Arts therapy fills the space that words cannot

Korea has the highest suicide rate among OECD countries with 25.7 deaths per 100,000 people in 2020 —more than twice the average of 10.6. In response, the Korean government has launched numerous mental health initiatives, including a large-scale psychological counseling program available to the entire population.

Closer examination reveals that these interventions are based primarily on talk therapy approaches, such as cognitive behavioral therapy (CBT). This raises an important question: Who will support those unable to articulate their inner worlds through words — including survivors of trauma, individuals experiencing communication challenges, children and adolescents who retreat into silence and older adults living in isolation — all of whom remain outside the boundaries of standard approaches and are effectively excluded from mainstream treatment?

This is where arts therapy comes in. Drawing, music, drama, dance and other creative modalities serve as safe bridges that enable individuals to express their emotions without relying on spoken language. Unlike traditional talk therapy, arts therapy engages not only the mind but also the body, senses and imagination, accessing hidden layers of experience and emotion. Recent neuroscience research shows that trauma recovery does not proceed solely through a “top-down” process, governed by cognitive functions like reasoning and reframing. Instead, “bottom-up” approaches that are rooted in sensory and emotional systems, and which engage bodily sensations and nonverbal expression, can be crucial for restoring emotional balance and fostering healing. Recovery often begins as individuals release wounds stored physically and reconnect with suppressed emotions through imagery and symbolism — a process which arts therapy facilitates exceptionally well.

In Korea, arts therapy began to gain broader acceptance in the early 1990s and has expanded into schools, hospitals and community centers. However, it does not yet have the large-scale scientific backing that underpins treatments like CBT and therefore is often unfairly perceived as less effective and less professional. This partly stems from the highly individualized nature of artistic practice. Rather than prioritizing extensive data collection, arts therapists focus on developing creative processes tailored to each client’s inner world, which makes it difficult to study as rigorously as more structured therapies like CBT. Much of the current evidence comes from case studies conducted in community settings, which, although valuable, do not carry the same scientific weight as large-scale trials. Additional challenges like limited funding and philosophical concerns about reducing art to quantifiable measures have also hindered broader research efforts. Therefore, building a stronger evidence base remains crucial to scientifically demonstrating arts therapy’s effectiveness.

Due to its lack of formal recognition and regulation, arts therapy has been largely marginalized in Korean policy and practice. The new national mental health counseling program, launched under the Mental Health Policy Innovation Plan, reflects this gap: Counseling methods remain entirely rooted in CBT, are capped at eight sessions per person and make no mention of arts therapy. For those whose experiences lie beyond the reach of conventional talk therapy, can transformative change result from such parameters? Without expanding therapeutic options, vulnerable individuals will continue to suffer in silence, unseen and unsupported. These individuals need safe, alternative avenues to express and process their emotions. Art offers a vital bridge toward healing and understanding.

A crucial step toward challenging perceptions of arts therapy as “unprofessional” would be the establishment of a national licensure system. This would ensure that only qualified practitioners with high ethical standards would deliver therapeutic services. In the absence of formal oversight, arts therapy remains vulnerable to being dominated by inadequately trained practitioners, undermining both therapeutic effectiveness and public trust. To address this, major arts therapy associations should be entrusted with developing a credible, standardized licensing framework that upholds rigorous professional standards and safeguards clients’ well-being.

Beyond professional regulation, the need for arts therapy also reflects the reality of a world increasingly beset by natural and societal crises and the emotional wounds they leave behind. Such events often inflict psychological harm that surpasses the scope of verbal interventions, particularly when experiences are too overwhelming to be expressed in words. In these moments, the distinct power of art to reach silent suffering underscores the pressing need to formally integrate arts therapy into our mental health systems and policies.

What Korea needs now is action beyond rhetorical calls for mental health reform, such as the deliberate inclusion of diverse therapeutic modalities that honor the full spectrum of human experience. Arts therapy has the unique capacity to help individuals explore their emotions through imagery, movement and creative expression, offering pathways to healing. Recognizing and formally supporting arts therapy is not simply a matter of professional standards; it is essential to safeguarding our collective mental health and well-being.

Lim Na-young, Ph.D, is Chair of the Department of Art Therapy at Gachon University. Ma Kyung-hee (kyungheem@daum.net) is a social work researcher.