The Expressive Therapies Continuum (ETC): Interdisciplinary bases of the ETC

Vija Bergs Lusebrink, Kristine Martinsone, Ilze Dzilna-Šilova

Research output: Contribution to journalArticlepeer-review

26 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)75-85
Number of pages11
JournalInternational Journal of Art Therapy: Inscape
Issue number2
Publication statusPublished - Jul 2013


  • art media applications in therapy
  • Art therapy
  • art therapy process
  • levels of visual expression
  • structural basis of the ETC
  • theories of art therapy

Field of Science*

  • 3.2 Clinical medicine
  • 3.3 Health sciences

Publication Type*

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database


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