MODULE 1: OVERVIEW EXPRESSIVE ART THERAPY

History of Art Therapy AND Historical Trends in Expressive Art Therapy

Art therapy has been used in psychology for over a century. Here are some key historical events
and figures in the development of art therapy in psychology:

1. Carl Jung: Jung, a Swiss psychiatrist and psychoanalyst, used art-making as a tool for
self-exploration and expression. He believed that art could reveal unconscious
thoughts and feelings that were not accessible through verbal communication.
2. Adrian Hill: Hill, a British artist, used art-making as a form of therapy while
recovering from tuberculosis in the 1930s. He later worked with psychiatric patients,
using art therapy to help them express their emotions and gain insight into their
experiences.
3. Margaret Naumburg: Naumburg, a psychotherapist and educator, is often
considered the founder of art therapy in the United States. In the 1940s, she
developed the "art as therapy" approach, which emphasized the therapeutic benefits
of the art-making process itself.
4. Edith Kramer: Kramer, an artist and art therapist, developed the "art as
communication" approach in the 1960s. This approach emphasized the use of art-
making as a tool for nonverbal communication and emotional expression.
5. The American Art Therapy Association (AATA): The AATA was founded in 1969 as
a professional organization for art therapists. It has since become a leading advocate
for the field, promoting research, education, and ethical standards.
6. The Diagnostic and Statistical Manual of Mental Disorders (DSM): The DSM, first
published in 1952, did not include art therapy as a recognized form of treatment.
However, subsequent editions of the DSM have recognized the therapeutic potential
of art-making and included it as a treatment option for certain mental health
conditions.
7. The International Expressive Arts Therapy Association (IEATA): The IEATA was
founded in 1994 as a professional organization for expressive arts therapists. It
promotes the integration of multiple arts modalities into therapy sessions and
provides training and education for practitioners.
Overall, the development of art therapy in psychology has been influenced by a range of
disciplines, including art, psychology, and psychoanalysis. It has evolved over time to encompass
a variety of approaches and techniques, but has always maintained a focus on the therapeutic
benefits of art-making.
JUNG AND ART THERAPY
Carl Jung, a Swiss psychiatrist and psychoanalyst, is considered one of the pioneers of modern
art therapy. Jung's theories of the human psyche, which emphasized the importance of the
unconscious and the symbolic language of dreams, had a significant influence on the
development of art therapy as a clinical practice.
Jung believed that art was a powerful means of accessing the unconscious, and that creating art
could help individuals express and integrate their deepest feelings and emotions. He used art-
making as a therapeutic tool with his clients, encouraging them to create drawings and paintings
that reflected their innermost thoughts and feelings.
One of Jung's most famous case studies involved a patient named "Miss Frank Miller," who
suffered from severe anxiety and depression. Jung encouraged Miller to create a series of
mandalas, circular drawings that represented the self, as a means of exploring and integrating
her inner experience. Over time, Miller's drawings became more complex and symbolically rich,
and she reported feeling more calm and centered as a result of the art-making process.
Jung's ideas about the healing power of art had a profound impact on the development of art
therapy as a field. In the 1930s and 1940s, art therapists began using art-making as a clinical
tool, and by the 1960s, art therapy had become an established form of psychotherapy.
Today, art therapists continue to draw on Jung's ideas and principles, incorporating art-making
into their clinical practice as a means of helping clients access and integrate their unconscious
thoughts and emotions. Jung's emphasis on the symbolic language of art also continues to
influence the way art therapists understand the creative process and its role in healing.

HISTORICAL TRENDS IN EXPRESSIVE ART THERAPY

Expressive art therapy has a rich history that has evolved over time. It is a form of
psychotherapy that incorporates creative activities such as drawing, painting, sculpting, music,
dance, and drama to promote healing and self-expression. Here are some of the historical trends
in expressive art therapy:
1. Art as therapy: This approach, also known as art psychotherapy, emerged in the 1940s
and 1950s. It involves the use of art-making as a form of self-expression and emotional
release. This approach views the art-making process as therapeutic, rather than focusing
on the final product.
2. Art in therapy: This approach emerged in the 1960s and 1970s and emphasizes the use
of art as a tool to facilitate communication between the therapist and client. The
therapist may use the client's artwork as a starting point for discussion or as a way to
help the client explore their emotions and experiences.
3. Art-based research: This approach emerged in the 1990s and emphasizes the use of
art-making as a way to generate data and insights for research purposes. It can be used
to explore a range of topics, from mental health to social justice.
4. Integrative approach: This approach emerged in the 2000s and emphasizes the
integration of multiple expressive art forms, such as music, dance, and drama, into
therapy sessions. This approach recognizes that different art forms can offer different
ways of expressing and processing emotions and experiences.
Overall, expressive art therapy has continued to evolve and adapt to meet the needs of clients
and practitioners. It has become a widely recognized and respected form of therapy, offering
individuals a unique and powerful way to explore their inner world and promote healing.

Defining Expressive Therapies: Arts Therapy, Music Therapy, Drama Therapy,

Dance/Movement Therapy, Expressive Writing/Poetry Therapy, Play Therapy
What is Expressive Art Therapy?
Expressive arts therapy is an integrative, multimodal approach that utilizes a variety of methods
including writing, music, visual arts, drama, and dance to help people achieve personal growth.
In this type of treatment, people work with a trained therapist who helps them explore and
understand their reactions to their experience with different forms of expressive art.
Difference between Art Therapy and Expressive Art Therapy
 Art Therapy Expressive Art Therapy
Focuses on the process of creating art as a Incorporates multiple art modalities (such as
means of self-expression and communication music, dance, drama, and writing) as a means
of creative expression and emotional healing.
Typically involves the use of traditional art Utilizes a range of art forms, depending on the
materials, such as paint, clay, and drawing needs and preferences of the individual.
tools.
May involve the creation of art in response to Emphasizes the importance of creative
specific themes or prompts, as a way of exploration and experimentation, rather than
exploring emotions and experiences. following specific guidelines or instructions.
Often used as a treatment for specific mental May be used as a form of personal growth and
health conditions, such as depression, development, or as a way of exploring issues
anxiety, or PTSD. related to identity, relationships, and life
transitions.
Typically led by a trained art therapist who Practitioners may come from a range of
has completed a graduate-level program in backgrounds, including psychology, social
art therapy. work, counseling, and art education.
Has a well-established theoretical framework Still developing as a field, with a focus on
and research base, with recognized ethical integrating multiple art forms and expanding
standards and best practices. the range of applications for expressive arts
therapy.
Overall, both Art Therapy and Expressive Art Therapy utilize creative expression as a means of
promoting emotional healing and growth, but Expressive Art Therapy is broader in scope and
utilizes a wider range of artistic modalities.
ART THERAPY

Art therapy is a form of psychotherapy that incorporates creative expression as a means

of promoting emotional healing and growth. It involves the use of art materials, such as
paint, clay, and drawing tools, to facilitate self-exploration, communication, and personal
development.

In art therapy, the focus is not on creating a finished product, but rather on the process of
creating art and the feelings and experiences that arise during that process. The therapist
may guide the individual through various art exercises, such as drawing or sculpting, and use
these exercises to help them explore their thoughts, feelings, and behaviors.

Art therapy can be used to treat a variety of mental health conditions, such as depression,
anxiety, PTSD, and addiction. It can also be helpful for individuals who have experienced
trauma, loss, or other life challenges.

Art therapists are trained mental health professionals who have completed a graduate-
level program in art therapy. They use their knowledge of psychology and art to create a
therapeutic environment that promotes emotional healing and growth. Art therapy sessions
may take place in a variety of settings, including schools, hospitals, community centers, and
private practices.

The goal of art therapy is to utilize the creative process to help people explore self-
expression and, in doing so, find new ways to gain personal insight and develop new
coping skills. The creation or appreciation of art is used to help people explore emotions,
develop self-awareness, cope with stress, boost self-esteem, and work on social skills.

Techniques used in art therapy can include:

  Collage
 Coloring
 Doodling and scribbling
 Drawing
 Finger painting
 Painting
 Photography
 Sculpting
 Working with clay

As clients create art, they may analyze what they have made and how it makes them feel.
Through exploring their art, people can look for themes and conflicts that may be affecting their
thoughts, emotions, and behaviors.1

What Art Therapy Can Help With?

Art therapy can be used to treat a wide range of mental disorders and psychological distress. In
many cases, it might be used in conjunction with other psychotherapy techniques such as group
therapy or cognitive-behavioral therapy (CBT).5

Some conditions that art therapy may be used to treat include: 1

 Aging-related issues6
 Anxiety
 Cancer7
 Depression
 Eating disorders8
 Emotional difficulties
 Family or relationship problems5
 Medical conditions
 Psychological symptoms associated with other medical issues
 Post-traumatic stress disorder (PTSD)5
 Psychosocial issues
 Stress
 Substance use disorder9

Benefits of Art Therapy

According to a 2016 study published in the Journal of the American Art Therapy
Association, less than an hour of creative activity can reduce your stress and have a
positive effect on your mental health, regardless of artistic experience or talent. 10

An art therapist may use a variety of art methods, including drawing, painting, sculpture, and
collage with clients ranging from young children to older adults. Clients who have experienced
emotional trauma, physical violence, domestic abuse, anxiety, depression, and other
psychological issues can benefit from expressing themselves creatively.

Some situations in which art therapy might be utilized include:

 Adults experiencing severe stress

 Children experiencing behavioral or social problems at school or at home
 Children or adults who have experienced a traumatic event
 Children with learning disabilities
 Individuals living with a brain injury
 People experiencing mental health problems11
Effectiveness

While research suggests that art therapy may be beneficial, some of the findings on its
effectiveness are mixed. Studies are often small and inconclusive, so further research is needed
to explore how and when art therapy may be most beneficial. 12 

 In studies of adults who experienced trauma, art therapy was found to significantly
reduce trauma symptoms and decrease levels of depression. 13
 One review of the effectiveness of art therapy found that this technique helped patients
undergoing medical treatment for cancer improve their quality of life and alleviated a
variety of psychological symptoms.12
 One study found that art therapy reduced depression and increased self-esteem in older
adults living in nursing homes.14

Things to Consider

If you or someone you love is thinking about art therapy, there are some common
misconceptions and facts you should know.

You Don't Have to Be Artistic

People do not need to have artistic ability or special talent to participate in art therapy, and
people of all ages including children, teens, and adults can benefit from it. Some research
suggests that just the presence of art can play a part in boosting mental health. 3
A 2017 study found that art displayed in hospital settings contributed to an environment where
patients felt safe. It also played a role in improving socialization and maintaining an identity
outside of the hospital.15
It's Not the Same as an Art Class

People often wonder how an art therapy session differs from an art class. Where an art class is
focused on teaching technique or creating a specific finished product, art therapy is more about
letting clients focus on their inner experience.3

In creating art, people are able to focus on their own perceptions, imagination, and feelings.
Clients are encouraged to create art that expresses their inner world more than making
something that is an expression of the outer world.

Art Therapy Can Take Place in a Variety of Settings

Inpatient offices, private mental health offices, schools, and community organizations are all
possible settings for art therapy services. Additionally, art therapy may be available in other
settings such as:

 Art studios
 Colleges and universities
 Community centers
 Correctional facilities16
 Elementary schools and high schools
 Group homes
 Homeless shelters
 Hospitals17
 Private therapy offices
 Residential treatment centers
 Senior centers
  Wellness center
 Women's shelters18

If specialized media or equipment is required, however, finding a suitable setting may become
challenging.

Art Therapy Is Not for Everyone

Art therapy isn’t for everyone. While high levels of creativity or artistic ability aren't necessary
for art therapy to be successful,10 many adults who believe they are not creative or artistic might
be resistant or skeptical of the process.

In addition, art therapy has not been found effective for all types of mental health conditions.
For example, one meta-analysis found that art therapy is not effective in reducing positive or
negative symptoms of schizophrenia.19

MUSIC THERAPY
Music therapy is a form of psychotherapy that uses music as a tool to promote emotional healing
and well-being. It involves the use of music, such as listening to music, singing, or playing
musical instruments, to facilitate communication, expression, and personal growth.
In music therapy, the therapist works with the individual to identify their emotional and
behavioral goals, and then uses music to address those goals. For example, someone struggling
with depression might work with a music therapist to create a playlist of uplifting songs, while
someone with anxiety might practice relaxation techniques while listening to calming music.
Music therapy is a therapeutic approach that uses the naturally mood-lifting properties of
music to help people improve their mental health and overall well-being. 1  It’s a goal-oriented
intervention that may involve:

 Making music
 Writing songs
 Singing
 Dancing
 Listening to music
 Discussing music  

This form of treatment may be helpful for people with depression and anxiety, and it may help
improve the quality of life for people with physical health problems. 2 Anyone can engage in
music therapy; you don’t need a background in music to experience its beneficial effects.

Types of Music Therapy

Music therapy can be an active process, where clients play a role in creating music, or a passive
one that involves listening or responding to music. Some therapists may use a combined
approach that involves both active and passive interactions with music. 3

There are a variety of approaches established in music therapy, including: 4

 Analytical music therapy: Analytical music therapy encourages you to use an

improvised, musical "dialogue" through singing or playing an instrument to express your
 unconscious thoughts, which you can reflect on and discuss with your therapist
afterward.
 Benenzon music therapy: This format combines some concepts of psychoanalysis with
the process of making music. Benenzon music therapy includes the search for your
"musical sound identity," which describes the external sounds that most closely match
your internal psychological state.
 Cognitive behavioral music therapy (CBMT): This approach combines cognitive
behavioral therapy (CBT) with music. In CBMT, music is used to reinforce some
behaviors and modify others. This approach is structured, not improvisational, and may
include listening to music, dancing, singing, or playing an instrument.
 Community music therapy: This format is focused on using music as a way to facilitate
change on the community level. It’s done in a group setting and requires a high level of
engagement from each member.
 Nordoff-Robbins music therapy: Also called creative music therapy, this method
involves playing an instrument (often a cymbal or drum) while the therapist
accompanies using another instrument. The improvisational process uses music as a
way to help enable self-expression.
 The Bonny method of guided imagery and music (GIM): This form of therapy uses
classical music as a way to stimulate the imagination. In this method, you explain the
feelings, sensations, memories, and imagery you experience while listening to the music.
 Vocal psychotherapy: In this format, you use various vocal exercises, natural sounds,
and breathing techniques to connect with your emotions and impulses. This practice is
meant to create a deeper sense of connection with yourself. 5

Music Therapy vs. Sound Therapy

Music therapy and sound therapy (or sound healing) are distinctive, and each approach has its
own goals, protocols, tools, and settings: 

 Music therapy is a relatively new discipline, while sound therapy is based on

ancient Tibetan cultural practices.
 Sound therapy uses tools to achieve specific sound frequencies, while music therapy
focuses on addressing symptoms like stress and pain.  
 The training and certifications that exist for sound therapy are not as standardized as
those for music therapists.
 Music therapists often work in hospitals, substance abuse treatment centers, or private
practices, while sound therapists may offer their service as a component of
complementary or alternative medicine.

Techniques:
When you begin working with a music therapist, you will start by identifying your goals. For
example, if you’re experiencing depression, you may hope to use music to naturally improve
your mood and increase your happiness. You may also want to try applying music therapy to
other symptoms of depression like anxiety, insomnia, or trouble focusing.
During a music therapy session, you may listen to different genres of music, play a musical
instrument, or even compose your own songs. You may be asked to sing or dance. Your
therapist may encourage you to improvise, or they may have a set structure for you to follow.

You may be asked to tune in to your emotions as you perform these tasks or to allow your
feelings to direct your actions. For example, if you are angry, you might play or sing loud, fast,
and dissonant chords.
You may also use music to explore ways to change how you feel. If you express anger or stress,
your music therapist might respond by having you listen to or create music with slow, soft,
soothing tones.

Music therapy is often one-on-one, but you may also choose to participate in group sessions if
they are available. Sessions with a music therapist take place wherever they practice, which
might be a:

 Clinic
 Community health center
 Correctional facility
 Hospital
 Private office
 Physical therapy practice
 Rehabilitation facility

Wherever it happens to be, the room you work in together will be a calm environment with no
outside distractions.

What Music Therapy Can Help With

Music therapy may be helpful for people experiencing: 6

 Alzheimer’s disease
 Anxiety or stress
 Autism
 Cardiac conditions
 Chronic pain
 Depression
 Diabetes
 Difficulties with verbal and nonverbal communication
 Emotional dysregulation
 Feelings of low self-esteem
 Headaches
 Impulsivity
 Negative mood
 Post-traumatic stress disorder (PTSD)
 Problems related to childbirth
 Rehabilitation after an injury or medical procedure
 Respiration problems
 Substance use disorders
 Surgery-related issues
 Traumatic brain injury (TBI)
 Trouble with movement or coordination

Research also suggests that it can be helpful for people with:

 Insomnia7
 Obsessive-compulsive disorder (OCD)8
 Schizophrenia9
 Stroke and neurological disorders10

Music therapy is also often used to help children and adolescents: 6

  Develop their identities
 Improve their communication skills
 Learn to regulate their emotions
 Recover from trauma
 Self-reflect

Benefits of Using Music as Therapy

Music therapy can be highly personalized, making it suitable for people of any age—even very
young children can benefit. It’s also versatile and offers benefits for people with a variety of
musical experience levels and with different mental or physical health challenges.

Engaging with music can:6

 Activate regions of the brain that influence things like memory, emotions, movement,
sensory relay, some involuntary functions, decision-making, and reward 11
 Fulfill social needs for older adults in group settings 12
 Lower heart rate and blood pressure
 Relax muscle tension
 Release endorphins13
 Relieve stress and encourage feelings of calm
 Strengthen motor skills and improve communication for children and young adults who
have developmental and/or learning disabilities 14

Research has also shown that music can have a powerful effect on people with dementia and
other memory-related disorders.15

Overall, music therapy can increase positive feelings, like: 6

 Calmness
 Euphoria
 Confidence and empowerment
 Emotional intimacy

Effectiveness

The uses and benefits of music therapy have been researched for decades. Key findings from
clinical studies have shown that music therapy may be helpful for people with depression and
anxiety, sleep disorders, and even cancer.

Depression 
Studies have shown that music therapy can be an effective component of depression
treatment.16 According to the research cited, the use of music therapy was most beneficial to
people with depression when it was combined with the usual treatments (such as
antidepressants and psychotherapy). 
When used in combination with other forms of treatment, music therapy may also help reduce
obsessive thoughts, depression, and anxiety in people with OCD.8
In 2016, researchers conducted a feasibility study that explored how music therapy could be
combined with CBT to treat depression.17 While additional research is needed, the initial results
were promising.
Insomnia 

Many people find that music, or even white noise, helps them fall asleep. 18 Research has shown
that music therapy may be helpful for people with sleep disorders or insomnia as a symptom of
depression.7

Compared to pharmaceuticals and other commonly prescribed treatments for sleep disorders,
music is less invasive, more affordable, and something a person can do on their own to self-
manage their condition.
Pain Management

Music has been explored as a potential strategy for acute and chronic pain management in all
age groups. Research has shown that listening to music when healing from surgery or an injury,
for example, may help both kids and adults cope with physical pain. 19

Music therapy may help reduce pain associated with:

 Chronic conditions: Music therapy can be part of a long-term plan for managing
chronic pain, and it may help people recapture and focus on positive memories from a
time before they had distressing long-term pain symptoms. 20
 Labor and childbirth: Music therapy-assisted childbirth appears to be a positive,
accessible, non-pharmacological option for pain management and anxiety reduction for
laboring people.21
 Surgery: When paired with standard post-operative hospital care, music therapy is an
effective way to lower pain levels, anxiety, heart rate, and blood pressure in people
recovering from surgery.22

Cancer 

Coping with a cancer diagnosis and going through cancer treatment is as much an emotional
experience as a physical one. People with cancer often need different sources of support to take
care of their emotional and spiritual well-being.

Music therapy has been shown to help reduce anxiety in people with cancer who are starting
radiation treatments. It may also help them cope with the side effects of chemotherapy, such as
nausea.23

Music therapy may also offer emotional benefits for people experiencing depression after
receiving their cancer diagnosis, while they’re undergoing treatment, or even after remission. 2

Things to Consider
On its own, music therapy may not constitute adequate treatment for medical conditions,
including mental health disorders. However, when combined with medication, psychotherapy,
and other interventions, it can be a valuable component of a treatment plan.

If you have difficulty hearing, wear a hearing aid, or have a hearing implant, you should talk
with your audiologist before undergoing music therapy to ensure that it’s safe for you.

Similarly, music therapy that incorporates movement or dancing may not be a good fit if you’re
experiencing pain, illness, injury, or a physical condition that makes it difficult to exercise.  
You'll also want to check your health insurance benefits prior to starting music therapy. Your
sessions may be covered or reimbursable under your plan, but you may need a referral from
your doctor.

DRAMA THERAPY

Drama therapy takes a unique approach by using drama and/or theater techniques, including
improvisation, role-playing, using puppets, and acting out stories. It is an
active, experiential form of creative therapy that may help you or someone you love gain self-
confidence and explore new problem-solving skills.

Drama therapy combines drama and psychotherapy methods to offer new ways to express what
you are thinking or feeling in order to cope more effectively with behavioral and emotional
problems.

How It Works?

No previous experience or dramatic training is needed to participate. A registered drama

therapist (RDT) facilitates this specialized type of therapy.

Depending on the therapeutic goals, drama therapy can take on many forms and include a range
of techniques, including:

 Drama exercises
 Enactment
 Improvisations
 Puppetry
 Role play
 Storytelling
 Theater games

Here's an example: If you're having a significant conflict with a sibling, you may be asked to role-
play a scene in which you pretend to be your sibling and speak from their perspective. 

In a group setting, each person acts out a role they take in the group, such as someone who
exhibits leadership or someone who is scapegoated by others.

Benefits of Drama Therapy

Drama therapy has been found effective in the general population as well as among the
following: 

 Abuse survivors
 At-risk youth
 Developmentally disabled persons
 Dysfunctional families
 Homeless persons
 Older adults
 People with AIDS
 People with behavioral health issues
 People recovering from addiction
 Prison inmates
Drama therapy can be beneficial in many ways, including helping people to: 1

 Feel less isolated

 Learn how to solve problems
 Express how they're feeling 
 Set goals
 Relate better to other people
 Understand themselves and their experiences more clearly
 Improve self-esteem and self-worth
 Develop better coping skills at home, school, and/or work
 Broaden the range of expression of emotion
 Use creativity, imagination, and play to practice reacting to difficult situations
 Get to the point of addressing problems quickly
 Escape from the pressures of life into the imagination for a little while
 Interact with others in a safe, comfortable environment

Why It's Appealing?

Drama therapy can feel like playing, as you rehearse new ways of being or acting. Other reasons
why it's appealing include:

 You get to tell your story to an audience 

 The story details and ending can be changed
 Acting out is encouraged as a learning tool
 You learn to look at problems from a different perspective 

Where Is Drama Therapy Offered?

According to the North American Drama Therapy Association, registered drama therapists work
in multiple mental health and community settings, including: 1

 Community centers
 Early intervention programs
 Group homes
 Hospices
 Hospitals
 Multicultural centers
 Outpatient and inpatient mental health settings
 Private practice
 Rehabilitative facilities
 Schools and after-school programs
 Shelters
 Wellness centers

DANCE THERAPY

Dance/movement therapy, or DMT, is the psychotherapeutic use of movement to promote

emotional, social, cognitive, and physical integration.1 DMT can help people with physical health
by increasing strength, improving flexibility, decreasing muscle tension, and boosting
coordination. It can also offer important mental health benefits including stress reduction and
even symptom relief from conditions such as anxiety and depression.
“DMT is a creative art psychotherapy that utilizes movement and dance to support the physical,
intellectual, and emotional health of an individual,” Katie Bohn, LPC, BC-DMT, SEP, RYT, a board-
certified dance/movement therapist. 

According to board-certified dance therapist Erica Hornthal, MA, LCPC, BC-DMT, dance therapy
uses movement and nonverbal communication in addition to talk therapy to manage
psychological and behavioral concerns that words alone do not address. "It’s about finding the
places inside that you might not know or have chosen to deny, and giving a voice to the
experiences and emotions," Hornthal says.

Techniques

DMT looks different for everyone depending on a sense of safety, access to the body, and
personal familiarity with an authentic expression of the body, explains Caroline Kinsley, LPC
intern, R-DMT, a dance/movement therapist. "The process may range from mostly verbal or
speaking to mostly nonverbal or movement," she says. 

In a dance therapy session, a therapist may:

 Help you explore and make meaning on the connection between movement and
your emotions
 Encourage tracking of bodily sensations and breath
 Help guide you through self-expressive and improvisational movements
 Offer specific movement or verbal therapeutic interventions to promote healing
 Help you process the feelings evoked by the movement

Dance therapists may utilize a technique known as mirroring, which involves copying another
person's movements. It can be a way to help people feel more connected to others and to
build feelings of empathy.

Dance/movement therapists provide the space for individuals to experience an invitation, a

sense of choice, validation, and to tolerate internal sensations. They also offer compassionate
and supportive ways to feel a sense of control and autonomy within your body. 

What Dance/Movement Therapy Can Help You With?

Dance and movement therapy can be used to treat a number of physical and mental health
issues. It can be helpful for improving self-esteem and can be useful for people who struggle
with body image issues. Some conditions that it may help with include:

 Anxiety
 Arthritis
 Chronic pain
 Communication issues
 Dementia
 Depression
 Disordered eating
 Low self-esteem
 Post-traumatic stress disorder (PTSD)

Benefits of Dance/Movement Therapy

Dance therapy has a number of benefits that can make it a helpful addition to other treatment
approaches. Where many treatment modalities, such as cognitive behavioral therapy (CBT),
focus on cognitions or behaviors, dance/movement therapy incorporates body-based strategies.

 Promotes calm: By using DMT, Kinsley says a therapist can provide body-based
strategies to support down-regulating the system, which allows for an increased sense of
calm.
 Self-awareness: In the treatment of eating disorders, building self-awareness can help
people feel more connected to their body's physical signals. "Emphasis on the body
supports the client in developing the awareness needed to identify physical and
emotional sensations of hunger and fullness."
 Coping skills: DMT can also serve as a way to build coping skills to use outside of the
therapy setting. "With the support of the therapist, you can use movement and
understanding of your movement preferences to explore strengths and signals of stress,
distress, and triggers," Kinsley says.

Building such skills allows you to recognize the change in your body-based experience outside of
the therapeutic space and use it as insight if you are tending towards maladaptive beliefs or
behaviors.

If you’re struggling with an eating disorder or another issue that affects body image, Bohn says
being able to reconnect with your body, change the relationship with your body, have access to
self-expression, and experience embodied relationships is significant in sustaining eating
disorder recovery. Dance/movement therapy is a unique modality that supports these goals. 

Effectiveness

Research also suggests that dance/movement therapy can be helpful in the treatment of a
number of different conditions. Some studies supporting its efficacy include:

 A 2019 review concluded that dance therapy was an effective intervention for the
treatment of adults with depression.2
 A 2019 review of studies concluded that dance movement therapy helped to reduce
anxiety and depression. It also enhanced interpersonal skills, cognitive skills, and overall
quality of life.3
 A small 2020 pilot study published in the Journal of Eating Disorders found that DMT can
be used as a complementary treatment option for eating disorders. Researchers
recruited 14 patients from a private clinic and assigned seven to a random group and the
other seven to a DMT group. After 14 weeks of treatment, the DMT group significantly
improved in body area satisfaction and appearance evaluation compared to the other
group.4

Things to Consider

While DMT can be an effective treatment option, there are some factors to consider before you
decide if dance/movement therapy is right for you:

 Comfort and safety: For people who have experienced trauma, creating a safe space and
going slowly is critical. "An individual may not be able to access body-based experiences
due to maintaining a sense of safety," Kinsley says.
 Health limitations: Therapists must also observe a person's physical and health
limitations. "An individual may be fragile and experience low energy levels and medical
complications due to malnutrition. Therefore, the presentation or expression of dance or
 movement will vary, and it is the role of the therapist to meet the client where they are,
and respond accordingly," Kinsley explains. 
 Difficult feelings: Bohn says individuals who struggle with conditions such as eating
disorders often dislike, blame, or disconnect from their bodies. "DMT provides an
opportunity to experience living in their body differently, an opportunity to externalize
and express feelings, gain a deeper connection to self, and eventually develop a sense of
appreciation on compassion towards one’s self and body," she says. 

It is also important to note that dance therapy should not be used on its own for some
conditions. Eating disorders such as anorexia nervosa, bulimia nervosa, and binge eating
disorder are serious mental health issues that require professional treatment from a therapist,
psychologist, or psychiatrist.

In addition to traditional treatment modalities like psychotherapy, experts may recommend

DMT as an adjunct or add-on form of therapy when managing conditions such as eating
disorders.

