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Understanding the Expressive Therapies Continuum Part 1: What is the ETC?

by Lauren Fallat, LPC LPAT ATR-BC


As one begins to encounter the world of expressive art therapy and slowly unravel the growing information on its healing capacity, there may be rising curiosities and wonderment about the innate power and therapeutic elements of such a modality. Many researchers in the field of art therapy cite the potential for those who engage in art therapeutic practice to experience improvements in self-regulation, grounding, creative self-expression, self-awareness, compassion, relaxation, centering, behavior management, soothing and mood improvement.


The term ‘expressive therapies’ is representative of a variety of interventions that use creative means to help people communicate and process their feelings. The term encompasses art therapy, music therapy, drama therapy, and dance/movement therapy. Though the specific methods used vary from one therapeutic discipline to another, all expressive therapies share a common goal: to create a safe and supportive environment in which people can explore their thoughts and feelings, and find new ways to communicate them.


In order to understand the healing functions of art therapy in a more structured way, researcher, author and scholar Dr. Vija Lusebrink along with Sandra (Kagan) Alcorn developed what is known as the Expressive Therapies Continuum (ETC) during the 1970s. In this blog post series, we will explore the significance of the ETC and how this particular framework can help us expand our knowledge of the different systems that exist in how we process information and in turn express ourselves creatively. We will also review how the ETC can help us achieve desired treatment goals and outcomes through knowledge of information processing across a continuum. In other words, by understanding the different levels of creative expression that exist in the art therapeutic process, it is possible to identify where one feels stuck, inhibited, or activated and also where one can then feel motivated, open and stabilized.


As an individual who may be seeking art therapeutic services and is interested in learning more about these processes, consider knowledge as power. It is important to balance the idea of ‘trusting the process’ with having information to explain what is being experienced and how that might be based in a physiological way with the mind-body connection. By understanding along with an art therapist, the ways that one comfortably processes information, art therapeutic interventions, materials and methods can be explored to find balance and promote healthy creative expression, psychological functioning and overall well being.


In a recent article written by Hinz, Van Meter, & Lusebrink (2022), the authors establish that the Expressive Therapies Continuum is meant to provide a structured framework for which art therapists can understand how the nervous system processes information as well as formulates mental images. In order to best collaborate with clients in a therapeutic experience, it may be important for those entering into an art therapeutic experience to understand what levels of information processing can assist in promoting different outcomes for treatment.


Lusebrink effectively outlined the neurological process of expression through art materials in an article from 2004, stating “The process of expression through art media and the products created in an art therapy session engage and are perceived predominantly through the tactile-haptic and visual sensory and perceptual channels, and then are processed for their affect, associations, and meaning through cognitive and verbal channels.” In this way, we are learning to understand that how we take in information from our environment and external experiences is processed through specific channels just as our way of moving that information toward emotional expression, meaning-making and verbalization processes navigate through other neurological channels.


In the Expressive Therapies Continuum there are 3 levels of information processing and 2 components on each level, including the kinesthetic/sensory level, perceptual/affective level and cognitive/symbolic level. Running through each level of information processing is what is known as the creative level, which can exist at any level of model. It is important to understand that there are no specific materials or methods that fall into any specific level of information processing and there are multiple variables that can shift one’s level of information processing, which include task structure, task complexity and materials or media properties, which was developed by Kagin in her research.


It can be beneficial for both the therapist and client to understand how different levels of creative expression can align with desired treatment goals and promote varied therapeutic experiences and outcomes. In our next blog post, we will explore further the kinesthetic level of information processing on the ETC.


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Works Cited:


Hinz, L. D. (2020). Expressive Therapies Continuum: A framework for using art in therapy (2nd ed.). Routledge. https://doi.org/10.4324/9780429299339


Lisa D. Hinz, Megan L. VanMeter & Vija B. Lusebrink (2022): Development of the Expressive Therapies Continuum: The Lifework of Vija B. Lusebrink, PhD, ATR-BC, HLM, Art Therapy, DOI: 10.1080/07421656.2022.2131951


Lusebrink, V. B. (2004). Art therapy and the brain: An attempt to understand the underlying processes of art expression in therapy. Art Therapy: Journal of the American Art Therapy Association, 21(3), 125-135. https://doi.org/10.1080/07421656.2004.10129496








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