© 2014 "Before and After Art Therapy" C. Malchiodi
Source: © 2014 "Before and After Art Therapy" C. Malchiodi

In “Child’s Play: How Play Therapy Works,” Casado-Frankel observes that parents often ask about the effectiveness of play therapy as a form of treatment and say, “But it’s just play!” Art therapy often attracts the same question and a similar response—“But it’s just arts and crafts!” Like play therapy is not just “play,” art therapy is not just “arts and crafts” or even its first cousin, the ubiquitous coloring book. And also like play, art created within the context of a therapeutic relationship is intended to help young clients not only to engage in self-exploration, it also involves purposeful meaning-making through specific art making.

Child art therapy is also often confused with play therapy and for many good reasons. Play therapists introduce various art-based activities in their work with children when appropriate; similarly, art therapists who work with children include play activities [toys, puppets, props and games] to supplement art therapy and stimulate children’s creative expression. Art making within the context of therapy is, however, a slightly different experience from play because it encourages the creation of a tangible product in most cases. Art therapists are also in the business of helping children visually express and record experiences, perceptions, feelings and imagination; they capitalize on their vast knowledge of art media and arts-based approaches to enhance young clients’ ability to communicate through creative expression. Here is a brief overview of how and why art therapy “works:”

Non-Verbal, Sensory-Based. By its simplest definition, art expression is a form of non-verbal communication. For children who may not be able to articulate thoughts, sensations, emotions or perceptions, it is one way to convey what may be difficult to express with words. For those who have experienced abuse, it is one way to “tell without talking” when they are unable or afraid to speak about specific events or feelings. It is also a sensory-based approach that allows the children to experience themselves and communicate on multiple levels—visual, tactile, kinesthetic and more—and to not only be heard [talk], but also be seen via images [art]. 

Growth and Development. Art expressions, particularly drawings, provide useful information on development in children, especially young clients who are 10 years or younger. For example, differences in artistic development can help us understand something about a child’s emotional experiences, cognition and sensory integration —but only up to a point because most of what has been widely published has been derived from largely Western cultures. Despite this challenge, the currently accepted stages of artistic development, especially with younger children, are still generally helpful and add valuable information not always apparent through talk therapy alone.

Self-Regulation. Neurobiology continues to inform mental health professionals about why specific art-based activities, within the context of therapy, may be helpful to children. In particular, certain sensory characteristics of art making seem to be effective in improving mood, sensory integration, and calming the body and mind, especially with children who have experienced traumatic events.

Meaning-Making. Like play therapy, art therapy provides an opportunity to express metaphor through art expression. In fact, one of the strengths of both approaches is their ability to encourage and enhance storytelling and narratives. Storytelling about a drawing, painting, collage or construction does not have to be literal to be therapeutic. In fact, a child who has experienced traumatic events or is challenged by an emotional disorder may only find it possible to generate imaginative stories. With the support and guidance of the therapist, these narratives serve as a way to slowly and safely release disturbing or terrorizing experiences.

Right-Hemisphere-to-Right Hemisphere. Finally, creative expression on its own is not a guaranteed “cure”; like play therapy, art therapy is predicated upon a relationship with a helping professional. All creative arts therapies are inherently relational therapies because they involve an active, sensory-based dynamic between practitioner and individual and emphasize the “right-hemisphere-to-right-hemisphere” connection between child and therapist. In this sense, art therapy can be helpful in repairing and reshaping attachment through experiential and sensory means and may tap those early relational states that existed before words are dominant, allowing the brain to establish new, more productive patterns. Any professional who effectively applies art therapy principles to work with children is well-versed in how to establish positive attachment, attunement and reflexive convergence, the latter referring to the experience in which two individuals feel “felt” by each other and thus deeply understood and unconditionally accepted. Art expression, like play, adds to these positive relational experiences on multiple levels involving sensory, affective and cognitive channels of communication.

This a very brief explanation of some of the reparative dynamics art therapy provides to children. The simplicity of children’s art expressions as well as imaginative play may seem deceptively simple at first glance. But as the fields of art therapy and play therapy continue to expand knowledge about their effectiveness, the more we extend the possibilities for best practices with all children in need of help and healing. And while there is still a lot we do not know about exactly “how it works” when it comes to art therapy, we do know that drawing, playing and pretending are all a natural part of the “work” of children.

Be well,

Cathy Malchiodi, PhD

© 2016 Cathy Malchiodi, PhD

Visit the Trauma-Informed Practices and Expressive Arts Therapy Institute for more information about expressive arts therapy with children, adults and families and educational offerings on trauma-informed expressive arts therapy.

Click here for the latest Expressive Arts Therapy E-Newsletter | January 2016 with links to resources, courses and article downloads on arts therapies, trauma-informed practice and more.

For more information on expressive arts and traumatized children, see Creative Interventions with Traumatized Children (2015, Guilford Publications) and Creative Arts and Play Therapy with Attachment Problems (2014, Guilford Publications).

For professional applications of art therapy, see Handbook of Art Therapy (2nd edition, Guilford Publications.

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