What is the Expressive Therapies Continuum Model?
The Expressive Therapies Continuum is a framework that popped up in the art therapy profession back in the 1970s. The co-creators of it, Vija Lusebrink and Sandra (Kagin) Graves-Alcorn, were art therapy pioneers who melded together the findings of their respective research and developed what would become a mega-model for assessment, treatment planning, intervention, progress monitoring, and case conceptualization all within one client-centered, outcome-informed system of nervous system data processing.
“What is the Expressive Therapy Continuum Model?”
I found this question on Google, signifying that searchers are a little confused about whether it’s the “Expressive Therapy Continuum” or “Expressive Therapies Continuum”. It’s the latter. And terminology is important, given how refined algorithms have become and how refined the Expressive Therapies Continuum actually is!
I’ll give you a little tour of the model, but first you should know that the co-creators of the Expressive Therapies Continuum, or ETC, were my professors in graduate school. I’ve been exposed to more of the ETC than the average art therapist, and this little tour I’m about to take you on is very small compared to the framework itself and all its nuances.
The Expressive Therapies Continuum is Based on Research
By the time Vija Lusebrink and Sandra (Kagin) Graves-Alcorn met at as faculty at the University of Louisville, they had each conducted research that cemented their ideas about important aspects of the art therapy process.
The Expressive Therapies Continuum Combines Mental Imagery Expression with Agents of Change
Lusebrink had focused on the evolution of mental imagery and its expression, and (Kagin) Graves-Alcorn had focused on agents of change that could be adjusted on a client-by-client basis. Their findings were fused together, thanks to a flash of insight on Lusebrink’s part, who had come to realize that different combinations of (Kagin) Graves-Alcorn’s agents of change could be harnessed to yield different levels of mental image expression.
It was a marriage made in heaven. You can read more about the origins of the Expressive Therapies Continuum here and here.
The Expressive Therapies Continuum Framework Relies on Responsiveness
Now that you know how the Expressive Therapies Continuum came into existence, what is it? Like I said earlier, it’s a framework for assessment, treatment planning, intervention, progress monitoring, and case conceptualization all within one client-centered, outcome-informed system of nervous system data processing.
In short, it’s responsive. What does responsive mean? Responsiveness is a quality that guides someone to do the right thing at the right time for the right situation. In art therapy and all the other therapies out there, responsiveness means that the therapist has the internal skills necessary for doing the right thing at the right time for the right client.
Treatment Within the Expressive Therapies Continuum is Individualized
The Expressive Therapies Continuum is not scripted. In a scripted approach to therapy, the therapist imposes interventions on the client based on preconceived notions about the client’s needs; these are largely diagnosis- or issue-related.
Art therapy directives and prompts fall into this category of scripted approaches, as the therapist generally shows up for the session with a directive or prompt in mind and doesn’t place primary emphasis on what the client is demonstrating through their art process, art products, and related verbalizations.
Responsiveness Guides Decisions Within the Expressive Therapies Continuum
A therapist who’s been appropriately trained in the Expressive Therapies Continuum isn’t likely to plan scripted interventions that are related to a client’s diagnosis or issue. Instead, the ETC-trained therapist will use in-the-moment data from the client’s art process, art products, and related verbalizations to guide their in-the-moment decisions about what needs to be done.
If a client is developmentally ready to engage in discussion about these decisions, it can be to everyone’s advantage for the therapist and client to reach consensus about next steps. This ensures that treatment makes sense to the client and feels safe or at least safeguarded.
How Does the Art Therapist Know What to Do?
The therapist’s knowledge of ETC indicators helps them recognize how the client is processing information within their nervous system, and this data is what the therapist is responding to when proposing any changes related to art materials or methods.
Beware of Idiosyncratic Ideas About the Expressive Therapies Continuum
It can become confusing within the Expressive Therapies Continuum framework if an art therapist hasn’t had much training in it or none at all. People in this category will often make up for the gaps in their understanding by filling in missing information with idiosyncratic ideas that range from the ETC as a model for helping clients become more creative to the ETC as a model that moves clients through a preconceived pathway.
Let’s just say that neither of these is true—instead, the ETC is a model for helping clients become more integrated, not creative, and it does this through therapist responsiveness to each client’s uniquely demonstrated pattern of information processing within their nervous system, not a preconceived pathway.
The Expressive Therapies Continuum was Ahead of its Time
You can read more about the Expressive Therapies Continuum in this longer article that takes you through some of the terms I’ve used here and gives you a better grasp of this ahead-of-its-time model, which has been garnering attention throughout the international art therapy community and beyond.
If only the ETC’s co-creators had been given the chance to train others the way they trained their students at the University of Louisville. This missed opportunity has implications for contemporary art therapy practice, education, and research.
Expressive Therapies Continuum Guidance is Available
Are you recognizing the need to level up your understanding of the Expressive Therapies Continuum? I offer ETC learning opportunities such as webinars and workshops to help my peers in art and the expressive therapies acquire didactic and experiential knowledge about this responsive, outcome-informed, client-centered framework.
Get a Free Expressive Therapies Continuum Resource
Join the Expressive Therapies Continuum newsletter and announcement list and get a free ETC bibliography—this is a great resource for practitioners, educators, and researchers alike. Plus you’ll always be in the know about upcoming ETC events for leveling up your familiarity with this integrative model.
Do You Need Expressive Therapies Continuum-based Art Therapy?
If you’re looking for art therapy services that are provided through the Expressive Therapies Continuum, I offer online art therapy for anxiety, online art therapy for attachment issues, online art therapy for burnout, online art therapy for depression, online art therapy for grief or loss, online art therapy for self-esteem issues, online art therapy for spirituality issues, and online art therapy for trauma.
I serve adults in Texas, Indiana, and Arizona, and I look forward to helping YOU integrate through responsiveness to the uniquely demonstrated pattern of information processing within your own nervous system. Contact me for a free consultation about how Expressive Therapies Continuum-based art therapy can help you feel like good news again.
References:
Hinz, L. D. (2020). Expressive Therapies Continuum: A framework for using art in therapy (2nd ed.). Routledge.
Hinz, L. D., VanMeter, M. L., & Lusebrink, V. B. (2022). Development of the Expressive Therapies Continuum: The lifework of Vija B. Lusebrink, PhD, ATR-BC, HLM. Art Therapy: Journal of the American Art Therapy Association, 39(4), 219-222.
Kagin, S. L., & Lusebrink, V. B. (1978). The Expressive Therapies Continuum. Art Psychotherapy, 5, 171-180.
VanMeter, M. L., & Hinz, L. D. (2024). A deeper dive into the Expressive Therapies Continuum; Structure, function, and the creative dimension. Art Therapy: Journal of the American Art Therapy Association, 41(2), 107-110.