Educating and meeting the multiple needs of students at risk of low academic achievement has been a growing concern for public schools in the United States. Many at-risk students require alternative school-based interventions. This study examined the operation, premise, and objectives of art therapy integrated in 14 school districts across the United States. Guided by the theoretical orientation of school art therapy, this grounded theory study aimed to determine how the targeted school art therapy programs function and how art therapy may assist at-risk students. Semistructured interviews with 16 participants who conducted art therapy in public school settings yielded data which were analyzed using emergent thematic coding and comparison. Findings indicated art therapy was a separate auxiliary service operated by registered art therapists. Art therapy was also used in art education classrooms by art teachers who were registered art therapists. The major objectives of school art therapy included helping students readjust socially, increase emotional regulation, improve self-concept, and improve academic readiness. The research also found that misconceptions of school art therapy existed among school faculty, school administrators, and the general public in districts where school art therapy programs operated. A model of school art therapy was developed which included the referral process, treatment, and assessment of students' progress toward academic readiness. Art therapy educators may use this model in their work with at-risk students with emotional and behavioral issues; this model could, in turn, promote at-risk students' social adjustment and chances of academic success. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]