Trauma-Informed Approaches to

Expressive Arts Therapy: A Toolkit for

Providers and Clients
Suraya Keating, MFT (#43996), REAT, RDT
Registered Expressive Arts Therapist • Registered Drama Therapist
suraya.org

Expressive Arts Therapy is the intentional use of multiple arts modalities, including but
not limited to visual art, creative writing, music, movement, and theater, to promote
psychological growth, healing, and wellbeing. Expressive Arts Therapy differs from
Art Therapy in that Expressive Arts Therapy draws on a variety of art modalities and is
frequently multimodal in its approach, meaning that it combines the use of different art
forms according to the needs of a particular client or group.

Trauma-informed care is an approach, based on knowledge of the impact of trauma,

focused on creating environments, offering interventions, and cultivating ways of being
with clients that are welcoming and engaging. This includes practices that promote safety,
empowerment, and healing.

In the field of trauma healing, there are two recognized pathways for transforming
trauma and helping one return to a state of wellbeing: 1) top-down approaches and 2)
bottom-up approaches. Top-down approaches, such as Trauma-Focused Cognitive
Behavioral Therapy, focus on an individual’s thinking processes and work with altering
thoughts, beliefs, and narratives in order to have a positive impact on one’s emotional and
somatic responses. In contrast, bottom-up approaches, such as Somatic Experiencing,
concentrate on the body as an initial route through which to treat the effects of trauma by
soothing and regulating the nervous system through a variety of sensory-based activities
and interventions.

The following toolkit includes simple, trauma-informed activities from Expressive Arts
Therapy that you can use for self-care, or in your work with individuals or groups. The
toolkit is intended for those working in the field of mental and behavioral health as
psychotherapists, psychologists, social workers, drug and alcohol recovery counselors,
and more. Most of the activities listed here can be done individually or in groups, while
select exercises (such as Mirror Dance in Groups and Group Rhythm) are for groups
only. Please note that while each activity is categorized according to its dominant art
modality, some exercises blend various arts forms, as it is characteristic of Expressive
Arts Therapy to flow from one modality to another. Each activity is also labeled from
a trauma-informed perspective as being bottom-up or top-down, or both (in exercises
where these two approaches are well-integrated).

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 Visual Arts
FOR INDIVIDUALS OR GROUPS

• Draw the Challenging Emotion (bottom-up)

Using paper and crayons or other art materials, create an image that represents whatever feeling is challenging you.
Then, see if the feeling wants to “speak” by giving it a voice either verbally or in writing. Does the feeling have any
messages for you?

• Help for the Challenging Emotion (bottom-up)

First, draw whatever feeling is a challenge for you at the center of a piece of paper. Next, ask yourself: What is helping
me with this challenge? Draw whatever is helping the challenging feeling, i.e., what is a resource for you. See if there
are any messages that want to be spoken by the resource verbally or in writing.

• Triptychs for Challenging Feelings (bottom-up and top-down)

Divide a piece of paper into three columns. At the top of the left column, write “Challenging Feeling.” At the top of the
right column, write “How I Want to Feel.” At the top of the middle column, write “What Will Help.” In other words, in the
middle column you are being invited to reflect on anything that will help you move through the challenging feeling and
feel the way you want to feel. Draw, paint, collage, or write anything that intuitively comes to you for each of the three
columns.

• Triptychs for Self-Esteem (bottom-up and top-down)

Divide a piece of paper into three columns. write “One thing I am proud of...” at the top of the left column, “Some
things I like about myself…” at the top of the middle column, and “One way I am growing is….” at the top of the right
column. Then, intuitively draw, collage, or write anything that feels true in response to the three prompts.

FOR GROUPS ONLY

• Theme Drawings in Groups (bottom-up and top-down)

Part 1: Invite a group of 3-8 people to choose a collective theme that is important to them. For example, the group
might choose love, forgiveness, conflict, depression, dreams, or something else.

Part 2: Using a large piece of paper and paints, crayons, or colored pencils, create a group art piece in which
everyone takes turns adding whatever they wish to the collective creation focused on the chosen theme. Another
option is to have everyone draw or paint on the same piece of paper at the same time.

Part 3: When the creation is finished, ask everyone in the group to come up with one word for the title. For example,
someone may choose the word “love” while another may choose the word “river” and still another may choose the
word “opening.” Compile each person’s chosen word in some way to create a group title for their art piece. For
example, if we were to combine the above three words, a possible group title might be “Love River Opening.”

