Using the Expressive Arts as an alternative therapeutic practice to increase self-determination, develop identity, and enhance self-esteem among young people transitioning out of foster care.
In New York city has 8,000 children in foster care and 50,000 families investigated for child maltreatment each year.(The Center for New York City Affairs; 2021). Up to 80% of youth in foster care have significant mental health issues, compared to 18-22% of the general population according to non-profit Specialized Alternatives for Families and Youth, Preserving Families Securing Futures.
Healthy Foster Care American Initiative identifies mental and behavioural health as the “greatest unmet health need for children and teens in foster care’. Foster care youth ace a range of high risk behavioural and mental health factors which include the history of complex trauma, frequently changing situations and transitions, moving placements, broken family and disorganised unpredictable relationships, inconsistent and inadequate access to mental health services, and the over-prescription of psychotropic medications.
Developmental disruptions, chronic feelings of feeling unsafe, and forming positive, secure relationships often combine to create significant challenges, which persist over time and interfere with a young person’s ability to cope.
Trauma factors, predominantly for older foster youth,
include negative effects on self-concept, emotional distress,
and developing interpersonal relationships and social skills.
Engagement is critically important like any process to support them on their way to health and holistic healing. Often youth coaches or youth workers may ask about struggles or challenges before having the opportunity to get to know the youth and support in developing these skills.
Phrasing is critically important as you begin to engage and build the relationship, which scaffolds your work towards being more empathic to create greater impact. The ideal response to young people is nurturing, collaborative, and specific. How you frame your intention from the beginning is important to preserve youth engagement and sustain their disposition to willingly stick with the supportive process, whether that be coaching, mentoring, social work and case planning, or mental health services.
I would encourage professionals working with this population to define the ending of a session with an affirming or inspirational phrase if the youth has been resistant to sharing during or after an initial session:
A sample phrase you could use:
“We did a lot today. I know it is not always easy to talk about the past, but you did great. You have many stories to share, and I’d love to hear more, when you’re ready to tell me’.
Expressive Arts
There are a range of strategies for coping with trauma, most of which require verbal discussion about a past-traumatic event
Below I share an alternative used to create impact among youth in foster care known as Expressive Arts Therapy or Expressive Arts in Counselling, which is proven to soothe both brain and body and enable a client to explore responses, insights, and encounters with art processes. It is the process which I will discuss, not just the processing of art-making that promotes growth and development.
An active form of therapeutic work significantly impacts how foster youth develop motivation for change and relational skills prior to transitioning out of care.
Purposeful applications of expressive arts therapy support the stress responses that result from traumatic events. They can be combined with standard approaches as well, i.e. Art therapy has been combined with mindfulness-based practices to induce and deepen relaxation.
Most expressive arts therapy sessions integrate rhythmic breathing, mindfulness-related practices, and other calming routines into the art piece, particularly when working with youth who have experienced a traumatic event or have complex trauma.
Following the completion of my Masters dissertation on the effectiveness of arts-based programming with disconnected youth based in London, I was offered my first job, where I would be a youth development specialist working with youth in foster care. During this time, it often occurred to me through interactions with my clients, that I could do more to support them and their needs. I decided to combine my passion for the arts and my interest in learning psychology and relational psychotherapy into a support structure that I could offer to the same group of young people in various mental health settings.
Having listened to many stories about damaged relationships and challenging circumstances that have affected resilience, I knew in order to give more I had to keep the momentum going to learn how to concretize and facilitate my passion.
I began studying a therapeutic practice known as drama therapy and then combined it with the expressive arts therapies; specialized disciplines within the field of psychology and mental health treatment. Drama therapy is the fusion of clinical psychology, the imaginative process within creative action, and the use of embodied storytelling I developed this expertise and learned to apply all of the expressive arts inter-modally in addition to restorative practices for group work. I started the first expressive arts mental health program in October of 2020 at Children’s Aid, one of the largest contracted fostering agencies in New York City.
I was hired as a social worker, and shortly after, I founded Create Your Shift, an expressive arts evidence-informed based program model for youth in and aging out of foster care ages 14-24 designed to focus on resilience building and restoring relationships. I developed Create Your Shift as a 10-12 week relational (relationship development model) that applies both person-centered creative arts techniques and restorative practices to support youth build their motivation and resilience, increase self-concept, identity, and self-esteem, sustain supportive relationships, and develop coping skills.
I track their ability to self-express openly and remain resilient, contributing to a more positive outlook on self, and stress responses over the course of the program through the use of survey scales. I noticed how critical resilience is for this unique population, and how important it is for youth to restore previously impaired relationships with their families.
I begin meeting with each youth individually, where they would participate in a customized survey which draws from the main categories that make up resilience. It is not my goal to overwhelm a client by asking too many questions during our first session. No young person, especially with a complex trauma history, wants to feel like they are being interrogated with a list of questions that begin with “can you tell me about the relationship with your mother.”
Instead I asked them to start by sharing their story. Following the sharing, I determine an opportune time to introduce them to the expressive arts project. Some are more ready to start than others, particularly if they naturally gravitate towards the arts as a means of coping with difficult emotions.
Most youth are not aware of how effective the arts are before we begin working together.
I intentionally point this out through the process of using “metaphor and aesthetic responses”, which includes the use of imagery, symbols, colours, objects, and mirroring as a collaborative co-creative approach to healing. This is the foundation. It’s effectiveness can be demonstrated by the following contributing factors/outcomes which signify how resilience is sustained throughout the act of participating
in arts as a process vs focusing on a product; an underlying message when working with the expressive therapies.
During my experiences working with young people transitioning out of foster care, I am convinced that as youth serving providers, we must highlight the resiliency of youth in our child welfare and mental health systems instead of merely focusing on their pain; the events that caused the trauma.
Many have asked me how I work effectively with this group, since they are known to be a difficult bunch to reach, much like the ever-changing dispositions of pre-adolescent children. When working with high risk young adults or those transitioning out of care, form an immediate alliance with the young person, but also make sure to be aware of your goal in creating a balance between knowledge sharing: practitioner listening to the story, providing feedback within a safe space for sharing, reframing, and pointing out new information to them, so that the young person is capable of grasping this alternate perspective in your offering without assuming they have all the answers. They want to learn from your journey as well.
Further to this process, I utilise the philosophy of a whole-person centered approach. It is a method that captures the individual expression of a client and enables them to find the power of their own voice to articulate their narrative in away that can involve all of the expressive arts applying a range of expressive arts techniques within a single session) whilst fusing one into the other i.e. visual art, movement, poetry, dance, music, drama, and expressive writing) in an intentional way that best suits the treatment goals and their individual relational needs.
