Expressive arts therapy is a multimodal approach to therapy similar to its cousins drama therapy and music therapy. Expressive arts therapy may incorporate writing, drama, dance, movement, painting, and/or music. People utilizing expressive arts therapy are encouraged by a qualified therapist to explore their responses, reactions, and insights through pictures, sounds, explorations, and encounters with art processes. A person is not required to have artistic ability to use or benefit from expressive arts therapy.

History of Expressive Arts Therapy

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Relatively new in its formation, expressive arts therapy began circa 1970 at the Leslie College Graduate School in Cambridge, Massachusetts. Paolo Knill, a leader in the field, founded the International Network of Expressive Arts Therapy Training Centers and, in 1984, began the ISIS European Training Institutes. Expressive arts therapy was formed as a distinct practice alongside the modalities at the root of its creation. It utilizes all expressive modalities such as art, music, drama, and dance therapies. Although expressive arts therapists are not experts in all of these areas (many have multiple proficiencies), they typically possess the sensitivity and ability to grasp the intermodal technique.

Expressive Arts Therapy Process

Use of the expressive arts multiplies the avenues by which a person in therapy may seek meaning, clarity, and healing. It deepens and transcends traditional talk therapy by acknowledging that each person’s process is unique. While one individual may like talk therapy, another person may prefer to use journaling, movement, art, or a combination of different experiences during therapy.

The accessibility of expressive arts therapy is due to the focus being not on artistic outcomes but rather on the process of creating. A person who utilizes expressive arts therapy is not required to have any artistic ability. Rather, it is through the use of the individual’s senses that the imagination can process, flourish, and support healing. As such, the process is often referred to as “low skill, high sensitivity.”

Each creative arts modality is unique, and the use of each is carefully considered by each expressive arts therapist. For example, journaling might be an appropriate expressive outlet for someone new to therapy. On the other side of the spectrum, a person who has already established a strong therapeutic relationship with his or her therapist may appreciate the use of movement or drama. Careful use of each modality is determined by the strength, timing, pacing, and readiness of the person in therapy. Different modalities may be used at any point throughout the therapeutic process as needed. Homework may also be issued for the person in therapy to complete between sessions.

Conditions Treated With Expressive Arts Therapy

Expressive arts therapy may be used as a part of the treatment strategy for a wide variety of behavioral, emotional, and mental health conditions. These include:

Expressive Arts Therapy Techniques

Many definitions of expressive arts therapy mention its use of distinct features such as music, movement, play, psychodrama, sculpture, painting, and drawing. If necessary, though, therapists may choose to combine several techniques in order to provide the most effective treatment for the individual in therapy.

Popular therapeutic approaches may involve the use of various drawing and art techniques, including:

  • Finger painting
  • The squiggle drawing game (sometimes used in other therapeutic approaches, especially with children)
  • Mask making
  • The blob and wet paper technique
  • The kinetic family drawing technique

To illustrate, finger painting may be used as a form of projective play wherein the therapist takes note of the types of lines drawn, the colors used, as well as the work rate and rhythm of the person in treatment.  

In a typical session the therapist will describe the process, but will not suggest a specific topic or the colors to be used. Instead, the therapist may provide broad instructions such as “paint something important to you” or “paint a picture of a dream you had.” The therapist then observes the content being produced and the behavior of the person in therapy. Once the picture is finished, the therapist will ask the affected individual to tell a story about the painting.

Finger painting has proven effective in the treatment of children with behavioral issues or other related mental health issues. Through consistent use of this technique, therapists may be able to learn about a child’s personality traits, motor skills, and inner world.   

Expressive Arts Therapy Research

The therapeutic impact of expressive arts therapy is focused on four major areas:

  • Expression
  • Imagination
  • Active participation
  • Mind-body connection.

Studies indicate that music may help individuals experiencing a wide range of social, developmental, and behavioral issues grow in self-awareness and self-confidence and learn new skills and concepts. Expressive arts therapy has also successfully helped children experiencing hyperactivity or social anxiety to control impulsive and aggressive behaviors. Though evidence from empirically valid studies is limited, expressive arts therapy has been used to help individuals with disordered eating habits to explore issues regarding body image, self-esteem, social isolation, and depression. 

People with medical illnesses may also benefit from expressive arts therapy. Past research has studied how creating artistic photographs may help people cope with the distress of hospitalization. Another study concluded elderly men and women who are part of an active choir report better health, less doctor visits, fewer falls, and less medication use than peers who are not part of an organized arts program. Finally, another body of research on children with cystic fibrosis who took part in a creative arts support program found the children learned how to better express themselves, reduce stress, and find meaning in their current health situation.

How Art Therapy Differs from Expressive Arts Therapy

Modalities such as art therapy, music therapy, poetry therapy, dance/movement therapy, and expressive arts therapy are all examples of creative arts therapy. While the majority of these disciplines are based in a single art modality, however, expressive arts therapy integrates therapeutic tools and techniques from many different art forms. The combination of a variety of arts-based therapeutic modalities creates a new approach which is distinct from its individual components. Certified expressive arts therapists rely on their creativity and training in order to decide which modality should be utilized at a particular time. Expressive arts therapists may even employ techniques from a range of other modalities in a single therapy session.

The focus of expressive arts therapy is on the therapeutic effect of the creative experience, and it highlights the human capacity to transform thoughts, emotions, and experiences into tangible shapes and forms. The approach is described as “integrative” when different art techniques are intentionally used in combination with traditional medicines to promote improved health.

Training for Expressive Arts Therapists

Training to be an expressive arts therapist requires at least a master’s degree in counseling with a concentration in expressive arts therapy from an accredited university. Additionally, some institutions offer certificate programs or studies in expressive arts for those who wish to use the expressive arts in related fields such as coaching, consulting, and education. Bachelor’s and PhD options are available, while certification and training continues to grow internationally.

For a list of current available resources, please visit the International Expressive Arts Therapy Association (IEATA), which highlights graduate training programs, certificates, and professional development programs in expressive arts therapy. Those wishing to access this type of therapy are encouraged to find a therapist certified in expressive arts therapy.

Limitations of Expressive Arts Therapy

One of the major criticisms of expressive arts therapy is the fact that the primary reason for healing is not clearly discernible. It is not clear whether healing occurs from the creative process or if it is due to positive interactions with the therapist. As currently published studies tend to focus on immeasurable qualitative benefits, a lack of empirical evidence in support of the effectiveness of the approach is a concern.


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