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What is Expressive Arts Therapy? 

EXA can be used for treating depression, anxiety, trauma, decision-making, and life transitions. This modality is for all ages, including youth, adolescents, and adults. You may have experienced the healing qualities of the arts in your daily life.


Expressive Arts Therapy (EXA): is a marriage of psychotherapy and the arts, including art therapy, music therapy, play therapy, and drama therapy.


Perhaps listening to a song on repeat, finding deep resonance in the music or the lyrics. You may have seen a piece of art or an image that has impacted you. You may have kept a diary, scrapbook, or journal. Or partook in an art making process you found therapeutic or cathartic.


Cathy A. Malchiodi describes this integration of creativity and therapy as,

“Art therapy is based on the idea that the creative process of art making is healing and life enhancing and is a form of nonverbal communication of thoughts and feelings. Life other forms of psychotherapy and counseling, it is used to encourage personal growth, increase self-understanding, and assist in emotional reparation and has been employed in a wide variety of settings with children, adults, families, and groups. It is a modality that can help individuals of all ages create meaning and achieve insight, find relief from overwhelming emotion or trauma, resolve conflicts and problems, enrich daily life, and achieve an increased sense of well-being.”


Common Misconceptions

There are common misconceptions about Expressive Art Therapy. The two I hear most often are “Art is for kids” and “I am not creative” or “I am not an artist”. Using creativity in therapy is used for all ages including children, adolescents, adults, couples, and families. It is used in a variety of settings such as private practice, schools, hospitals, and group therapies. 


It’s Not Just an Art Class

EXA is not about being an artist or even being good at art at all. It is a process-based practice, the intention of the outcome is not to create a masterpiece. Malchiodi explains, “Art therapy supports the belief that all individuals have the capacity to express themselves creatively and that the product is less important than the therapeutic process involved.” This process is not about creating a piece of art, it is a co-creation exploration in a contained space while being witnessed in your process. In fact, using creativity in therapy can be facilitated using existing images such as image cards, postcards, community art, and art pieces.

This process is not about creating a piece of art, it is a co-creation exploration in a contained space while being witnessed in your process.

Rather than the client creating a song, the client could share a song with the therapist and they could explore this music together. This can relieve the pressure of creating something new. Natalie Rogers reassures readers, “Expressive Arts Therapy uses various arts-movement, drawing, painting, sculpting, music, writing, sound, and improvisation in a supportive setting to facilitate growth and healing.

What does Expressive Arts Therapy Look Like in Therapy?

In Creative Connection, Rogers explains, “Part of the psychotherapeutic process is to awaken the creative life force energy. Thus, creativity and therapy overlap. What is creative is frequently therapeutic. What is therapeutic is frequently a creative process.” There are a variety of ways to utilize creativity in psychotherapy.

Through the multimodal expressive arts therapy process you and your therapist have the space to explore alternative forms of expression together.

It Can be Creative Without Words

There are many forms of expression beyond verbal expression in addition to what is nonverbal and preverbal. EXA provides a space where alternative forms of expression are invited and welcome. For some folks it can feel like a relief not to have to “talk about it” or I’ve heard people say, “It’s hard to put into words.”


Exploring Alternative Forms of Expression

This framework gives you permission not to have to rely on verbal expression to explore your inner and outer world, relationships, moods, and stressors. Through the multimodal expressive arts therapy process you and your therapist have the space to explore alternative forms of expression together.

An Image can Depict a Thousand Words

For example, a client may choose an image to explore together, this can be made or pre-existing. The therapy may ask the client what they notice about the image, likes, dislikes, examining colors and emotions. The image may remind the client of memory or may describe an emotion. This image could be familiar, unfamiliar, or surprising. The image may unlock or unfreeze an emotion within the client that wasn’t able to be accessed through words. The client may feel drawn to the colors or may tell a story about this image.




Perhaps there is symbolism to this image, words, or inspires writing or song. This image can remain as is or added onto using art materials. The image can be reconstructed using scissors or tearing it apart. The image can be held by therapist, taken by the client, or destroyed. The possibilities are endless in this exploration as a way to support clients to process and explore what is coming up for them using a creative process. 


Co-Creating Art

The arts can also provide containment, co-creating a process together within a piece of paper, shape, or box provides a container and boundaries for this exploration. This can help clients develop safety working within this holding space. Pictures can provide a tangible form for fear, anxiety, sadness, joy – a spectrum of emotions.



When these parts are externalized their grip can lesson and we can get to know these parts of ourselves with compassion and curiosity. Rogers explains, “We express inner feelings by creating outer forms. Expressive art is referred to using the emotional, intuitive aspects of ourselves in various media. To use the arts expressively means going into our inner realms to discover feelings and to express them through.”



About the Author

Sara Levey is an Licensed Marriage and Family Therapist (LMFT) at Well Clinic in San Francisco. In her words, “By creating a safe, contained, relational space healing and shifts are able to occur.”

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