Class & Illness

Timeline Themes: class, race, age, mental illness and physical illness

These introductions to student entries offer different focal perspectives across wide range of events, people, and cultural works in the art therapy timeline.

age, class, and physical illness

Sarj, Tabitha Kunkes, & Poppy Liu
April 23, 2019

Art therapy, in the United States, is a faceted profession that is regulated by the American Art Therapy Credentials Board under three different board credentials (ATCB, 2019). Art therapy plays a role in the mental health field and healthcare as a whole. Art therapists are employed in settings such as hospitals, schools, mental health clinics, and residential and rehabilitation centers. Our group explored the themes of physical illness, socioeconomic class and age in regards to the role these play in the profession of art therapy. We explored these topics by examining who can practice art therapy, who receives care, how those who get care can afford to get care and how they feel about that care.

Age plays a role in healthcare through laws that define the level of services and self-advocacy available for people – both depending on their age and through including age in the requirements needed to become licensed to provide healthcare. The American Medical Association created standards that require a medical degree to practice medicine and standards for what is needed to obtain said medical degree (AMA, 2019). These standards were created in 1847 and were revised in 1852 to include the need to be over the age of 21. Licensed professionals who hold a degree are then the ones who are legally eligible to diagnose and provide care, therefore determining physical illness and the needed treatment. Similarly, art therapists are required to have both a higher education degree and board-certified licensure: this puts them in the position of power to treat a person’s diagnosed physical illness (ATCB, 2019). Thus, art therapists in the United States are typically at least 24 years old when they start practicing as a licensed professional.

Requiring a degree and licensure to practice medicine reinforces the divide of socioeconomic classes. Who is ill and who benefits from someone else’s ailment? Paying for healthcare is a key part of getting care. Socioeconomic class is divided into a set of hierarchical social categories, the most recognized being the upper, middle, and lower classes. Government healthcare funding plays an essential role in many people’s lives in the United States, specifically the people in the lower socioeconomic class. In 1965, the Social Security Act Amendment was signed into law (“Social Security Act Amendments”, 1965). The act is known for its inclusion of Medicare and Medicaid. It has established a health insurance program for the elderly and people in the lower socioeconomic class. Also, from an international lens, in Chengdu, China, a government-aided health insurance program called Mutual Funds for Children was established for children and adolescents from rural to urban communities in Chengdu. A new version of the policy came out recently that revised to increase the price and an enlarged range in protection in population ( “Mutual Funds for Children”, n.d.).

Our timeline entries address these topics through situating events, people, and laws that have a direct impact on our understanding of art therapy as a multi-dimensional profession. Art therapists provide services to individuals who have specific historical, social, and cultural contexts. Among many factors, art therapists should consider their clients’ age, socioeconomic class, and physical health. This analysis only begins to do this task.


AMA. (2019). American Medical Association. Retrieved from

ATCB. (2019). Art Therapy Credentials Board. Retrieved from

class, race, and mental illness

Sanya Jaffer, Lucia Lopez, & Zemaye Okediji
April 22, 2019

The direct impact of Western imperialism and intervention in foreign affairs is substantial and affects a lot more than just the broad economic dynamics within the country under colonization–it affects the social dynamics of class, race, and mental illness. The concept of having a class system was implemented in many countries by the colonizers themselves as a means of exerting control, influence, and exploitation over the population and resources. The creation of this division amongst the population into categories of the working, middle, and upper classes, defines who has access to what resources, who can participate in what work fields, and also shapes personal experiences. Even though this concept is a part of globalization, the concepts of class, race, mental illness, and who has access to what, can be found throughout U.S. history, and in its current events. These control structures are tied to U.S. legislature at the federal, state and local level and form the socio-economic systems that govern our healthcare, housing, education and labor.

Before the economic devastation of the 1930s, the U.S. in the 1920s saw African American advancements in employment and policies edging toward equality in the New Deal inciting a backlash in racialized federal housing policy. When the Great Depression and various catastrophes occurred, all races and classes across the nation were hard-hit, yet, a color-coded Federal Housing Act manual that benefited only the white labor class was formed. The FHA dictated which “race” and “class” had access to housing loans citing the need to preserve neighborhood “stability” (1939 FHA manual). In 1944, the GI Bill further limited access of returning veterans of color to housing loans and quality elementary education. This lowered the chances of admittance to quality colleges, ultimately making starker the class system and intergenerational wealth gap. After the Housing Act of 1967, it was not until another economic crisis in 1974, that Section 8 housing was introduced to serve at-risk people and the homeless in urban areas. These policies created the context that gave rise to a predominantly white upper-class membership in the American Art Therapy Association (AATA) since its growth in the 1970s, and people of color as the predominant clientele, which can still be seen today. It was against this national backdrop of inequality that Cliff Joseph advocated for alternate forms of entry to the field, other than a costly masters degree, which would broaden the limited access to an ethnocentric art therapy field.