EXPRESSIVE WRITING AND POETRY THERAPY

Expressive writing and poetry therapy are two forms of psychotherapy that use writing and
poetry as tools for emotional healing and growth.
Expressive writing involves writing about one's thoughts, feelings, and experiences in a
way that promotes emotional processing and healing. The technique involves writing for a
set amount of time each day, focusing on one's emotions and experiences. The goal is to increase
self-awareness, gain insight into one's emotions, and develop greater emotional regulation.
Poetry Therapy
Poetry therapy, a form of expressive arts therapy, involves the therapeutic use of poems,
narratives, and other spoken or written media to promote well-being and healing.
Therapists may use existing literature as part of treatment or encourage those in therapy to
produce their own literary works to express deep-seated emotions. In either case, they offer a
safe, non-judgmental atmosphere in which people in therapy are able to explore their written
expressions and associated emotional responses.
In more recent history, reading and expressive writing were employed as supplementary
treatments for those experiencing mental or emotional distress.
Today, poetry therapy is practiced internationally by hundreds of professionals, including
psychologists, psychiatrists, counselors, social workers, educators and librarians. The approach
has been used successfully in a number of settings—schools, libraries, hospitals, rehabilitation
centers, and correctional institutions, to name a few—with various populations, including
children, adolescents and the elderly.
HOW DOES POETRY THERAPY WORK?
As part of therapy, some people may wish to explore feelings and memories buried in the
subconscious and identify how they may relate to current life circumstances. Poetry is believed
to be beneficial to this process as it can often:

 Be used as a vehicle for the expression of emotions that might otherwise be difficult to
express
  Promote self-reflection and exploration, increasing self-awareness and helping
individuals make sense of their world
 Help individuals redefine their situation by opening up new ways of perceiving reality
 Validate emotional experiences and improve group cohesiveness by helping people
realize many of their experiences are shared by others
 Help therapists gain deeper insight into those they are treating
 Although the selection of material is usually done by the therapist, those being treated
might be asked to bring to therapy a poem or other form of literature they identify with,
as this may also provide valuable insight into their feelings and emotions.
TECHNIQUES USED IN POETRY THERAPY
A few different models of poetry therapy exist, but the most popular and most frequently used is
the model introduced by Nicholas Mazza. According to this model, poetry therapy involves
three major components: receptive/prescriptive, expressive/creative, and
symbolic/ceremonial.
In the receptive/prescriptive component

 the therapist will introduce a poem or piece of literature and encourage the person in
therapy to react.
 Selected material is usually read aloud by the therapist or the person in therapy so the
tone and rhythm of the poem can be fully experienced. During family session, turn-by-
turn reading is done
 While the poem is being read, the therapist notes the verbal and nonverbal reactions of
the individual, and these reactions are generally explored after the reading with
questions such as, "I noticed you were smiling as the poem was being read. Can you tell
me about your reaction?" "Is there a particular line in the poem that touched you?" "How
does this poem make you feel?"
The expressive/creative component involves

 the use of creative writing—poetry, letters, and journal entries--for the purpose of
assessment and treatment.
 The process of writing can be both cathartic and empowering, often freeing blocked
emotions or buried memories and giving voice to one's concerns and strengths.
 Therapists might also provide stem poems from which to work or introduce sense
poems for those who struggle with imagery.
 A therapist might also share a poem with the individual and then ask them to select a
line that touched them in some way and then use that line to start their own poem.
 In group therapy, poems may be written individually or collaboratively. Group members
are sometimes given a single word, topic, or sentence stem and asked to respond to it
spontaneously. The contributions of group members are compiled to create a single
poem which can then be used to stimulate group discussion.
 In couples therapy, the couple may be asked to write a dyadic poem by contributing
alternating lines.
The symbolic/ceremonial component involves

 the use of metaphors, storytelling, and rituals as tools for effecting change. Metaphors,
which are essentially symbols, can help individuals to explain complex emotions and
experiences in a concise yet profound manner.
  Rituals may be particularly effective to help those who have experienced a loss or
ending, such as a divorce or death of a loved one, to address their feelings around that
event.
 Writing and then burning a letter to someone who died suddenly, for example, may be a
helpful step in the process of accepting and coping with grief.
HOW CAN POETRY THERAPY HELP?
Poetry therapy has been used as part of the treatment approach for a number of concerns,
including
borderline personality, suicidal ideation, identity issues, perfectionism, and grief
Depression, PTSD (repeatedly shown to relieve depressive symptoms, improve self-esteem and
self-understanding, and encourage the expression of feelings)
Terminal Illness - reduce anxiety and distress
Some individuals who have survived trauma or abuse may have difficulty processing the
experience cognitively and, as a result, suppress associated memories and emotions. Through
poetry therapy, many are able to integrate these feelings, reframe traumatic events, and develop
a more positive outlook for the future.
Addiction Management – to explore their feelings regarding the substance abuse, perceive drug
use in a new light, and develop or strengthen coping skills. Express their thoughts on treatment
and behavior change.
Schizophrenia - Poetry writing may be a helpful method of describe mental experiences and can
allow therapists to better understand the thought processes of those they are treating. Also,
improve social functioning skills and foster more organized thought processes.
Things to Consider:
It is important to note in most instances, especially in cases of moderate to severe mental health
concerns, poetry therapy is used in combination with another type of therapy, not as the sole
approach to treatment
While expressive writing and poetry therapy can be beneficial, it is important to consider the
individual's comfort level with writing and poetry. Some individuals may find these techniques
difficult or triggering, so it is important for the therapist to gauge the individual's readiness and
comfort level. Additionally, it is important to ensure that the therapist has appropriate training
and expertise in these techniques, as they require specialized knowledge and skills.
PLAY THERAPY
Play therapy is a form of psychotherapy and can be effective in helping children through
emotional and mental issues. Children often use play to express themselves and navigate the
world and play therapy takes advantage of this. Play therapy is primarily used with children.
Although, it can also be used with adults. It is typically used with children who are aged between
3 and 12.
The primary goal of play therapy is to help children who might struggle with expressing
themselves or their emotions to express themselves through play.
A play therapist will guide a person through play therapy in a free and safe environment where
they feel most comfortable expressing themselves. Play therapists use play activities a child
might enjoy from painting to dancing to board games. At times play therapist will ask other
family members or parents and guardians to also get involved in the playtime activities.
Types of Play Therapy
There are two main forms of play therapy used by play therapists: 

 Directive Play Therapy: With directive play therapy, the therapist takes a hands-on
approach and leads the child through guided play activities to help them express
themselves. They’ll typically give specific instructions and supervise the child as they go
through it. 
 Non-directive Play Therapy: Non-directive play therapy makes use of a less controlled
environment. The therapist leaves the child to engage in whatever play activities they
might enjoy and express themselves with limited interference. 
Techniques 
Many different techniques can be applied during play therapy. The technique used during a
therapy session largely depends on your child’s needs and what play mediums they feel most
comfortable using.
A typical play therapy session usually lasts between 30 and 45 minutes. During a play therapy
session, the therapist will create a comfortable and safe environment for the child to play. The
therapist will then observe the child’s interactions with the toys that are provided.
As the child grows more comfortable in the therapist’s playroom, more specific play activities
that target the issues the child is dealing with will be introduced. Some of the most common
techniques used by play therapists across the world include: 

 Using building blocks

 Using art
 Sand play 
 Board games 
 Play with dolls 
 Puppet play
 Tea party play 
 Card games 
 Strategy games like chess or checkers 
 Hide-and-seek 
 LEGO play
What Play Therapy Can Help With?
Play therapy is particularly beneficial for people who struggle with communicating and
expressing themselves in a positive and healthy manner.
Children who have been abused or experienced extremely traumatic or stressful events might
benefit from play therapy to regain a sense of normalcy in their lives.  Children with certain
disorders which hamper their emotional and social expressions typically benefit greatly from
play therapy.
These could include children with behavioral disorders or learning disabilities. There has been
some research into the effectiveness of play therapy on children with the following conditions:

 Autism 
  Attention deficit hyperactivity disorder (ADHD)
 Depression
 Anxiety disorders
 Post-traumatic stress disorder 
 Physical and emotional trauma 
 Sexual abuse
 Physical or emotional abuse2
Benefits of Play Therapy 
People are often dismissive of play therapy and the benefits they hold. Concerned parents often
find it hard to understand what benefits their children gain from “just playing.” However, the fact
is that with or without the guidance of a therapist, children like to communicate through play,
whether you might have noticed it or not. A child playing violently with toys might be dismissed
as aggressive when in reality, he might be mirroring a violent domestic situation he has been
witnessing.
Here are some of the benefits of play therapy:
1. Play therapy gives children who are having a hard time communicating verbally to
express themselves through play activities. For instance, a child who refuses to speak
might instead draw or paint out their thoughts or needs.
2. It creates a space where a child will feel comfortable being themselves instead of other
more traditional forms of psychotherapy.
3. It allows the child to take charge of their therapy process. Effective play therapy allows
the child to use toys and mediums they are most comfortable with and go at their own
pace.
4. It helps children understand their emotions, especially if they had struggled with doing
this before.
5. It helps children build up their communication and social skills with time. After several
sessions, a child who wasn’t speaking might start to utter several phrases.
Effectiveness 
Most traditional forms of therapy might not connect with children who are as young as 3 to 12
years old.
In a 2009 study on the effectiveness of play therapy with aggressive children, researchers
divided a group of students with a history of aggressive behavior into two groups. One group
was exposed to play therapy and the other group was used as a control group. At the end of the
study, the researchers found that the children who had been exposed to play therapy showed
significant improvement in aggressive behaviors over the children in the control group.
A 2005 analysis of 93 studies conducted between 1953 to 2000 on the effectiveness of play
therapy with children also supports the theory that it’s an effective method of therapy for
children.4 The review found that this form of therapy produced positive effects, even more so
when the parents of the child in therapy were involved. It also found that this form of therapy
appeared to be effective across age and gender.
Things to Consider 
While a play therapist will take the lead during play therapy, the child’s parent or guardian also
has an important role to play.
The play therapist will typically have a joint consultation with the parent and guardian and the
child and also separate consultations with all parties involves. This is done to completely
understand the child’s needs. When looking for a play therapist for your child, it’s important to
ensure they have the relevant experience and expertise. 
How to Get Started 
If you have a child who might benefit from play therapy or know someone who could you should
get started by getting in touch with a licensed psychologist or psychotherapist who has
experience dealing with children, and with play therapy. Play therapy is typically done over
several sessions, it’s also important to work with someone with who your child feels absolutely
comfortable. 
Need of Art Therapy: Why and How the Art Therapist Helps
The need for expressive art therapy arises from the understanding that artistic expression can
be a powerful tool for emotional healing and growth. Expressive art therapy is a form of
psychotherapy that uses a variety of creative modalities, such as visual art, music, dance, drama,
and writing to help individuals explore and process their emotions, develop coping skills, and
gain insight into their experiences.
Expressive art therapists help their clients in a variety of ways. Here are some examples:
1. Providing a safe and supportive environment: The expressive art therapist creates a
safe and supportive environment in which the individual can express themselves freely
without fear of judgment or criticism. This environment allows for the exploration of
difficult emotions and experiences.
2. Encouraging creative expression: The expressive art therapist encourages creative
expression as a means of exploring emotions and experiences. Through this process, the
individual may gain new insights and perspectives on their situation.
3. Facilitating self-awareness: The expressive art therapist helps the individual develop
greater self-awareness by exploring their inner experiences and emotions through
artistic expression. This can help the individual gain a deeper understanding of
themselves and their needs.
4. Developing coping skills: The expressive art therapist helps the individual develop
coping skills to manage difficult emotions and experiences. By exploring these
experiences through art, the individual can develop new ways of thinking and
responding to difficult situations.
5. Building self-esteem: The expressive art therapist helps the individual build self-
esteem by validating their artistic expression and encouraging them to view their art as
a valuable form of self-expression.
Overall, the expressive art therapist helps individuals express themselves creatively, explore
their emotions and experiences, and gain insight into their lives. By doing so, expressive art
therapy can be a powerful tool for emotional healing and growth.
Limitations And Concerns Of Art Therapy
One of the major concerns of art therapy is the effectiveness of the approach. Though
many support its efficacy, others are skeptical. Adults in particular may not be inclined to
cooperate fully and openly with the treatment process or may refuse this type of treatment
entirely. Additionally, some individuals may believe they are not creative or artistic
enough for the treatment to be successful, although the goal of treatment is to express
one's thoughts and emotions, not produce artistic masterpieces. The effectiveness of art
therapy may also be criticized, due to a lack of supporting empirical evidence.
Those who do proceed with art therapy treatment may find they have to commit to a
series of sessions before they begin to experience the therapeutic benefits of the
approach. Other concerns include the costs associated with the purchase of needed
tools, media, and other materials. Obtaining a suitable setting for therapy to take
place (especially if fluid media, special lighting, or other specialized equipment is
used) may also prove challenging. 

MODULE 2: ART THERAPY & CLINICAL NEUROSCIENCE

Art therapy and clinical neuroscience are two related fields that focus on the intersection
of art, psychology, and neuroscience. Art therapy is a form of psychotherapy that uses creative
expression as a means of promoting mental, emotional, and physical well-being. It is based on
the idea that the creative process can help individuals to explore their feelings, reconcile
emotional conflicts, develop self-awareness, manage behavior and addictions, reduce anxiety
and stress, and increase self-esteem and resilience.
Clinical neuroscience, on the other hand, is the study of the brain and nervous system and their
relationship to behavior and mental processes. It aims to understand the biological and
neurological mechanisms that underlie different mental health disorders and to develop more
effective treatments based on this understanding.
The two fields are related in that art therapy draws on insights from neuroscience to better
understand how creative expression can promote mental health and well-being. Art
therapists may use neuroscientific research to inform their practice and to develop new
approaches to working with clients. The combination of art therapy and clinical neuroscience
offers a unique and powerful approach to promoting mental health and well-being,
blending creative expression with scientific understanding to help individuals lead
healthier, more fulfilling lives.
Mind-Body Connectivity

 The study of mind-body connections looks at how experiences, emotions, behavior, and
physical health interact. Mind-body approaches explore how the nervous, endocrine, and
immune systems connect to create physiological and psychological changes.
 Psychoneuroimmunology (PNI) is a discipline that studies these complex, chemical,
bodily connections.
 Understanding the neurobiological connections between the mind and body is
important for effective therapy. The idea of separating the mind and body as two
separate entities is not useful in this field.
  The mind-body connection is evident in the organization of the nervous system.
 The central nervous system consists of the brain and spinal cord.
 The peripheral nervous system controls both involuntary and voluntary responses.
 The autonomic nervous system controls involuntary responses, maintains normal
functions, and restores homeostasis.
 The somatic nervous system conveys sensory information and controls voluntary
actions.
 The autonomic nervous system has two branches, the sympathetic and
parasympathetic nervous systems.
 The sympathetic nervous system helps us adapt quickly to environmental and
relational situations and propels us into action. The flight or fight response is
associated with SNS activation.
 The parasympathetic nervous system returns a person to a relaxed state after the
SNS response.
 The SNS and PNS functions complement each other and mildly shift a person between
mild variations of excitation and relaxation states.
Initially, novel demands may cause excitement and anticipation, but if the task is not mastered,
the SNS stress response may increase.

 Art therapy can help clients deal with psychosocial stressors.

 Drawing or sculpting in session can help clients feel a sense of control and safety.
 Afferent nerves carry incoming sensory information from touching the art materials,
while efferent nerves cause the necessary muscle contraction needed for drawing,
painting, and sculpting.
 Art therapy experiences can provide relief through the expression of emotions and
kinesthetic and voluntary actions.
 The vagal nerve, which has connections to the brain, chest, and abdominal areas, can
influence our "gut feelings."
  In art therapy, it's important to talk to clients about how their thoughts and
emotions can affect their response to stress. The cerebral cortex, the top part of
the brain, controls thoughts and is responsible for sophisticated social cognition,
emotional appraisal, and voluntary movement. The neocortex covers the limbic
system structures located in the central brain and most of the brainstem. The cortex
has two hemispheres, each divided into five lobes. The cortex links information from
the body, brainstem, and limbic system.
 frontal lobes integrate visual data
 parietal lobes sense space and navigation
 temporal lobes process auditory and visual information

Connections between the temporal lobes and the limbic system allow emotions,
recognition, and memory to influence the meaning of visual information. The right
temporal lobe is associated with nonverbal response-oriented activities.

