Art Therapy in the Treatment of Traumatic Stress: A Narrative Review

Art therapy is a nonverbal form of therapy that can provide individuals with a safe and supportive environment for expression and processing, particularly of trauma-related emotions and memories. For individuals who have experienced trauma, this nonverbal, creative, and tactile modality may serve as a beneficial complement, integrative aspect, or alternative to current gold-standard forms of care, including exposure-based cognitive behavioral therapy, cognitive processing therapy, and pharmacotherapy. In this narrative review, findings across the hierarchy of evidence, from theory and case studies to controlled trials and meta-analyses, in both adults and youth, are summarized to explore the benefits and limitations of art therapy to address trauma and related psychopathology. Findings are contextualized within the Expressive Therapies Continuum (ETC). The majority of available evidence comes from case and cohort studies conducted with small samples of one to 30 individuals per study. Systematic reviews and meta-analyses were largely limited by inconsistencies in providers, protocols, and assessments, as well as a lack of long-term follow-up data to understand the persistent effects of art therapy. While a singular narrative review cannot fully reflect the diversity and richness of art therapy or types of traumatic stress in different societies and situations, this article aims to guide future research, with specific design recommendations, prioritization of randomized-controlled trials, and a call for manualized treatment protocols.