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Severe maltreatment and missing attachment figures in early years disrupt adverse brain development, shaping how trauma is processed. Research suggests traumatic memories are stored in the right hemisphere, which can make verbal, declarative trauma memories harder to access. The article synthesizes current neuroscience findings to justify expressive, nonverbal therapeutic interventions tailored to attachment difficulties.",{"@graph":69,"@context":113},[70,84,104],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/expressive-therapy-with-severely-maltreated-children-neuroscience-contributions/592092/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":98,"encodingFormat":97,"isAccessibleForFree":99,"interactionStatistic":100},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/expressive-therapy-with-severely-maltreated-children-neuroscience-contributions/592092.png","ImageObject",300,407,{"name":92,"@type":93},"Grenda","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-15",true,{"@type":101,"interactionType":102,"userInteractionCount":8},"InteractionCounter",{"@type":103},"ViewAction",{"@type":105,"mainEntity":106},"FAQPage",[107],{"name":108,"@type":109,"acceptedAnswer":110},"What is the paper’s rationale for expressive therapy in this population?","Question",{"text":111,"@type":112},"Because expressive therapies are nonverbal, they can better engage trauma-related processing in children with attachment difficulties, where verbal approaches may be limited.","Answer","https://schema.org",{"og:url":83,"og:type":115,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":117,"canonical":83},"index,follow",{"doc_id":119,"site_id":62},592092,1792078831,{"code":4,"msg":5,"data":122},{"doc_id":119,"user_id":123,"nickname":92,"user_avatar":124,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":125,"file_id":126,"file_url":127,"file_type":128,"file_size":129,"view_count":8,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":130,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":131,"faqs":132,"seo_title":133,"seo_description":67,"update_tm":134,"read_time":46},7971474921005,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","Expressive Therapy with Severely Maltreated Children: Neuroscience Contributions  \nP. Gussie Klorer, Clayton, MO  \nAbstract  \nRecent developments in neuroscience provide important information for therapists working with maltreated children. Severe maltreatment and lack of significant attachment figures in the crucial early years lead to adverse brain development (De Bellis, 2001). It appears evident that traumatic memories are stored in the right hemisphere, making verbal declarative memory of the trauma more difficult (Schiffer, Teicher, & Papanicolaou, 1995). This research lays the groundwork for understanding why nonverbal, expressive therapies can be more effective than verbal therapies in work with severely maltreated children exhibiting attachment difficulties. This article explores current research in neuroscience and provides a rationale for expressive therapy as a treatment intervention for this population.  \nIntroduction: Definition of Terms  \nDefining severe maltreatment is not an easy task. When a call to a child-abuse hotline is made, the suspicion that a child is being or has been abused is reported. To be substantiated, there must be physical evidence, reliable witnesses, or disclosure by the child. If the hotline call is substantiated and the child is referred for treatment, the treatment focus may need to go much deeper than the initial signs of abuse that brought the child to the attention of the authorities. For example, Erin’s black eye, which initiated an investigation, will heal, but it is nothing compared to the emotional effects of Erin not being fed and being forced to sleep on the floor of a closet amid urine-soaked clothes, waiting for someone to unlock the door of her imprisonment. Erin isn’t going to readily talk about this. Children rarely talk about experiencing severe maltreatment, especially when inflicted by the person on whom they must rely for their basic needs. Much more often, we see children protecting the abusive parent and longing to return home if placed in a foster home. Erin isn’t talking; she cries for her mother. When a child isn’t talking, ascertaining that a child has been severely maltreated is difficult.  \nEditor’s note: P. Gussie Klorer, PhD, ATR-BC, LCSW, LCPC, is the Director of the Graduate Art Therapy Counseling program at Southern Illinois University in Edwardsville. Her work in expressive therapy with severely abused and neglected children has spanned over 20 years. Correspondence regarding this article may be sent to Dr. Klorer via e-mail at[pklorer@siue.edu](pklorer@siue.edu).  \nIn a special issue of Child Maltreatment (Haugaard, 2004), severely maltreated children are defined as those who display behaviors suggesting severe disturbance—even if their reported maltreatment does not seem severe—because the extent of what these children have experienced may be completely unknown. This definition also includes those children who have experienced forms of maltreatment that are likely to result in severe disturbance—even if that disturbance is not evident behaviorally—because research shows that consequences may emerge later. Severe maltreatment can be characterized as chronic and involving considerable pain; it is also physically invasive or causes the child to fear death or permanent injury (Haugaard, 2004; Saywitz, Mannarino, Berliner, & Cohen, 2000) .  \nIdentifying attachment problems is also difficult. According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (1994), the criteria for a diagnosis of reactive attachment disorder (RAD) include evidence of pathogenic care and persistent disregard of the child’s basic physical or emotional needs. Also included is evidence of disturbed and developmentally inappropriate social relatedness beginning before 5 years of age. The inhibited type of RAD is described as a failure to initiate or respond appropriately in social interactions, and the disinhibited type is cha","cbCair4TqX7NO4zm","https://ap.wps.com/l/cbCair4TqX7NO4zm","pdf",112429,"English","# Abstract\n# Introduction: Definition of Terms\n## Editor’s note\n## Defining severe maltreatment\n## Attachment problems and RAD criteria\n# Normal Brain Development","[{\"question\":\"What is the paper’s rationale for expressive therapy in this population?\",\"answer\":\"Because expressive therapies are nonverbal, they can better engage trauma-related processing in children with attachment difficulties, where verbal approaches may be limited.\"}]","Expressive Therapy with Severely Maltreated Children: Neuroscience Contributions | PDF",1792073842]