Creative Activation Therapy (CreATe™): A Framework for Pre-Creative Therapeutic Engagement.

Revised  8/30/2025, by Dr. Gregory lyons, PsyD, LCPC.

Abstract.

Creative Activation Therapy (CreATe™) presents an innovative therapeutic framework that prioritizes reflection, cognitive processing, and emotional assessment before engaging in creative expression. CreATe™ is different from art and creative therapies because it is based on the process of analyzing intention-setting, symbolic reasoning, and mindfulness prior to artistic engagement, rather than focusing on post-creative analysis. CreATe™ is grounded in theoretical frameworks, including mindfulness-based cognitive therapy (MBCT), gestalt therapy, EMDR, and mindfulness practices, functioning as both a self-directed and professionally adaptable approach. The purpose of this document is to present possible therapeutic applications using CreATe™. It seeks data and reflects possible positive returns that creativity can play a vital role in therapy, particularly through introspection and mindfulness practices that an individual can use to identify possible negative or destructive behavioral practices.

Keywords: Creative Activation Therapy, Visualization, Meditation, Creative Practice, Reflection.

Introduction.

Historically, the human drive to create has functioned as an aesthetic pursuit and a way of presenting information without the use of language or specific cultural use of characters that could be identified as letters or an alphabet. When presented through different approaches involving therapeutic modalities      individuals can use applications for mindful discipline, and a means of emotional release. Creativity is often used in therapeutic dynamics (Csikszentmihalyi, 1996; Stuckey & Nobel, 2010) to encourage the client to enhance self-awareness, identify feelings, and promote internal emotional healing (Malchiodi, 2013).

Most clinical models of creative self-expression emphasize the process of creation and the analysis of its outcomes. This approach, while valuable, frequently neglects the nuanced and reflective processes that precede artistic expression. What if the genuine site of transformation exists not in the completed work, but in the silent self-evaluation, or the process of implementation (Mezirow, 1991; Winnicott, 1971) which precedes the initial moment when the individual places the pencil to the canvas? CreATe™ looks at the possibility of creativity originating from moments of reflection, and a symbolic identification of a moment of time or memory with an individual's life experiences.

In many studies there are positive findings that show creative expression can be identified and acknowledged for its ability to alleviate emotional blockages, represent psychological distress, and facilitate connections with repressed facets of emotional identity. Other theories speculate that through the collection of plausible data, clients may be able to use this mindfulness practice as an avenue of self-expression, and as a means of a subconscious inventory of emotions, which at times are limited or inhibited through self-expression by the clients.

CreATe™ examines this more deeply to analyze this phenomenon. The basis of the approach using CreATe™ examines emotional assessment and reflective strategizing before implementing a creative representation through the act of using an artistic medium. It fosters an examination of the underlying reasons for creation, facilitating more profound meaning, enhancing the therapeutic relationship with oneself. This document examines existing data from studies that may be identified as relevant to this hypothesis through analyzing the current implementation of theories, principles, and methodologies that reflect the application of CreATe™ and discusses its possible application within and beyond clinical contexts.

Theoretical Background.

CreATe™ arises from a synthesis of various psychological and philosophical traditions. This method effectively gathers clients' feelings, emotions, and personal reflections on past events. CreATe™ integrates modalities such as gestalt therapy, which enables clients to possibly focus on present awareness, with EMDR's approach to reprocessed memories to activate pre-conscious emotional material. It promotes the individual to try to understand their driving feeling to present a creative representation of their thoughts, emotions, or feelings via conscious awareness and symbolic interpretation. Unlike therapeutic traditions that focus on output analysis, CreATe™ examines intention and perception before expression.

CreATe™ is the process that promotes contemplating what to express prior to actual expression, serving as a reflective space for integration and emotional assessment. This reflects the concept of 'liminality' as articulated by Turner (1969), in which transformation occurs during transitional psychological states.

CreATe™ integrates elements of symbolic interactionism, suggesting that creative components—such as color, shape, and subject—possess personal significance. These symbols provide therapeutic insight upon reflection. The CreATe™ process parallels Gendlin's 'Focusing' method, wherein bodily felt senses precede articulated understanding (Gendlin, 1981).

Key Principles of CreATe™.

Cognitive activation constitutes the fundamental approach of the CreATe™ model. The theory is that before a client enacts the creative process, holding a pen or brush in their hands, they are encouraged to examine their primary emotions, thoughts, and memories that drove them to participate in the desire to create. This process may involve recalling past events, revisiting early creative practices, or sensing symbolic images that emerge in the mind's eye. The objective of this approach is to examine, possibly dissect, and identify the internal dynamics and their significance.

