This study aims to explore the effects of comprehensive art therapy on test anxiety among middle school students. In this study, 10 students with typical test anxiety symptoms were selected to receive individual psychological counseling and art therapy before the test for a period of 3 to 12 months. Using grounded theory to analyze their art therapy process, using case analysis to analyze the changes in cognitive response, physiological arousal, behavioral performance and test performance of 10 students with test anxiety before and after counseling, and using classification analysis to analyze the intervention effect of group counseling on a large scale, validated the use of art therapy as a good intervention for alleviating test anxiety. The research results show that: 1. Art therapy based on comprehensive theoretical models of psychodynamics, neuroscience, cognitive behavior, and humanism has a significant intervention effect on middle school students' test anxiety. 2. The core factor affecting middle school students' test anxiety is the fragility of self-regulation ability. 3. Whether it is long-term case intervention or short-term group consultation, art therapy has obvious curative effect4. The intervention of art test anxiety treatment needs to adopt structured, semi-structured and open treatment forms according to the different intervention objects.