The Effects of Expressive Arts Therapy on Emotion Regulation and Aggression in Violent Offenders: A Randomized Controlled Trial

Violent crime is a widely recognized public health concern. According to emotion regulation theory, aggressive behavior in violent offenders is linked to maladaptive emotion regulation strategies. However, few studies have explored interventions targeting emotional factors to reduce aggression in this population. Expressive arts therapy (EAT), which facilitates emotional expression and release, has shown therapeutic potential, but its effectiveness for violent offenders remains understudied. This randomized controlled trial examined the effects of an 8-week EAT program on emotion regulation and aggressive behavior in male violent offenders from a prison in China. Participants were assigned to either the intervention group (n = 31) or the control group (n = 34). Outcomes were assessed using cognitive reappraisal tasks, the Implicit Association Test, visual analogue mood scales, and the Emotion Regulation Strategies for Artistic Creative Activities Scale. Key findings revealed that, after 4 weeks of intervention, the experimental group demonstrated significantly improved cognitive reappraisal abilities and weakened “violence-positive” implicit associations, suggesting that enhanced cognitive reappraisal may be one key mechanism through which EAT operates. These results suggest that EAT effectively fosters positive psychological resources (i.e., cognitive reappraisal) and promotes non-violent implicit attitudes among violent offenders. This study provides initial quantitative evidence for EAT as a promising intervention for reducing aggression-related cognitive and implicit processes. Future research should further investigate its long-term effects and underlying mechanisms.