Symbolic resonance can be seen to denote the intentional choice of symbols, shapes, and themes that possess significance. For instance, it has been speculated that an individual may opt to depict a tree not for its aesthetic appeal, but due to its association with a secure location from their childhood. Identifying symbolic resonance enables individuals (Jung, 1964; Moon, 2007) to participate in a more profound and personalized process of emotional decoding.

Therapeutic professionals can participate in the process by applying the CreATe™ approach, but it is designed to be an interpersonal practice. This encourages the client to be creative within their own space and environment, free from clinical constraints and therapeutic expectations, with the hopes of having them present a finished artistic representation that was created with autonomy, authenticity, and accessibility. This decentralization reduces scrutiny and facilitator bias and enhances empowerment among participants.

Reflection without evaluation posits that the outcome of the creative process should not be the focus of analysis. This approach will hopefully facilitate a practice where the client is encouraged to identify the insights gained from the process rather than evaluating artistic merit. This can encourage the client to engage without the apprehension of judgment or failure. The client has the decision to share the work with the facilitator or the therapist at their discretion, but interpretation by others is not obligatory.

Applications and Methodology.

CreATe™ is designed for an eclectic approach involving accessibility and adaptability. It may be conducted in individual sessions or within therapeutic group environments, with the presence of a licensed facilitator. The strategy involves three reflective steps:

• Identifying the client's motivation for starting the creative process.

• Reflecting on the process and tools involved, emphasizing an individualized process of mindful creation.

• Self-reflection and the optional choice of sharing the finished project. This may present in any way the client wishes to express themselves; journaling, visual arts, dance, music, or other personally significant mediums.

The model highlights autonomy, allowing individuals to select their mode of expression and participate at a pace that is emotionally secure and productive.

In clinical practice, CreATe™ may serve as an adjunct to conventional therapy. This can take different approaches that should be suggested with the nuances or personal criteria that the client presents in mind. The client could be asked to contemplate a memory or emotional pattern and subsequently choose symbols or imagery that align with their experience. The suggestion should be presented as a request for the client to be aware of a greater sense of internal coherence, solidifying their identification of their symbolic processing, self-narrative, and disciplined mindfulness approach to the process.

CreATe™ can also be applied in a non-clinical, home-based setting. This can be done in activities like creating mandalas, music playlists, or constructing collages (Curry & Kasser, 2005; Henderson et al., 2007), or any other creative way that can be used for self-representation. The focus is on the psychological intention underlying the use of the medium, rather than the medium itself. Clients should be encouraged to maintain a journal to make notes about the cognitive processes and emotional insights that they have experienced before and after each project. This journal can be shared and discussed with their therapist in an upcoming session.

Collaborative activities with CreATe™ may involve preliminary exercises such as free writing or squiggle drawings, thematic prompts, and collective reflection that prioritizes empathy over critique. Workbooks can provide structure and enhance participant commitment. One of the key observational practices would be for the facilitator not to influence the clients by being vigilant of any directions or influences that may cause the clients to make choices and uphold autonomy while subtly directing participants.

Two Example Approaches for Using the CreATe™  Modality.

Approach 1: The Systematic, Evidence-Based Method.

This approach is an exercise to focus on the practice of disciplines that are used by professional artists, highlighting the importance of preparation and intentionality. Clients are advised to conduct preliminary research on the topic they intend to creatively present. For example, they may wish to depict a beach at sunset.

The first step of this approach would be to have them search online and gather images of sunsets from various locations around the world that interest them, observing what attracted them to these images. It could be the differences in color, cloud formations, and the appealing atmosphere of the scene. While they are doing so, they would be asked to be mindful of what elements elicited an emotional or cognitive response to the image they selected to create.

Essential Steps:

1. Conduct research and gather references for the item, place, or object they wish to creatively present artistically.

2. Cognitively investigate their possible emotional motivations for selecting the images they collected.

3. Select tools and materials purposefully (e.g., watercolors versus acrylics, smooth, colored, or textured paper).

4. Develop a color palette, providing a rationale for the selection of each color.

5. Create thumbnails or sketches with these images as references collected. The first ten thumbnails would be two inches by two inches, drawn in the span of two minutes. Then, five that are four inches by four inches, picking out elements, spacing, or movement they found interesting or attractive from the first ten, in four minutes. Then, three thumbnails using the same philosophy in five minutes, which are five inches by five inches. The speed of the process, the identification, and the decision of what elements the client wishes to pull forward are key in this process. After these steps, the client would try to reflect on what they chose in those steps and why, analyzing why these were relevant, what emotion they present, and how they can be disregarded or unused in the final creative artist’s presentation.

