Open Access. Powered by Scholars. Published by Universities.®

Digital Commons Network™

Open Access. Powered by Scholars. Published by Universities.®

Theses/Dissertations

Discipline
Institution
Keyword
Publication Year
Publication

Articles 1 - 30 of 195

Full-Text Articles in Entire DC Network

Nurturing The Nurturers: Caritas Literacy Wellness Program, Pakeeza Ali May 2026

Nurturing The Nurturers: Caritas Literacy Wellness Program, Pakeeza Ali

Doctoral Projects

Burnout, compassion fatigue, and emotional exhaustion remain significant concerns among oncology staff in high-demand ambulatory settings. This quality improvement project implemented the Caritas Literacy and Resilience Training Program (CLARITY), a microlearning-based intervention grounded in Watson’s Caring Science Theory, to support self-caring behaviors and emotional resilience among oncology staff in an ambulatory cancer center. A quasi-experimental, mixed-methods design was used, incorporating pre- and post-intervention survey data and qualitative focus group feedback. Quantitative outcomes were assessed using the Watson Caritas Self-Rating Score (WCSR) and post-intervention ratings of perceived effectiveness of the microlearning format. Wilcoxon signed-rank tests were used to examine pre-post change …


Relationships Between Adolescents With Substance Use Disorders, Their Guardians, And Expressive Arts Therapy: A Literature Review, Sarah K. Unkefer Apr 2026

Relationships Between Adolescents With Substance Use Disorders, Their Guardians, And Expressive Arts Therapy: A Literature Review, Sarah K. Unkefer

Expressive Therapies Theses

This literature review collects the comprehensive, current research around effective treatment of adolescents with substance use disorder (SUD) and explores ways to provide psychoeducation for the adolescent and their guardians to foster healthy relationships and open communication. This author explores the ways that expressive arts therapy influences treatment and long-term recovery of adolescents with substance use disorders (SUDs) by addressing familial communication and internalized stigma. Previous studies have shown that the current primary reaction from guardians is forcing abstinence, which often damages the adolescent-guardian relationship. Since this is one of the most important relationships in an adolescent’s projected recovery journey, …


Creativity In A Flash: Exploring The Perceived Therapeutic Effects Of Combining Creative Arts Therapies And Flash Technique, Celia J. Gagnon Jan 2026

Creativity In A Flash: Exploring The Perceived Therapeutic Effects Of Combining Creative Arts Therapies And Flash Technique, Celia J. Gagnon

Art Therapy | Doctoral Dissertations

Since the onset of the COVID-19 pandemic, research has revealed a significant strain on mental healthcare systems and healthcare professionals. Concurrently, there has been a rapid escalation in the prevalence of anxiety, depression, loneliness, and adolescent suicide rates, all of which have reached critical levels (World Health Organization, 2025; World Health Organization, 2022; Institute for Health Metrics and Evaluation, 2025; American Psychiatric Association, 2024). Post-pandemic, these statistics continue to rise across all nations and socioeconomic groups (WHO, 2025). Consequently, there is an urgent need to intensify research that supports the enhancement of mental health services globally (Institute for Health Metrics …


Exploring The Impact Of Pre-Assessment Rapport-Building On Children’S Evaluation Outcomes, Alyssa N. Springstead Knutz Jan 2026

Exploring The Impact Of Pre-Assessment Rapport-Building On Children’S Evaluation Outcomes, Alyssa N. Springstead Knutz

Doctor of Psychology (PsyD)

Psychological assessment with children is vulnerable to inequities that arise from cultural mismatch, situational anxiety, and the interpretive nature of examiner judgement. This pilot study examined whether a brief, standardized pre-assessment sandtray activity could enhance children’s assessment experience and observational richness by supporting rapport prior to testing. Using a within-subjects, counterbalanced crossover design, 10 children (ages 7-10) completed two assessment sessions on separate days: one session included a 20-minute guided sandtray task immediately before testing and one session proceeded directly to testing. Quantitative outcomes included state anxiety (SAI-CH-6), general self-efficacy (GSE), and performance on brief standardized tasks (WJ-IV Math Fluency …


The Potential For Improv As A Therapeutic Tool In The Context Of Dialectical Behavior Therapy: Suggestions For Dbt Clinicians, Jocelyn Borden Jun 2025

