Expressive Arts Therapy | Creative Arts Therapies

The International Society for Traumatic Stress Studies (ISTSS) (Foa et al, 2009) provides a comprehensive summary of the role of the creative art therapies, including art therapy, in the treatment of posttraumatic stress disorder (PTSD). The ISTSS statement underscores the growing interest the relationship between the creative arts therapies and the brain, including how the brain processes traumatic events and the possibilities for reparation through art, music, movement, play, and drama therapies.


Creative interventions have been formalized through the disciplines of art therapy, music therapy, dance/movement therapy, drama therapy or psychodrama, poetry therapy, and play therapy, including sand tray therapy. Each discipline has been applied in psychotherapy and counseling with individuals of all ages and particularly children for more than 50 years. Art, music, dance, drama, and poetry therapies are referred to as “creative arts therapies” and "expressive arts therapy" because of their roots in the arts and theories of creativity. These therapies and others that utilize self-expression in treatment are also called “expressive therapies” (Malchiodi, 2005). Expressive therapies are defined as the use of art, music, dance/movement, drama, poetry/creative writing, bibliotherapy, play, and sand tray within the context of psychotherapy, counseling, rehabilitation, or medicine. Additionally, expressive therapies are sometimes referred to as “integrative” when used in combination in treatment.

 These individual approaches are defined as follows:


Art therapy is defined as the use of art media, images, and the creative process, and respects patient/client responses to the created products as reflections of development, abilities, personality, interests, concerns, and conflicts. It is a therapeutic means of reconciling emotional conflicts, fostering self-awareness, developing social skills, managing behavior, solving problems, reducing anxiety, aiding reality orientation, and increasing self-esteem.

Music therapy is the prescribed use of music to effect positive changes in the psychological, physical, cognitive, or social functioning of individuals with health or educational problems (see

Drama therapy is the systematic and intentional use of drama/theater processes, products, and associations to achieve the therapeutic goals of symptom relief, emotional and physical integration, and personal growth. It is an active approach that helps the client tell his or her story to solve a problem, achieve a catharsis, extend the depth and breadth of inner experience, understand the meaning of images, and strengthen the ability to observe personal roles while increasing flexibility between roles (see

Dance/movement therapy is based on the assumption that body and mind are interrelated and is defined as the psychotherapeutic use of movement as a process which furthers the emotional, cognitive and physical integration of the individual. Dance/movement therapy effects changes in feelings, cognition, physical functioning, and behavior (

Poetry therapy and bibliotherapy are terms used synonymously to describe the intentional use of poetry and other forms of literature for healing and personal growth (


Related Approaches


Play therapy is the systematic use of a theoretical model to establish an interpersonal process wherein trained play therapists use the therapeutic powers of play to help clients prevent or resolve psychosocial difficulties and achieve optimal growth and development (

Sandplay therapy is a creative form of psychotherapy that uses a sandbox and a large collection of miniatures to enable a client to explore the deeper layers of the psyche in a totally new format; by constructing a series of "sand pictures," a client is helped to illustrate and integrate his or her psychological condition (see

Integrative approaches involve two or more expressive therapies to foster awareness, encourage emotional growth and enhance relationships with others.



Foa, E., Keane, T., Friedman, M., & Cohen, J. (2009). Effective treatment for PTSD: Practice guidelines from the International Society for Trauma Stress Studies. New York: Guilford Press.

Malchiodi, C. (2005). Expressive therapies. New York: Guilford Press.

Creative Interventions with Cathy Malchiodi, PhD

Creative Interventions with Traumatized Children, 2nd Edition, Cathy Malchiodi, PhD, Editor


Rich with case material and artwork samples, this volume demonstrates a range of creative approaches for facilitating children's emotional reparation and recovery from trauma. Contributors include experienced practitioners of play, art, music, movement and drama therapies, bibliotherapy, and integrative therapies, who describe step-by-step strategies for working with individual children, families, and groups. The case-based format makes the book especially practical and user-friendly. Specific types of stressful experiences addressed include parental loss, child abuse, accidents, family violence, bullying, and mass trauma. Broader approaches to promoting resilience and preventing posttraumatic problems in children at risk are also presented. Available from Guilford Publications, Self-Esteem Bookstore, Amazon and more.