 Art therapy facilitates mind-body connectivity and helps remediate acute and chronic
stress.
 Other mind-body interventions include biofeedback, EMDR, relaxation techniques,
mindfulness meditation, and hypnosis.
 Most mind-body approaches focus on intrapersonal remediation of stress, while art
therapy includes expressive and relational foci.
 Art therapy promotes self-expression and interpersonal connectivity through the
therapeutic relationship.
 Art therapy provides clients with support for generalizing their experiences in
session to the outside world.
Establishing connectivity: Development and Learning

 Early relationships between caregivers and infants affect the development of the
emotional brain.
 From birth, the subcortical regions of the central brain, responsible for emotional
processing, are actively making neural connections. Consequently, the
infant/caregiver affective relationship has a large impact on neural networks’
connectivity thus shaping brain development and maturation.
  Neurons are the building blocks of the brain's connectivity and have a basic
structure that includes dendrites, axons, and myelin sheathing.
 Neurons communicate with each other through chemical messengers called
neurotransmitters that cross synapses between them.
 Repeated firing of neurons thickens dendritic connections and contributes to
learning and memory formation.
 Sensory art experiences can strengthen memories
 Synaptic pruning removes unused and damaged neuronal connections in the brain.
Disruptions in synaptic pruning can harm effective communication in the brain, as
seen in autism.
 Myelination is a white sheath around axons that facilitates unimpeded electrical
communication. Myelination is mostly genetically determined and occurs sequentially
from back to front in the brain.
 Synaptic shaping and myelination contribute to brain weight and volume, and
processing efficiency. Synaptic shaping and myelination contribute to brain growth
and maturation.
First two years of life are crucial for experience-dependent brain maturation. Non-verbal
communication between mother and infant organizes neurobiological systems. Infant's social
brain matures according to a timeline of critical periods. Self-regulation of the infant's growth of
the nervous system, linking subcortical areas with the developing cortex.
Art therapists working with mothers and caregivers may want to share how somatosensory
regulatory experiences of holding, touching and gazing help organize their child’s nervous
system. The interactive brain is social as mothers and babies continue to soothe each other and
grow in shared contexts of emotion and behaviour.

 Relational art activities can increase mother-child trust and attachment

 Therapeutic art-making can help mitigate postpartum and clinical depression
 Consistent and responsive care and early childhood interventions correlate with
positive development trajectory
  Caution must be taken not to overwhelm developing brains with too much
somatosensory stimuli
 Severe child abuse and neglect can result in deprivation of brain stimulation and
neuronal death
 Neurobiological consequences of childhood abuse and neglect can lead to enduring
states of fear and perpetuating violence
 The frontal lobes responsible for attention, concentration, and sophisticated
decision-making myelinate and reorganize during adolescence
 Extensive synaptic changes during adolescence contribute to social-emotional
turmoil
 The brain continues to organize and change throughout the lifespan by means of
social-emotional experiences.
Brain Plasticity

 Brain plasticity is the brain's ability to renew and rewire to compensate for deficits
 Brain plasticity is not limited to early development, but is also an adult
phenomenon
 Neuroimaging has shown that the brain can alter its shape within weeks through
physical and mental activity
 Greater brain usage increases dendrites and synaptic activity, thickening brain gray
matter and resulting in heavier brains
 Heavier brains are less vulnerable to neurogenerative diseases like Alzheimer's
and can better compensate for brain injury
 Aerobic exercise and cognitive behavioral therapies modify neural circuitry function,
increasing brain volume and function while reducing cortical atrophy associated with
aging
 Making art and consistently communicating through art forms may have similar
positive effects on the brain
 Hippocampus holds short-term memory and regenerates adult neurons during
physical exercise and learning new tasks
 Chronic stress can harm hippocampal neurons, but treatments for depression can
enhance hippocampal neurogenesis and treat mood disorders.
Mood disorders like depression and anxiety have to do with problems regulating emotions.
The social brain is responsible for expressing and regulating emotions from infancy to
adulthood. This process involves connections between different parts of the brain such as
the subcortical, limbic, and cortical areas. Art therapy can help with emotional
expression and regulation through the use of colours and textures that can stimulate
emotional memories. Creating art provides an opportunity for expressing, understanding,
and integrating emotions in the present moment.
Affect Regulation and Integration
 Affective neuroscience emphasizes connecting limbic emotions with right
prefrontal cortex communication.
 The orbital frontal cortex (OFC) is the common area of activation for both core and
social affects.
 The OFC is considered the pinnacle of emotional processing and is located just above the
central brain, connecting limbic emotions with the frontal cortex.
 Right OFC inhibits defensive behavior and responds to rewarding visual stimuli.
Abstract and patterned visual stimuli activate right OFC.
 Lower OFC regions inhibit fear and stress responses.
 Frontal areas of OFC activate for expected visual stimuli.
 The anterior cingulate cortex (ACC) helps with OFC processing of limbic emotions
and mediates affect regulation and anxiety associated with unfamiliar patterns.
 The insular cortex, located within the lateral sulcus, contributes to a sense of self
through embodied cognitions and transmits visceral bodily events associated with
emotions into conscious feelings.
 The somatosensory cortex and motor strips also contribute to the connections
between the body and brain, and engaging in sensory-based activities is important for
children's development.
 "Art as therapy" can activate neural pathways related to tactile and kinesthetic
sensations associated with the primary somatosensory cortex.
 Sensory experiences include touch, movement, visual and sound.
 Polymodal integration areas, such as the superior temporal gyrus, are junctures
where different areas in the brain meet.
 Sensory integration activities and kinesthetic movement associated with art therapy
activities can help express, experience, and learn how to regulate affects more easily.
 Non-verbal exploration and expression of emotions through sensory art-making
processes can encourage vertical integration of brain function and result in complex
feelings such as authorship.
  Expression of more complex cortical feelings such as a determination to problem-
solve or the anticipation of pride or shame can be entrained through the non-verbal
exploration and expression of emotions.
 Art therapy can potentially facilitate integrating left and right hemisphere
function.
 The corpus callosum connects the hemispheres.
 The right hemisphere is more emotional and non-verbal, while the left hemisphere
is more problem-solving and language oriented.
 A bilateral art protocol can facilitate systemic integration of hemispheric right-left
functions.
 The protocol involves drawing conflicting choices with different hands on each side
of the page and revisiting the page to create a response drawing with the opposite hand
or both hands.
 Art therapy can regulate limbic affects by engaging left cortical functions. Clients can be
asked to title artwork and talk about their feelings. The left hemisphere specializes in
language reception and production. Language and social communication are essential
for affect regulation.
 The brain has two main language centers: Wernicke's and Broca's areas
 Talking about art engages cortical shifts and can reduce amygdala activity
 Titling and talking about artwork may become routine and increase prefrontal
activation.
Expressions of Relational Empathy and Mindfulness

 Affect regulation is influenced by relationships with others.

 Interpersonal relationships can evoke or alleviate stressful emotions.
 The goal of interpersonal neurobiology is to increase flexible, adaptive, coherent,
energized and stable states of mind.
 Humans can learn through empathic imitation and observation of another’s actions
facilitated by mirror neurons.
 Mirror neurons were first discovered in the brains of Macaque monkeys and fired when
the monkeys performed purposeful hand and feet actions or recognized purposeful and
successful acts performed by others. Mirror neurons may play a role in the empathic
connectivity between art therapist and client.
 Interpersonal relationships are important for affect regulation. Therapeutic goals
include increasing flexible, adaptive, coherent, energized, and stable states of
mind.
 Empathic resonance is evoked through networks of similar brain areas responding
and firing, facilitated by mirror neurons. Mirror neurons fire in response to
purposeful tool use.
 Planning and executing purposeful actions require self-regulation, which involves
the prefrontal lobes associated with executive functions like perceiving, verbalizing,
motivating, and coordinating.
 Carefully choosing art therapy media can help regulate expressivity and integrate affect
with willful action.
 Traditional structured media like pencils may stifle expressivity and not provide enough
impetus for integrating affect and cognition.
 Subtle media differences, like using tempera paint instead of acrylic, can encourage
necessary expression of emotions.
  Painting with pastels can be structured and integrate emotional experiences through a
range of soft to hard pastels, color restrictions, and paper gradations.

Three self-portraits

 The first portrait (on the left) shows emotional conflict expressed through the
gliding of soft pastels on fine sandpaper
 The use of soft and hard pastels in the middle portrait allowed for more reflection
and a recognizable face to emerge
 The final portrait is affected by the restricted color palette and traditional pastel
paper, allowing for more space on the page and a new dialogue within the artist
 The last portrait is more effortful, but not necessarily more realistic, and allows for a
mindful expression of the self.
CREATE: Art Therapy Relational Neuroscience Principles (ATR-N)
CREATE: Art Therapy Relational Neuroscience Principles (ATR-N) is a framework that
integrates the principles of art therapy and neuroscience to provide a comprehensive
understanding of the therapeutic process. The framework emphasizes the role of the
relationship between the art therapist and client in the therapeutic process and highlights the
importance of regulating emotions and integrating affective experiences through creative
expression.
The ATR-N framework is based on six principles: Connection, Regulation, Embodiment,
Affect, Transformation, and Existence. These principles form the foundation of the
therapeutic process and guide the art therapist in understanding and responding to the client's
needs.
1. The first principle, Connection, emphasizes the importance of building a safe and
trusting relationship between the art therapist and the client. The art therapist
must create a non-judgmental and supportive environment in which the client feels
comfortable exploring their emotions and expressing themselves creatively.
2. The second principle, Regulation, highlights the role of the prefrontal cortex in
regulating emotions and integrating affective experiences. The art therapist must
 help the client develop self-regulation skills through creative expression, allowing them
to better manage their emotions and respond to stressors in their daily life.
3. The third principle, Embodiment, recognizes the importance of embodied
experiences in creative expression. The art therapist must encourage the client to
connect with their bodily sensations and use art materials to express these experiences.
4. The fourth principle, Affect, emphasizes the role of emotions in the therapeutic
process. The art therapist must help the client identify and express their emotions
through creative expression, allowing for a deeper understanding and integration of
these experiences.
5. The fifth principle, Transformation, recognizes the transformative power of creative
expression. The art therapist must facilitate the process of transformation, allowing the
client to explore and integrate new perspectives and experiences through their artwork.
6. The sixth principle, Existence, acknowledges the unique and subjective experiences
of each individual. The art therapist must honour and validate the client's experiences
and work collaboratively with them to achieve their therapeutic goals.
Overall, the ATR-N framework provides a comprehensive and holistic approach to art therapy,
integrating the principles of neuroscience to better understand the therapeutic process. It
emphasizes the importance of the therapeutic relationship, emotion regulation, and creative
expression in promoting healing and transformation.
Applications of CREATE: Art Therapy Relational Neuroscience Principles (ATR-N)
CREATE: Art Therapy Relational Neuroscience Principles (ATR-N) can be applied in various
settings, including clinical and non-clinical contexts. Here are some examples:

 Clinical Practice: CREATE principles can be used in clinical practice to support clients
with various mental health issues, such as depression, anxiety, trauma, and substance
abuse. Art therapists can use CREATE to develop individualized treatment plans that are
tailored to their clients' needs and preferences. For instance, CREATE can be used to help
clients develop emotional regulation skills, enhance social connection, and promote
positive neuroplasticity.
 Group Therapy: ATR-N can also be used in group therapy settings to facilitate group
cohesion, empathy, and self-regulation. By creating a shared understanding of the
neurobiological underpinnings of emotional experience and interpersonal
communication, ATR-N can help group members build stronger and more supportive
relationships.
 Trauma Treatment: ATR-N can be particularly useful in trauma treatment, as it can
help art therapists understand how traumatic experiences can affect the brain and the
body. By applying ATR-N principles, art therapists can help clients develop greater
awareness and regulation of their emotional and physical responses to trauma triggers.
 Education: CREATE principles can be integrated into art therapy education programs to
help train future art therapists. By incorporating neuroscience research and principles
into the curriculum, students can gain a deeper understanding of the neurobiological
underpinnings of art therapy and how to apply them in clinical practice.
 Research: CREATE can be used to guide art therapy research, particularly in
investigating the efficacy of art therapy interventions. By using a neuroscience-based
framework, researchers can explore the neural mechanisms underlying art therapy and
better understand how art therapy can promote healing and growth.
 Community Settings: CREATE can be applied in non-clinical settings, such as
community art programs, to promote well-being and enhance social connections. For
 instance, CREATE principles can be used to develop art-based programs that target
specific populations, such as older adults or individuals with disabilities, to help reduce
social isolation and enhance quality of life.
 Organizational Settings: CREATE can also be applied in organizational settings, such as
workplaces, to promote employee well-being and productivity. By integrating art-based
activities and practices that align with CREATE principles, organizations can help
employees reduce stress, enhance creativity, and promote positive social interactions.
In summary, CREATE: Art Therapy Relational Neuroscience Principles (ATR-N) can be
applied in various settings to promote well-being and support individuals with mental health
issues. By incorporating neuroscience research and principles into art therapy practice,
education, and research, art therapists can enhance their understanding of the therapeutic
process and improve treatment outcomes.

