Integrating art-based activities in racial stress and trauma treatment: Therapists' perspectives on benefits, challenges, and techniques

Racial stress and trauma profoundly affect the mental health of racialized individuals, yet culturally responsive therapeutic approaches remain underdeveloped. Art-based activities may provide alternative pathways for emotional processing and engagement. This study explored therapists' perspectives on integrating art-based activities into racial trauma treatment, focusing on clinicians trained in the Healing Racial Trauma Protocol, a manualized cognitive-behavioral intervention.

Semistructured interviews were conducted with 10 therapists (six Black, Indigenous, and People of Color, four White; M_age = 36.6 years; 70% female) who had delivered the Healing Racial Trauma Protocol. Framework analysis was used to identify themes related to prior use of art-based activities in psychotherapy, perceived benefits and barriers, client suitability, therapists' experiences of discomfort discussing race, and conditions necessary for effective integration.

Therapists reported multiple benefits of art-based activities, including increased engagement, emotional expression, and insight. Creative activities were considered particularly helpful for clients with limited verbal expression or tendencies toward overintellectualization. Barriers included client hesitancy, cultural considerations, and practical constraints. White therapists described discomfort navigating racial dynamics, highlighting the importance of cultural humility and supervision. Effective integration depended on flexible timing, individualized adaptation, and adequate training and support.

Findings support a preliminary process model identifying key components for the ethical and effective integration of art-based activities into racial trauma treatment. Results inform therapist training and culturally responsive clinical practice. (PsycInfo Database Record (c) 2026 APA, all rights reserved).