Date of Award

Spring 4-15-2019

Document Type


Degree Name

MAE - Master of Arts in Expressive Therapies


Expressive Therapies


Sarah Hamil


Substance use disorders (SUDs) currently affect a significant number of people, directly and indirectly, in the United States. Low rates of treatment and high rates of relapse point to the need for an increased and diversified engagement of SUDs theoretically and clinically. This literature review explores current research on SUDs and attachment, SUDs and shame, and SUDs and the Expressive Therapies. The literature review provides relevant theoretical frameworks and current clinical applications for treatment of SUDs considering attachment and shame’s role in substance use from an Expressive Therapies perspective. The role of relationships and imagination in both the maintenance and treatment of SUDs is highlighted throughout each section of the literature review and focused on in the final discussion. The literature review stresses the flexibility and complexity underlying SUD’s and the need for complex and flexible interventions. Based upon the findings and grounded in an Expressive Therapies perspective, future research integrating a multicultural perspective is recommended, as is research exploring substance use as self-harm and substance use as affect intensifier.

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.




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