The Potential For Improv As A Therapeutic Tool In The Context Of Dialectical Behavior Therapy: Suggestions For Dbt Clinicians, Jocelyn Borden

University Honors Theses

This thesis explores the theoretical and practical intersections between improvisational theater and Dialectical Behavior Therapy (DBT), proposing that the core tenets of improv closely align with the philosophical foundation and therapeutic goals of DBT. Aimed at mental health professionals, this work provides a conceptual framework and praxis for incorporating improv-based activities into DBT skills training to enhance client engagement, experiential learning, and emotional resilience. Through an examination of improv theory, parallels with DBT principles, and practical suggestions for integration, the thesis outlines how applied improvisation can be used as a supplemental tool in traditional DBT treatment. The final section includes …


How Does An Art Therapist Build Rapport With Socially Isolated Older Adults?, Elizabeth L. Levering May 2025

How Does An Art Therapist Build Rapport With Socially Isolated Older Adults?, Elizabeth L. Levering

Expressive Therapies Theses

This study was done to explore the fundamental aspects that are woven into the report-building process and the therapeutic alliance with socially isolated older adults. Research has been done on the effects that social isolation and loneliness have on this underserved population, however report building is less researched and can be translated into the mental health field. Person-centered therapy, developmental stages of older adults, and the growing field of art therapy and its benefits are also well documented. This qualitative arts-based study takes the intersectionality of these topics by observing three sessions with two separate residents and analyzing the results. …


How Can Tattoos Be Understood As Intermodal Expressive Arts Therapy?: Integrating Visual Art, Personal Narrative, And Embodied Experience: Development Of A Method, Rachel S. Hall May 2025

How Can Tattoos Be Understood As Intermodal Expressive Arts Therapy?: Integrating Visual Art, Personal Narrative, And Embodied Experience: Development Of A Method, Rachel S. Hall

Expressive Therapies Theses

This paper explores the inherent intermodal nature of tattoos through the lens of expressive arts therapy, demonstrating how tattoos integrate visual art, personal narrative, and embodied experience. A group intervention was designed and implemented in an outpatient setting, drawing on existing literature and the Expressive Therapies Continuum (ETC) to examine how tattoos function as therapeutic tools that support identity formation, emotional healing, and self-expression. The intervention guided participants through an intermodal process that began with reflective writing on identity-forming experiences, followed by visual art-making and somatic engagement. This approach illuminated the transformative potential of tattoo conceptualization within a therapeutic context, …


Multimodal Dance/Movement Therapy For Children With Autism, Riley K. Cornacchini May 2025

Multimodal Dance/Movement Therapy For Children With Autism, Riley K. Cornacchini

Expressive Therapies Theses

This literature review examines the potential of creative arts therapies, particularly multimodal approaches, in improving social connection and communication for children with autism spectrum disorder (ASD). The review explores how expressive arts therapy, including dance/movement, music, art, and drama therapy, engages children with ASD in non-verbal and emotionally expressive ways. Emphasizing early intervention, it highlights how these therapies promote emotional regulation, social and motor skills, and self-expression, enabling children to connect with others and navigate their social worlds. Drawing on both research and personal experience, the review illustrates how creative arts therapy can provide flexible, individualized interventions to meet the …


To Bear Witness: Analyzing Dmt As An Effective Trauma-Informed Approach For Treating Youth & Adolescents: A Critical Review Of The Literature, Jade Dennis May 2025

To Bear Witness: Analyzing Dmt As An Effective Trauma-Informed Approach For Treating Youth & Adolescents: A Critical Review Of The Literature, Jade Dennis

Expressive Therapies Theses

This literature review proposes dance/movement therapy (DMT) as a trauma-informed intervention for children and adolescents who have experienced psychological, emotional, or physical trauma. The project, inspired by internship experiences with young trauma survivors, explores the ways in which trauma manifests in the body, indicating that DMT may offer effective pathways toward healing. Many children exposed to potentially traumatic events exhibit emotional dysregulation, insecure attachment patterns, and behavioral or somatic symptoms that are not easily addressed through traditional talk therapy. As a body-based expressive arts modality, DMT engages the sensory, emotional, and relational aspects of trauma by supporting nonverbal expression, self-regulation, …


Developing Art Resources To Reduce Stress And Increase Well-Being For Healthcare Professionals, Elisabeth Ruth Baird May 2025

