This Viewpoint essay serves three purposes: (1) revealing the life experiences of Vija Lusebrink that shaped what would become the pantheoretical art therapy assessment and treatment model known as the Expressive Therapies Continuum; (2) clarifying the broad and deep scope of this model; and (3) encouraging the art therapy audience to recognize this model as a complex marriage of information processing and agents of change. The Expressive Therapies Continuum (ETC) lends itself to outcome-informed treatment in art therapy as a systems-oriented means of gauging client responses to multidimensional interventive inputs and modifying the therapist's approach accordingly. It is important for art therapists to share a unified understanding of the ETC that is consistent with the ideas of its co-creators.

The Expressive Therapies Continuum (ETC) originally incorporated creativity as the Creative "level." This denotation as a separate level is a misnomer because creativity can be present at any ETC level. Also, innate distinctive characteristics of the creative process differ from those of the other three levels. The objectives of this article are to help delineate the features of the Creative "level" within the ETC, designate its name as a Creative "dimension" to avoid confusion, and to provide case illustrations to help clarify these concepts. Creative functioning within the ETC model has been described as the integrative and self-actualizing forces within the individual occurring during expressive activities. Creative functioning has been described as comprising moments of self-realization and unique self-expression associated with well-being. These moments share similarities with the concepts of Flow, everyday creativity, small-c creativity, and mini-c creativity; concepts that can further describe creative activity in art therapy.

Emotion regulation (ER) is a vital modality for understanding and controlling depression and consists of three major interdependent components: positive and negative affects, the mutuality of emotions and cognition, and the physiological mechanisms of emotions. Studies have noted that art therapy is effective in alleviating depression and stress, promoting emotional openness, and improving general health. Clay art therapy (CAT) has shown significant effects on the reparation and recovery from depression by strengthening ER. Clay as an art medium can induce intense haptic, proprioceptive, and visual sensations that foster ideal cognitive arousal through rhythmic kinesthetic movements to attune inner pleasure and encourage emotional expression. Building upon the expressive therapies continuum (ETC) construct, the CAT model adopts a bottom-up treatment approach by initiating kinesthetic/sensory stimulation and subsequently promoting positive affective and cognitive experiences. The CAT protocol endorses a two-stage intervention design that progressively embeds levels of the ETC model in its activities.

This article presents the structures and functions of three large scale brain networks (LSBN) in cognition and suggests parallels with functioning of the Cognitive and Symbolic components of the Expressive Therapies Continuum (ETC). Comparisons explored include connectivity in adaptive functioning, disconnection in psychopathology, and compensation among functional components. The purpose of this article is to illustrate the functional similarities between the Cognitive/Symbolic level of the ETC and three LSBN in cognition and thus enhance the understanding of the process of and promote research in art therapy. A case study illustrates the application of the ETC with reference to LSBN.

After primary treatment, many cancer survivors experience low mood and depression. Music therapy is successfully addressing these issues. A case study, based on a music therapy example with a 65-year-old cancer survivor Anna, illustrates the assessment, planning and delivery of treatment of cancer-related depression based on the Expressive Therapies Continuum. The hierarchy of creative expression helped to understand Anna's functioning, facilitated the setting of a safe starting point and provided clear structure for therapy. It also served as an explanatory model for the creative transitions that the client/patient went through the therapy.

Abstract The theoretical concept of the Expressive Therapies Continuum (ETC), proposed by Kagin and Lusebrink in 1978, incorporates several US art therapy pioneers' approaches to art therapy. The ETC consists of three stepwise levels—Kinaesthetic/Sensory, Perceptual/Affective and Cognitive/Symbolic—interconnected by the creative level. Each level of the ETC encompasses two polarities, whereby the emphasis on one polarity decreases the involvement of the other polarity. The therapeutic aspects of the ETC are based on the following art therapy approaches: art as therapy, gestalt art therapy, phenomenological art therapy, psychodynamic art therapy, and cognitive art therapy. The stepwise three-tiered structure of the ETC incorporates concepts from cognitive psychology and art education, namely perception and imagery, visual information processing, stages of graphic development, and different expressive styles. Based on Fuster's (2003) theory about areas of the brain involved in processing perceptual information, Lusebrink has hypothesised that the three levels of the ETC reflect three different areas of the brain in processing visual information. The article elaborates on the practical applications of the ETC concept in therapy and the use of art media on its different levels. The goal of the article is to expand the range of art-based strategies and to further understanding of art expressions in therapy.

The application of new techniques in brain imaging has expanded the understanding of the different functions and structures of the brain involved in information processing. This paper presents the main areas and functions activated in emotional states, the formation of memories, and the processing of motor, visual, and somatosensory information. The relationship between the processes of art expressions and brain functions is approached from the viewpoint of the different levels of the Expressive Therapies Continuum (Lusebrink, 1990, 1991) with examples from art therapy interventions. The basic level of interventions with art media is through sensory stimulation. Visual feature recognition and spatial placement are processed by the ventral and dorsal branches of the visual information processing system. Mood-state drawings echo the differences in the activation of different brain areas in emotional states. The cognitive and symbolic aspects of memories can be explored through the activation of their sensory components.

The present study investigated the relationships between different criteria of personality factors as measured by the NEO Personality Inventory and sandtray expressions of normal adult subjects. Several of the quantitative sandtray rating criteria correlated significantly with the Neuroticism and Openness factors. The Neuroticism facets of Impulsivity and Hostility were related to the amount of space used and the presence of fences; Anxiety was related to the amount of space used and Vulnerability to the use of fences. The Openness factor correlated with the number of archetypal figures used and the total amount of figures present in the constructions. The use of archetypal figures correlated significantly with the Value facet of the Openness factor, and the total number of objects used to the Aesthetics facet. The correlations of the lexically based NEO-PI with the imagery based sandtray expressions imply the commonalities of these two modes of expression for the two personality styles.

"Freeing the Creative Spirit: Drawing on the Power of Art to Tap the Magic and Wisdom Within." Art Therapy, 10(4), pp. 245–246

A survey of art therapists with doctoral degrees was conducted to obtain information on the types of doctorates received by art therapists and the research topics and methodologies of the dissertations. The 78 responses received showed that there has been a rapid increase in the number of art therapists with doctoral degrees in the last several years. The dissertation topics were diverse; the predominant topics were studies of art therapy assessment tools, identification of abuse, and the use of art therapy in the treatment of serious illness/grief. Art therapists equally utilized quantitative and qualitative research methods.A mentor and resource pool, based on the information gathered in this survey, is recommended to assist art therapists conducting research.

A survey of 29 graduate and undergraduate faculty in art therapy showed that both graduate and undergraduate programs rely heavily on part-time faculty. The part-time faculty do only teaching and do not receive any benefits, except for a couple of instances. The full-time faculty's duties, in addition to teaching, include research and service requirements which range from 0–25%. They all receive medical insurance, but only two-thirds of the programs offer retirement benefits for their full-time faculty.