Expressive Arts Therapy: Art in Mental Health

Neelam Hiranandani
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Last Updated:

7 min read

art therapy hong kong

Words are powerful, but they have limits. We may not always be able to put feelings into words, especially when it comes to “raw”, profound ones. 


Art comes in useful as the better “translator” in such cases. Bypassing the boundaries of words, this non-verbal form of expression provides a different perspective to process one’s own thoughts and heal.  


Expressive art therapy draws on various forms of artistic expressions to encourage self-expression and dialogue within yourself. Read on to understand its approach and how it can benefit you.

What is expressive arts therapy?

Expressive arts therapy integrates psychology and creative art to promote soul-healing and emotional growth. This multi-modal approach presents different creative channels for communication, e.g. writing, play, movement, painting or music, etc. Throughout the therapy session, you are encouraged to explore your behavior, inner emotional responses and discoveries during your artistic encounters. 


While expressive arts therapy is beneficial for people of all ages, it is particularly effective for children. Children’s inner worlds are usually full of fantasies and imaginations, which they may not have the capabilities to describe and communicate their emotions through words due to the lack of vocabulary. Children tend to respond with a pouting expression, relentless hugging and wailing upon being asked why they are upset. As children are more inclined to act it out rather than using words to express emotions, it is easier for them to draw their experience or engage in activities to set their inner self free. Expressive arts therapy can thereby give full play to children’s emotional and creative space. 


Therapists will take note of the emotions expressed through art, build rapport with the individual and delve into the creative experience together to arouse awareness.

Benefits of expressive arts therapy

The therapeutic effect of expressive arts therapy lies in the imagination and active participation of the individual. An effective expressive arts therapy is conducive to fostering the mind-body connection


By way of illustration, music therapy can help individuals who experience social, behavioral, and developmental issues gain self-awareness and renew self-confidence, as they are encouraged to acquire new skills and concepts to confront the problems at hand. 


Early in 1999, a study in the US revealed that expressive therapies can also empower children with attention deficits, hyperactivity or social anxiety to channel their impulsive or aggressive behaviors.  


In treating eating disorders, growing evidence suggests that exploring issues about body image, self-esteem and depression in expressive arts therapy supports an individual to identify maladaptive cognitive patterns. 


Expressive arts therapy may also help people with medical conditions, such as children with cancer and individuals with HIV. Previous research from the Journal of Alternative and Complementary Medicine found positive impacts of artistic creation on stress coping in hospitalization. Another research by Windsor reported better general health in elderly participating in a choir practice than peers who do not. Besides, children with cystic fibrosis (i.e. a genetic disorder that affects mostly the lungs, and also the pancreas, liver, kidneys, and intestine) found meaning in their health conditions while learning better self-expression and stress management through creative arts support programs.


Conditions treated with expressive arts therapy

Expressive arts therapy can be used in treatment of several behavioral and psychological conditions, including:

Process of expressive arts therapy

The ultimate goal of expressive arts therapy is to heal the soul. Just like traditional talk therapy, expressive arts therapy centers on unique personal experiences. However, instead of forcing the use of talk, it takes the approach to the next level by offering several routes to express one’s own experiences alongside the exploration of meaning and clarity. Combinations of art forms are utilized in some cases to better express one's innermost emotions. 


The therapy is readily accessible because the focus is not on the artistic outcomes but the creation process. Participants do not need any special skills, abilities or background in art. Indeed, it stresses more on utilizing various sensory modalities (often used interchangeably with senses), such as light, sound, taste, temperature, pressure and smell, to capture a more vivid understanding of their experience. 


As a participant can have multiple art modalities, expressive arts therapists will carefully consider the use of each art modality based on the past experiences of the participants, the therapy progress and their therapeutic relationship. A more static approach, such as journaling, will first be suggested for the therapist’s initial connection with the individual’s emotional experience. Once a better therapeutic relationship has been established, the participant can build a deeper connection with the therapist, as more interactions are introduced in drama or dance therapy to express their innermost feelings. Besides the therapeutic relationship, the strength, pacing and readiness of the person are also determining factors in the choice of modality.  


Therapists may also assign homework to encourage participants to take a more active role in navigating their own experience.

