ABSTRACT
This chapter discusses an issue that is especially germane to working with individuals with severe and persistent mental illness (SPMI): therapeutic boundaries. The stigma associated with mental illness persists. It follows that the ethical practice of art therapy with individuals who have SPMI requires not only sensitivity to the cultural stigma, but also an understanding of the complex and variable nature of SPMI. Some of America’s most marginalized and misunderstood individuals reside within the walls of long-term psychiatric hospitals and residential facilities. These individuals struggle not only with the debilitating effects of severe and persistent mental illness; their day-to-day realities are lived within the confines of institutional settings. Clinicians and their clients were called to embark on a road to recovery which was dotted with potholes. When working with individuals who have SPMI, often there are many forces at play. Respecting the clients’ right to choose is especially important in a residential setting.
