Art therapists who work with children must sometimes satisfy their cli
ents' immediate requirements by using modalities other than art, thus
adopting a creative arts approach. Although art remained the primary m
edium during 3 years of therapy with a borderline psychotic boy, cruci
al moments of contact, focus, and sublimation were also achieved throu
gh music, play, and puppetry. The boy harbored memories of maternal de
privation during infancy; his mother was widowed and subsequently beca
me depressed. His father was killed in the Yom Kippur War shortly befo
re his birth in 1973 and his mother's unresolved bereavement prevented
readjustment to normal family life. Therapy was terminated when the c
hild achieved the transition from a fantasy world of fears and assumed
identities to one in which he could relate to his peers and enter a n
ormal school environment.