Addressing Anxiety with Creative Arts Therapies

What is Anxiety?

Everyone has experienced a situation where they have felt stress, worry, or nervous – unsure of the outcome of a given situation, discomfort in a new environment, or fear of the unknown. To many people, brief moments of anxiety, or episodes of uncertainty are not something that needs to be examined by a medical professional, but to some children and adults, anxiety interferes with daily life.

For children, anxiety is associated with hyper-arousal (‘flight or fight response’) and with behavioral and verbal inhibition. Children with anxiety disorders show deficits in their ability to communicate their emotions to other people. Creative arts therapies (dance, music, and art) are recommended for children with anxiety due to their direct and at times, non-verbal, approach to perception, expression, and regulation of emotions, as well as the motivational and engaging nature of the therapies.

Creative Arts Therapies may take the form of individual or group therapies. Many children with anxiety may start in individual therapy in order to build a trusting relationship with the therapist and become familiar with the environment. The goal for many children with anxiety is not only to work on increasing self expression and decreasing feelings of anxiety, but also to feel comfortable in social settings.

In Music Therapy, children use musical play to express and regulate emotions, listen to specific relaxation music to regulate their psychophysical hyperarousal and stress level, and begin to communicate their feelings to other people (Goldbeck, L., Ellerkamp, T., 2012). Music therapists lead engaging songs and instrument playing activities, based on the interests of each individual. Music has the ability to trigger various emotions in all people, so identification and expression of emotions from ‘happy’ or ‘scared’, to ‘sad’ or ‘excited’ is a common goal of music therapy sessions. For example, a child may work on a song writing activity that discusses something ‘happy’ – such as a birthday. The therapist may then facilitate the song writing to develop a scenario about a birthday party, which may be a trigger for social anxiety. After the song is written, the child may be encouraged to find various instruments to demonstrate various parts of the song. The tambourine might represent the excitement of waking up on your birthday and opening presents, while the drum might represent the loud and overwhelming sounds of a crowd at a party. The child has now musically expressed various emotions and the music therapist can build discussion or future experiences from that point, dependent on the individual’s needs and abilities.

In Dance/Movement Therapy, individuals with anxiety can develop a heightened awareness of themselves, their emotions, and how to manage their physiologic responses to anxiety producing situations. The mind may over-analyze anxiety producing situations, and the body may respond with muscle tension, headaches and heightened blood pressure. Therefore, dance and movement exercises addressing anxiety may include: Relaxation Visualization exercises to increase body awareness, release emotional tension, and gain an effective coping strategy (Bourne 2005) and Mindfulness to help accept the current situation, foster patience and interrupt anxiety thinking (Foxman, 2007).
A dance/movement therapy session will incorporate role-play frequently throughout the activities. A child will develop individual ideas and creativity, while the therapist facilitates the use of non-verbal gestures, facial expressions, and interactions. Specific anxiety producing scenarios can be acted out and then re-played in various forms in order to work on developing and practicing coping strategies.

Art Therapy provides opportunities in self-expression, development of coping strategies, and improved self-regulation. In addition, art therapy opens the door for deeper communication into anxiety producing situations by first encouraging the child to engage in an art –making experience without using any verbal interaction, encouraging the creativity, and then finally processing verbally with the therapist. The art therapist will be aware of the use of various colors, force, and space within a creation and will then analyze the meanings behind this non-verbal expression in future experiences or conversations. Many art therapists also encourage daily ‘art’ journals, as an alternative to a written journal, which may be more motivating for a child.

Further Reading
Bourne, E. (2005). The Anxiety & Phobia Workbook Fourth Edition. Oakland, CA: New Harbinger Publications, Inc.
Foxman, P. (2007). Dancing with Fear. CA: Hunter House Publishers.
Goldbeck, L., Ellerkamp, T. (2012). A Randomized controlled trial of multimodal music therapy for children with anxiety disorders. Journal of Music Therapy, 49(4), 395-413.

By Kathleen Nace