Expressive Therapy For Substance Abuse

Last Edited: September 30, 2020

Patricia Howard, LMFT, CADC

Clinically Reviewed
Jim Brown, CDCA

All of the information on this page has been reviewed and certified by an addiction professional.

What is Expressive Therapy?

Expressive therapy is the use of music, art, drama, dance/movement, and creative writing as a therapeutic strategy in psychotherapy, rehabilitation, and counseling. This method is used in conjunction with group and individual therapy sessions as a technique of expression when normal verbal communication is not preferred by the individual.

When an addict has been abusing drugs for numerous years their brain becomes hardwired to obtain the drug as it is the greatest reward at the time. Little development in creativity or expression occur when drug abuse is involved and by incorporating expressive therapy to their treatment plan, this modality becomes an outlet for their frustrations and/or a method of curbing cravings.

Studies have shown success with this modality in children trying to communicate trauma with their therapist. An adaptation of this practice is being used for substance abuse as recovering addict may be harboring similar traumatic events that caused the drug abuse or traumatic events that occurred during their drug induced lifestyle.

Techniques of Expressive Therapy

Expressive therapy is a plethora of therapies that focuses on the person expressing themselves through a creative outlet when verbal communication is too painful to discuss at the moment. Below is a list of each type of therapy and how is implemented:

Art therapy uses creative expression with colors, media, magazine clippings and/or image representation. The finished product often reflects interests, perception of self, concerns, abilities, personality, mood, problems, and conflicts. This therapeutic technique can express emotional conflicts, encourage fostering self-awareness, progress in developing social skills, method of solving their problems, reducing anxiety or nervousness, focuses thoughts away from negative cravings or loathsome thinking patterns, and increasing self-esteem through accomplishment. The therapist will engage the person in a short instruction of what to express ( i.e. your mood, representation of self, how your feeling, how you think your progress is going) and if they are comfortable with their creation they can explain their art in group therapy.

Poetry Therapy and Journaling are used for healing and personal growth. Having plenty of time to reflect of the life influence by drugs, many keep journals, write poetry, or create lyrics that can portray their emotions and progress in therapy. The use of journals during rehab shows the recovering addict their progress of their own record and installs self-confidence when they identify themselves that they are healing. Many experiences involving drugs and that lifestyle are tragic and disturbing. Having a private outlet that is free of judgement and criticism is a healthy way of ‘getting it off your chest’ without actually having to talk to someone.

Music Therapy uses lyrics from artists or actual instruments to express mood, feelings, or calm the individual during mood swings. Lyrics from favorite artists can be examined in a group and them expressed by the listeners about how it makes them feel or what the song means to them. Those who are inclined can pick up an instrument during their free time to focus on creating their own sound that releases their angst. Classical music has been known to generate a sense of calming or creativity in individuals who are unbalanced and are on the cusp of aggression due to substance withdrawals. Current studies are exploring the effects of sounds waves and brain mapping.

Drama Therapy is the use of drama/theatre processes to convey therapeutic goals of personal growth, symptom relief, emotional expression, or character reflection. Sometimes this therapy is referred to psychodrama therapy. The therapist insists the person pick a role they connect with as a method of expression through a fictional character. Those in family therapy sessions will use this technique as a role reversal in conveying a family’s perspective of the situation or addict’s behavior. Overall this method is used to help the client tell his or her story without suffering the trauma that normal communication could cause.

Dance/Movement Therapy is used to express changes in mood, feelings, improve physical function, and behavior. Partner dancing improves relationships with others and stimulates healthy brain functions associated with dance/movement. Dance/movement therapy can range from jogging, yoga, ballet, or ballroom dancing.

Overall, these types of expressive therapies all encourage personal growth and healthy methods of expressing mood and feelings. They put the focus on therapy and must be paired with other treatment modalities to ensure full recovery. These therapies are often guided by professionals that know how to instruct without limiting creative expression. Therapists must become certified or trained in proper implementation as aggression and/or negative repercussions can occur; defusing those situations are kind in preventing relapse.

Expressive Art Therapy integrates all of the arts in a safe, non-judgmental setting to facilitate personal growth and healing. To use the arts expressively means going into our inner realms to discover feelings and to express them through visual art, movement, sound, writing or drama. This process fosters release, self-understanding, insight and awakens creativity and transpersonal states of consciousness. – Natalie Rogers”

Benefits of Expressive Therapies

Each facet of expressive therapy has its own therapeutic properties depending on its implementation. Some therapists prefer to use these methods as a form of assessment as most of these therapies can be documented to show progress in treatment and help determine the needs of each individual. Many addicts has co-existing mental health problems that encourage drug abuse as a method of self-medication. Many of these therapies can be a method of identifying those underline problems.

  • Visual expression therapies are more private and enhances the process of individuation, self-expression, and personal growth. Whether the person chooses to example the rational, if there is any, behind their interpretation of their work is entirely up to them.
  • Music invokes feeling and stimulates mood. This type of therapy may lead to socialization by collaboration in song or in playing instruments with another.
  • Dance/movement therapy can form trust and healthy relationships.

Conflicts in Treatment

It is only natural for therapy to have its’ limits and conflicts with full recovery. Expressive therapy must be paired with other treatment modalities to ensure proper rehabilitation and must not be used as a stand-alone treatment. Children or adolescence seem to be more open minded about embracing the benefits of these therapies, however, adults tend to be more hesitant to fully accepting these types of therapies as they may think that they lack creativity or artistic expression. They may not believe or find merit in these types of treatments and have a negative mind frame around the idea of acting or dancing. Therapists tend to find negative initial responses to these activities and tend to require these types of therapies to be done in a group setting as they are more whiling to try it when other people are doing it too. Professionals who lack training in expressive therapies, tend to want to interpret the recovering addict’s visual work or link what they see in their art with their addiction or underlining mental illness. Untrained therapists in expressive therapy may be tempted to draw their own conclusions about content resulting in missing the recovering addicts intended meaning.

Neukrug, E. (2011). Counseling theory and practice. Australia: Brooks/Cole, Cengage Learning.
Center for Substance Abuse Treatment. Brief Interventions and Brief Therapies for Substance Abuse. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 1999. (Treatment Improvement Protocol (TIP) Series, No. 34.) Available from: