7.5 Cognitive, Developmental & Belief-Based Instruments: CATA, LECATA, FSA & BATA

Four Named Instruments for Cognition, Development, and Belief

The ATCBE content outline lists the Cognitive Art Therapy Assessment (CATA), the Levick Emotional and Cognitive Art Therapy Assessment (LECATA), the Face Stimulus Assessment (FSA), and the Belief Art Therapy Assessment (BATA) by name. They are grouped here because none of them primarily asks about psychopathology: each is designed to establish a developmental, cognitive, communicative, or spiritual baseline, most often with clients whose verbal access is limited.

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Cognitive Art Therapy Assessment (CATA)

Developed by: Ellen G. Horovitz (published as Horovitz-Darby), who also developed the BATA and an art therapy dream assessment.

Structure: The CATA presents the client with a sequence of media of differing resistance and dimensionality — commonly a drawing medium such as pencil, a color medium such as markers or oil pastels, and a three-dimensional medium such as plasticine clay — with an open directive to make whatever they wish in each.

What it measures: Cognitive and developmental functioning, read against Piagetian stages and Lowenfeld's stages of artistic development. Because the same open directive is repeated across media, the CATA reveals whether performance is stable or varies with the demands of the material — a client may organize competently in two dimensions and fragment in three, or the reverse.

Typical uses: Establishing a functional baseline for clients with intellectual and developmental disabilities, acquired brain injury, dementia, or severe mental illness, where verbal testing under-represents ability.

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Levick Emotional and Cognitive Art Therapy Assessment (LECATA)

Developed by: Myra F. Levick, originally as a school-based instrument for the Miami-Dade County Public Schools to identify special-needs children's therapeutic requirements.

Population: Principally children aged 3 to 11, including children who are non-verbal but able to draw.

Materials: A set of 16 crayons and white drawing paper, with pencil and eraser supplied on request.

The five tasks, in order:

1. A free art task, followed by the child telling a story about what they made.
2. Draw yourself.
3. A scribble drawing made with one color, from which the child then develops a picture.
4. A place task — for ages 3 to 5, a place the child would like to be; for ages 6 to 11, a place that is important to them.
5. Draw a family.

Theoretical frame: The LECATA is explicitly psychoanalytic in its emotional scoring, reading the artwork for normative defense mechanisms appropriate to the child's age, while the cognitive scoring is developmental. The output is a profile comparing the child's emotional and cognitive developmental levels against age expectations — a divergence between the two is the finding of interest.

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Face Stimulus Assessment (FSA)

Developed by: Donna Betts, to enable art production and assessment with clients who have communication disorders, developmental disabilities, or very limited expressive language.

Structure — three pictures administered in sequence:

Design principle: The sequence embodies behavioral fading — the client receives progressively fewer cues with each successive drawing, so the assessment reveals how much external structure the person requires in order to produce. A client who works competently on Picture 1, hesitates on Picture 2, and cannot begin Picture 3 has given the clinician precise information about scaffolding needs for every subsequent session.

Materials: A standardized marker set is used so that color choice remains comparable across administrations and clients.

Clinical value: The FSA is one of the few art-based instruments designed from the outset for clients who cannot complete verbal assessments, and its findings translate directly into treatment planning: how much structure, how many cues, what degree of open-endedness the person can tolerate.

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Belief Art Therapy Assessment (BATA)

Developed by: Ellen G. Horovitz (Horovitz-Darby), described in her work on spiritual art therapy.

Structure: A two-part directive in which the client is invited to depict their concept of God, a higher power, or what they believe in, and then to depict its opposite — what stands against or negates that belief. Media are offered in choice, and the client's selection is itself recorded. A structured inquiry follows each image.

What it explores: The client's spiritual and religious framework, including whether belief is a resource, a source of conflict, an absence, or a system imposed from outside. Horovitz situates these findings within a family-systems reading, since belief systems are transmitted, contested, and enforced within families.

Clinical uses: Hospice and palliative care, moral injury, religious trauma, grief and bereavement, recovery programs that include a higher-power component, and any presentation in which the client's meaning-making system is central.

[!IMPORTANT] The BATA requires particular care with informed consent and cultural humility. Spiritual material is sensitive, some traditions prohibit depicting the divine in image form, and a client's refusal of the directive is a legitimate response to be respected rather than an assessment finding. The ATCB Code's cultural-responsiveness obligations apply with full force, and the therapist's own beliefs must not enter the inquiry.

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Comparative Summary