Part 4: Then, invite each person in the group to share what they see or imagine in the group creation and/or any
wisdom arising from the images.

Movement/Dance
FOR INDIVIDUALS OR GROUPS

• Free Dance with Writing (bottom-up)

For at least five minutes, play a song that soothes or inspires you, and let your body move freely. When you are
finished moving, use the following prompts for journal writing: “I feel….” “I notice…” “I imagine….” Write stream-of-
consciousness style—there is no right or wrong.

mhttcnetwork.org/pacificsouthwest • / @psmhttc
• Body Scan with Visual Art (bottom-up)

Part 1: Lay down or find a comfortable seated position where you can sense your body and breath. Notice those
sensations or emotions that you like or are pleasant to you. Next, notice any sensations you dislike or find unpleasant.
Often, we “judge” what is happening in our bodies, label things good or bad, and then try to avoid sensations that we
feel are bad or unpleasant. At the same time, we often become attached to sensations or emotions that we label as
good or pleasing. Instead of judging a sensation as good or bad, try to replace judgment with curiosity, as best as you
can, as you stay aware of your inbreath and outbreath. Cultivate the spirit of loving curiosity inside your body as much
as possible. Spend at least five minutes sensing sensations and emotions in the body.

Part 2: Draw an outline of your body on a blank piece of paper. Then, color and/or write where in your body you felt
particular sensations or emotions. Take as much time as you like with this visual art segment, and let your intuition
guide you in terms of what colors, shapes, images or words you add to the outline of your body.

• Giving Voice to Body Parts (bottom-up)

Part 1: This practice begins by doing Part 1 of the above Body Scan activity for at least five minutes.

Part 2: While doing the scan, ask your body: Is there a specific body part or area of my body that wants to speak?
Wait and see what arises. Perhaps your lower back, your heart, your hands, or some other part of you wants to share
something with you. After you have intuitively identified which part wants to speak to you, ask this part the following
questions: What do you want to express? What do you want me to know? What do you need? If you like, journal
your responses to these questions.

• Inner Place of Stillness (bottom-up)

Part 1: Find a comfortable position for your body, either lying down or seated. Unite your awareness with your
breath. Breath into the perimeter of your body with each inhale, and with each exhale, let the breath pour out of you
in all directions. Notice any sensations or emotions that arise as you breathe in and out. As you continue to feel and
observe whatever waves of sensations or emotions are present, simultaneously begin to tune into your own inner
place of stillness. Where in your body do you sense an inner sanctuary of peace and quiet? This refers to a place
inside you that is an anchor of peace and stillness even as you experience waves of many kinds, including more
pleasant emotions such as joy and gratitude, as well as more challenging sensations and emotions such as body
tension, contraction, anger, hurt, resentment, and more. As you continue to feel whatever you feel, let each breath
amplify your inner place of stillness.

Part 2: As you continue to sense into your inner sanctuary of stillness, ask yourself the following questions: Is there
an image that you sense captures this inner place of stillness? Is there a color that expresses this sense of stillness
and peace? Is there a symbol or object of any kind that captures your inner sanctuary? Write or draw anything that
arises.

Part 3: If this inner place of stillness were to give you a message, what would it be?

FOR GROUPS ONLY

• Mirror Dance in Groups (bottom-up)

Invite one person to choose a song that soothes or inspires them. Then, ask for an initial volunteer to play the “leader”
role, with the other group members taking on the “follower” role. The leader moves to the music in a way that feels
good to their body, while the followers copy the leader’s movements (while honoring their own body’s specific needs
and limitations). After 1-2 minutes of one person leading, switch leaders, until everyone in the group who wants to has
taken a turn in the leader role.

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 Music
FOR INDIVIDUALS OR GROUPS

• Soothing Songs Playlist with Visual Art (bottom-up and top-down)

Create a playlist of three or more songs that feel soothing to your body, heart, and mind. While listening to this playlist,
engage in coloring, painting, or some other form of visual art, or simply listen to the songs and breathe them in as
nourishment. If you create visual art, give the art you make a title in the form of an affirmation. E.g., “I am ocean peace
eternity.” or “Strength abounds within me and around me.”

• Energizing Songs Playlist with Movement and Sound (bottom-up)

Create a playlist of three or more energizing songs. While listening to the songs, let your body move organically to
the music as you simultaneously allow yourself to make any sounds that want to be expressed. After listening, sit for
a few minutes in silence and notice if anything feels different. Then, engage in journal writing with the prompt: “What’s
moving through me is…”

FOR GROUPS ONLY

• Group Rhythm (bottom-up)

In a group of three or more people, one person starts a rhythm using their hands, feet, body, or voice. One by one,
each person adds to the group rhythm by choosing a new beat or sound to contribute. Continue until everyone in the
group has offered a sound to the group rhythm. Invite the person who started the group rhythm to make a gesture that
also ends the co-created song.

