Assessment in Expressive Therapies

Assessment in expressive therapies: Bridging clinical, creative, and cultural approaches


Nancy Beardall, Raquel Chapin Stephenson, Karen Estrella, Rebecca Zarate

In our work as expressive therapists, assessment is both a distinct phase in treatment and is also present in every moment. The five-phase cycle of treatment: assessment, case conceptualization, planning, intervention, and evaluation begins with a formal or informal assessment – the ‘big A’ assessment. This assessment identifies the client’s needs and informs the remainder of the treatment cycle. However, we are also continuously assessing our clients, the therapeutic relationship, the progress of treatment – the ‘little a’ assessment. ‘Big A’ assessment can be seen as being absolute – that the answers and information we gain are truth, often determining (and limiting) future treatment and opportunity.  These absolutes can create misperceptions and limit our understanding of clients and their needs.  The arts give us tools to challenge these absolutes, working within metaphor and abstraction to experience our clients in their richness and complexity (multiplicity).  Within this creative space, we gain a wealth of potential information regarding the therapeutic alliance and the client’s progress, helping us utilize the ‘little a’ assessment as an on-going, creative, dynamic process.  This presentation will explore the ‘big A’ and ‘little a’ assessments in expressive therapies, with a specific focus on creative and cultural components of formal and informal assessments. It will also examine the experience of teaching expressive therapies students to use both types of assessment through creatively engaging with the various actual and imagined windmills and giants that arise in our journey with clients – questioning ‘truth’ and leading with curiosity.



Raquel Stephenson, PhD, ATR-BC, LCAT is Associate Professor in Expressive Therapies, Program Coordinator of Lesley University’s Art Therapy Program, and Faculty Fellow in Lesley’s Institute for the Arts in Health. She is also adjunct faculty at New York University. She was a Fulbright Scholar to Estonia, teaching at Tallinn University. Dr. Stephenson is a board certified, registered art therapist (ATR-BC) and a licensed creative arts therapist (LCAT). She serves on the National Advisory Council and Program Advisory Committee of Arts for the Aging, and the Advisory Council of the Art Therapy Outreach Center. She serves on the editorial board of the International Journal of Creativity and Human Development and has been an active member of AATA. Committed to improving the lives of older adults through the arts, Dr. Stephenson’s clinical work and research focuses on the intersection of arts and aging.


Nancy Beardall, PhD, BC-DMT, LMHC, CMA is the Dance/Movement Therapy Coordinator in the Graduate School of Arts and Sciences at Lesley University. As a dance/movement therapist, consultant, Certified Movement Analyst, and educator, Dr. Beardall’s work has focused on dance, dance therapy and cognitive, social/emotional and relational development using dance/movement therapy and the expressive arts in the public schools with students K-12 of all populations. Dr. Beardall was part of the original collaborative team that designed the Hybrid DMT Master’s program at Lesley University. Currently she is involved with the prevention project regarding relationship abuse, Beardall co-facilitates ‘Future of the Past’, an annual Lesley event co-sponsored by Violence Transformed, dedicated to looking through the lens of what we learn from the past’s mass violence experiences and the role art plays in this process.


Karen Estrella, PhD, REAT, ATR-BC, MT-BC, Professor, is coordinator of the Expressive Arts Therapy specialization at Lesley University. Her research interests include developing competencies in expressive arts therapy as a unique specialization, mental health counseling and multicultural issues in practice and supervision, and clinical case work in art therapy, music therapy, and expressive arts therapy.  


Rebecca Zarate Ph.D., MT-BC, AVPT, LCAT – Assistant Professor/Coordinator of music therapy. Rebecca has a background in clinical improvisation and vocal psychotherapy. Her clinical and research interests are in social anxiety, critical social perspectives and improvisation theory and practice.


Recent Publications

Raquel Stephenson

Stephenson, R.C. (2017). Economics and Opportunities of Creative Aging Programs: Can creative arts programs reduce health care costs in the USA? International Journal of Creativity and Human Development, 5(1).

Stephenson, R.C. (2018, September) Art and Joy: Reclaiming Elderhood: Reframing late life potential, creativity and the benefits of the arts in health and wellbeing (Keynote presenter) Lesley University Institute for Arts and Health Annual Conference, Cambridge, MA.

