When Anna Westrum was 5 years old, the thought of going to school was terrifying enough to keep her up nights. She was so afraid to leave home that the trip to the bus stop was marked by tantrums, vomiting and clinging to her mom.

Anna's parents, Amy and Jason Westrum of Ramsey, were at their wits' ends, unable to find help. Anna was spoiled, they were told. Put her in time-out. Make her get on the bus.

In their search for a family therapist, they came across Virginia Shaver, an Anoka psychotherapist who specializes in art therapy.

Shaver helped the family create routines that were comforting to Anna, and over the course of weekly and monthly sessions, she worked with Anna and the family on talking about feelings so pent-up emotions didn't explode in tantrums. Sometimes they'd finger-paint, or smear colors with melting crayons on a warm surface. They've made puppets and, recently, a yarn octopus, each of whose eight legs represents a different emotion -- "mad, happy, sad," Anna noted.

At home, Shaver encouraged Anna to keep a journal about her feelings, in words and pictures. During a recent visit to her home, Anna produced an example: a scrap of paper printed with "I'm mad at my sister," and a drawing of a squiggle-frowned mad face.

"It was a big deal learning how to talk about her feelings," Amy Westrum said. "When she started with Virginia, she couldn't answer the question, 'What makes you happy?'"

Nowadays, Anna is a self-possessed and talkative 8-year-old, who sat contentedly for the better part of a recent hour coloring a Halloween picture of sheet-draped ghosts against a deep blue sky. In the mornings, she walks to the bus stop independently, her mother said. She's still a homebody, her dad added, but life is a lot better.

Her parents give a lot of the credit to Shaver.

There is a couch in Shaver's treetop office, but she's just as likely to get to the crux of things at a large wooden table nearby. Clients -- children, teens, adults and families -- are given a choice of media, anything from paint to collage materials to found objects they use to make sculptures.

'Words are too easy'

The idea behind art therapy is that creating artwork gives clients an additional language in which to identify and explore the issues that trouble them, Shaver said. While analytical word descriptions originate in the left side of the brain, the art engages the right brain and can offer additional insight.

With kids, studying the artwork together can help to identify issues; with kids who tend to be guarded, being creative can lower their defenses and make them more comfortable talking about their feelings.

"By describing it, you get a better handle on it; by describing it you have a better chance of figuring out what to do with it," Shaver said. "Sometimes words are too easy; sometimes they're too hard."

There are about 30 registered art therapists in Minnesota, but the number is growing with new training opportunities, according to Jorie Kulseth, president of the Minnesota Art Therapy Association.

Masters'-level clinical training in art therapy can include studio art, clinical psychology and social work. Some therapists, like Shaver, have independent practices; others work in schools, hospitals or other settings.

Art therapists are certified in Minnesota by the Board of Behavioral Health and Therapy, but it's been a long process to have the discipline recognized by the state and insurers, Kulseth said.

Still, acceptance of art therapy has increased since Shaver, who has earned a doctorate in art therapy, began practicing in 1980. Besides her practice in the Twin Cities, she has worked with patients in Milwaukee and with people suffering from post-traumatic stress in South Africa since 1992.

"Some really love it; some are kind of dubious about it," Shaver said. "But most kids are pretty much OK with drawing."