Art therapy for people who use


“Stigma makes a relationship with substances hard to talk about with just words,” said Glenn Ontiveros, a counselor at the Stonewall Project. “Imagine if you wanted to change how you were using substances, and you had to say, ‘I’m using meth right now,’ or, ‘I want to stop using heroin.’ It can be really difficult to say those kinds of things in front of a counselor or in front of a group. There can be a lot of shame.”

This difficulty, explained Ontiveros, makes it necessary for substance use counselors to find other ways for clients to express what they’re feeling and thinking—and even help people first figure out what they think and feel as they navigate the complicated relationship they have with substances.

Art therapy, or expressive art therapy, provides an outlet for people who use drugs and people with a history of personal trauma. The Stonewall Project, a substance use counseling program of San Francisco AIDS Foundation, runs an expressive arts counseling drop-in group once every week to allow people to acknowledge and express the role substances play in their lives, without having to explain it in words.

During the 90-minute meetings, Ontiveros and fellow Stonewall Project counselor Tiana Beard prompt attendees with creative exercises and open-ended arts projects.

Ontiveros explained one structured activity where participants were asked to envision, then create, a picture of their life during a period of chaotic substance use. And another, during a period when their substance use was under control. At the end of the exercise, participants were able to compare the two scenes and reflect on how their lives change with the influence of drugs. During another exercise, participants were asked to draw three animals, each representing the self: One showing how you see yourself; one showing how the world perceives you; and one showing how you want to the world to perceive you. 

Imagery created by a Harm Reduction and Expressive Arts drop-in group member. (Left titled: “Persecution,” right titled: “Retribution”) 

“This was about helping people see and think about their place in the world, and getting them to think of themselves in another light—and maybe with more positive characteristics. We want people to see that they’re not just a ‘drug user,’ said Beard, acknowledging the harmful stigma often surrounding people who use. “A lot of times, we ask people to focus on their relationships. We have them focus on their relationships with substances, with themselves, and with other people.”  

The expressive art therapy healing process can work differently for different people, said Ontiveros. But one unifying feature is its positive impact on people who have experienced trauma.

“This group is especially helpful for guys who have experienced trauma—and a lot of our group members have,” said Beard.

This right-brain, emotional process is helpful for people who have experienced trauma, said Ontiveros, because trauma can be processed and experienced in ways that are not verbal. The effect of past emotional and physical traumas can lie just beneath the surface of our psyche—but still impact the way we interact and experience the world. Art therapy, bypassing the verbal part of our brains, taps into that subterranean minefield of emotion and pain.

“This isn’t a ‘talk’ group. We actually request that it be quiet in the room,” said Beard. “We like it to be that way to facilitate more of an internal process—people need to get what’s inside of them out, onto paper.”

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Read more about the benefit of art therapy in trauma-informed work in a short article by the American Art Therapy Association.

The Harm Reduction and Expressive Arts drop-in group by the Stonewall Project is open to gay, bi and trans men and other men who have sex with men. It meets at San Francisco AIDS Foundation, 1035 Market Street, Suite 400 on Wednesdays from 1:30 pm – 3 pm, room 3D. See the Stonewall Project website for additional information.  


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