelmed.
The Power of Narrative and Symbolism
One of the most important findings of this research is how visual narrative supports integration.
The tree ring structure allows individuals to:
See their life as a continuous story
Recognize patterns of growth and resilience
Reframe difficult experiences as part of a larger whole
Rather than asking, “What’s wrong with me?”, participants begin to understand,
“This is my story—and I can hold all of it.”
Clinical Implications
This research suggests that the Tree Ring Self-Portrait can be used as both:
A therapeutic intervention for anxiety
An assessment tool that provides insight into emotional processing, coping styles, and life narrative
It is particularly beneficial for individuals who:
Struggle with verbal processing
Experience high self-criticism
Feel overwhelmed by traditional talk therapy
Are seeking a more creative, reflective approach to healing
Accessing the Full Dissertation
The full dissertation will be available online through Dominican Scholar in Summer 2026, providing open access to the complete research, methodology, and findings.
Final Thoughts
Anxiety is not just about symptoms, it is deeply connected to how we relate to ourselves. This research highlights the importance of self-acceptance, narrative integration, and creative expression as pathways to healing.
Art therapy offers a unique and powerful way to access these processes, helping individuals move from overwhelm and self-criticism toward clarity, compassion, and a more integrated sense of self.