Developing Art Resources To Reduce Stress And Increase Well-Being For Healthcare Professionals, Elisabeth Ruth Baird

Theses - ALL

This study explored how art-based wellness resources can support healthcare professionals who provide direct patient care in hospital settings. A focus group of these providers shared their experiences with stress and burnout, identifying key challenges and needs. Based on their feedback, a Mini Wellness Manual was developed with practical, research-based art activities designed to help reduce stress and promote well-being. In a second focus group, participants reviewed the manual and provided feedback on its usefulness and accessibility. Findings showed that self-care interventions often place the burden on individuals rather than addressing the larger systemic issues that contribute to burnout, highlighting …


Beyond Stigma: Role Theory And Drama Therapy In Reentry And Rehabilitation, Mackenzee Donham-Stradling May 2025

Beyond Stigma: Role Theory And Drama Therapy In Reentry And Rehabilitation, Mackenzee Donham-Stradling

Expressive Therapies Theses

To be system-impacted often means facing stigmatization. The experience of incarceration is profoundly dehumanizing, eroding self-worth and identity. This thesis examines the application of a 3-week drama therapy method for formerly incarcerated women residing in a transitional facility with co-occurring mental health and substance use disorders. This project integrated a drama therapy framework with Robert Landy’s Role Theory to create a method aimed at assisting formerly incarcerated clients in expanding their role repertoire and discarding those roles that perpetuate their disempowerment. This thesis begins with a literature review of role in drama therapy, the experiences of incarcerated women in the …


Abracadabra: Empowering Trans And Gender Nonconforming Adolescents’ Identities Through Integrated Narrative Expressive Arts Therapy: A Literature Review, Alexandra Douglas-Deutsch May 2025

Abracadabra: Empowering Trans And Gender Nonconforming Adolescents’ Identities Through Integrated Narrative Expressive Arts Therapy: A Literature Review, Alexandra Douglas-Deutsch

Expressive Therapies Theses

This literature review is an exploration of how a blended narrative and expressive arts therapeutic framework can be utilized to best suit the mental health needs of transgender and gender non-conforming adolescents as they develop their identities. Areas of research include an examination and analysis of the established bodies of research that pertain to transgender and gender nonconforming (TGNC) populations, adolescent identity development, relevant critical sociocultural theories, narrative and expressive arts therapy frameworks, and future directions of mental health counseling with TGNC youth as it pertains to identity.

It is this author’s intention to scaffold the areas of research in …


Adolescents And Addictions: An Expressive Arts Therapy Prevention Intervention In India – Development Of A Method, Ravtesh Kaur May 2025

Adolescents And Addictions: An Expressive Arts Therapy Prevention Intervention In India – Development Of A Method, Ravtesh Kaur

Expressive Therapies Theses

This thesis aims to propose an expressive arts therapy prevention intervention for substance use among adolescents in India. Adolescence is a period defined by many physiological and psychological changes and is considered to be a time of high-risk for the initiation of substance use. The prevalence of substance use amongst Indian adolescents is growing every year, with most adolescents engaging in frequent use of alcohol, tobacco, cannabis, and inhalants. This thesis intends to develop and implement an expressive arts therapy prevention intervention for adolescents. The current research was conducted in a private school in Punjab, India with 50 students of …


Power Word Queer: Using Tabletop Role-Playing Games As Expressive Art Therapy For The Queer Community: A Literature Review, Aliza King May 2025

Power Word Queer: Using Tabletop Role-Playing Games As Expressive Art Therapy For The Queer Community: A Literature Review, Aliza King

Expressive Therapies Capstone Theses

At a time when homophobia and transphobia are on the rise, and hard-won rights are being taken away, the Queer community needs heroes, magic, and hope. Tabletop role-playing games have become increasingly popular, particularly in the Queer community (Diamond, 2022). This literature review examines the existing research regarding TTRPGs as a psychological intervention, with particular focus on their value as an expressive art therapy intervention for Queer clients, using a socio-ecological model of Queer mental health (Mink et al., 2014) and drawing from core expressive arts theories. The results suggest that TTRPGs show promise as an effective tool for growth …


Performance Art Is Ripe For Layering: Performance Art As A Therapeutic Intervention, Nur Greene Jan 2025

Performance Art Is Ripe For Layering: Performance Art As A Therapeutic Intervention, Nur Greene