Drama
FOR INDIVIDUALS OR GROUPS

• Emotional Sculptures (bottom-up)

Choose an emotion A, which you like to feel (joy, peace, gratitude, etc.), and an emotion B, which is challenging to feel
(anger, sadness, jealousy, etc.). Create a pose with your body that represents emotion A. Remember this pose. Then,
create a pose with your body that represents emotion B and remember this pose. Spend 3-5 minutes in the pose of
emotion A and invite in any messages that want to be verbalized from this emotion. Then do the same for emotion B.

• Superheroine/Superhero Creation (top-down)

Create your own superheroine/superhero by identifying the following:
- your superheroine/superhero name
- three clothing items or accessories that the character wears
- any special powers of these clothing items or accessories
- one or more superpowers your superheroine/superhero possesses
- their unique way of walking and speaking
- how this superheroine/superhero could be helpful in your own life

• Fantasy Endings (top-down)

Part 1: Think of a challenge you are currently experiencing in your life. Write at least one paragraph describing the
challenge.

Part 2: Imagine two different fantasy endings for the challenge you are going through. For fantasy ending number
one, answer the following questions: What happens at the end? How do you feel when this happens? What might
you do in order to create this ending, or create this feeling? For fantasy ending number two, answer the following
questions: What happens at the end? How do you feel when this happens? What might you do in order to create this
ending, or create this feeling?

Creative Writing
FOR INDIVIDUALS OR GROUPS

• Letter from your Wise Self (top-down)

Write yourself a letter from your “Wise Self”—that part of you that is rooted in deep wisdom, love, compassion, and
care for your well-being. Begin the letter with the prompt: “Dear (your name): I am always here for you, and right now
I really want you to know……….Love, Your Wise Self.” After you are finished writing to yourself, read the words you
have written and notice how this makes you feel.

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 • Word Gardens (top-down)

Part 1: For each of the following categories, write down 5-10 words that you feel drawn to, or that soothe or inspire
you. The list of words you create is called a Word Garden.

- ANIMALS (e.g., wolf, dolphin, bear, horse, butterfly, etc.)

- COLORS (e.g., red, purple, blue, gold, rainbow, etc.)
- IMAGES FROM NATURE (e.g., beach, redwood forest, starry sky, etc.)
- FEELING WORDS (e.g., loving, peaceful, excited, etc.)
- ACTION WORDS (e.g., dancing, laughing, running, flying, etc.)

Part 2: Write a six-line poem by filling in the spaces below with words from the designated category from the Word
Garden you created.

- My heart is a (FEELING WORD) (COLOR) (ANIMAL).

- My soul is a (COLOR) (ACTION WORD) (IMAGE FROM NATURE).
- My heart longs for (FEELING) (IMAGE FROM NATURE).
- My soul longs to (ACTION WORD) (ACTION WORD) and (ACTION WORD).
- My heart knows (FEELING WORD) (COLOR) (ANIMAL).
- My soul knows (FEELING WORD) (FEELING WORD) (ANY WORD).

Part 3: Read your poem to yourself a few times. Does any line stand out as a kind of affirmation you can take with
you into your day? If so, write it down somewhere you can see it, and repeat it to yourself often throughout the day.

• Themed Poetry with Collage (top-down)

Choose a quality that would be helpful to you in your life at the moment, such as hope, joy, courage, acceptance,
forgiveness, gentleness, etc. Once you have chosen the quality that feels important, write a 4–8-line poem in which
every line starts with the word you have chosen, plus the word “is” in the following way.

Hope is…
Hope is...
Hope is…
Hope is…

After completing your 4–8-line poem, read the poem again and create a collage that represents the essence of what
the poem is about.

FOR GROUPS ONLY

• Themed Poetry with Collage in Groups (top-down)

Repeat the Themed Poetry with Collage exercise as described above with a group of 3-8 people. Depending on how
similar/different the group needs are, you might have each person choose a separate word for their themed poem, or
you might have the entire group choose a word together. After each person finishes their poem, create a group poetry
piece in which each participant contributes one line. Then, combine each person’s collage to create a group collage.

mhttcnetwork.org/pacificsouthwest • / @psmhttc