A four-drawing art therapy trauma and resiliency protocol study


Art therapy relational neuroscience, ATR-N, Imagination, Memory reconsolidation, Creativity, Resiliency, Negative affect, Pain, Art therapy protocol, Four-drawing protocol, Quantitative, Trauma, Coping resources, Curiosity


Resiliency, as fostered by creativity, imagination, and the arts therapies, is a critical factor in managing the impact of adversity. This pilot study investigated the potential effectiveness of a four-drawing art therapy trauma and resiliency protocol for coping with adverse life events. The protocol is designed according to memory reconsolidation research and based in art therapy relational neuroscience (ATR-N) principles and trauma models. The hypotheses were that participation in the four-drawing protocol would result in: decreases in overall effect of the traumatic event (hypothesis one), decreases in negative affect endorsement and rating as expressed by sadness, grief, depression and anxiety (hypothesis two and three), reductions in pain endorsement and rating (hypothesis four and five), increases in resiliency-based resources (hypothesis six), positively rated impact on participants’ understanding of the problem and resources (hypothesis seven), increases in posttraumatic growth cognitions (hypothesis eight), and increases in relational security (hypothesis nine). The positive effects of the four-drawing protocol components, including the drawings, questionnaires, and inquiry were examined. Main findings included significant decreases in the rating of the effect of the traumatic event (hypothesis one), self-reported endorsement and ratings of negative affect (hypothesis two and three), trends in pain reduction ratings (hypothesis five), significant increases in endorsed resiliency resources (hypothesis six), and positive ratings of the impact of the drawing activity (hypothesis seven), but no significant changes in endorsement of pain (hypothesis four), posttraumatic growth cognitions (hypothesis eight), or relational security (hypothesis nine). Additional results revealed that decreased endorsement and ratings of negative affect continued to be maintained at follow-up, and that the inquiry had a self-reported positive impact on participants’ understanding and meaning-making of the traumatic event. It is possible that memory reconsolidation processes may account for the positive changes.

Original Publication Citation

Hass-Cohen, N., Bokoch, R. Clyde Findlay, J., Banford Witting, A.(2018). A Four-DrawingArt Therapy Trauma and Resiliency Protocol Study. The Arts in Psychotherapy. DOI: 10.1016/j.aip.2018.02.003

Document Type

Peer-Reviewed Article

Publication Date



The Arts in Psychotherapy




Family, Home, and Social Sciences


Family Life

University Standing at Time of Publication

Full Professor