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Background: Self-created artworks are central to both patients and therapists in art therapy. Creating a work of art seems particularly effective because an art piece conveys emotions, memories, and symbolic meaning that extend beyond the object’s physical form. The patients’ decision whether to take their artwork home or leave it behind raises methodological and ethical questions which have not yet been the focus of extensive research.

Research question: What is the significance of a patients’ artwork that is left behind from an art therapist’s perspective?

Methods: Art therapists with extensive professional experience (minimum four years; n=4) were surveyed for this mixed-media study (QUAL + QUAN) to collect data through structured expert interviews and a study-specific piloted questionnaire over a seven-month period. Data analysis included qualitative content analysis (acc. to Mayring) and a descriptive analysis of frequencies and correlations using the Chi-squared test of independence and Spearman’s rank correlation coefficient.

Results: Quantitative analysis revealed that 45.16% of art therapy works are left behind. Patients leave behind art pieces for seven primary reasons: avoiding memories, insufficient integration of the therapeutic process, weak attachment to therapy, depositing difficult emotions, self-deprecation, illness-specific factors and death/suicide. Art therapists typically keep these works for a minimum of three years, while emotionally significant pieces are kept for much longer. The act of leaving works behind can elicit emotional responses in art therapists, ranging from appreciation to grief.

Discussion: These findings suggest that patients’ art therapy works should be further studied within the context of their creation. This includes examining the central role of art therapists and their strategies for therapeutic interventions. Leaving artworks behind can also serve as a legitimate protective function for patients and requires further research.