Techniques of expressive arts therapy

As expressive art therapy incorporates different features such as music, movement, play and drama, combinations of several techniques are also possible in order to achieve the best treatment outcome in regard to one’s personal experience. Some drawing and art techniques are commonly used in the therapy, including:


Finger painting




It is a form of projective play being viewed within a session. While there are no limitations to themes or colors, the direction of the drawing is personally significant and holds to the individual, for example about a memorable dream or fondly remembered family activity, etc.  


Maintaining objectivity in art, the therapist focuses on observing the individual’s behavior and art content, particularly the role of the individual in the art piece, the rate and rhythm of production and the interaction with other individuals in the art piece. 


The therapy not only depends on the therapist’s observation but also the collaborative discussion of the production. Participants may be asked to share a story behind the work and discuss how this art piece reminds them of real-life events. Since the work signifies and represents the central part of the individual’s personality, it can facilitate the treatment of children with behavioral problems or neuroses. By highlighting the individual’s personality and motor skills (i.e. things most of us do without even thinking about them), finger painting can visualize and bring the child’s inner world into full display. It is a useful tool to document the growth of the individual’s sense of self along with the progress of the treatment.


The squiggle drawing game




With a squiggle first drawn, the therapist will ask the individual to draw in any way to wriggle out of the squiggle. The roles then switch in the game, where the therapist will share a story about the drawing and the individual can ask any questions about it. 


Taking turns, the game is a pleasant and therapeutic method for the unconscious mind to be uncovered with squiggles as the medium of one’s inner world.






It is a journey into the past with its roots in the ceremonies of indigenous cultures as a cultural heritage. Participants can have a personal taste of spiritual evolution through making masks, usually done immediately after a guided imagery is provided by the therapist.  


Mask-making guides individuals to discover and differentiate between their persona and genuine self. The mask will bridge the outer physical world and the inner spiritual world to heal its counterpart. By probing into who they really are, participants can explore their deeper qualities and express these qualities through the mask. Eventually, the individuals can acquire full meaning and appreciation of themselves.


The kinetic family drawing technique




This technique requires the individual to draw one’s entire family (usually engaging in some activities). The drawing can elicit the individual’s attitudes toward the family and the family dynamics. The therapist will then ask questions about the work to analyze specific characteristics, namely its level of consistency with the reality, or differences in the depiction of family members. 


Some therapists may invite family members to join the therapy and create their own drawings. They can then share their drawings with one another and discuss the differences in the details of their work. Throughout the therapy, the therapist will observe the communication styles, control issues, affection and other behavior among the individuals and their family members.  


Meanwhile, the individuals can understand how their family members perceive one another in the sharing sessions. As family is a fundamental component in one’s upbringing and social learning, the technique is conducive to self and mutual understanding.

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Who can be an expressive arts therapist?

In Hong Kong, there are currently no official regulations for expressive arts therapists. Therapists are mainly registered under the International Expressive Arts Therapy Association (IEATA) and the Australian, New Zealand and Asian Creative Arts Therapy Association (ANZACATA). 


Under the IEATA, the therapists are required to complete training of a Master’s Degree in Expressive Arts Therapy or any equivalency in a Creative Arts Therapy Program. The completion of the training involves a practicum of at least 500 hours of supervised clinical practice. It also requires 50 hours of supervised expressive arts therapy work experience to demonstrate the competency in performing arts practice and experience. The Registered Expressive Arts Therapist (REAT) must comply with IEATA’s Standards of Professional Practice and Code of Ethics.  


Under the ANZACATA, the therapist must receive training for arts therapy from the approved courses offered by Universities and Colleges in Australia, New Zealand and the Asia/Pacific region. The programs incorporate at least a 2-year masters degree with a 750-hour supervised clinical placement in the mental health arena. Registered Arts Therapists (AThR) are required to comply with ANZACATA’s Standards of Professional Practice and Code of Ethics. 


To find out more about expressive arts therapy in Hong Kong, check out the website of Expressive Arts Therapy Association of Hong Kong.


What are the different forms of expressive arts therapy?

There are generally four types of expressive arts therapy, including music, art, dance and writing. In different types of therapy, you can express your inner world through different art forms, such as painting, drawing or sculpting in art therapy.

What does an expressive arts therapist do?
What are the benefits of expressive arts therapy?
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This article was independently written by Healthy Matters and is not sponsored. It is informative only and not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be relied upon for specific medical advice.

Neelam Hiranandani
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