The Importance of Expressive Therapies in Healing

By Sarah Friebert, MD, and Erica Wade, BS
Wednesday, April 12, 2017

The potential of Expressive Therapy (ET) to provide relief and healing for children with a variety of medical conditions, including those with mental and behavioral health concerns, has wide-reaching implications for healthcare providers.

Simply defined, ET is facilitated therapeutic healing in which a safe space allows relationship exploration through a variety of creative outlets. Focused on process, not product, ET enables the development of personal awareness together with a sense of community. Regardless of the modality employed by the therapist or chosen by the participant, ET is a powerful healing tool for achieving therapeutic and medical goals. These include easing distressing symptoms (pain, nausea and anxiety); coaxing out hidden feelings and dynamics (anger, sadness and disappointment); enhancing patient choices and control (especially when their external situations are out of their control); facilitating growth and life opportunities; enabling inward focus and relaxation; and nurturing helpless, exhausted and distraught caregivers. Other family members, such as siblings who are often “forgotten” during a child’s medical crisis, also benefit from ET, which is truly family-centered in its approach.

ET is effective for patients because it helps them gain many skills and empowers them to focus on healing. Patients may have many skill levels, ages or experiences, and no prior experience with the arts is required for participation. The purpose is to use the preferred art modality to interact with patients and families who need more options or outlets than other therapies offer, such as talk therapy. For physicians, it can be helpful to think about this approach in terms of a child’s point of view: Young children do not yet understand or have the words to express their emotions verbally. How, then, can talk therapy be effective? If you are that same child, for whom creativity is a familiar concept, what better way to express your emotions and pain than by using those things you understand, such as art, music or dance? We have found that for many patients, ET facilitates coping with feelings of fear, depression, isolation, withdrawal, anxiety and even physical pain, creating physiologic benefits through reductions in stress and harmful pain pathways. Further, we have observed that some of these patients require less pain medication for their medical treatment because of the healing power of art.

Expressive therapies can be of key importance not only for the child receiving care, but also for the family members and caregivers of the child. Incorporating ET into treatment can provide a sense of normalcy in the patient’s and family’s hospital experience, giving families a chance to be together away from the hospital room (if they are able) and a chance to decrease feelings of isolation while increasing communication.

Overall, ET can help children and families focus on healing by reducing the child’s perception of pain and anxiety, teaching them relaxation and stress management skills and thereby providing support for them during difficult times.


Dr. Sarah Friebert is board certified in Pediatric Hematology/Oncology, and Hospice and Palliative Medicine. She is Director of the Akron Children’s Hospital Pediatric Palliative Care division. Erica Wade is Coordinator for the Emily Cooper Welty Expressive Therapy Center at Akron Children’s Hospital.