Digital Painting-Based Art Therapy for Mental Health: A Narrative Review of Psychological Mechanisms in Technology-Mediated Visual Creation

Abstract

This narrative review examines Digital Painting-Based Art Therapy as an emerging form of technology-mediated visual creation in mental health contexts. Rather than treating digital painting as a simple digital substitute for traditional art therapy, this article defines it as an active visual creation process supported by tablets, styluses, drawing software, screen interfaces, layer functions, undo/redo functions, digital storage, and online sharing. Using thematic narrative synthesis, the review integrates interdisciplinary literature from art therapy, digital health, human–computer interaction, creative technology, and mental health studies. The article clarifies the conceptual boundary between Digital Painting-Based Art Therapy and broader digital art therapy, online therapy, virtual reality art therapy, digital mental health interventions, and AI-generated images. It proposes an explanatory psychological mechanism framework consisting of three interrelated pathways: emotional externalization and emotion regulation; agency, control, and psychological safety; and immersion, self-narrative, and therapeutic communication. The review also highlights clinical and ethical boundaries, including trauma disclosure, crisis situations, severe psychiatric symptoms, privacy, data security, children’s consent, and group sharing risks. The article contributes a mechanism-oriented framework for future qualitative research, clinical practice, and intervention design.