MODULE 3: CLINICAL APPROACHES TO ART THERAPY

Psychoanalytic Approaches
The psychoanalytic approach to art therapy is based on the principles of psychoanalysis,
which emphasizes the unconscious mind, early childhood experiences, and the
therapeutic relationship between the therapist and client. This approach to art therapy is
rooted in the belief that art can be used to express unconscious thoughts and feelings, and
that the therapist can help the client gain insight and understanding by interpreting their
art.
The goal of psychoanalytic art therapy is to help clients gain insight into their
unconscious thoughts and emotions, and to use this insight to bring about positive change
in their lives. The therapist encourages the client to create art without any preconceived
notions or goals, and then uses the artwork as a starting point for discussion.
The therapist will typically ask open-ended questions about the artwork, such as "What
does this image mean to you?" or "How do you feel about this image?" The client's
responses are then used to explore deeper issues and emotions.
The therapist may also use free association techniques, which involve asking the client to say
whatever comes to mind when looking at a particular image or object in their artwork.
This can help to uncover unconscious thoughts and feelings that the client may not be aware of.
One of the key principles of psychoanalytic art therapy is transference, which refers to the
way in which the client may unconsciously transfer feelings or attitudes they have
towards someone else (such as a parent or authority figure) onto the therapist. The therapist
may use this transference to help the client gain insight into their relationship patterns and
explore ways to make positive changes.
Cognitive Behavioral Approaches
Cognitive behavioral approaches to art therapy are based on the principles of cognitive
behavioral therapy (CBT), which is a widely used form of talk therapy. This approach to art
therapy is grounded in the belief that a person's thoughts, feelings, and behaviors are
interconnected, and that by changing one of these areas, the others can be positively
impacted.
In cognitive behavioral art therapy, the therapist works with the client to identify negative
thoughts and beliefs that may be contributing to their mental health issues. The client is
then encouraged to create art that challenges these negative thoughts and beliefs, and to
identify and explore alternative ways of thinking and behaving.
For example, if a client is struggling with anxiety and has negative thoughts such as "I'm not
good enough" or "I can't handle this situation", the therapist may encourage them to create an
artwork that challenges these thoughts. This could involve creating an image that shows the
client being successful in a situation that they are anxious about, or creating an artwork that
portrays their strengths and abilities.
The therapist may also use cognitive restructuring techniques, which involve helping the
client to identify and challenge negative thought patterns. For example, the therapist may
ask the client to create an artwork that represents a negative thought, and then work with them
to reframe that thought into a more positive and realistic one.
Cognitive behavioral art therapy can also involve the use of behavioral techniques, such
as exposure therapy, which involves gradually exposing the client to situations or stimuli
that they are afraid of or anxious about, while teaching them coping skills to manage
their anxiety.
Cognitive-behavioural therapy and image making are combined in art therapy to reduce
negative thoughts. Image making complements verbal therapy and offers visual
communication to enhance therapy.
Collaborating with the therapist on creative visual strategies can lead to change. Therapy
benefits continue with imagery-related homework and hands-on strategies.
A cognitive behavioural approach to art therapy reframes dysfunctional patterns and
supports a positive sense of self. Overall, cognitive behavioral approaches to art therapy can
be effective in helping clients to identify and challenge negative thought patterns, and to
develop new coping skills and strategies.
Humanistic Approaches
Humanistic approaches to art therapy emphasize the client's capacity for self-discovery
and self-actualization. These approaches are grounded in the belief that every person has
inherent worth and dignity, and that the therapeutic relationship should be based on
empathy, authenticity, and unconditional positive regard.
The humanistic approach to art therapy emphasizes the present moment and the subjective
experience of the client, with the therapist acting as a supportive and non-judgmental
presence. The therapist may encourage the client to explore their emotions and feelings
through art, and may also use reflective listening techniques to help the client gain insight
into their experience.
One key principle of humanistic art therapy is the concept of self-expression, which
involves helping clients to express their inner thoughts and feelings through art. The
therapist may also focus on helping clients to develop their sense of self-awareness, self-
acceptance, and self-esteem.
Another important principle of humanistic art therapy is the belief in the power of creativity
to promote growth and healing. The therapist may use artmaking as a way to facilitate the
client's exploration of their inner world and to help them tap into their inner resources
and strengths.
Humanistic approaches to art therapy emphasize the importance of the person in the
therapeutic process. These approaches include examining life's existential meaning
through art, experiential techniques of Gestalt art therapy, and contemplative methods
used in transpersonal work.
Unconditional regard, human potential, free will, self-actualization, and self-
transcendence are concepts that complement the application of art expression in therapy. All
forms of artistic expression are seen as a will to meaning, and the belief is that individuals
have the ability to find wellness through creative exploration.
Overall, the humanistic approach to art therapy emphasizes the client's unique experience
and inner wisdom, and seeks to empower the client to take an active role in their own
healing process. It can be a powerful tool for promoting personal growth and self-discovery.
Existential Approaches
Existential approaches to art therapy are based on the premise that art-making can
facilitate the exploration of existential themes such as freedom, choice, responsibility,
and meaning-making. These approaches emphasize the individual’s subjective experience
and encourage clients to explore their feelings and beliefs through creative expression. The
therapeutic process involves the creation of art as well as the verbal exploration of the
artwork, which is used to uncover existential concerns and promote self-awareness.
Existential approaches to art therapy are influenced by the work of existential philosophers
and psychologists such as Jean-Paul Sartre, Martin Heidegger, and Rollo May. These
thinkers emphasized the importance of subjective experience and the need for individuals
to find meaning and purpose in life. They also acknowledged the anxiety and uncertainty
that accompany the search for meaning and the importance of making choices and taking
responsibility for one’s own life.
In art therapy, existential themes can be explored through a variety of media, including
drawing, painting, sculpture, and collage. Clients may be asked to create artwork that
represents their fears, hopes, and desires, or that reflects their experience of freedom,
choice, and responsibility. The therapist may also encourage clients to reflect on the artwork
and discuss how it relates to their lives and their sense of meaning.
Existential approaches to art therapy also emphasize the importance of the therapeutic
relationship, which is viewed as a partnership between the client and therapist. The
therapist serves as a guide and facilitator, helping the client to explore their inner world
and providing support and validation as they confront existential concerns.
Overall, existential approaches to art therapy provide a means for clients to explore the
complexities of the human experience and to find meaning and purpose in their lives. By
engaging in creative expression, clients can gain insight into their own values and beliefs, and
develop a greater sense of self-awareness and personal growth.
Gestalt Approaches
Gestalt therapy is an experiential and humanistic approach to psychotherapy that
emphasizes present moment awareness, personal responsibility, and the integration of
thoughts, emotions, and behaviors. It is a holistic approach that focuses on the individual's
lived experience, emphasizing personal growth and self-awareness. Gestalt therapy
encourages individuals to become aware of their feelings, thoughts, and behaviors, and to
take responsibility for their own experiences.
In Gestalt art therapy, art-making is used as a tool for exploration and self-discovery. The
focus is on the process of creating art, rather than the final product, and the therapist
encourages the client to be fully present in the moment, using their senses and intuition to
guide their creative process. The therapist may also ask the client to reflect on their artwork
and explore their feelings, thoughts, and behaviors that emerged during the art-making
process.
One of the central concepts of Gestalt therapy is the idea of the "here and now". This means
that the therapist focuses on the client's current experience, rather than exploring past
events or future goals. In Gestalt art therapy, this means that the therapist encourages the
client to be present in the moment and to create artwork that reflects their current
emotional and psychological state.
Another key aspect of Gestalt therapy is the emphasis on personal responsibility. The
therapist encourages the client to take responsibility for their own experiences, thoughts,
and feelings, and to explore how they contribute to their own growth and development. In
Gestalt art therapy, this may involve exploring the client's artistic choices and the symbolism
and meaning behind their artwork.
The therapist in Gestalt art therapy is seen as a collaborator and co-creator with the client,
rather than an expert or authority figure. The therapist works with the client to explore
their thoughts, feelings, and behaviors, using art-making as a tool for self-exploration and
personal growth. The therapist may also use techniques such as role-playing, dialogue, and
movement to help the client gain a deeper understanding of their experiences and patterns of
behavior.
Overall, Gestalt art therapy is a holistic and experiential approach that emphasizes personal
growth, self-awareness, and the integration of thoughts, emotions, and behaviors. It
encourages individuals to become fully present in the moment and to take responsibility for
their own experiences, using art-making as a tool for self-exploration and personal
development.
Narrative Approaches
Narrative approaches to art therapy involve the use of storytelling and the creation of visual
narratives to help clients explore and express their life experiences. This approach is based
on the belief that people create meaning through their experiences and that by exploring
and reshaping their stories, clients can gain a new perspective on their lives.
In narrative art therapy, clients are encouraged to create art that tells a story or reflects a
particular experience. The therapist may ask open-ended questions about the artwork,
such as "What is happening in this image?" or "What emotions do you see in this picture?"
These questions help to elicit the client's narrative and give them an opportunity to explore
their thoughts and feelings in a safe and supportive environment.
The therapist may also use guided imagery techniques to help the client visualize their
narrative in a more concrete way. For example, they may ask the client to imagine themselves
in a specific situation and then create artwork that reflects that experience.
Through the process of creating and exploring their narrative, clients can gain insight into
their emotions, beliefs, and values. They may also discover new ways of understanding
their experiences and find a sense of empowerment through the act of reshaping their
stories.
Overall, narrative approaches to art therapy offer a powerful way for clients to explore and
express their life experiences, gain insight and perspective, and develop a sense of agency
and resilience.
Solution-Focused Approaches
Solution-focused approaches to art therapy are based on the principles of solution-focused
brief therapy (SFBT). This approach focuses on helping clients identify and build upon
their strengths and resources, rather than dwelling on their problems or issues. In art
therapy, the therapist may ask the client to create an image that represents their desired
outcome or goal, and then use this image as a starting point for discussion.
The therapist will often ask questions that focus on identifying the client's strengths,
resources, and previous successes. The goal is to help the client recognize that they have
the ability to create positive change in their life, and to empower them to take action
towards achieving their goals.
The solution-focused approach to art therapy is often brief and goal-oriented, with a focus on
identifying specific, measurable outcomes. The therapist and client work collaboratively to
develop a plan of action and identify steps that the client can take to move towards their
desired outcome.
This approach can be particularly effective for clients who are feeling stuck or
overwhelmed, as it encourages them to focus on what they can do to create change, rather
than feeling helpless or defeated by their problems. It also emphasizes the client's agency and
autonomy, which can help to increase their sense of self-efficacy and confidence.
Developmental Approaches
Developmental approaches to art therapy are based on the theory that artistic expression can
provide insights into a person's developmental stages and processes. This approach
focuses on the individual's developmental needs and the use of art to facilitate growth and
healing.
Developmental art therapy is typically used with children, adolescents, and adults who have
experienced developmental trauma or are struggling with developmental challenges. The
approach is designed to help individuals identify and work through developmental issues
that may be impacting their current functioning.
It involves creating art that reflects one's experiences, emotions, and developmental
stages, and using this art as a tool for self-discovery, expression, and growth. The art
therapist may provide guidance and support in identifying and interpreting the developmental
themes that emerge from the artwork. The goal of developmental art therapy is to promote
personal growth and development, increase self-awareness and insight, and facilitate
healing and well-being.
The developmental stages that are typically addressed in art therapy include early childhood,
middle childhood, adolescence, and adulthood. For each stage, developmental art therapy
interventions are tailored to address the specific developmental tasks and challenges that
individuals face. For example, in early childhood, art therapy interventions might focus on
developing sensory-motor skills and exploring emotions related to separation and
individuation. In adolescence, art therapy interventions might focus on exploring identity
formation and managing complex emotions.
Developmental approaches to art therapy also incorporate a variety of artistic media, such as
painting, drawing, sculpture, and collage, to provide individuals with multiple ways to
express themselves. The therapist may also use developmental assessments to guide the art
therapy interventions and to monitor progress over time.
Overall, the goal of developmental approaches to art therapy is to promote emotional
growth, increase self-awareness and self-esteem, and help individuals navigate the
challenges of their developmental stage.
Multimodal Approaches
Multimodal approaches to art therapy incorporate various forms of art-making techniques,
including visual arts, movement, music, drama, and creative writing, to address the
psychological and emotional needs of clients. This approach recognizes that individuals
have different learning styles, modes of expression, and emotional states, and therefore
offers a diverse range of art forms to facilitate the therapeutic process.
Multimodal art therapy aims to create an integrative approach that recognizes the whole
person and their unique expression of self. The approach is based on the assumption that the
integration of multiple modalities can enhance self-expression, increase awareness of
emotions and behaviors, and promote self-reflection and personal growth.
One of the core tenets of multimodal art therapy is the principle of complementarity, which
involves using different art forms in combination to achieve a common therapeutic goal.
For example, a client may create a drawing to express their emotions, followed by using
movement to embody and process the emotions expressed in the drawing. The use of multiple
modalities in this way allows for a more holistic approach to therapy, as it can help to
address the multiple dimensions of a person's experiences.
Multimodal art therapy can be particularly effective for clients who struggle with verbal
expression or who find it difficult to connect with their emotions. By offering alternative
modes of expression, multimodal art therapy can enable clients to communicate their
thoughts, feelings, and experiences in a more accessible way. This can help to increase self-
awareness, self-esteem, and emotional regulation, leading to a more fulfilling and satisfying
life.
Multimodal art therapy can be used to address a range of mental health issues, including
anxiety, depression, trauma, and addiction. It can also be effective in helping individuals who
have experienced loss or who are struggling with life transitions. The approach can be used
with clients of all ages, from children to the elderly, and can be adapted to meet the specific
needs of each individual.
In summary, multimodal approaches to art therapy offer a diverse and integrative way to
facilitate personal growth and healing. By incorporating various art forms, therapists can
support clients in exploring and expressing their emotions and experiences in a safe and
non-judgmental space. This approach can lead to increased self-awareness, emotional
regulation, and overall well-being.
MODULE 4
 CLINICAL APPLICATION WITH CHILDREN AND ADOLESCENTS

Art therapy is a type of therapy that uses art-making as a form of communication and self-
expression. It is a helpful tool for children and adolescents who may have difficulty expressing
their thoughts and feelings through words alone.
According to the Handbook of Art Therapy edited by Cathy A. Malchiodi, expressive art therapy
can be used as a clinical intervention with children and adolescents to address a range of
emotional and behavioral issues. Here are some of the clinical applications of expressive art
therapy:
1. Trauma and PTSD: Expressive art therapy can help children and adolescents who have
experienced trauma to process and express their emotions and experiences in a safe and
supportive environment. This can include the use of art materials to create visual
representations of their experiences, as well as other creative techniques such as
movement and storytelling.
2. Anxiety and Depression: Art therapy can be used to help children and adolescents who
are struggling with anxiety and depression to express their feelings and develop coping
skills. This might involve the use of art materials to create images that represent their
emotions, as well as mindfulness and relaxation techniques.
3. ADHD and behavioral issues: Expressive art therapy can help children with ADHD and
other behavioral issues to develop self-regulation skills and improve their ability to
focus and concentrate. This might involve the use of art materials to create images that
help them focus, as well as other techniques such as mindfulness and meditation.
4. Autism and Developmental Disabilities: Art therapy can be used to help children with
autism and other developmental disabilities to develop social skills, improve
communication, and express themselves creatively. This might involve the use of art
materials to create images that help them communicate their thoughts and feelings, as
well as other creative techniques such as drama and music therapy.
5. Grief and Loss: Art therapy can be used to help children and adolescents who are
grieving the loss of a loved one or experiencing other types of loss. This might involve
the use of art materials to create visual representations of their feelings and memories,
as well as other creative techniques such as journaling and storytelling.

Overall, expressive art therapy can be a powerful and effective clinical intervention for children
and adolescents who are struggling with emotional and behavioral issues. It provides a safe and
supportive environment in which they can express themselves creatively and develop the skills
they need to cope with the challenges they face.
ART THERAPY AND PLAY THERAPY WITH SEXUALLY ABUSED CHILDREN
According to the Handbook of Art Therapy edited by Cathy A. Malchiodi, art and play therapy
can be effective in the clinical treatment of sexually abused children. The following are some
clinical applications of art and play therapy with sexually abused children:
1. Using art therapy to help children express their feelings: Art therapy can help
children who have been sexually abused to express their feelings in a safe and non-
threatening way. Children can use art to communicate their emotions, thoughts, and
experiences without having to rely solely on verbal communication.
2. Using play therapy to create a safe space: Play therapy can create a safe and
supportive environment for sexually abused children. Through play, children can explore
their feelings, relationships, and experiences in a non-judgmental and nurturing setting.
3. Using art and play therapy to help children develop coping strategies: Art and play
therapy can help children develop coping strategies to deal with the aftermath of sexual
abuse. Through creative expression and play, children can learn how to manage their
emotions, reduce stress, and build resilience.
 4. Using art and play therapy to help children regain a sense of control: Sexual abuse
can leave children feeling powerless and out of control. Art and play therapy can help
children regain a sense of control by allowing them to make choices, create their own
art, and direct their play activities.
5. Using art and play therapy to help children process traumatic memories: Art and
play therapy can help children process traumatic memories related to their sexual abuse.
Through creative expression and play, children can explore their memories and feelings
in a safe and supportive environment.