6. Before starting their final creative process, the client needs to be mindful of their breathing at the onset of the creative process to establish a consistent rhythm similar to an athlete's pacing. Through the process, this can be aided by an occasional body reading of their heart rate or any discomfort they are experiencing.

7. When finishing, the client should take a moment and reflect on what had transpired, understanding when to stop, and why, and use an inner focus meditation practice to help them come back to the present moment and ground themselves in the emotional experience.

Approach 2: The Expressive and Intuitive Method.

This method highlights the importance of creative spontaneity and emotional expression. The clients are encouraged to do a self-investigational inventory of an emotion, feeling, or creative representation they are experiencing at that time that was important to them at that moment, then allowing the imagery to emerge spontaneously without premeditation. This exercise can also be done while looking at an image or an object.

The process should encourage the use of gestural marks such as bold strokes, squiggles, and fast reactionary movements that the client "feels" or presents as being important in their artistic expressions. These "reactionary movements" without guidelines or direction from the therapist serve as a method for expressing internal experiences.

Essential Steps:

1. Recognize an emotion as the initial basis for creativity.

2. Choose materials that will be adequate for this exercise, knowing the possible limitations for the implementation of this exercise.

3. Initiate with gestural or free-form marks, avoiding pre-drawn guides.

4. Sustain a consistent breathing pattern during the creative process.

5. Analyze the implications of spontaneous choices on underlying internal states post-event.

6. Analyze intuitive outcomes alongside structured processes to enhance self-awareness.

7. When finishing, the client should take a moment and reflect on what had transpired, understanding when it was important to stop, and why, and use an inner focus meditation practice to help them come to the moment and ground themselves in the emotional experience.

Reflection and Integration.

The dual methodologies of CreATe™ enable clients to investigate both structured intentionality and spontaneous emotional expression. Each choice—the brush that is used, the paper, the palette of colors chosen—serves as a cognitive or subconscious decision, providing avenues for personal creative emotional representation. This process can be designed as a discipline and repetition of action that could resemble a Japanese tea ceremony, in which even the most minor actions hold importance. By engaging in steady breathing and reflective practice, clients develop the ability to link internal states with external creative expressions.

Creating mandalas, curating music playlists, or constructing collages that reflect a certain goal or feeling have been shown to serve as methods of creative expression that could be used in the CreATe™ process. The focus lies not on the medium but rather on the psychological intent that takes place as the client evaluates their emotional process in the final artistic representation. Individuals are suggested to keep a journal, either chronological or some form of graphic representation, that records their cognitive process and emotional insights before and after engaging in the CreATe™ process.

Practicing the CreATe™ model can include other preliminary exercises, such as writing short stories or poetry, or unconscious small creations of squiggle drawings, personal thematic presentations or movement. CreATe™ can be used in group reflections that prioritize empathy over critique Worksheets or workbooks are currently in development to facilitate analysis and reflection. In every in-person application, facilitators should strive to uphold the right of the client's autonomy of personal creation while subtly directing participants to investigate more profound emotional aspects.

Comparison with Traditional Art Therapy.

Art therapy has a well-established history (Rubin, 2016; Malchiodi, 1998) as a clinically validated method of self-expression for psychotherapy. The process generally involves the client creating artwork in a session with a clinician, followed by therapeutic critique, reflection, and analysis. This process can include the interpretation of symbols, colors, medium used, placement of key graphic elements, and the client's style in presenting their creative work through brush and line work. This is usually done in a session, with others as a group, or facilitated by a clinician. (Kaplan, 2000).

Both CreATe™ and art therapy acknowledge the psychological benefits of creative expression; however, their emphases diverge. In CreATe™, reflection prior to creation serves as the fundamental therapeutic activity. Creation is regarded as a consequence rather than the origin of healing. The pre-creative focus is what differentiates CreATe™. Rather than interpreting the creation itself, CreATe™ encourages individuals to explore the underlying motivations that prompted their act of creation.

CreATe™ can be seen as a deeper investigation of the creative process. This approach starts before the client begins to express themselves creatively. The therapeutic potential of CreATe™ enables the client to have a deeper retrospective of their lives, learn an introspective process, and allow them to develop mindfulness practices, connecting awareness to identification of emotions or feelings they may be experiencing. This facilitates enhanced integration, particularly for individuals who may lack comfort or proficiency in conventional artistic expressions.

Clinical and Personal Benefits.

