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Rather than focusing on artistic skill, Expressive Arts Therapy emphasises the process of creating as a way to explore feelings, experiences, and inner conflicts that may be difficult to express verbally.
Guided by a trained therapist, persons living with dementia use multiple art forms to access insight, reduce stress, build resilience, and foster integration of mind, body, and emotions in a safe, supportive environment.
What Expressive Arts Therapy Is
Expressive Arts Therapy or EXAT is a form of psychotherapy that integrates multiple art forms—such as visual art, music, dance/movement, drama, and writing—within a therapeutic process. It is grounded in person-centred and humanistic theories; and based on models like the Expressive Therapies Continuum (ETC) and principles of intermodal arts integration.
EXAT differs from traditional, single-modality art therapies, for example art therapy or music therapy, by intentionally combining diverse artistic forms to support emotional expression, self-exploration, cognitive stimulation, and psychological healing. It provides a non-verbal, sensory-rich pathway of communication for persons living with dementia, as verbal communication often becomes more challenging as dementia progresses.
The table below shows how different art forms can be used in EXAT with a specific intention:
Art Form | Examples of Use | Intention |
Music | Listen to music, singing, or playing instruments. | To reduce agitation and anxiety; moderate mood; and support non-verbal communication. |
Drama | Use movement, role-play, puppetry, mirroring, or improvisational storytelling. | To externalise inner conflicts and gain new perspectives in a safe and supported environment. |
Dance/ Movement | Use body movements and gestures to express emotions, opinons, thoughts, and identity. | To promote mind-body sensitivity and awareness, emotional release and expression. |
Poetry/ Storytelling | Journal down poetry, narrative storytelling, free writing. | Bridges the gap between visuals and feelings, allowing one to articulate unspoken thoughts, gain insights and construct meanings. |
Visual Art | Create or engage with images through painting, drawing, sculpting or art appreciation. | To access, process and communicate complex emotions, thoughts, and trauma. |
Differentiate Expressive Arts Therapy from Expressive Arts Programmes
EXAT is often misunderstood as or confused with Expressive Arts Programme. It is, therefore, essential to know the differences between these two approaches.
What Expressive Arts Therapy (EXAT) Is | What Expressive Arts Programme Is |
A psychotherapy approach delivered by a trained mental health professional that integrates multiple art modalities within a therapeutic framework. | Recreational, educational, or social activities involving art, music, dance, or other creative forms without a formal therapeutic process. |
Grounded in psychological and art-based theories, it aims to explore emotions, identity, cognitive stimulation, and psychological healing. | Focuses on enjoyment, reminiscence, cultural engagement, entertainment, or sensory stimulation. |
Facilitated by trained expressive arts therapists. | Facilitated by activity staff, volunteers, or artists without clinical training. |
Between the two, only EXAT is designed to cater for psychological and emotional needs through a structured therapeutic process.
Benefits of Expressive Arts Therapy (EXAT)
EXAT provides a safe, supportive, and flexible space for participants—including persons living with dementia and caregivers—who seek emotional and/or psychological support.
Benefits for Persons Living with Dementia
- Bypasses verbal limitations by offering sensory, emotional, and embodied ways to express themselves.
- Reconnects individuals to their sense of identity and life story.
- Addresses unmet emotional and sensory needs, contributing to reduced agitation, anxiety, and wandering.
- Enhances mood, confidence, and a sense of self-worth.
Benefits for Caregivers
- Provides a safe space to process emotional stress and grief.
- Strengthens self-awareness and reconnects caregivers to their own identity beyond the caregiving role.
- Offers creative tools for stress relief and emotional release.
- Builds resilience and emotional regulation skills to cope with daily challenges.
Getting Started
You may wish to consider any of these simple activities to help you get started:
Try clapping games, guided drumming, music instrument jamming or using balls to bounce to the rhythm.
Tip: Music doesn’t always need to be familiar; try introducing different types of music.
Create a collaborative mural on butcher paper using dots, lines, or scribblings.
Tip: Explore different textures such as sponges, leaves, or bubble wraps.
Use mirroring games or invite participants to make simple shapes or gestures with their bodies.
Tip: Play around simple gestures by exaggerating its dynamics, energy, control, and speed. Playing with facial expressions is a form of movement too.
Build a creative story in groups by adding one word or phrase from each person in each group or use picture dice or cards to spark short narratives.
Scribble Activity:
Invite participants to scribble to different types of music, switching to a new piece of paper every 15-20 seconds as the music changes. When all the scribbles are done, lay them out and simply look at them together, noticing colours, lines, and the overall feel of each other’s work.
Reflection:
Keep the reflection light and supportive. You can ask questions such as:
- “Which one feels nice to look at?”
- “What stands out to you in this picture?”
- “If you could give this scribble a title, what would you call it?”
Group Adaptation:
In a group, each person can contribute one scribble to a shared collection, then view everyone’s pieces together to enjoy the different styles and rhythms that appeared.
Additional Tips
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#1Create space by clearing clutter and arranging chairs in a circle.
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#2Be a part of the activity to set the tone that you are not there to teach the activity.
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#3Use prompts that invite exploration, play and curiosity, such as: “Let’s see what happens if we do this,” rather than giving direct instructions.
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#4Be warm and supportive without slipping into “child-like” language.
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#5Speak with respect, using clear and simple phrasing while preserving the dignity of each person.
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#6Give participants some breathing space. There is no need to fill every minute with tasks. It is all right to experience moments of silence. If someone chooses not to take part in the activity, let him be — he may simply need more time to feel safe. Some participants may take a few sessions to settle in, so allow the pace to unfold naturally.
Conclusion
The use of diverse art modalities creates a relaxed, playful and engaging environment where participants can express their feelings and experiences.
For persons living with dementia, EXAT can help bypass cognitive limitations by tapping into sensorial, emotional, and embodied forms of communication. For caregivers, EXAT provides a safe outlet to express emotions, manage stress, reconnect with their inner selves, and improves overall well-being.
It nurtures curiosity, invites play, and supports a sense of identity and self-worth by offering opportunities for meaningful self-expression despite the changes dementia brings.
Author's Bio
Rachel Lim is a registered expressive arts therapist with ANZACATA and currently leads the development of Expressive Arts Therapy services at Dementia Singapore Ltd. With a master’s degree in Expressive Arts Therapy from the University of Hong Kong and a background in psychology, Rachel specialises in supporting persons living with dementia and their caregivers through creative, sensory-based approaches.
Lusebrink, V. B. (2010). Assessment and therapeutic application of the expressive therapies continuum: Implications for brain structures and functions. Art Therapy, 27(4), 168-177.
