Working with trauma: expanding, examining, and evidencing the value of art therapy

The call for articles for this special issue of the International Journal of Art Therapy, on the theme of art therapy with people who have experienced trauma, led to submissions from art therapists and other professionals working with a range of client groups in different ways and from a variety of perspectives, across the world. As a team of Guest Editors from different professional backgrounds (Ali Coles: Art Psychotherapist, Naomi Murphy: Clinical Psychologist, and Neil Winter: Barrister and former Art Therapee) we welcomed this diversity, and the selected articles challenge the profession to consider a variety of perspectives on this area of work. We are very grateful to all the submitting authors.

In this special issue

Two articles focus on structured art therapy approaches to working with people who have experienced trauma. Pearce et al. (2023) report on the piloting of a six-session trauma-focused art therapy group in Zambia, the UK and Italy. Noting the importance of careful description of art therapy interventions as a basis for developing research evidence for art therapy to address trauma symptoms, they outline the structure, approaches and aims of the trauma protocol and discuss how the pilot groups helped the participants, concluding that the replicability of the protocol makes it suitable for use within research. Carter’s et al. (2023) research article on integrating cognitive behavioural therapy and art psychotherapy, aimed at helping women who had experienced childhood sexual abuse, presents data from seven groups which used a standardised group therapy model. This data was gathered routinely before and after each group, and the findings are an encouragement to further research on a larger scale.

Taking a broader perspective, Song and McFerran’s (2024) literature review focuses on the link between the conceptual frameworks within which the needs of young people with adverse life experiences are viewed, and art therapy approaches. The article calls for an adaptive therapeutic approach which encourages self-empowerment and creative participation and highlights the need for art therapist critical reflexivity when working with theories around trauma. The importance of art therapist reflexivity is also highlighted in Van Den Berg’s (2024) opinion piece which explores the trauma which can be experienced by people as a result of their lesbian, gay, bisexual, trans, queer, intersex, or asexual (LGBTQIA+) identity. The author calls on the profession to recognise and address this, describing various ways in which art therapy can be helpful.

Geraghty’s et al. (2024) practice article about how art therapy is embedded in multidisciplinary trauma-informed teamwork with young men in prison is, appropriately, authored by a multidisciplinary group of professionals: a forensic psychologist, an art therapist, and an assistant psychologist. It describes a range of ways in which the art therapist’s expertise is employed, from facilitating an arts intervention to improve the prison environment to direct therapeutic work. Another practice article by Ortner (2024) also relates to work in a secure forensic setting. Here, Ortner focuses on their experience as a trainee art therapist and explores the interplay between a therapist’s personal experiences of trauma and clients’ experiences of trauma, highlighting how engaging in creative arts practices can help in navigating complex dynamics and supporting therapist wellbeing.

Guest Editor reflections

As Guest Editors, we wondered about the number of submissions relative to the number of art therapists. There are over 2500 art therapists in the UK alone and the International Journal of Art Therapy has an international reach. We know that people often come to art therapy with a history of unresolved trauma that directly influences the difficulties for which they are seeking help. So, if art therapists frequently work with people with a wide range of traumatic histories, including relational trauma, why did this not lead to many more submissions to this special issue? Is the work considered too commonplace to write about? Is there an assumption that there is a core way of working with trauma that is shared by all art therapists? Is there a lack of confidence within the profession about sharing new knowledge and ideas, innovative practice, and emerging insights? Or do practicing art therapists not see this as their role? The articles in this special issue would suggest that there is a breadth and depth of trauma-focused art therapy work which deserves to be shared, and which could be of great value to the profession.

From our individual personal perspectives, we have seen that art therapy can be successful when other modalities become unstuck, which most commonly happens when working with people who have experienced extensive trauma. Many of the skills needed for robust trauma-focused work include those which are a core part of art therapy: providing a safe container without wrestling power from the client; working gently at a pace that matches the client’s capability; engaging in embodied processes that facilitate hemispheric integration; offering communication when words and memories fail. When putting together this special issue we wondered whether art therapists are ‘hiding their light under a bushel’. How can art therapists better communicate the efficacy of their approach so that art therapy progresses and expands? And how are art therapists making the most of theory from other branches of therapy, and ensuring that their work is relevant to meeting pressing needs within society? The call for submissions for this special issue listed a number of areas of interest including trauma resulting from experiences of racism, which has been identified as a key area of concern for the profession (Eastwood et al., 2023).

Encouragingly, one of the articles in this issue was written by a recently qualified art therapist (Ortner) and the International Journal of Art Therapy has been working hard to encourage submissions by trainees and those who are at an early stage in their careers, acknowledging that their contributions can refresh and energise the profession (Coles & Jury, 2022). This article focuses on Ortner’s own experiences of trauma and we recognise the unique contribution that dual experience art therapists can offer to our understanding of art therapy theory and practice (Woods & Springham, 2011). The cover image by Bromley, ‘Never the Twain Shall Meet Met’, similarly highlights the value of first-hand knowledge of the role of art in addressing trauma, as an art therapist. However, there was a notable lack of submissions which were co-produced with people who had been the recipients of art therapy, especially as this had been highlighted in the call for submissions. Two of us have direct experience of collaborating on an article about art therapy for trauma symptoms (Winter & Coles, 2021) from the therapist and therapee (client) perspectives, which was published in a previous special issue of our journal on co-production. All of us agree with Springham and Xenophontes (2021) that art therapists need to be working alongside people who use art therapy services to investigate and develop our practice and theoretical frameworks. In particular, involving people who can think ‘outside the box’ of traditional ways of working and professional orthodoxy is a powerful force for innovation, ensuring that art therapy evolves, grows and strengthens (Coles & Winter, 2022). We urge art therapists to recognise the value of co-producing research, practice and opinion papers, whilst acknowledging that this can be a complex and challenging process for all parties.

Concluding remarks

We hope that the articles in this special issue are an encouragement to others to investigate and publish their research and practice relating to art therapy with people who have experienced trauma. Art therapists may ‘know’ how valuable art therapy can be for addressing trauma, but evidence of this efficacy needs to be captured and communicated in a variety of ways, including through small-scale qualitative practice reports as well as substantial research projects. We look forward to seeing what will emerge in the years to come.