Unforeseen and precipitous violence is a reality of the times we live in, but it has always been a reality in the mental health profession. The main premise of this book is to make art therapists aware of the unpredictable violence that may occur in their day-to-day work with clients and the presence of potential danger. The author stresses the importance of preventive measures to ensure safety. The preface describes the horrific event the author witnessed and her realization that psychotherapy is a dangerous profession. The first chapter sets the stage for the exploration of mass murders, violence, creativity, and mental illness. Chapter 2 provides framework for the cultural context concerning the contemporary societal and cultural landscape within which mass murders exist. Major changes in mental health laws are discussed, including the individual versus community rights in mental health systems. Chapter 3 is a brief history of the treatment of violence in the United States mental health system. Gun violence, the stigma of mental illness, and the threat assessment in schools are explored. Chapter 4 examines art, violence, and mental illness, including historic artistic figures in which violence and/or mental illness was an issue. The artwork of serial killers such as Adolf Hitler, the psychiatrically institutionalized artist Martin Ramirez, and the Outsider artist Henry Darger are discussed. The author also describes her own experience as an expert witness for the trial of serial killer Eric Leonard. Chapter 5 displays the author's mass murderers’ artwork with a brief description of each event. Chapter 6 depicts the mass murders that occurred in the United States, October 2017 through September 2018. Chapter 7 portrays a reaction to the Marjorie Stone Douglas school shooting and the essay evoked by this tragedy. Chapter 8 offers practical suggestions to help art therapists find assistance and support in a dangerous practice. Safety orientation in art therapy education programs and job orientation are provided. Chapter 9 discusses additional practical suggestions for art therapists with help and support in a dangerous practice and culture. The last chapter encompasses final comments including the danger and calling of art therapy. This unique book will be of special interest to mental health practitioners, art therapists, social workers, educational therapists, and consultants.