Overall, art and play therapy can be powerful tools in the clinical treatment of sexually abused
children. These therapies can help children express their feelings, create a safe space, develop
coping strategies, regain a sense of control, and process traumatic memories.
ART THERAPY FOR CHILDREN WITH DISABILITIES
According to the Handbook of Art Therapy edited by Cathy A. Malchiodi, art therapy can be a
valuable clinical intervention for children with disabilities. Some of the key clinical applications
of art therapy for this population include:
1. Enhancing communication: Children with disabilities often struggle with
communication, whether it be verbal or nonverbal. Art therapy can provide a safe and
supportive environment for children to express themselves and communicate their
thoughts, feelings, and experiences.
2. Building self-esteem: Children with disabilities may face challenges that can impact
their self-esteem and confidence. Art therapy can help them develop a sense of mastery
and accomplishment, which can increase their self-esteem.
3. Improving motor skills: Children with physical disabilities can benefit from art therapy
as a way to improve their fine motor skills and coordination.
4. Managing emotions: Art therapy can help children with disabilities learn how to
manage their emotions, express their feelings, and cope with stress.
5. Facilitating social connections: Children with disabilities may struggle with
socialization and making connections with peers. Art therapy can provide a structured
and supportive environment for children to interact with others and build social skills.
6. Providing a sense of control: Children with disabilities may feel a lack of control over
their lives due to their condition. Art therapy can help them feel more in control and
empowered by giving them choices and opportunities to express themselves.

Overall, art therapy can be a valuable clinical intervention for children with disabilities, helping
them to enhance communication, build self-esteem, improve motor skills, manage emotions,
facilitate social connections, and provide a sense of control.
ART THERAPY WITH AUTISTIC CHILDREN
According to "Handbook of Art Therapy" edited by Cathy A. Malchiodi, art therapy has a number
of clinical applications with autistic children. Here are a few examples:
1. Improving communication skills: Art therapy can be used to help autistic children
develop better communication skills. By engaging in creative activities, children can
learn to express their thoughts, feelings, and experiences in a nonverbal way. This can
help them develop greater self-awareness and better understand the emotions of others.
2. Developing social skills: Art therapy can also be used to help autistic children improve
their social skills. By working in groups or pairs, children can learn to interact with
others in a safe and supportive environment. Through creative activities, they can learn
to take turns, share materials, and collaborate on projects.
3. Reducing anxiety: Art therapy can be a powerful tool for reducing anxiety in autistic
children. By engaging in creative activities, children can relax and focus their attention
 on something other than their worries. This can help them feel more calm and in control,
and may reduce the need for medication or other interventions.
4. Enhancing sensory integration: Many autistic children have difficulty with sensory
integration, which can make them feel overwhelmed or uncomfortable in certain
environments. Art therapy can be used to help children develop greater sensory
awareness and tolerance. By working with different materials and textures, children can
learn to regulate their sensory input and feel more comfortable in their bodies.
5. Art therapy can be used to address sensory issues common in children with ASD. For
example, some children may be overly sensitive to certain textures, colors, or smells. Art
therapists can work with these children to create art that gradually introduces new
sensory experiences in a safe and supportive environment.
6. Art therapy can help children with ASD develop fine motor skills and improve hand-
eye coordination. By working with different art materials and tools, children can
improve their dexterity and control.
7. Art therapy can also be used to help children with ASD manage anxiety and stress.
Creating art can be a calming and meditative activity that can help children relax and feel
more centered.

These are just a few examples of the ways in which art therapy can be used to support autistic
children. It is important to note that each child is unique, and their needs and interests will vary.
A trained art therapist can work with each child to develop a personalized treatment plan that
meets their specific needs.
ART THERAPY WITH ADOLESCENT DEPRESSION
According to "The Handbook of Art Therapy," edited by Cathy A. Malchiodi, there are several
clinical applications of art therapy for adolescents with depression. Art therapy is a form of
psychotherapy that uses creative expression to help individuals address emotional,
psychological, and social issues.
One approach to using art therapy with adolescents with depression is to use it as a tool for
self-expression. Through the use of art materials such as paint, markers, and clay, adolescents
can express their emotions and feelings in a non-verbal way, which may be less intimidating
than talking about their feelings. The therapist can then help the adolescent explore and
understand their emotions through the artwork.
Another approach is to use art therapy as a means of increasing self-esteem and self-
awareness. Adolescents with depression may struggle with negative self-talk and feelings of
worthlessness. Art therapy can help them develop a more positive self-image by creating
artwork that represents their strengths and positive qualities.
Art therapy can also be used to help adolescents with depression develop coping skills. The
therapist can guide the adolescent in creating artwork that represents different coping
strategies, such as deep breathing, visualization, or physical exercise. Through this process,
the adolescent can practice and internalize these coping skills, which can help them manage
their symptoms of depression.
Overall, art therapy can be a valuable tool in the treatment of adolescents with depression, as it
allows for self-expression, increases self-esteem and self-awareness, and helps develop coping
skills. However, it is important to note that art therapy should always be used in conjunction
with other forms of treatment, such as medication and talk therapy, to ensure the best
possible outcome for the adolescent.
ART THERAPY WITH ADHD
According to the Handbook of Art Therapy edited by Cathy A. Malchiodi, art therapy has several
clinical applications for individuals with ADHD (Attention Deficit Hyperactivity Disorder).
One of the main benefits of art therapy for ADHD is that it provides a nonverbal means of
expression, allowing individuals with ADHD to communicate their thoughts, feelings, and
experiences in a way that may be less intimidating than traditional talk therapy. Art therapy can
also help individuals with ADHD develop better self-awareness, impulse control, and
emotional regulation.
In the book, it is suggested that art therapy can be particularly helpful for children with ADHD,
as they may struggle with traditional talk therapy due to their difficulty with verbal expression
and sitting still for extended periods of time. Art therapy can provide a more engaging and
stimulating therapeutic experience for these children.
Art therapy can help individuals with ADHD in the following ways:
1. Improve focus and attention: Art therapy can help individuals with ADHD improve
their focus and attention by engaging them in a task that requires concentration and
attention to detail.
2. Reduce hyperactivity: Art therapy can provide a calming effect and help reduce
hyperactivity in individuals with ADHD.
3. Increase self-esteem: Art therapy can provide a sense of accomplishment and increase
self-esteem in individuals with ADHD who may struggle with academic and social
challenges.
4. Improve social skills: Art therapy can provide opportunities for social interaction and
collaboration, which can help improve social skills in individuals with ADHD.
5. Develop coping strategies: Art therapy can help individuals with ADHD develop coping
strategies to manage their symptoms and improve their quality of life.

Some specific art therapy techniques that may be effective for individuals with ADHD include:
1. Creating mandalas: Mandalas are circular designs that can be colored in or created
using various art materials. Mandalas can help individuals with ADHD focus their
attention and calm their minds.
2. Collage: Collage involves combining different materials such as paper, fabric, and found
objects to create a new image. This can be helpful for individuals with ADHD who may
struggle with organization and decision-making, as collage allows them to explore
different possibilities and experiment with different materials.
3. Drawing or painting: These traditional art forms can also be effective for individuals
with ADHD, as they can help promote focus and attention to detail.

Overall, art therapy can be a valuable tool for individuals with ADHD, helping them to develop
self-awareness, emotional regulation, and communication skills in a nonverbal and engaging
way.
HELPING THE NORMAL CHILD THROUGH ART THERAPY
According to the "Handbook of Art Therapy" edited by Cathy A. Malchiodi, art therapy can be a
useful intervention for normal children who may be experiencing emotional or behavioral
challenges. Here are some possible clinical applications of art therapy for helping normal
children:
1. Enhancing emotional expression: Art therapy can provide a safe and non-threatening
way for children to express their emotions and feelings. By using art materials such as
paints, crayons, and clay, children can create images that represent their emotions,
which can be helpful in identifying and processing their feelings.
2. Developing self-awareness: Art therapy can help children develop a better
understanding of themselves and their place in the world. By creating artwork that
 represents their experiences, children can gain insight into their own thoughts, feelings,
and behaviors.
3. Improving social skills: Art therapy can be used to help children develop social skills
such as communication, cooperation, and empathy. Group art therapy sessions can
provide a supportive environment for children to practice these skills and learn from
each other.
4. Coping with stress and trauma: Art therapy can be a useful intervention for children
who have experienced stress or trauma. By using art materials to create images of their
experiences, children can gain a sense of control over their emotions and begin to
process their trauma in a safe and supportive environment.
5. Developing problem-solving skills: Art therapy can be used to help children develop
problem-solving skills and improve their ability to think creatively. By engaging in art-
making activities that require planning and decision-making, children can develop these
skills in a fun and engaging way.

It is important to note that these are just a few examples of the clinical applications of art
therapy for normal children, and that each child's needs and goals will be different. A trained art
therapist can work with each child individually to develop an appropriate treatment plan based
on their unique strengths and challenges.
CLINICAL APPLICATIONS WITH ADULTS

According to the Handbook of Art Therapy edited by Cathy A. Malchiodi, there are several
clinical applications of art therapy with adults. Some of these include:
1. Trauma: Art therapy can be helpful in treating trauma by allowing individuals to
express their feelings and experiences through art, which can be less overwhelming than
talking about them directly.
2. Depression: Art therapy can help individuals with depression to express and explore
their emotions, gain insight into their thoughts and feelings, and develop coping
strategies.
3. Anxiety: Art therapy can be used to help individuals with anxiety to identify and
manage their symptoms, reduce stress, and increase relaxation.
4. Addiction: Art therapy can be an effective part of addiction treatment by providing a
non-verbal outlet for emotions, reducing stress and anxiety, and increasing self-
awareness.
5. Chronic illness: Art therapy can help individuals with chronic illness to cope with the
emotional and physical challenges of their condition, express their feelings about their
illness, and develop a sense of control over their lives.
6. Aging: Art therapy can be helpful for older adults by promoting socialization, increasing
cognitive function, and improving mood.
7. Expressing emotions: Art therapy can help adults express and process difficult
emotions that may be hard to put into words. For example, creating art can help
individuals explore feelings of anger, sadness, fear, or shame.
8. Mindfulness: Art therapy can also help individuals develop mindfulness skills, which
can be beneficial for managing stress and anxiety. Through the process of creating art,
individuals can learn to focus on the present moment and develop a greater awareness
of their thoughts and emotions.
9. Trauma recovery: Art therapy can be an effective tool for individuals who have
experienced trauma. Creating art can provide a safe and nonverbal way for individuals to
process traumatic experiences and begin the healing process.
10. Addiction recovery: Art therapy can be incorporated into addiction recovery programs
to help individuals explore underlying emotions and triggers that may contribute to
 addictive behaviors. Additionally, creating art can provide a healthy outlet for individuals
in recovery.
11. Self-discovery: Art therapy can help individuals gain a deeper understanding of
themselves and their experiences. Through the creative process, individuals can explore
their identities, values, and beliefs.

Overall, art therapy can be a valuable tool for adults in a variety of clinical settings and can help
individuals to express themselves, cope with difficult emotions, and improve their overall well-
being.
ART THERAPY WITH PARENTS
The Handbook of Art Therapy, edited by Cathy A. Malchiodi, covers a wide range of clinical
applications of art therapy. One of the areas in which art therapy can be applied is with parents.
Art therapy can be used as a means to help parents explore and express their thoughts, feelings,
and experiences related to parenting. By engaging in art-making, parents can gain insight into
their own emotional processes and develop a deeper understanding of their relationship with
their child.
According to the Handbook of Art Therapy, some of the clinical applications of art therapy with
parents include:
1. Parent-child interaction: Art therapy can be used to facilitate communication and
improve the quality of the relationship between parent and child. For example, a
therapist might use art-making to help a parent and child create a joint art project,
which can promote cooperation and bonding.
2. Parental self-care: Parenting can be a stressful and challenging experience, and art
therapy can help parents explore their own needs and emotions related to parenting.
This can lead to increased self-awareness and better self-care practices.
3. Parental grief and loss: Art therapy can be used to help parents who have experienced
a loss or trauma related to their child, such as a miscarriage or the death of a child. By
engaging in art-making, parents can process their grief and find meaning in their
experiences.
4. Parental mental health: Art therapy can be used to help parents who are struggling
with mental health issues such as depression or anxiety. By engaging in art-making,
parents can express and explore their emotions in a safe and supportive environment.

When it comes to working with parents, art therapy can be a useful tool for improving
communication, enhancing understanding, and promoting emotional expression.
One clinical application of art therapy with parents is in family therapy. In family therapy, art
therapy can be used to help family members express themselves, communicate their emotions,
and explore their relationships with one another. Through the use of art materials, family
members can create images that represent their thoughts and feelings, which can then be used
as a starting point for discussion and exploration.
Another clinical application of art therapy with parents is in parent-child therapy. In this
context, art therapy can be used to help parents better understand their children's emotions,
behaviors, and needs. Through the creation of art together, parents and children can engage in a
shared experience that promotes mutual understanding and empathy.
Art therapy can also be used to address specific issues that parents may be facing, such as grief
and loss, trauma, or chronic illness. Through the use of art materials, parents can explore their
feelings and emotions related to these issues in a safe and supportive environment. Art therapy
can also provide a sense of control and empowerment for parents, who may feel overwhelmed
or powerless in the face of challenging situations.
Overall, the Handbook of Art Therapy highlights the many ways in which art therapy can be used
to support parents in a variety of clinical contexts. Whether in family therapy, parent-child
therapy, or individual therapy, art therapy can be a powerful tool for promoting emotional
expression, improving communication, and enhancing understanding.
Art therapy can be a valuable tool for helping parents improve their emotional well-being and
the quality of their relationship with their child. The Handbook of Art Therapy provides
additional information and case examples for the use of art therapy with parents.
ART THERAPY WITH SEVERE MENTAL ILLNESS
According to the Handbook of Art Therapy, edited by Cathy A. Malchiodi, there are several
clinical applications of art therapy for individuals with severe mental illness. Here are a few
examples:
1. Schizophrenia: Art therapy can help individuals with schizophrenia express themselves
and cope with the symptoms of their illness, such as delusions and hallucinations. It can
also improve their social skills and help them build self-esteem.
2. Bipolar disorder: Art therapy can help individuals with bipolar disorder regulate their
emotions and manage their mood swings. It can also help them express their feelings
and develop coping skills.
3. Borderline personality disorder: Art therapy can help individuals with borderline
personality disorder regulate their emotions and reduce self-harm behaviors. It can also
help them develop a sense of self and improve their relationships with others.
4. Eating disorders: Art therapy can help individuals with eating disorders explore their
feelings about their body image and develop a more positive self-image. It can also help
them identify triggers for their disordered eating behaviors and develop coping skills.
5. Expressive Art Therapy for Psychosis: This approach involves the use of a variety of
art materials to facilitate expression and exploration of emotions, experiences, and
perceptions in individuals with psychosis. The aim is to help individuals gain insight into
their experiences, reduce symptoms, and improve coping skills.
6. Art Therapy for Trauma-Related Disorders: Art therapy can be effective in helping
individuals with severe mental illness who have experienced trauma to process their
experiences and emotions. The use of art materials can provide a nonverbal means of
expression, which can be particularly helpful for individuals who have difficulty talking
about their experiences.

