Mandy uses both top-down and bottom-up art therapy interventions, depending on the issues the client is facing or which stage of the therapeutic process, the client is at.

Using a top-down approach means that the session has more structure and specific instructions. For example: “Find some images in these magazines that represent a place you enjoy being / a place you find relaxing and safe. You are going to use these pictures to create a collage…”

Often when a top-down art therapy intervention is used, an object will be made, which the client can take home as a reminder of the session.

On the contrary, when a bottom-up approach is used the client is guided and supported to become aware of their senses, make contact with the art materials and express themselves using the art materials. Sometimes there may be a lot of silence during the session wherein the client focuses deeply on the process and what they are physically, mentally, and emotionally experiencing. Followed by some discussion and cognitive processing of what is occurring within the session. This enables the client to make sense of what they have experienced and how that relates to their everyday life. In this case, the client takes home a shift in their body memory and consequently they often notice positive changes occurring in their daily life with regard to how they perceive situations and how they react.