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The Rise of Expressive Therapies

Creative arts therapies have gained global acceptance—due in large part to the work of Lesley's pioneering faculty and international alumni.

How can an Ethiopian refugee cope with the trauma of leaving her home? And how does a soldier manage his memories of a brutal war? Or an autistic child learn to temper the feelings that cause him to act out?

Thousands of people around the world are discovering the power of creative expression—participating in art, dance, drama, expressive arts, music, and writing—to improve their mental, emotional, and physical well being.

Where it started

Expressive therapies, also known as creative arts therapies, has a history that extends back to the ancient Egyptians. Lesley Professor Shaun McNiff, who established the Expressive Therapies program in 1974, calls it "arts-based knowing." Expressive therapies came into a more prominent role in current culture with the arrival of psychiatry in the late 1800s and early 1900s. It gained significance throughout the 20th century and is now used in medical facilities, schools and veteran’s groups worldwide. Today, rigorous standards and licensure requirements have earned expressive therapies greater recognition from health professionals and the public. 

Lesley's pivotal role

Lesley plays a pivotal leadership role in the global expressive therapies movement. Our graduates contribute to, and extend, the reach of this movement across the U.S. and internationally.  

As one of the first degree programs, we've encouraged and advanced the practice of creative arts therapies in over 120 countries. Today, our students specialize in art therapy, dance therapy, drama therapy, expressive arts therapy, or music therapy. In just over 40 years, this little understood mind/body healing practice has become an accepted healing force. As Dr. McNiff notes, “The empirical evidence is staggering. We started something that has spawned a field.”


Experience-based evidence

There is clear, usage-based evidence of the positive effects of expressive therapies in helping treat children and adults who've experienced trauma, cancer patients, people with post-traumatic stress disorder (PTSD), dementia and more. Creative therapies have also been shown to improve concentration, lower anxiety and possibly prevent suicide. 

Some form of creative therapy has been practiced by cultures throughout the ages as a way to provide relief from acute emotional distress. As neuroscience unfolds more about the mind/body connection, practitioners point to the benefits of engaging in a creative process that helps promote healing. Studies tracking brain changes during these engagements point to an alteration in brain function, which may contribute to the relearning of key skills and mental, emotional, and physical healing.

“Our alumni and students are out there doing the work, watching its effects," says Michele Forinash, division director in Expressive Therapies. "We’ve helped Boston Marathon bombing victims, soldiers coming back from the war, and our graduates are taking that skill and knowledge back out into the field,” says Dr. Forinash.

Effective use in PTSD and beyond

PTSD is defined as “an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened." PTSD affects all aspects of a person's life, from jobs to relationships. Children who suffer from PTSD can have difficulty in school and experience behavioral issues, isolation, and phobias.

In a study of PTSD sufferers, Joshua Smyth, PhD, at Pennsylvania State University, related the need for, and evidence of, results with what he calls “alternative therapies” that provide access to sufferers’ experiences without directly recalling these experiences verbally. 

“Each of these approaches allows individuals with PTSD to experience and/or express their thoughts and feelings without necessarily having to verbalize the trauma, share this verbalizing with others, or directly confront the trauma, if they are not ready. Alternative therapies, in general, also focus on creating an environment in which the patient feels safe, and then providing an expressive medium that does not threaten that feeling of safety.”1 

A number of non-traditional creative/expressive therapies have demonstrated at least preliminary effectiveness in reducing PTSD symptoms, reducing the severity of depression (which often accompanies PTSD), and/or improving quality of life. The documented impact of the creative arts therapies on symptoms of trauma and post-traumatic stress disorder has inspired two national summits on arts and health in the military by Walter Reed National Military Medical Center.

In an issue of Advances in Psychiatric Treatment, Karen Baikie and Kay Wilhelm outline the emotional and physical health benefits of expressive writing on PTSD sufferers. While short term results show an increase in distress and negative mood, longer term results show improved moods, liver and lung functions, as well as behavioral improvements which include reduced absenteeism, improved memory, higher grade point averages and less depressive symptoms.

The neuroscience of arts and healing

Over the past decade, health psychologists have begun looking at how the arts might be used to heal emotional injuries, increase understanding of oneself and others, develop a capacity for self-reflection, reduce symptoms, and alter behaviors and thinking patterns.

Researchers are looking into the role of the arts, particularly music, in calming neural activity in the brain. A study by R.E. Krout suggests that music may go so far as to restore functioning in the immune system. He writes: "The activity levels of neurons in the central nucleus of the amygdala decrease in response to calming effects of music, there may be corresponding reductions in the signals being sent to other parts of the brain.”

Early trials show promise

Evidence hints at the effectiveness of arts therapies to aid physical healing through the management of stress. Unsurprisingly, stress is a major factor in the treatment of cancer. Female cancer patients in one study described ongoing difficulties such as fear, pain, sleeplessness, activity restriction, reduced self-confidence, and altered social relationships.

When the women engaged in different types of visual art—working in textiles and card-making, collages, pottery, or in paint—they focused more on “positive life experiences” than on their condition. They felt greater self-worth as they worked toward a goal, and found a social identity beyond that of being a “cancer patient.” In the very act of “doing,” these women, overall, found a place of expression that words alone could not provide.2

The arts and healing in Israel

Professor Vivien Marcow-Speiser collaborated with Dr. McNiff on the graduate degree programs in Expressive Therapies. She spearheaded Lesley’s 1980s extension program in Israel. Dr. Marcow-Speiser's early work in dance therapy treatments in Israel convinced her of the relevance and effectiveness of this “act of doing” and self-expression.

It was clear to her that those who practiced dance, music, and art therapies—the earliest established treatments—began to witness transformations. “The sense of ease, of expression, the palpable relief people received was undeniable,” she says. It was this hands-on experience that convinced her of the viability of the program’s goals at a time when scholarship had little to stand on. “When we went out to do placements, no one did it. The students became the innovators.”

The Israeli Extension program, while no longer in existence, left a lasting legacy in Israel. In its 34 years the program was able to, in the words of Dr. Marcow-Speiser “influence the development of the creative arts therapy field in Israel, where almost half of the country's 5,000 creative arts therapists have been educated at Lesley.” Alumni of the program practice worldwide as therapeutic practitioners and scholars.

The Expressive Therapies field is thriving, as evidence for its effectiveness mounts and neuroscience gains a better understanding of the mind/body connection. “Our goal,” Dr. Forinash says, “is to provide treatment and care to as many people as we can help, through whatever methods allow us to reach them and aid them most effectively.”


(1) Arts & Healing, Creative, Artistic, and Expressive Therapies for PTSD; Advances in Psychiatric Treatment, Emotional and physical health benefits of expressive writing

(2) American Journal of Public Health, The Connection Between Art, Healing, and Public Health: A Review of Current Literature

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