Joseph, the first black member of AATA, using themes of war, racial segregation and common experience in his art, recognized the unique opportunity art presented for social change as well as in his art therapy work in prisons and education. His social interventions were through his artistic practice, advocacy in the AATA, and through direct protest and negotiation with art institutions that birthed the formation of the Black Emergency Cultural Coalition (BEEC). Advocacy by the BEEC drew public attention to the need for more equitable labor standards and reformed access to combat the entrenched history of marginalization that is still upheld today.

sexuality, disability, and mental illness

Erica Wang, Laura Young, Susannah Ward, & Denise Majka
April 24, 2019

In order to understand the intersectionality of sexuality, disability, and mental illness, we have presented some key medical, sociocultural, and policy milestones in history that have formed and evolved that context in the United States. As future art therapists, it is vital to work through and understand intersectionality and all its facets in order to best serve our clients.

Medical: The AIDS Crisis seemed a clear choice to be included under the umbrella of our group’s collective topic – due to the numerous connections to various cultural components. In terms of who was being affected by the virus various groups were involved, especially marginalized ones. In the specific case brought to the timeline regarding Robert R. these identities included being a homosexual male, and a man of color living in the midwestern United States during the 1960’s. Moving forward in time, the addition of the entry examining eating disorders through an LGBTQ+ lens served to connect the group’s topic to modern times through a cultural context. Eating disorders have long been associated with a very specific client type, but the findings introduced in the collaborative survey conducted by NEDA and the Trevor Project challenged and altered this belief in a very public sphere.

Sociocultural: Paul B. Preciado, author of Testo-Junkie, outlines the era we live in today (that began in the 1970’s) that commodifies and capitalizes sex. Through the production of products such as Viagra, the Pill, testosterone, estrogen, etc., corporations have become “managers” of human bodies. In socializing the ideas that certain bodies fail to have sex “normally”, society capitalizes upon the formation of a “disability”. Mental illness easily fits into this conversation as products such as birth control and Viagra can, “fuel violent and aggressive behavior in men” (Milman & Arnold 2002), while different birth controls can, “affect the user’s mood and increase the risk of depression or other emotional changes” (Smith, 2018). A more current event, the foundation of the Tyler Clementi Foundation, also highlights each topic thoroughly. This foundation was organized after 18 year old Tyler Clementi died by suicide following abuse from his roommate. Clementi’s roommate recorded an intimate sexual encounter between Clementi and another man without permission which was then shared across their school’s campus. Easily encompassing sexuality and mental illness, the topic of disability is a bit harder to suss out in this example. However, disability can be defined as a “a disadvantage or handicap”. In identifying as LGBTQ+, many workplaces and religions can legally discriminate against such individuals, therefore creating a disadvantage – or disability.

Throughout history, disability has served as a marker of difference and, like any other marker of difference, a site of speculation. Starting in the 1840s, travelling exhibits called “Freak Shows” toured America showcasing exotified and sensationalized bodies for the masses, further marking their difference in their notoriety. Cognitively and physically disabled black men (“What Is It?”), Sartje Baartman (“The Hottentot Venus”), and Julia Pastrana (“The Ugliest Woman in the World”) were just some of the many marketed as “missing links” between modern humanity and its primitive ancestry. The popularity of freak shows dwindled in the 1940s with the rise of a more medical model of disability, where the public’s gaze went from carnivals and state fairs to operating rooms and doctor offices. And with the rise of a medical model came the pressure for a “cure” -a solution to the problem of disability, and of difference. With cure as the ultimate aspirational goal, a television advertisement that aired during the 2000 Super Bowl featuring the famously super and disabled Christopher Reeve walking through CGI shocked the nation. With some disabled viewers calling their doctors to request whatever treatment Reeve was getting, to others criticizing Reeve’s involvement as ableist and ultimately harmful to disabled folks, to others being moved to tears upon seeing Reeve’s triumphant first few digitally edited steps, the commercial was polarizing.

Policy: It is imperative to consider the legal structures that defined the lives of those living under such categories of identity and citizenship; or, in other words, the institutionalization of social inequality in the US. The Eugenics Movement dominated the early 20th century, from the US Public Health Service inspecting arriving immigrants for infectious and hereditary diseases to the legal segregation and/or forced sterilization of those deemed “unfit” or “feebleminded,” which the Supreme Court upheld in Buck vs Bell (1927). The legitimization of heredity and race as indicators of human superiority by state and federal laws perpetuated the White, middle-class concepts of illness and disease as well as justified social inequalities. The federal ACE (Adverse Childhood Experiences) Study established that the more ACEs reported, the more likely and more prevalent the negative health outcomes as well as fall victim to crime. Only when the Violent Crime Control and Law Enforcement Act of 1994 was established did the Hate Crime Statistics Act (HCSA) of 1990 get amended to include violence and crimes with bias against persons with disabilities. In 2009, Rosa’s Law was passed to replace all language using “mental retardation” with the “intellectual disability in federal health, education and labor laws. Also in 2009, gender and gender orientation would be added to the HCSA.