What is Expressive Arts Therapy?
Expressive arts therapy is a therapeutic approach that integrates creative arts and the imaginative process to facilitate healing, self-awareness, and community building. Unlike specialized arts therapies (art therapy, music therapy, dance/movement therapy, drama therapy) which focus on a single modality, expressive arts therapy draws from a variety of art forms such as writing, psychodrama, dance, movement, painting, drawing, sculpting, play and music (or a combination of them). The practice emphasizes an “intermodal” approach, meaning practitioners fluidly move between different artistic disciplines within a single session.
EXAT is based on what we call poiesis, the Greek word for making or shaping. This philosophical foundation prioritizes the creative process itself—the act of making—over artistic skill or the finished product. A person is not required to have artistic ability to use or benefit from expressive arts therapy. The artwork serves as a container for emotional expression and as a bridge to insight that may be difficult to access through verbal communication alone.
Origins & Lineage
The field of Expressive Arts Therapy (EXA) was founded in the early 1970’s by Shaun McNiff, Paolo Knill and others at Lesley University Graduate School in Cambridge, MA. He created the first integrated arts in therapy and education graduate program at Lesley University in 1974 and was recognized in 2009 with citations from the Commonwealth of Massachusetts House of Representatives and Senate as ‘Founder and Champion of Expressive Arts Therapy’.
Paolo Knill, trained in musicology, psychology, and systems theory, developed the theory of intermodality, in which he clarified the use of the different sensory modalities and artistic disciplines in therapeutic practice. The theory was shaped and documented in Principles and Practice of Expressive Arts Therapy (Knill, Levine, & Levine, 2005). Knill introduced the method of “intermodal decentering” in the 1990s.
Natalie Rogers, daughter of humanistic psychologist Carl Rogers, emerged as another central figure. Natalie Rogers (1928–2015) was an early contributor to the field of humanistic psychology, person centered psychology, expressive arts therapy, and the founder of Person-Centered Expressive Arts. This combination of the arts with psychotherapy is sometimes referred to by Rogers as The Creative Connection. Natalie founded the Person-Centered Expressive Therapy Institute in Santa Rosa, CA where she trained practitioners in Person-Centered Expressive Arts for over 20 years.
It is rooted in phenomenology, the deliberations of systems theory, and ideas of humanist psychology. While the visual arts, drama, and movement have been used therapeutically since the early 20th century, expressive arts therapy distinguished itself by refusing to privilege psychology over the arts themselves. From the start, the Lesley University program put the arts at the centre, searching for theories that come from the practice of art-making, what was called “theory indigenous to art.”
How It’s Practiced
Expressive arts therapy sessions are characterized by their fluidity between modalities. In EXA it is common to use these modalities in tandem during the course of a session. A client might begin by creating a collage, then write a poem in response to the visual image, move their body to embody the poem’s emotional content, and finally create sounds or music to capture the movement. This intermodal transfer deepens the therapeutic process.
Practitioners prioritize the creative process and the therapeutic relationship over interpretation. Art-in-Relationship is our motto. The therapist may engage in art-making alongside the client, and both may offer “aesthetic responses”—creative reflections on what emerges in the session. There is less emphasis on analyzing artwork through a psychological lens and more focus on what the creative process itself reveals and transforms.
Sessions occur in private practice, mental health clinics, hospitals, schools, community centers, and wellness programs. The approach is used with individuals, groups, couples, and families to address trauma, anxiety, depression, grief, identity exploration, and personal growth.
Expressive Arts Therapy Today
The International Expressive Arts Therapy Association (IEATA) is a non-profit organization founded in 1994. IEATA offers gold-standard professional registration in the expressive arts, both for therapists and for facilitators, consultants, and educators. The two primary credentials are REAT (Registered Expressive Arts Therapist) for those working in psychotherapy contexts, and REACE (Registered Expressive Arts Consultant and Educator) for those applying the work in education, organizational development, and community settings.
Graduate programs, certificate programs, and professional trainings now exist worldwide, including programs at Lesley University, Appalachian State University, the European Graduate School in Switzerland, and training institutes across Europe, Asia, and Latin America. The field continues to evolve with growing research on its effectiveness for trauma recovery, resilience building, and cross-cultural healing.
Practitioners today work in private practice, integrate expressive arts into existing psychotherapy or counseling licenses, or work in educational and community contexts. Retreats, workshops, and online courses have made the approach increasingly accessible to those seeking creative healing modalities outside traditional clinical settings.
Common Misconceptions
Expressive arts therapy is not art therapy. The difference between expressive arts therapy and art therapy is that expressive arts therapy draws from a variety of art forms such as writing, psychodrama, dance, movement, painting, drawing, sculpting, play and music (or a combination of them), while art therapy is based on one particular art form. Art therapy is rooted in the field of psychology, whereas expressive arts was birthed and remains embedded within the arts.
It is not recreational art-making or art class. While the atmosphere may be playful, the practice is grounded in therapeutic principles and intentional facilitation aimed at psychological, emotional, and spiritual growth. EXPRESSIVE ARTS is facilitated by a professionally trained instructor. The goal of Expressive art is to promote healing and reveal any hidden truths or conflicts.
Expressive arts therapy is not a quick fix or a substitute for medical treatment when indicated. It is a depth-oriented process that unfolds over time. It does not require clients to “be artistic” or produce aesthetically pleasing work; the value lies entirely in the process of creation and exploration, not in the product.
How to Begin
For those curious about experiencing expressive arts therapy, seek out a Registered Expressive Arts Therapist (REAT) through the IEATA directory or a licensed mental health professional trained in expressive arts modalities. Many practitioners offer introductory workshops that allow participants to explore the intermodal approach in a group setting before committing to individual therapy.
Key texts include Natalie Rogers’ The Creative Connection: Expressive Arts as Healing (1993), which outlines her person-centered approach, and Paolo Knill, Ellen Levine, and Stephen Levine’s Principles and Practice of Expressive Arts Therapy: Toward a Therapeutic Aesthetics (2005), which provides the philosophical and methodological foundation of the field. Shaun McNiff’s Art as Medicine (1992) and Trust the Process (1998) offer accessible entry points for understanding how creative expression facilitates healing.
Those interested in professional training should research IEATA-recognized programs and understand that becoming a REAT typically requires graduate-level education, supervised clinical hours, and demonstrated competency across multiple artistic modalities.