Expressive Therapies Capstone Theses

Performance art is an artform which benefits Expressive Arts Therapy (ExAT), the field of expressive therapies, and the mental health profession itself. For the purposes of this literature review, performance art is defined as any expression which attempts to be transformative, is witnessed by self or other, matching at least two modes of creative expression, often interacting with those witnessing, and which offers some element of experiment. Expressive Arts Therapy, a modality of therapy within the expressive therapies aimed to move (transfer) creative expression from one artform to another and develop a connection between different artistic representations and one’s psyche, …


Combining Internal Family Systems Therapy And Dance Movement Therapy To Treat Survivors Of Sexual Assault, Tierney O'Keefe Jan 2025

Combining Internal Family Systems Therapy And Dance Movement Therapy To Treat Survivors Of Sexual Assault, Tierney O'Keefe

Scripps Senior Theses

The mammalian nervous system is primed to connect with loved ones, flee from danger, and shut down when overwhelmed. The nervous system frequently enters a state of chronic dysregulation after a traumatic event, such as a sexual assault. In order to properly heal from such trauma, treatment must address both the body and the mind. Internal family systems therapy and dance movement therapy provide two frameworks to address nervous system dysregulation and restore balance to the system as a whole. This study combines both therapies into a hybrid therapy treatment as an attempt to address the somatic nature of stored …


Creative Psychotherapy, Including Art. A Module For Pluralistic Identities And A Case Study From An Artist's Perspective., Amani Alsaad Jan 2025

Creative Psychotherapy, Including Art. A Module For Pluralistic Identities And A Case Study From An Artist's Perspective., Amani Alsaad

School of Art, Design and Architecture Theses

This thesis investigates the complexities of pluralistic identities, focusing on Arab Muslims in non-Muslim countries and Westerners residing in the Arabian Gulf. Grounded in the author’s dual heritage as an Arab Muslim artist and psychological practitioner, this study offers a distinctive perspective informed by lived experience. The author’s unique background, shaped by a Saudi Arabian birthplace and upbringing in the United Kingdom, serves as a foundation for this multidisciplinary research.The study aims to develop a creative psychotherapy module integrating art-making as a therapeutic technique to address the mental health challenges faced by individuals with pluralistic identities. These challenges, arising from …


Eye Movement Desensitization Reprocessing Treatment Protocol For Telehealth, Lisa Bozzoli Dec 2024

Eye Movement Desensitization Reprocessing Treatment Protocol For Telehealth, Lisa Bozzoli

Walden Dissertations and Doctoral Studies

This study addressed the research problem of limited access to eye movement desensitization reprocessing (EMDR) treatment due to factors restricting face to face (F2F) options, resulting in clients not receiving necessary help. The purpose for this quantitative, quasi-experimental, ex post facto study was to explore the effectiveness of EMDR provided through two delivery modalities (e.g., via telehealth versus F2F) compared as evidenced by a reduction in the SUD and an increase in the VOC between the two groups when controlling for the number of targets as the covariate. Shapiro’s adaptive information processing (AIP) model provided the theoretical framework and the …


Animation As Therapy For Mental Health Treatment Across Diverse Populations And Contexts, A Literature Review, Daneile Tabana Sep 2024

Animation As Therapy For Mental Health Treatment Across Diverse Populations And Contexts, A Literature Review, Daneile Tabana

Expressive Therapies Capstone Theses

Scientific research has explored and identified the beneficial relationship between health and creative expression, recognizing art therapy as a source of healing. Animation has been newly recognized as an art therapy medium with potential for therapeutic healing and increased psychological well-being. This review of the literature on animation therapy explores the history of the modality’s interaction with the population observed and the effects of animation on the cognitive processes, discusses current theoretical orientations and treatment options for treating a range of conditions that affect mood, thinking, and behavior with animation therapy, and considers culturally informed and client-centered practices alongside traditional …


Drawing Closer: Enhancing Connection In Romantic Relationships Through Expressive Arts – An Autoethnographic Community Engagement Exploration, Jessica Surprenant May 2024

Drawing Closer: Enhancing Connection In Romantic Relationships Through Expressive Arts – An Autoethnographic Community Engagement Exploration, Jessica Surprenant

