Expressive arts therapy interventions for strengthening family communication : a scoping review

Abstract

This scoping review aims to map existing research on the use of Expressive Arts Therapy (EAT) and related creative interventions, with a particular focus on the application in strengthening communication between adolescents and their families. Guided by the Arksey and O’Malley methodological framework and PRISMA-ScR guidelines, a systematic search was conducted across PubMed, PsycINFO, Scopus, and Google Scholar. The review included peer-reviewed studies published in English between 2016 and 2026 that examined therapeutic EAT interventions targeting family communication outcomes within families containing adolescents aged 10 to 19 years. Sixteen studies met the inclusion criteria. A thematic synthesis revealed that EAT improves family communication through three key mechanisms: (1) physiological and emotional co-regulation, (2) empathy, mentalization, and perspective-taking, and (3) nonverbal and symbolic communication processes. While EAT effectively bypasses verbal defensiveness, the research landscape remains fragmented. Critical gaps include a reliance on qualitative methodologies with small sample sizes and inconsistent outcome measures. Findings suggest that EAT provides a vital, non-verbal bridge for families facing distress and conflict, demonstrating that symbolic and sensory communication pathways for relational healing. This review underscores the practical need for practitioners to treat the family unit systemically by integrating "bottom-up" arts processes with "top-down" psychoeducation, while highlighting an urgent theoretical need for longitudinal and cross-cultural research to mature the field.