Abstract The purpose of the study is to realize Hill's the application of Dream work used in art therapy and to explore the treatment outcome. Then the research result can be applied in clinical work. In the study, Grounded therapy was adopted to investigate the effectiveness of Hill's Dream work applied in Art therapy process. Qualitative research was applied to realize 22 participants’ understanding of therapy process and content of therapeutic agents of this work model template. Participants were interviewed after receiving six to eight therapy sessions. Materials obtained from the interviews which were transcribed and then analyzed by Grounded Theory methodology. The results indicated that three stages, before therapy process, the formal therapy process, after therapy process, with differed therapeutic effects. Among which, therapeutic factors can be further categorized to the client's personal awareness factor, therapist's factor, and art material factors which affected on the therapy process. Client's personal factors included to make sure motivation, relationship with dream and change within art therapy and dream work. Therapist's factors were to provide safe environment, empathetic, positive attitude, interpretation of dream picture, encourage and to be a guide. Art material factors were meant to use different colour, the characteristic of art material, to change the art tools in art therapy process, to be aware of the dream meaning in art, and to make sense of creative behaviour. The subsequent therapeutic effect were to be applied in daily life, more interest in creation, to extend the insight of dream and positive attitude for life, and to be a reminder after therapy session. According to the research results, the model of change mechanism on therapy processes and therapeutic agents were then provided. Finally, findings in this research were discussed and implications and suggestions for practice art work, clinical counselling work and future study were also provided.