Background: Patients with psychosis due to illness often causes anxiety behavior. It will affect patients’ emotional mood and loss of self-confidence. It was also a negative impact decreasing quality of life. Purposes: To understand the teaching contents of Zentangle; and to investigate the impact of psychosis patients on self-esteem and anxiety interaction support by using Zentangle 8 weeks courses. Methods: This research started from November 28, 2014 and ended to January 9, 2015. Self-esteem and social interaction anxiety questionnaires were used. A program of introducing Zentangle activities were used for 60 minutes, once a week for eight weeks. Samples 44 of patients were randomly assigned to the control group 22 and 22 to the experimental group. In addition to the experimental group of routine occupational therapy activities, another add activity was Zentangle. Data processing by SPSS 17.0 statistical software package were used to analyze data. Results: The results showed the experimental group in self-esteem part by the pretest was (M = 3.81) and eight weeks after intervention of Zentangle activity was (M= 4.32), There were significant difference between pre and posttest. For social interaction anxiety scores, before the intervention was 4.12, after intervention 8 weeks decreasing to 2.77. There were significantly differences between before and after using Zentangle intervention. Control group for self-esteem part was (M = 3.65) and the eight weeks (M = 3.98); social interaction anxiety before was 4.09 and after eighth weeks 4.32, there were no decreasing anxiety. There were no significant difference between before and after test for control group.. Conclusion / Practical application: The results of this study could be used as reference for clinical personnel Education on thinking sleep disorder care of patients.