Overall, art therapy can be a valuable tool in the treatment of severe mental illness. It can help
individuals express themselves in a nonverbal way, process difficult emotions, and develop
coping skills to manage their symptoms.
ART THERAPY WITH ADDICTS
According to the Handbook of Art Therapy edited by Cathy A. Malchiodi, art therapy can be a
valuable clinical intervention for individuals struggling with addiction. Here are some key points
and clinical applications discussed in the book:
1. Art therapy can help clients express and explore their emotions in a nonverbal way.
This can be particularly helpful for individuals who struggle to articulate their feelings
or who may feel shame or guilt about their addiction.
2. Art therapy can also help clients develop new coping skills and self-regulation
strategies. For example, creating art can help clients learn to regulate their breathing
and heart rate, which can be particularly helpful during times of stress or cravings.
3. The process of creating art can also help clients increase their self-awareness and
gain insight into their addiction. Art therapists may use prompts or directives to
 encourage clients to explore topics such as triggers, relapse prevention, and the
impact of addiction on their relationships and daily life.
4. Art therapy can be used in individual or group settings, and can be integrated into a
broader treatment plan that includes other forms of therapy and support. For example,
art therapy may be used in conjunction with cognitive-behavioral therapy (CBT),
motivational interviewing, or 12-step programs.
5. Art therapy interventions for addiction may include a range of media, such as
painting, drawing, collage, sculpture, and photography. The specific approach used
will depend on the individual client's needs and preferences.

Overall, the Handbook of Art Therapy suggests that art therapy can be a valuable addition to
addiction treatment programs. By helping clients to express and explore their emotions, develop
new coping strategies, and gain insight into their addiction, art therapy can support individuals
on their path to recovery.
ART THERAPY WITH OLDER ADULTS
According to "Handbook of Art Therapy," edited by Cathy A. Malchiodi, art therapy can be a
beneficial intervention for older adults in various clinical settings, including nursing homes,
rehabilitation centers, and outpatient clinics.
Here are some examples of clinical applications of art therapy with older adults:
1. Dementia Care: Art therapy can be used to promote cognitive functioning, improve
communication skills, and increase social engagement among older adults with
dementia. Art interventions may include creating memory books or collages, drawing, or
painting.
2. Hospice and Palliative Care: Art therapy can be an effective tool for managing pain,
reducing anxiety and depression, and enhancing spiritual well-being in older adults
facing end-of-life care. Therapeutic art activities may include creating legacy projects,
expressing emotions through art-making, or using guided imagery and relaxation
techniques.
3. Depression and Anxiety: Art therapy can help older adults cope with feelings of
isolation, loss, and grief that may be associated with depression and anxiety. Art
interventions may include exploring feelings and emotions through drawing or painting,
creating mandalas or other symbolic imagery, or using mindfulness techniques.
4. Rehabilitation: Art therapy can be used to enhance physical, emotional, and cognitive
functioning in older adults undergoing rehabilitation for injuries or illnesses.
Therapeutic art activities may include using fine motor skills to create art, exploring
feelings and emotions through art-making, or using guided imagery and relaxation
techniques.
5. Promoting reminiscence and life review: Art therapy can be used to help older adults
recall and reflect on their life experiences, which can promote feelings of self-worth and
fulfillment.
6. Facilitating emotional expression: Art therapy can provide a non-verbal means for
older adults to express difficult emotions, such as grief, loss, and depression.
7. Improving cognitive function: Art therapy can be used to improve cognitive function
and memory in older adults, particularly those with dementia or other cognitive
impairments.
8. Enhancing social connections: Art therapy can provide an opportunity for older adults
to engage in a creative and social activity, which can promote feelings of connectedness
and reduce social isolation.
9. Promoting physical health: Art therapy can be used to promote physical health in
older adults by providing a means for engaging in physical activity, such as painting or
sculpting.
Overall, art therapy can provide a non-verbal means of expression, promote social interaction,
and enhance quality of life for older adults in a variety of clinical settings.

MODULE 5
CLINICAL APPLICATION WITH GROUPS, FAMILY AND COUPLES

According to the Handbook of Art Therapy edited by Cathy A. Malchiodi, expressive art therapy
can be used effectively with groups, families, and couples. Here are some clinical applications of
expressive art therapy with each of these populations:

1. Groups: Expressive art therapy can be used with groups to foster communication,
encourage emotional expression, and promote group cohesion. In group sessions,
participants can use different art materials to express their thoughts and feelings, and
then share their artwork with others in the group. This process can help individuals
build trust and develop connections with one another, as well as develop insights into
their own experiences through the feedback they receive from others in the group.

2. Families: Expressive art therapy can be used with families to help them communicate
more effectively and work through conflicts. In family sessions, family members can use
art materials to express their emotions and explore family dynamics. The therapist can
then use the artwork as a starting point for discussion, helping family members to
understand each other's perspectives and work toward solutions to family problems.

3. Couples: Expressive art therapy can be used with couples to help them deepen their
emotional connection and improve communication. In couples sessions, partners can
use art materials to express their emotions and explore their relationship dynamics. The
therapist can then use the artwork to facilitate discussion and help the couple identify
patterns of interaction that may be contributing to relationship problems. This can help
couples to develop new ways of relating to one another and improve their overall
relationship satisfaction.

Overall, expressive art therapy can be a powerful tool for promoting emotional expression,
communication, and personal growth in a variety of therapeutic contexts.
GROUP ART THERAPY
According to the "Handbook of Art Therapy" edited by Cathy A. Malchodi, group art therapy can
be categorized into several types based on different criteria.
1. Therapeutic Goals:
 Psychoanalytic Group Art Therapy: This approach focuses on exploring the
unconscious material through creative processes within a group setting.
 Gestalt Group Art Therapy: This approach emphasizes the present moment
and the integration of thoughts, emotions, and behaviors in a group setting.
 Person-Centered Group Art Therapy: This approach is based on the principles
of humanistic psychology and emphasizes the importance of empathy,
acceptance, and unconditional positive regard in a group setting.
 Behavioral Group Art Therapy: This approach focuses on the use of art-making
activities to modify behaviors and reinforce positive behaviors in a group setting.
  Cognitive-Behavioral Group Art Therapy: This approach combines cognitive-
behavioral techniques with art-making activities to address negative thoughts
and behaviors in a group setting.

2. Population:
 Children's Group Art Therapy: This approach is designed for children and
adolescents and focuses on their unique developmental needs and issues.
 Adult Group Art Therapy: This approach is designed for adults and focuses on
their specific mental health issues, such as anxiety, depression, and trauma.
 Older Adults Group Art Therapy: This approach is designed for older adults
and focuses on their specific mental health issues related to aging, such as
dementia and social isolation.
 Couples Group Art Therapy: This approach is designed for couples and focuses
on improving communication, emotional expression, and intimacy through art-
making activities in a group setting.

3. Setting:
 Inpatient Group Art Therapy: This approach is provided in a hospital or
psychiatric facility for individuals who require intensive mental health
treatment.
 Outpatient Group Art Therapy: This approach is provided in a community
mental health center or private practice setting for individuals who require less
intensive mental health treatment.
 School-Based Group Art Therapy: This approach is provided in a school setting
for children and adolescents who require mental health support and
intervention.

These are just a few examples of how group art therapy can be categorized based on the
Handbook of Art Therapy edited by Cathy A. Malchodi. It's worth noting that there are many
other approaches and criteria for categorizing group art therapy, and each art therapist may
have their own unique approach.
ART THERAPY WITH PARENTS
The Handbook of Art Therapy, edited by Cathy A. Malchiodi, includes several chapters that
discuss art therapy with parents. Some of the key themes that emerge from these chapters
include:

1. Art therapy can help parents communicate with their children: Through the use of
art materials, parents can engage in nonverbal communication with their children. This
can be particularly helpful for parents who struggle to express themselves verbally or for
children who have difficulty understanding or expressing their emotions.
2. Art therapy can facilitate attachment and bonding: Art therapy can help parents and
children develop a stronger sense of connection and attachment. By creating art
together, parents and children can share a positive experience that can enhance their
relationship.
3. Art therapy can help parents understand their child's experiences: Art therapy can
provide insight into a child's thoughts, feelings, and experiences. Through art-making,
parents can gain a better understanding of their child's perspective and can use this
information to better support their child.
4. Art therapy can be used to address specific issues: Art therapy can be tailored to
address specific issues that parents and children may be facing. For example, art therapy
can be used to help children who are experiencing anxiety or to help parents who are
struggling to manage their own stress.
Overall, art therapy can be a powerful tool for working with parents and children. By providing a
nonverbal means of communication, promoting attachment and bonding, and addressing
specific issues, art therapy can help parents and children develop stronger, healthier
relationships.
FAMILY ART THERAPY
The Handbook of Art Therapy edited by Cathy A. Malchiodi provides an overview of the theory,
practice, and research of art therapy. Family art therapy is a specific approach to art therapy that
involves the participation of family members in the therapeutic process. The following is a
summary of the key points about family art therapy from the book:

1. Family art therapy is a systemic approach to therapy that recognizes the

interconnectedness of family members and their relationships. The goal of family art
therapy is to improve communication, enhance relationships, and promote healing
and growth within the family system.
2. Family art therapy can be used to address a variety of issues, including trauma, grief
and loss, relationship difficulties, and behavioral problems.
3. Family art therapy sessions typically involve a combination of individual and group
art-making activities, along with verbal processing and discussion.
4. The art-making process can help family members express themselves, explore their
feelings, and gain new insights into their relationships and dynamics.
5. Family art therapy is often used in conjunction with other therapeutic approaches,
such as cognitive-behavioral therapy, play therapy, or family systems therapy.
6. Family art therapists should have training and experience in both art therapy and
family therapy, as well as an understanding of the developmental needs and challenges
of children and adolescents.
7. The effectiveness of family art therapy has been supported by research, with studies
showing improvements in family communication, relationships, and overall
functioning.

Overall, family art therapy is a valuable approach to therapy that can help families improve their
relationships, communication, and overall well-being.
ART THERAPY WITH COUPLES
The Handbook of Art Therapy edited by Cathy A. Malchiodi provides some guidance on how to
use art therapy with couples. Here are some key points:

1. Use of art materials: Provide a variety of art materials to the couples, such as paints,
markers, crayons, clay, and collage materials. Allow them to choose what they want to
use and encourage them to experiment with different materials.
2. Setting: Create a safe and comfortable setting where the couples can engage in the art-
making process. Make sure there is adequate space for them to work, good lighting, and
a relaxing atmosphere.
3. Process-oriented approach: Encourage the couples to focus on the process of creating
art rather than the end product. Help them to explore their feelings, thoughts, and
behaviors through the art-making process.
4. Collaborative art-making: Encourage the couples to work together on a piece of art,
such as a painting or sculpture. This can help them to build trust and enhance their
communication and problem-solving skills.
5. Symbolic meaning: Help the couples to explore the symbolic meaning of their artwork.
Ask them questions such as, "What does this image represent for you?" or "What feelings
come up when you look at this?"
 6. Reflection: Allow time for the couples to reflect on their artwork and the process of
creating it. This can help them to gain insights into their relationship and their individual
experiences.
7. Integration: Encourage the couples to integrate what they have learned from the art
therapy sessions into their daily lives. Help them to develop coping strategies and
problem-solving skills that they can use outside of therapy.

Overall, art therapy can be a valuable tool for couples to explore and enhance their relationship.
It can help them to communicate more effectively, build trust, and gain insights into their own
and each other's experiences.

INTRODUCTION TO ART-BASED ASSESSMENT

The Handbook of Art Therapy, edited by Cathy A. Malchodi, is a comprehensive guide to the field
of art therapy, including different techniques and approaches used in art-based assessment. Art-
based assessment is a process of using art-making as a tool for gathering information
about an individual's psychological, emotional, and cognitive functioning.
The book highlights the importance of understanding the client's artistic ability and
preference before initiating any art-based assessment. The therapist uses different art
materials and techniques such as drawing, painting, sculpture, collage, and photography to help
the client create art that reflects their inner world. The therapist may also use specific art-
based assessment tools, such as the Diagnostic Drawing Series (DDS), to gather
information about the client's personality traits, emotional states, and cognitive
processes.
Art-based assessment is considered an effective tool for individuals who have difficulty
expressing themselves verbally, such as children, people with autism, and those with
intellectual disabilities. It also provides a non-intrusive way of identifying psychological
and emotional problems, such as trauma, anxiety, depression, and addiction.
Overall, the Handbook of Art Therapy provides a comprehensive guide to art-based assessment,
offering insights into how art therapy can be used to promote mental health and wellbeing. The
book emphasizes the importance of the therapist's understanding of art-based assessment tools
and techniques to ensure effective outcomes for clients.
THE DIAGNOSTIC DRAWING SERIES (page no. 401 in book)
The Diagnostic Drawing Series (DDS) is a projective art therapy assessment tool developed by
Dr. Barry M. Cohen and Dr. Harriet Wadeson in the 1980s. The DDS was designed to help
clinicians and therapists gain insight into a patient's psychological and emotional state
through their art-making process.
The DDS consists of three drawing tasks: the Kinetic Family Drawing (KFD), the Bridge
Drawing, and the Family Portrait Drawing. Each task is designed to elicit specific themes and
emotions related to family dynamics, relationships, and attachment styles.
The Kinetic Family Drawing involves drawing a picture of the family engaged in an activity
or event. This task is used to gather information about family structure, roles, and
interactions. The Bridge Drawing involves drawing a picture of a bridge and is used to
explore themes related to change, transition, and coping. The Family Portrait Drawing
involves drawing a picture of the family as they would like to be seen or remembered. This
task is used to explore family ideals, values, and beliefs.
After completing the DDS, the therapist or clinician will analyze the drawings and discuss the
patient's thoughts and feelings about the images they created. The DDS can provide
valuable information about a patient's personality, relationships, and coping mechanisms.
It can also be used to identify areas of strength and areas that may need further attention in
therapy.
THE SILVER DRAWING TEST OF COGNITION AND EMOTION (pg no.
410)
The Silver Drawing Test of Cognition and Emotion (SDT) is a projective drawing test that
assesses cognitive and emotional functioning in individuals aged five to 85 years old. The
test consists of a series of 14 stimuli cards with black-and-white line drawings of
ambiguous scenes, such as a man with an umbrella or a woman sitting on a bench. The
examinee is asked to use a silver pencil to complete the drawings by adding details and
shading as they see fit.
The SDT is designed to assess a range of cognitive and emotional processes, including
visual-spatial ability, attention, memory, problem-solving, emotional expression, and
coping mechanisms. The test is often used in art therapy, clinical psychology, and
educational settings to diagnose cognitive and emotional impairments, monitor progress
in therapy, and facilitate communication between therapists and clients.
The administration of the SDT typically takes between 45 minutes to an hour and involves a
standardized set of instructions and prompts. After completing the drawings, the therapist or
evaluator scores the responses based on a set of criteria related to the complexity and quality of
the drawings, as well as the content and emotional expression portrayed in the completed
images.
The SDT has been used in research and clinical settings to assess a range of populations,
including children with learning disabilities, individuals with neurological impairments,
and adults with depression and anxiety. Overall, the SDT is a versatile and useful tool for
assessing cognitive and emotional functioning through the medium of art therapy.
THE FORMAL ELEMENTS ART THERAPY SCALE (pg no. 420)
The Formal Elements Art Therapy Scale (FEATS) is a tool used in art therapy to evaluate and
measure the formal elements of a client's artwork. It was developed by Lisa Furman and
Cathy Malchiodi, and it is based on the principles of Gestalt therapy, which emphasizes the
importance of visual organization and integration.
The FEATS scale includes six formal elements that are assessed in the artwork:

1. Organization: This refers to the overall composition and arrangement of the artwork on
the page or canvas.
2. Color: This includes the use of color and the emotional impact of color choices.
3. Shape: This refers to the forms and shapes used in the artwork, and their relationship to
one another.
4. Line: This includes the quality and direction of lines used in the artwork.
5. Texture: This includes the tactile quality of the artwork, and the use of different
materials and techniques to create texture.
6. Space: This refers to the use of space in the artwork, including positive and negative
space, and the relationship between objects in the artwork.

