What is Trauma-Informed Expressive Arts Therapy

Here are seven principles for expressive trauma-informed practice.

Like many of my colleagues who traveled around the US and internationally to lecture pre-pandemic, I am finding myself preparing for online webinars. Trauma-Informed Expressive Arts Therapy is one of the frameworks that forms a foundation for these educational sessions. It is a concept I have been formulating, revising, and expanding for the past decade and is the basis for applying expressive arts [imagery, music, sound, movement, enactment, improv, storytelling, and creative writing] within the context of trauma-informed work. I am sharing this evolving framework with readers in this brief post for both psychotherapeutic work and future reference.

As I have repeatedly noted, each of us finds an approach, set of methods, or model that makes sense to us as helping professionals. For me, trauma-informed practice has helped to provide a logical part of the framework I needed to support individuals through the process of reparation and to apply expressive arts therapy to trauma integration. It forced me to clarify the role of body, mind, and brain in treatment and to de-pathologize intervention by providing expressive methods that most people generally perceive as engaging, pleasurable, and empowering. Most importantly, I found that the principles of trauma-informed practice emphasized individuals’ capacities to go beyond surviving to thriving and ultimately make meaning through use of imagination, creativity, and play.

Trauma-informed expressive arts therapy is a model for arts-based approaches that integrates current best practices in trauma-informed care with what is known about how the expressive arts and play assist in trauma reparation and integration. Based on the concepts of trauma-informed practice and the characteristics of expressive arts therapy, the following seven points summarize the major components of trauma-informed expressive arts therapy (for more detailed information, see Malchiodi, 2020).

1. Neurodevelopment and neurobiology inform the application of expressive arts therapy to trauma-informed intervention. As previously stated, trauma is not just a psychological experience; it is also a mind–body experience. The role of neurodevelopment and neurobiology is central to using the expressive arts to address trauma reactions and to assist individuals in reconnecting implicit (sensory) and explicit (declarative) memories of trauma. In particular, neurodevelopment provides a framework for determining how to apply expressive arts interventions to various goals of treatment, including when and how to support self- regulation and self-efficacy, positive attachment, and resilience-building.

2. Expressive arts therapy is focused on supporting self-regulation and co-regulation. Overactivation, hyperarousal, and general anxiety are common manifestations of not only post-traumatic stress, but also other trauma-related challenges. Expressive arts interventions are used not only to support individuals’ own internal resources, but also to provide various creative, action-oriented approaches to self-regulation and co-regulation when applied within groups.

3. Expressive arts therapy is used to help identify and ameliorate the body’s experience of distress. Individuals who are experiencing trauma-related reactions typically experience the impact of these reactions not only in altered thinking, but also in various somatic experiences. Because the expressive arts are “embodied” experiences, they are helpful in identifying and repairing the body’s responses to trauma. In particular, key trauma- informed practices are (a) using expressive arts to support individuals’ bodies as resources (Levine, 1997, 2015) and (b) normalizing the body’s reactions to trauma as adaptive coping rather than pathology,

4. Expressive arts therapy is used to establish and support a sense of safety, positive attachment, and prosocial relationships. Reconnecting with a sense of safety is central to trauma-informed practice. In particular, expressive arts approaches are used to help individuals recover a sense of well-being internally and in relationships with others. This also includes providing various opportunities for the individual to engage in creative experimentation that integrates experiences of unconditional appreciation, guidance, and support, experiences found in families with secure attachment relationships. When applied as group interventions, expressive arts support prosocial interactions and connect individuals through community.

5. Expressive arts therapy is used to support strengths and enhance resilience. Trauma-informed practice encourages helping professionals to see all individuals as capable of growth and reparation. It also holds the concept of resiliency as central to recovery. Expressive arts interventions are life-affirming and honor individuals’ capacity for resilience and personal strength by encouraging mastery, with a goal of moving individuals’ self-perceptions from victim to survivor to “thriver.”

6. Expressive arts therapy respects the individual’s preferences for self-expression, particularly of trauma narratives. Trauma-informed practice emphasizes the role of individuals in their own treatment and their preferences for participation. These preferences are determined by culture, previous experiences, world views, values, and other dynamics. Arts-based approaches offer a variety of ways for expressing “what happened,” dependent on the individual’s comfort level with self-expression. These therapies also respect the use of personal metaphors and symbols that allow individuals to control how they communicate sensitive experiences.

7. Expressive arts therapy provides meaning-making experiences and ways to imagine new narratives post-trauma. As previously stated, expressive arts in particular allow individuals to convey what is often unspeakable. They also allow survivors to explore, restructure, reframe, and re-story trauma and loss through nonverbal, asset-driven, participatory, and self-empowering ways.

Again, this is a very brief summary. But I hope it gives practitioners a foundation for understanding and applying these principles in psychotherapeutic and even community and educational settings when addressing traumatic stress.