# Situation: A mental health day program at a government hospital serves adults with mood disorders. During the weekly clinic, the nurse reviews each client's treatment plan. A 33-year-old woman with depression after a traumatic loss is not yet able to talk about the event. The team refers her to art therapy. What is the main purpose of this referral?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=630215  
> language: ko  
> subject: Nursing Practice V — Care of Clients with Maladaptive Patterns of Behavior; Care of Clients with Life-Threatening Conditions, Acute Multi-Organ Problems, High Acuity and Emergency Situations

## 문제

Situation: A mental health day program at a government hospital serves adults with mood disorders. During the weekly clinic, the nurse reviews each client's treatment plan.

A 33-year-old woman with depression after a traumatic loss is not yet able to talk about the event. The team refers her to art therapy. What is the main purpose of this referral?

## 보기

1. To build a craft skill she can use to earn income after discharge
2. To let her express feelings she cannot yet put into words **✔ 정답**
3. To allow the therapist to diagnose her illness from her drawings
4. To distract her from sad thoughts until her medicine takes effect

**정답: 2**

## 해설

Art therapy uses drawing, painting, and clay to give clients a nonverbal way to express feelings they cannot yet put into words. As in all activity therapies, the process matters more than the product.

## 심화 해설

Core concept: Art therapy as a nonverbal channel for trauma-related emotion

The referral to art therapy is not about producing a beautiful or marketable object. It is a clinical intervention that gives the client an alternative route to externalize what she cannot yet verbalize. After a traumatic loss, the brain’s language centers are often functionally offline during recall, while sensory and motor pathways remain accessible. Drawing, painting, or working with clay engages those sensorimotor channels and allows the person to approach the memory indirectly, at a pace that feels tolerable. This is why the process of creating is more therapeutic than the product that results.

The core mechanism is that art therapy provides a safe, supportive, nonverbal environment for expressing and processing trauma-related emotions and memories that the client cannot yet put into words. This aligns with the narrative review describing art therapy as a nonverbal modality that can complement or serve as an alternative to standard trauma-focused treatments [1]. The client in the scenario is not refusing to talk; she is unable to talk about the event yet. Forcing verbal disclosure too early can retraumatize. Art therapy respects that developmental readiness.

Watch out! Option 4 sounds caring, but distraction is not the goal. Art therapy is not a waiting-room activity to fill time until medication takes effect. It is an active, expressive treatment that facilitates emotional processing, not avoidance. Similarly, option 1 confuses art therapy with vocational rehabilitation or craft training. The purpose is emotional, not economic. Option 3 misrepresents the role of the therapist: drawings are not used as a standalone diagnostic test for a specific illness. The therapist uses the art-making process and the client’s own narrative about the work to understand her experience, not to “read” a diagnosis from the image itself.

The evidence base supports this understanding. A randomized controlled trial among Syrian refugee children with PTSD found that expressive arts provide nonverbal therapeutic tools that help individuals overcome language and cultural barriers when addressing trauma [4]. Although that study involved children, the underlying principle is the same for adults: when words are blocked, the creative channel remains open. A study of adolescents grieving war-related loss similarly identified art as a way to explore emotions that were too overwhelming to articulate directly . The proposed trauma-focused art therapy protocol also emphasizes the indirect, non-verbal experiential approach as a key benefit for patients with psychological trauma .

In activity therapies, the therapeutic value lies in the doing — the choice of color, the pressure of the stroke, the act of shaping clay — not in the finished artwork. For this 33-year-old woman, the referral means she can begin to approach the traumatic loss through images, symbols, and tactile work before she is ready to speak about it. That is the main purpose of the referral.

| Option | Why it is incorrect |
| --- | --- |
| 1 Earn income after discharge | Confuses art therapy with vocational training; the goal is emotional expression, not skill acquisition for livelihood. |
| 3 Diagnose illness from drawings | Art is not a diagnostic test; the therapist interprets the process and the client’s meaning, not a hidden code in the image. |
| 4 Distract until medicine works | Distraction implies avoidance; art therapy is an active processing tool, not a placeholder. |

Key point! When a client with trauma cannot verbalize the event, the nurse should recognize that nonverbal modalities such as art therapy are indicated precisely because they bypass the demand for spoken language. The referral is therapeutic in itself, not preparatory or secondary.References (research sources)

- [1]Art Therapy in the Treatment of Traumatic Stress: A Narrative ReviewResearch articleAl-Nouri J, Feen-Calligan H, Grasser LR. (2026) · DOI: 10.20944/preprints202606.1467.v1

- [4]Healing Beyond Words: A Randomized Controlled Trial of Sandplay and Art Therapies for PTSD Among Syrian Refugee Children in Jordan.RCT/clinical trialAl-Fakih A, Alzoubi A, Alrawashdeh A, Alsulaiman JW, Ba-Shammakh SA, Khasawneh A, Dannecker K, Kheirallah KA. (2026) · DOI: 10.1155/ijpe/7636252

## 임상 시나리오

Art Therapy for Trauma-Related DepressionWhy the process matters more than the product
Art therapy provides a nonverbal channel for clients to express emotions they cannot yet verbalize. After traumatic loss, language centers may be less accessible while sensorimotor pathways remain open, making drawing or clay work a tolerable way to approach painful memories.

The goal is emotional processing, not skill-building or diagnosis. The therapeutic value lies in the process of creating, not the final product. Forcing verbal disclosure too early can retraumatize the client.

CautionDo not use art therapy as a distraction while waiting for medication to take effect. It is an active, expressive treatment that facilitates emotional processing, not avoidance.

## 핵심 개념

- **Art therapy** — A therapeutic modality using creative media to help clients express and process emotions nonverbally.
- **Nonverbal communication** — Expression of feelings through means other than words, such as art, gestures, or body language.
- **Traumatic loss** — A loss experience that overwhelms the individual's coping capacity and may impair verbal processing.
- **Therapeutic process** — The ongoing interaction and activity in therapy that promotes healing, valued over the final product.

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