Participants who engage in CreATe™ may report possible positive reflections of feeling they were able to experience while identifying their emotions, and may have a clearer thought process to use when evaluating their presence of mind. The activation of memory and emotional states before creation has been found to foster a clearer understanding of personal insight (Brown & Ryan, 2003; Baikie & Wilhelm, 2005).

The purpose of CreATe™ is to encourage the client to work on subconscious elements, such as symbolic processing of ideas or creative expressions of their emotions, before engaging in a creative expression, which can be a way for the client to facilitate the integration of fragmented memories.

Clinical observations in past studies that reflect this approach suggest findings that clients characterize the pre-creative phase as an emotionally liberating experience. Individuals may conclude that this process positively affects agency over their narratives, reducing their dependence on unconscious influences. CreATe™ is presented with the goal of promoting personal agency. By empowering clients to choose their medium and explore their subconscious and emotional internal world without pressure, CreATe™ supports the theory that healing originates from within. CreATe™ can be seen to enable the client to possibly experience and understand their creativity in a non-clinical context. It can create a reflective and exploratory spirit that is often hindered by adulthood or societal expectations. This practice could be seen as a form of self-care, functioning as an internal sanctuary for individuals to reconnect with meaning.

Limitations and Future Directions.

Currently, the CreATe™ approach has not yet been validated by empirical research (Koch et al., 2014; Slayton et al., 2010). The data collected within this paper were gleaned from clinical observations, practitioner experiences, and similar qualitative accounts that are based in art and creative and dynamic. However, ETC, or Expressive Therapies Continuum was a model proposed in 1978 and is currently used in art therapy modalities. ETC maps how clients process experiences during artmaking: kinesthetic/sensory → perceptual/affective → cognitive/symbolic → creative integration. CreATe focuses on the pre-creative pause: the mindful orientation, ritual, and reflective choice-making before (and after) art expression. Therefore, ETC provides CreATe a recognized theoretical anchor in therapy, while CreATe™ keeps its identity by emphasizing the pause, ritual, and reflective framing rather than just the act of creating.

This document could be interpreted as a call to action for clinicians to pursue applicable venues or situations to collect data, with the hopes of showing positive data that could promote applicable scenarios using CreATe™. The data presented could present information that clients may benefit from participating in the application using CreATe™ through controlled studies that may focus on assessing outcomes like emotional regulation, stress reduction, and self-efficacy.

Self-guided models may be found to possess inherent limitations. Some individuals may not have the introspective skills or emotional resilience necessary to engage with the process. Without a clinician to report and guide the process, clients may not have the ability for self-examination or misinterpret their emotional cues.

Also, future directions may involve the creation of standardized tools, including reflective questionnaires, symbolic inventories, and guided audio meditations.

Conclusion.

Creative Activation Therapy (CreATe™) could present as a unique and timely contribution to the field of expressive therapies. This could be done by shifting the focus from what is created to *why* we create. CreATe™ could be seen to assist the client in reclaiming the process of introspection, with the hopes that they may be able to use it as a powerful site of healing. CreATe™ can be seen to provide individuals with accessible, meaningful ways to reflect on their emotional world, identify recurring patterns, and build symbolic coherence—all before a single line is drawn or note is sung.

As society continues to move toward automation and commodification of creativity, CreATe™ can be a process that reminds individuals that the intrinsic value of self-expression has the ability for identification of negative behavioral practices, possible traumatic events within their lives that may need to be discussed, and the construction of mindfulness practices that may be able to use to ease their symptoms of a behavioral diagnosis. It can be used to encourage clients to pause, explore, and reclaim the reflective spark that defines our inner life. CreATe™ does not ask us to be artists; it invites individuals to be curious witnesses to our own experience.

CreATe™ can possibly provide new approaches to the domain of expressive therapies. By redirecting attention from the outcomes of creation to the motivations behind it, CreATe™ has the possibility to act as an introspective, significant avenue for healing. This approach may help individuals to use a possible reflective method for subconsciously identifying dynamics that could represent a process where they are able to reflect on their emotional experiences, recognizing recurring patterns, and establishing symbolic coherence, all before any artistic expression.

As society progresses towards automation and the commodification of creativity, CreATe™ has the possibility to present as a strategic approach in evaluating the client's roots or drives involving their self-expression. Its design is meant to help individuals to pause, investigate, and restore the reflective essence that may characterize our inner existence. CreATe™ encourages us to adopt a stance of curiosity, allowing us to observe our own experiences without the expectation of artistic creation.

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CreATe™ is a proprietary therapeutic model developed by Dr. Gregory Lyons. All rights reserved.