Altered Books, Blackout Poetry


The Therapeutic Potential of Repurposed Books or Altered Books

by Ruby Garyfalakis, “The Process Tells the Story”, Canadian Art Therapy Association Conference, 2017

Physicality The physical characteristics of the books can inspire creativity. Found objects and tactile materials can facilitate sensory connections. The finished product is a reminder of the insights gained through the therapeutic process.

Positive Coping A connection with self comforting and coping strategies which are expressed within the book as journal.

A Sense of Sharing Collaboration during art making, sharing the work in progress and the finished product with others. Sharing can be verbal and visual. Metaphor and symbolism provide safety.

The Struggle:  The creative process required preparation, patience and perseverance. After wrestling with the process, there came a point where the struggle shifted and the process gradually became easier or started to flow on its own, resulting in positive outcomes. One of the most significant outcomes was the experience of overcoming the struggle itself. This led to enjoyment and surprise abilities.

Surprise-Ability Participants surprise themselves by rediscovering hidden talents, which result in a sense of accomplishment.

Ambivalence to Support Change The opportunities to alter materials and redirect creatively evoke ambivalence, and the multiple pages hold enough space to contain a variety of expressions—ideas, thoughts, emotions. By altering pre-existing elements there is a sense of an unfinished art project or an ongoing work in progress. This provides an outlet for ambivalence which creates freedom to experiment with change within and beyond the art making process. In this case ambivalence refers to the unfixed nature of our identity.

An altered book can find a client’s narrative in the words of another. It can also facilitate the exploration of alternative narratives. It helps client’s also potentially re-author their lives.

The altered book intervention encourages freedom of expression, and it is useful to evoke different stories about one’s life’s experiences.


Artwork Reference: Gioia Chilton,

“Altering books is a mixed media art from that repurposes a pre-existing book in to a new creation by using art materials and processes such as cut and paste, drawing, collage, painting, sewing, and assemblage to alter the book. In the context of art therapy, altered books can be used as a container for the therapeutic process and a record of the client’s unfolding narrative” (Gioia Chilton, “Altered Books in Art Therapy with Adolescents”)

Altered Books in Art Therapy with Adolescents by Gioia Chilton, Art Therapy: Journal of the American Art Therapy Association. 

Altered Book Making as a Form of Art Therapy: A Narrative Approach, Journal of Family Psychotherapy.

An Altered Book, Erin Partridge,


Photo from which hosts an altered book club with the following goal:

An altered book in art therapy “is a form of mixed media artwork that changes a book from its original form into a different form, altering its appearance and/or meaning. Altered books may be as simple as adding a drawing or text to a page, or as complex as creating an intricate book sculpture”. (Boulder Art Therapy Collective)




Blackout Poems above by Austin Kleon,


Artist: Tom Phillips


Artist: John Carroll, Blackout Poetry





Photo: Carolina Della Valle, Making Me