Expressive Therapies Capstone Theses

This literature review aims to raise awareness around the many physical and mental health risks associated with loneliness, especially in today’s sociopolitical climate. It explores how fostering healthy relationships with feelings of connection and intimacy is one promising avenue toward mitigating those risks. Through synthesizing existing research on successful relationships, this thesis proposes a list of five beneficial relationship characteristics and traits that can be cultivated through expressive arts therapy. To further the investigation, this thesis includes an autoethnographic community engagement project exploring a real-life application of collaborative, creative artmaking. Due to researcher demographics, the information presented is geared towards …


Expressive Arts Therapy And Oncology Care Teams, Edwige Raimbault May 2024

Expressive Arts Therapy And Oncology Care Teams, Edwige Raimbault

Expressive Therapies Capstone Theses

This literature review offers an overview of the mental health of oncology care team members, medical professionals as well as oncology floor hospital staff, and the therapeutic benefits of expressive therapies on that specific population. Working on an oncology floor means interacting with patients and their loved ones at a time of utmost suffering, uncertainty, and possible death. This environment presents risks of burnout, compassion fatigue, and a sense of isolation for the medical and non-medical professionals working with cancer patients. The results of qualitative, quantitative, and art-based studies conducted pre-and post-Covid-19 pandemic show multi-faceted and multi-layered positive impacts of …


All In The Image: Nightmares, Posttraumatic Stress, And Expressive Therapy: Critical Literature Review, Emma Geller May 2024

All In The Image: Nightmares, Posttraumatic Stress, And Expressive Therapy: Critical Literature Review, Emma Geller

Expressive Therapies Capstone Theses

This paper reviews the therapeutic potential of combining expressive therapy approaches with dreamwork protocol in treating recurrent nightmares seen in populations with PTSD. The intersection between the dreaming state, nightmares, dreamwork, and trauma can provide important insights into the purpose of dreaming, subconscious processing of trauma, and effective treatments for individuals struggling with nightmares. Clinical implications of dreamwork are considered in working with posttraumatic stress disorder along with this condition’s connection to recurrent nightmares. In working with trauma and the arts at a sensory and affective level of experience, there is potential for individuals to explore and process their recurrent …


Dance/Movement Therapy: A Novel Approach For Latino Males With Incarceration Histories In Sud Treatment, Aletia Egipciaco May 2024

Dance/Movement Therapy: A Novel Approach For Latino Males With Incarceration Histories In Sud Treatment, Aletia Egipciaco

Expressive Therapies Capstone Theses

This paper investigates how open clients would be to participating and engaging in Dance/Movement Therapy (DMT) sessions at a residential SUD facility. The questions asked were (1) What level of engagement would clients have and (2) How would they engage in DMT group sessions at a residential substance use disorder facility? A program lasting 8 weeks, aimed at facilitating DMT group sessions, was conducted at a residential SUD facility twice a week. The objective was to assess participant engagement levels and observe their involvement in the DMT sessions. Residents of the facility were invited voluntarily to attend the DMT groups. …


A Comparison Of Body-Based Therapies Of Infant Development: A Literature Review, Nicole Rivera May 2024

A Comparison Of Body-Based Therapies Of Infant Development: A Literature Review, Nicole Rivera

Expressive Therapies Capstone Theses

In this thesis, I discuss two body-based therapies and explore their theory, body movement observation, assessments, application, and qualifications within an infant population. After my research, I have a more in-depth understanding of the differences and similarities between the methods and have more comprehension around what makes dance/movement therapy unique. I discovered that dance/movement therapists can collaboratively work alongside any medical facility due to the extensive training one must go through. A dance/movement therapist can use an assortment of assessments to give a client a treatment plan designed uniquely for them and their therapeutic goals. A dance/movement therapist can hold …


A Music Therapist’S Clinical Improvised Songwriting To Explore Countertransference In The Therapeutic Relationship For An Individual With Multiple Disabilities, Isabella Sances May 2024

A Music Therapist’S Clinical Improvised Songwriting To Explore Countertransference In The Therapeutic Relationship For An Individual With Multiple Disabilities, Isabella Sances

Expressive Therapies Capstone Theses

This qualitative and arts-based capstone thesis discusses working with individuals with multiple disabilities, songwriting in music therapy, intersubjective communication and theory, and countertransference in music therapy, by sharing the literature and presenting a method of how a music therapist’s own clinical improvised songwriting explores countertransference in the therapeutic relationship for an individual with multiple disabilities. Music therapy is used to treat individuals with multiple disabilities. The literature demonstrates that music therapy and improvisation can support communication development in clients with multiple disabilities. However, there is little research regarding countertransference and reflections by music therapists. This thesis explored post-session improvised songwriting …


