One of my first jobs as an art therapist and expressive arts therapist was with children in shelters for survivors of domestic violence. That work set me on the life-long path of developing and refining trauma-informed art-based (Trauma-Informed Art Therapy®) and expressive arts therapies (Trauma-Informed Expressive Arts Therapy®) approaches for the past two decades. I have been fortunate to be able to apply these methods with children, adults, families and communities that have experienced interpersonal violence, witness to homicide, combat or war, natural disasters, terrorism, complicated grief, and medical illness. For those who are unfamiliar with the term "expressive arts therapy," it is defined as the use of creative arts (music, art, movement, and other artforms) as a form of therapy (Malchiodi, 2005). As I have written in previous posts, the sensory-based qualities of art and expressive arts are key to helping individuals communicate traumatic memories, repair and recover.
Physician and neurosequential development pioneer Bruce Perry has noted that arts therapies can be a normalizing experience for children, one which children in all cultures recognize (in Malchiodi, 2008). Expressive arts therapy has a unique role as an intervention with traumatized children. In fact, the International Society for Traumatic Stress Studies (ISTSS) (Foa et al, 2009) provides a comprehensive summary of the role of the creative art therapies in the treatment of posttraumatic stress disorder (PTSD). The ISTSS statement underscores the growing interest the relationship between the creative arts therapies and the brain, including how the brain processes traumatic events and the possibilities for reparation through expressive arts therapies-- art, music, movement, play, and drama interventions.
Trauma-informed expressive arts therapy includes many concepts unique to the practice of expressive therapy (such as the Expressive Therapies Continuum which I will talk about it another post), but in brief it integrates neurodevelopmental knowledge and the sensory qualities of the arts in trauma intervention (Malchiodi, 2012). In general, this approach takes into consideration, but is not limited to, the following 1) how the mind and body respond to traumatic events; 2) recognition that symptoms are adaptive coping strategies rather than pathology; 3) emphasis on cultural sensitivity and empowerment; and 4) helping to move individuals from being not only survivors, but ultimately to becoming "thrivers" through skill building, support networks, and resilience enhancement (Malchiodi, 2011).
Because survivors of trauma may also be without the means to place memories in historical context through language, expressive arts therapy combined with neurobiological, somatic, and cognitive-behavioral approaches can assist individuals in bridging sensory memories and narrative. Trauma-informed expressive arts therapy is based on the idea that art expression is helpful in reconnecting implicit (sensory) and explicit (declarative) memories of trauma and in the treatment of PTSD (Malchiodi, 2012). In particular, it is an approach that assists the individual's capacity to self-regulate affect and modulate the body's reactions to traumatic experiences in the earliest stages to set the stage for eventual trauma integration and recovery.
Five Components of Trauma-Informed Art Therapy and Trauma-Informed Expressive Arts Therapy®
1. Uses a "neurosequential approach" via expressive arts therapies to stabilize the body's responses.
2. Identifies of the body's reactions to stressful events and memories through trauma-informed evaluation and sensory-based activities using expressive arts.
3. Responds to the body's reactions to traumatic events through somatic and sensory approaches to self-regulation.
4. Reinforces a sense of safety through reconnection with positive attachment and self-soothing.
5. Builds strengths by using the arts to normalize and enhance resilience.
And that's a brief overview! For more information, you can also visit the Trauma-Informed Practices and Expressive Arts Institute [http://www.trauma-informedpractice.com]and check out the resources below.
© 2012 Cathy Malchiodi
Foa, E., Keane, T., Friedman, M., & Cohen, J. (2009). Effective treatment for PTSD: Practice guidelines from the International Society for Trauma Stress Studies. New York: Guilford Press.
Malchiodi, C. (2005). Expressive therapies. New York: Guilford Press.
Malchiodi, C. (2012). Art therapy and the brain. In C. Malchiodi (ed.), Handbook of Art Therapy. New York: Guilford Press.
Malchiodi, C. (2008). Creative interventions with traumatized children. New York: Guilford Press.
Malchiodi, C. (2011). Trauma informed art therapy with sexually abused children. In Paris Goodyear-Brown (Ed.), Handbook of Child Sexual Abuse: Prevention, Assessment, and Treatment. New York: Wiley.
Substance Abuse and Mental Health Services Administration (2010). Trauma informed care. Retrieved September 12, 2010 from http://mentalhealth.samhsa.gov/nctic/trauma.asp.