Stephenson, R.C. (2018, September) Creative Aging Programs: Caring for Older Adults with the Arts Therapies (Invited presenter) Tallinn University, Tallinn Estonia.

Stephenson, R.C. (2017, November) JCHE Creative Aging (Peer-reviewed presentation) American Art Therapy Conference, Albuquerque, NM.

Stephenson, R.C. & Estrella, K. (2017, September). Seeing a song, hearing a painting: Interconnection of rhythm and imagery in music and art therapy. Workshop presented at Tallinn University, Estonia. (Invited workshop presenter) 


Nancy Beardall

Beardall, N., Bloom, K., Cathcart, J., Tortora, S., Young, J. (2018, October). Foregrounding Social Justice in Dance/Movement Therapy Education, ADTA Conference, Salt Lake City, UT.

Zarate, R., & Beardall, N. (2018). Reflections on critical arts-based teaching in music therapy and dance/movement therapy. Critical Pedagogy in Creative Arts Therapies.

Beardall, N. (2017). Dance/movement therapy and embodied knowing with adolescents. In:  Karkou, V., Sycouris, S., Oliver, S. (Eds.), The Oxford Handbook of Dance and Well-Being. Edinburgh, England: The Oxford University Press.

Beardall, N., Blanc, V., Cardillo, N. Karman, S., Wiles, J. (2016). Creating the online body: Educating dance/movement therapists using a hybrid low-residency model. American Journal of Dance Therapy 38: 407-428. doi: 10.1007/s10465- 016-9228-y

Beardall, N., Brownell, A., Cardillo, N., Harmel, P., Karman, S., Marcow-Speiser, V., Newman-Bluestein, D., McKim, E., Smulian-Siegel, D. (2014). The Legacy of Norma Canner. American Journal of Dance Therapy 36 113-124. doi: 10.1007/s10465-04-9167-4.


Karen Estrella

Estrella, K. (2018, April). Postcards from the self: Developing arts-based experientials for all ages. Workshop presented at the Creativity and the Arts in Healing, Expressive Therapies Summit in LA, CA.

Estrella, K. (2017). Music therapy with Hispanic/Latino clients. In: Whitehead-Pleaux, A. & Tan, X. (Eds.), Cultural intersections in music therapy: Music, health, and the person (pp. 35-50)Dallas, TX: Barcelona Publishers. 

Estrella, K., Leone, L., & Napoli, M. (2017, November). Mindful: Exploring mental health through art – a panel discussion and workshop. Fuller Craft Museum, Brockton, MA. (Invited panel moderator and workshop facilitator)

Stephenson, R.C. & Estrella, K. (2017, September). Seeing a song, hearing a painting: Interconnection of rhythm and imagery in music and art therapy. Workshop presented at Tallinn University, Estonia. (Invited workshop presenter) 

Estrella, K. (2017, April). Postcards from Lucy: Exploring culture through writing and the expressive arts. Workshop presented at the Narrative Medicine Symposium hosted by the Brigham and Women’s Hospital Center for Faculty Development & Diversity and Boston College Medical Humanities, Boston, MA. (Invited workshop presenter)


Rebecca Zarate

Zarate, R., & Beardall, N. (2018). Reflections on critical arts-based teaching in music therapy and dance/movement therapy. Critical Pedagogy in Creative Arts Therapies.

Zarate, R. (2017). Creative arts therapies and business in the USA: Perspectives and perception. In: Thomas, D. and Abad, V. (Eds.), The economics of therapy: caring for clients, colleagues, competitors and cash-flow. London, UK: Jessica Kingsley Publishers.                                

Sajnani, N., Marxen, E., Zarate, R. (2017). Critical perspectives in the arts therapies: Response/ability across a continuum of practice. The Arts in Psychotherapy, 54, 1-10.

Zarate, R (2016). The social architecture of anxiety and potential role of music therapy. Voices: A World forum for Music Therapy, 16, 1.

Zarate, R. (2016). Clinical improvisation and its effect on anxiety: A multiple single subject design: The Arts in Psychotherapy, 48, 46-53.