Trauma-Informed Expressive & Creative Arts Therapy With Survivors Of Mass Shootings, Jessica Heiler May 2024

Trauma-Informed Expressive & Creative Arts Therapy With Survivors Of Mass Shootings, Jessica Heiler

Expressive Therapies Capstone Theses

Survivors of mass shootings often suffer from psychological impact and mental health issues, such as post-traumatic stress disorder (PTSD), prolonged grief, depression, and anxiety. These individuals, who have been directly or indirectly exposed to the trauma, may find it challenging to find support and services that cater to their unique needs. Currently, there is no established framework for treating survivors of mass shootings. However, practitioners have proposed guidelines that incorporate trauma-informed practices. This literature review aims to explore how the use of trauma-informed expressive and creative arts therapies can provide an alternative to talk-based therapies when working with individuals and …


Elementary School Teacher’S Experiences Of Open Studio Process In Examining Diversity, Equity, And Inclusion Topics, Tiffany Thompson May 2024

Elementary School Teacher’S Experiences Of Open Studio Process In Examining Diversity, Equity, And Inclusion Topics, Tiffany Thompson

Expressive Therapies Dissertations

ABSTRACT

This qualitative research study examined the experiences of two Black female teachers and six White female teachers who participated in five Diversity, Equity, and Inclusion (DEI) workshops that incorporated Open Studio Process (OSP) using Expressive Therapy Continuum (ETC). It is informed by research on defensiveness and resistance that often accompanies and presents barriers to effective DEI training.

All eight study participants were elementary school teachers, ages 22-56. Participants engaged in five workshops that used artistic mediums to explore DEI topics. Participants visually and metaphorically represented their experiences. Results were analyzed using qualitative techniques.

Findings are that OSP using ETC …


Re-Member Selfhood A Drama Therapy Intervention, Option 1, Angelique Beauchêne May 2024

Re-Member Selfhood A Drama Therapy Intervention, Option 1, Angelique Beauchêne

Expressive Therapies Capstone Theses

Re-member Selfhood is a specific trauma-informed, drama therapy, intervention designed to meet the needs of adults with exposure to trauma and traumatic stress, who have pertinent adverse childhood experience scores and/or experience persistent trauma cycles over the lifespan concurrent with somatization. The aim of this thesis was to introduce an intervention which could function as indirect exposure and assist in the integration process taking the whole being of trauma sufferers into account, including body, mind, and soul. Additionally, the hope of this intervention is to decrease perceived physical pain, assist in the integration of the rejected aspect of self, and …


Neuroqueering Art Therapy: Bringing Neurodivergent Gender Diversity Into The Creative Arts Therapy Room: A Literature Review, Avital Eisen May 2024

Neuroqueering Art Therapy: Bringing Neurodivergent Gender Diversity Into The Creative Arts Therapy Room: A Literature Review, Avital Eisen

Expressive Therapies Capstone Theses

Recent research across disciplines has established the significance of the overlap between neurodivergence and gender diversity, a truth long espoused by the community. Acting on this research, some mental health disciplines have begun addressing neurodivergent transgender and gender diverse people as a unified population in their research, but the field of art therapy has not yet followed suit. Theoretical frameworks of intersectionality, queer theory, and disability justice highlight the importance of centering the unique experiences and needs of neurodivergent gender diversity. Using these frameworks, this literature review synthesizes community knowledge with art therapy research on both neurodivergence and gender diversity, …


Adolescents, Complex Trauma, And Making Meaning Through Art, Teresa N. Grame Jan 2024

Adolescents, Complex Trauma, And Making Meaning Through Art, Teresa N. Grame

Art Therapy | Doctoral Dissertations

This qualitative study generated new knowledge and deepened understanding of how adolescent survivors make meaning of trauma recovery through art. Narrative inquiry methods applied art making with adolescent survivors of complex trauma who used art to express their experiences of healing. Eleven adolescents, ages 13-18, created three separate pieces of art representing how they see themselves and the world, in the past, present, and future. Narrative themes came alive through art in the form of metanarratives and storylines based on analysis of the formal elements of art and the Expressive Therapies Continuum. Art elements and art materials gave voice to …