Each of these elements is scored on a scale of 1 to 5, with 1 indicating a low level of

integration and organization, and 5 indicating a high level of integration and
organization. The FEATS scale can be used to assess the effectiveness of art therapy
interventions, to track progress over time, and to inform treatment planning.
DRAW A PERSON PICKING AN APPLE FROM A TREE (pg no. 420)
To draw a person picking an apple from a tree according to the Handbook of Art Therapy edited
by Cathy A. Malchodi.
Here are some steps you can follow:
1. Draw the outline of the person picking the apple, including their body shape, arms, and
legs.
2. Draw a tree with branches and leaves above the person.
3. Sketch an apple hanging from one of the tree's branches.
4. Add details to the person, such as facial features, hair, and clothing.
5. Draw the person reaching up to the apple with one hand and holding a basket with the
other hand.
6. Add shading and texture to the drawing to make it more realistic.

In this case, drawing a person picking an apple from a tree could potentially be used as a tool for
expressive therapy. The act of drawing the image could allow an individual to explore the
theme of growth, as well as the idea of taking action to obtain something that is desired.
The act of picking the apple could represent a sense of accomplishment or fulfillment. The
therapist could guide the individual to explore what emotions or thoughts come up during
the process of creating the drawing, and use that information to facilitate further exploration
and growth.
Remember, this is just one approach to drawing a person picking an apple from a tree, and there
are many other ways to create a beautiful and meaningful artwork. Don't be afraid to
experiment and let your creativity guide you!
MARI ASSESSMENT (pg no.428 )
The MARI (Mandala Assessment Research Instrument) is a tool used in art therapy to assess
various aspects of a client's personality, emotions, and behavior. It was developed by
psychologist Joan Kellogg in the 1970s and is based on the concept of the mandala, a circular
symbol that represents wholeness and unity in many cultures.
According to the Handbook of Art Therapy edited by Cathy A. Malchodi, the MARI assessment
consists of a set of pre-drawn mandalas that the client is asked to color or complete in
some way. The therapist then analyzes the completed mandalas using a set of guidelines
and scoring criteria to gain insight into the client's inner world.
The MARI assessment focuses on four major areas: affective responses, cognitive style,
interpersonal relationships, and self-image. It provides information on a client's emotional
state, coping mechanisms, communication style, and level of self-awareness.
The MARI assessment has been used in various settings, including mental health clinics,
hospitals, and schools, and can be administered to individuals or groups. It is considered a
valuable tool in art therapy, as it allows therapists to gain a deeper understanding of their
clients and tailor treatment plans accordingly.

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Common Questions:
Question - Importance of Utilizing Art Therapy for individuals with Severe Mental Illness
Art therapy can be an essential intervention for individuals with severe mental illness, such as
schizophrenia, bipolar disorder, and severe depression. Here are some of the ways in which art
therapy can be important for these individuals:

 Nonverbal Expression: Individuals with severe mental illness may have difficulty
expressing themselves verbally, which can limit their ability to communicate with others
and make it harder to receive effective treatment. Art therapy provides an alternative
means of expression, allowing these individuals to convey their thoughts, emotions, and
experiences through visual media.
 Emotional Regulation: People with severe mental illness may struggle with regulating
their emotions and may experience intense mood swings or outbursts. Art therapy can
help individuals learn to manage their emotions in a safe and constructive way, reducing
the risk of self-harm or harm to others.
 Socialization: People with severe mental illness may struggle with socialization, either
due to symptoms of their illness or social isolation resulting from stigma. Art therapy
can provide a supportive, structured environment for individuals to engage with others
and build relationships.
 Self-Esteem: Individuals with severe mental illness may experience low self-esteem,
feelings of worthlessness or shame, and struggle with their sense of identity. Art therapy
can help individuals build self-esteem by providing a means to create and express
something unique and valuable.
 Therapeutic Alliance: Art therapy can provide an opportunity for individuals with
severe mental illness to develop a strong therapeutic alliance with their therapist. This
alliance can provide a foundation for trust, safety, and exploration in therapy, leading to
greater insight and positive change.
Overall, art therapy can provide a unique and effective approach to addressing the complex
needs of individuals with severe mental illness. It can help individuals to access their inner
resources, develop new coping skills, build relationships, and improve their sense of self-worth
and quality of life.

Question - Is Art Therapy relevant in India? Explain today's trends of Art Therapy in India
Yes, Art Therapy is relevant in India and has been gaining popularity in recent years. India has a
rich history of using art and creativity as a form of healing, with practices such as mandala
making, rangoli, and henna being widely used as therapeutic techniques.
Today, Art Therapy is increasingly being recognized as a valuable form of therapy in India,
particularly for individuals with mental health issues. With the rise in mental health awareness,
many individuals are seeking out alternative forms of therapy, including Art Therapy, as a way to
cope with their mental health issues.
Art Therapy is being used in various settings in India, including hospitals, rehabilitation centers,
schools, and community centers. It is also being used in conjunction with traditional forms of
therapy, such as cognitive-behavioral therapy and psychotherapy.
The trend in Art Therapy in India is towards the use of culturally relevant techniques and
practices, such as Indian folk art, classical Indian dance, and music. Additionally, there is a
growing emphasis on the use of technology in Art Therapy, with the development of virtual Art
Therapy programs and apps.
Overall, the trends in Art Therapy in India are towards the integration of traditional Indian
practices with modern therapeutic techniques, as well as the incorporation of technology in the
field.

Question - Discuss the Use of Art Therapy With Parents, Elderly and Children
Parents
Art therapy can be a valuable tool in working with parents to improve their emotional well-
being and parenting skills. Parents can use art-making to explore and express their own
emotions, work through challenges and conflicts, and develop coping strategies. Through
art therapy, parents can also learn how to communicate more effectively with their
children, develop better self-awareness and self-care practices, and build stronger
relationships with their families.
In art therapy sessions, parents may be asked to create art that represents their emotions,
thoughts, or experiences related to their parenting. This can include creating images of their
children, creating collages that represent their values and beliefs as parents, or creating images
of their family dynamics. Art-making can also be used to explore the parent's own childhood
experiences and how they may impact their parenting style.
Art therapy can also be used in family therapy sessions to help parents and children
communicate and work through conflicts. Through art-making, family members can express
their thoughts and feelings in a nonverbal way and explore different perspectives. Art-making
can also be used to develop new ways of problem-solving and to build positive communication
skills.
Elderly
Art therapy can be a beneficial approach for older adults as they cope with a range of physical,
emotional, and cognitive challenges. Art-making can provide an outlet for self-expression,
reduce feelings of isolation and depression, and improve cognitive function and physical well-
being.
In art therapy sessions with older adults, individuals may be asked to create art that represents
their life experiences, memories, or feelings. This can include creating collages, painting,
drawing, or sculpting. Art-making can also be used as a way to process grief or loss, or to explore
issues related to aging, such as physical limitations, changing roles and relationships, and end-
of-life concerns.
Art therapy can also be used in group settings with older adults to build social connections and
improve emotional well-being. Group art-making can promote feelings of community and
belonging, encourage social interaction and communication, and provide opportunities for
learning and self-discovery.
Children
Art therapy can be an effective approach for working with children who may have difficulty
expressing their thoughts and feelings verbally. Through art-making, children can explore their
emotions, develop new coping skills, and express their creativity.
In art therapy sessions with children, art materials are often used as a tool for self-expression,
exploration, and communication. Children may be asked to create images of themselves or their
families, or to create artwork that represents their feelings, such as anger or sadness. Art-
making can also be used to help children build social skills and improve their self-esteem.
Art therapy can also be used in play therapy sessions, where children are encouraged to use art
materials and toys to play out different scenarios and express themselves creatively. Play
therapy sessions can be especially effective for younger children who may have difficulty
expressing themselves verbally.
Overall, art therapy provides a safe and nonjudgmental space for children to express themselves
creatively and explore their emotions. Art therapy can be used in a variety of settings, including
schools, mental health clinics, and hospitals, to support children's emotional well-being and
development.

Q- Importance of Expressive Art Therapies along with relevant examples.

Expressive art therapy is a powerful tool that utilizes creative expression to promote emotional,
cognitive, and physical healing and growth. Here are some important aspects of the importance
of expressive art therapies:

 Non-Verbal Communication: Expressive art therapy allows individuals to express

themselves in a non-verbal way, bypassing the limitations of language. Art, music, and
movement have a universal language that can express complex emotions and thoughts
that may be difficult to put into words. For people who struggle with verbal
communication, expressive art therapy can be a valuable way to communicate their
experiences.
 Emotional Release: Expressive art therapy offers a safe and non-judgmental
environment where individuals can release and express their emotions. Through art,
music, or movement, individuals can explore their feelings and release pent-up emotions
that may have been held inside for a long time. This release can promote emotional
regulation, stress reduction, and overall well-being.
 Creative Exploration: Expressive art therapy encourages creative exploration, which
can lead to increased self-awareness, personal growth, and self-discovery. The creative
process can help individuals to explore their inner world, connect with their authentic
selves, and develop a greater sense of purpose and meaning in life.
 Trauma Healing: Expressive art therapy has been shown to be effective in healing
trauma. Trauma can be stored in the body and can be difficult to access and process
through traditional talk therapy alone. Through the creative process, individuals can
access and release trauma in a safe and supportive environment, leading to healing and
recovery.
 Community Building: Expressive art therapy can be used in group settings to promote
community building and social support. Creating art together can promote feelings of
connection and belonging, and can be a valuable tool in group therapy settings.
Two relevant examples of the importance of using expressive art therapies are:

 Art therapy for children with chronic illness: Children with chronic illness often
experience physical and emotional pain, which can impact their quality of life.
Expressive art therapies, such as art therapy, music therapy, and dance/movement
therapy, can help children to express their feelings and manage their symptoms. By
engaging in creative activities, children can gain a sense of control over their illness, and
can develop coping strategies to manage their pain and stress.
  Art therapy for individuals with substance abuse disorders: Substance abuse
disorders often co-occur with trauma and other mental health disorders. Expressive art
therapies, such as art therapy, music therapy, and drama therapy, can be used as a
complementary treatment for substance abuse disorders. By engaging in creative
activities, individuals can explore their emotions, develop new coping skills, and address
underlying trauma and mental health issues. This can lead to sustained recovery and
overall well-being.

Question - Explain the Jungian Approach to Art Psychotherapy.

The Jungian approach to art psychotherapy is based on the theories and concepts of the Swiss
psychiatrist, Carl Jung. This approach emphasizes the exploration and integration of the
unconscious aspects of the psyche through the use of art-making processes. Jung believed
that the unconscious contained important and valuable material for personal growth and
development, and that through self-awareness and the integration of the unconscious,
individuals could achieve greater wholeness and self-realization.
In Jungian art psychotherapy, the therapist works with the client to explore the symbolism
and imagery in their artwork, helping the client to understand the unconscious messages
and meanings that are being expressed through their art. This process involves exploring
the personal and collective unconscious, which includes universal symbols and archetypes
that are shared by all human beings.
The therapist also works with the client to identify and explore patterns and themes in their
artwork, as well as in their thoughts, feelings, and behaviors. Through this process, the client
gains insight into their inner world and can work towards integrating their unconscious
material into their conscious awareness.
The use of art materials in Jungian art psychotherapy is seen as a way to access and
express unconscious material that may be difficult to express through words alone. The
therapist may use a variety of art-making materials and techniques, including painting, drawing,
sculpture, and collage, to help the client access and express their unconscious material.
Overall, the Jungian approach to art psychotherapy offers a holistic and integrative approach
to healing that emphasizes the importance of exploring and integrating the unconscious
aspects of the psyche. By working with the symbolism and imagery expressed through art-
making processes, clients can gain greater insight and awareness of their inner world and
work towards achieving greater wholeness and self-realization.

Question - Applications of Expressive Art Therapies (General)

Expressive art therapies have a wide range of applications in various settings, including mental
health clinics, hospitals, rehabilitation centers, schools, and community organizations. Some of
the applications of expressive art therapies are:

 Mental Health: Expressive art therapies are widely used in mental health settings to
address various mental health issues, such as depression, anxiety, trauma, and substance
abuse. Art therapy, music therapy, dance/movement therapy, and drama therapy are
effective in helping individuals process and express their emotions, reduce symptoms of
anxiety and depression, and increase self-awareness and self-esteem.
  Physical Health: Expressive art therapies are also used in medical settings to help
patients cope with physical health conditions such as chronic pain, cancer, and
neurological disorders. Art therapy, music therapy, and dance/movement therapy have
been shown to reduce pain, improve mood, and enhance the quality of life for patients.
 Education: Expressive art therapies are used in educational settings to enhance learning
and promote creativity. Art therapy, music therapy, and drama therapy have been shown
to improve cognitive skills, academic performance, and social skills in children and
adolescents.
 Community Outreach: Expressive art therapies are also used in community outreach
programs to promote wellness and social change. Art therapy, music therapy, and
dance/movement therapy are effective in engaging individuals and communities in
creative activities that promote self-expression, healing, and social connection.
 Rehabilitation: Expressive art therapies are used in rehabilitation centers to help
individuals recover from physical injuries or disabilities. Art therapy, music therapy, and
dance/movement therapy have been shown to improve physical functioning, reduce
pain, and enhance emotional well-being.
Overall, expressive art therapies are versatile and can be used in various settings to promote
healing, creativity, and personal growth.

Question - Applications of Expressive Art Therapies in India with Case Example

Expressive Art Therapies have been gaining popularity in India in recent years as a
complementary approach to traditional psychotherapies. It has been applied in various settings,
including mental health centers, hospitals, schools, and rehabilitation centers.
One of the main applications of expressive art therapies in India is in the treatment of
trauma and stress-related disorders. For example, after the 2008 Mumbai terror attacks,
art therapists were called upon to work with survivors and help them process their
emotions through creative expression.
Expressive art therapies have also been used in India to address mental health issues
related to aging, such as dementia and Alzheimer's disease. In some cases, it has been found
that art therapy can help individuals with these conditions improve their cognitive abilities,
reduce depression, and enhance their overall quality of life.
Another application of expressive art therapies in India is in the education sector. Many
schools and colleges have started to integrate art therapy into their curriculum to help
students cope with stress and anxiety, improve their self-esteem, and enhance their
creativity.
Overall, the application of expressive art therapies in India is still in its nascent stage, but it is
steadily gaining recognition and acceptance as an effective therapeutic tool. The current trend is
towards integrating art therapy into mainstream healthcare and education systems, and there is
a growing demand for trained art therapists in the country.