I had always wondered who wrote the exam questions for professional license exams. After I took the art therapy board certification exam(ATBCE), I wish things were a little different; I thought some of the questions could have been shorter and more comprehensive. Some questions only apply to certain situations that were more relevant in the older clinical days. Well, as soon as I thought that after I passed my board certification exam, I had the unique opportunity to make changes on this very exam that was needing an update.
I was an exam writer for the Art Therapy Credential Board between 2018-2020, I gained a lot from this volunteering experience. Below I am sharing how I became an exam writer and my experience volunteering for the Art Therapy Credentials Board.
My practice as an exam writer was greatly informed by my own experience with the exam itself. In 2017 I was qualified to take the ATBC exam to become Board Certified. Like many, I dreaded the 200 questions and the 3-hour marathon session of the exam. I was motivated to take the exam mainly because I was interested to expand my practice to include supervision for students and new professionals.
To my surprise, I passed the exam in one try. I gained a great deal of respect for the vigor of the Board Certification Exam and fully comprehend its value after I took it. Even though I was confident in my knowledge going in, the board certification exam was a challenge.
After the exam, I recognized a few things; first, the exam asks you to think as an art therapist and test your professional judgment in clinical situations. It was obvious that it expects you to know what is helpful and consider the contextual elements. Secondly, I felt some of the exam questions were too long. With 200 questions that include clinical vignettes, it was a lot to read. English is my third language. I felt the exam was partly an endurance test, a demanding factor irrelevant to my art therapy competency.
Admittedly, I was so overstimulated after the exam, I had to bury my face in a pillow for hours that evening to recover. It was an unintended outcome that made the exam an unforgettable experience. Thirdly, I felt some of the questions and answers can be read and understood from different perspectives. There are many variables for the diverse art therapy settings and possible decisions that can be made by an art therapist. I felt more than one answer can be right in some of the situations; if you think about a presenting situation in a different context.
Walking away from it, I felt things can be done to the exam to make it more user-friendly while maintaining its vigor. Some of the questions test specific knowledge but the way it was presented wasn’t the most useful. Knowing the history of the field, I believe to make it better requires the member’s engagement. Therefore when the Board called for volunteers to develop the exam, I jumped to the opportunity.
My experience as a therapist influences my perspective when I wrote for these exams.
Much of what we do is to hold others: We hold the time and the therapeutic space in the art room. We hold others’ emotional experiences and keep their stories in our minds. We hold their artwork. As an exam writer, I hold other art therapists’ perspectives and their practice in mind and think about what would make sense for people practicing in different parts of the world and in different cities around the country.
I personally know art therapists practicing outside of the US, as well as in 10 states across the country. Art therapists everywhere continue to push boundaries and set up art therapy practices in places without art therapy before. My career in diverse settings with a wide range of populations also informed my thoughts about the exam. There are fundamental principles and boundaries that allow an art therapist to work across different environments. It is important that working art therapists share these values and understandings of how to work and succeed in different settings.
Everything written for the exam was grounded in current research and available literature. Even though a lot of us have empirical knowledge that we learned from our teachers or have gained in the field, unless things were written in a peer-reviewed publication, we were not able to apply them to the exam. In this way, the exam developed as the field of knowledge dids. Reversely, it stimulates me as a practitioner to become interested to contribute to the field’s literature. It can be quite interesting to think about how to create questions based on what was written in a book or journal article. At the same time, it had become obvious to me that we need more people to help develop the field and reflect its diversity.
We know that art therapists have to constantly make choices and decisions that are ethically sound during client care, I made a point to focus on measures of competency but not to put the candidates in awkward positions. There were times I review an exam item that gave at least two choices that can both be right, only that one of them was not wrong, and the other one was considered the correct answer. Recalling my own experience with the exam, I made a point to rewrite items like such so that we can focus on competency, especially when it comes to following certain rules.
Volunteering for the ATCB exam board had many benefits. I received training on how to construct exam items. I learned about the philosophy and techniques involved in constructing exam questions. I worked remotely and anonymously with other qualified exam writers; we reviewed each other’s exam items. We were each assigned topic areas of our choice, and pitched in on items others have drafted. Through the experience made possible by the new online platform, this process allowed us to focus on what was acceptable by a group of diverse art therapists across the board.
Volunteering for the ATCB board had brought some welcomed changes to my professional practice. It satisfied some of my own scholarly interests. By reading and mapping the history of the literature within my area of interest, I began to see the things that could be done better in the field. The lack of literature in some areas also meant the lack of knowledge to be passed to the newer generations of art therapists. This had ignited my interest to consider writing about my own practice.
Another aspect I enjoyed about exam writing was that it calls for critical thinking and editing skills. Being a non-native speaker, I focused on writing items that get to the point and nothing more. I focused on keeping the core question intact with the least amount of words. Much of the ethics of Hemingway’s writing (short and to the point) and The Elements of Style (you can only read it one way and it means only one thing) were called for. I believe in efficiency. I think what I brought to the table was a lean approach to exam writing. I called out things that I feel weren’t relevant to art therapy competency.
Much like the job of an art therapist, making something user-friendly is a covert act; when you do it well, it is not noticeable, but you know you are making a difference.
Here are a list of books recommended by the Art Therapy Credentials Board for ATBCE preparation.
These are not secrets and are publicly available information provided on the ATCB website.
The exam preparation guide published by the ATCB is updated and give you really clear examples.
Within the guide, they suggested the following books:
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.) Washington, DC: Author.
Gussak, D. & Rosal, M. (Eds.). (2016). The Wiley handbook of art therapy. West Sussex, UK: Wiley Blackwell.
Malchiodi, C. (2012). The handbook of art therapy (2nd ed.). New York, NY: Guilford.
Rubin, J. (2016). Approaches to art therapy: Theory and technique (3rd ed.). Philadelphia, PA:Brunner-Routledge.
If you feel unfamiliar with a certain topic, you should read on that topic across the three books mentioned above or in other journal articles addressing that issue. You will get a sense of what is the general standard of how to approach that particular issue. This way you will familiarize yourself with the standard of the field on that particular area.
Good luck!
Shan Ru Lin, ATR-BC, ATCS, LCPC is a National Recognized Art Therapy Expert by the United States Department of Labor. She is a Certified Art Therapy Supervisor (ATCS), an off-site supervisor for ATR, and a professor in art therapy.