Paths & Door to FaTE: Fashion as an Expressive Arts Therapy

Fashion design and expressive dress as a healing modality.

Hello Hesitation Media readers! As I’m preparing for our next chapter on the platform and season 3 of the podcast, I wanted to send an academic text on psychodynamic therapy and fashion to you.

After a few rounds with some editors at a Journal of Creativity in Mental Health, it has become clear that the article below scope is quite broad and will probably become 2 or 3 articles that are sharpened with the editors knife.

With that said, the below was originally born as wild, sometimes divergent, but mostly focused, round, squishy whole that I feel deserves to be released before it makes its official debut in a shaved and toned state.

Enjoy!

Paths & Door to FaTE: Introducing Expressive Dress into the Counselor's Toolkit

Brian J. Nuckols

Abstract

“The psychological rule says that when an inner situation is not made conscious, it happens outside, as fate.”

—C.G. Jung, Aion: Researches into the Phenomenology of the Self, Collected Works Vol. 9, Part 2

This paper introduces Fashion as Therapeutic Expression (FaTE), a theoretical framework that incorporates fashion design and expressive dress as creative counseling interventions to foster growth and healing in patients. Grounded in Analytical Psychology, FaTE harnesses the symbolic resonance and cultural significance of clothing to facilitate psychological growth and transformation. The framework builds upon Jung's concepts of individuation and active imagination, positioning garments as tangible bridges between conscious and unconscious material. In an effort to provide a holistic conceptual understanding theoretical foundations, practical applications, and case illustrations are provided. In sum, this material highlights how fashion-based interventions benefit diverse client presentations, particularly those who have not responded to prominent first line approaches for mental health treatment in the United States. The scientific rationale for FaTE is examined through established psychological treatment standards, with recommendations for implementation and future research. By expanding the creative counselor's toolkit to include fashion, this article acts as both a path and a door. The path leads both clinicians and patients through the lineages and conceptual developments that helped bring forth FaTe as expressive arts counseling intervention in the 21st century. The door invites both clinicians and patients into a world where the fashion arts offer various embodied vehicles towards self-discovery, healing, and individuation.

The Roots of Expressive Arts Therapy

The expressive arts movement traces its origins to the humanistic turn of the 1960s, when the cultural revolution opened new possibilities for psychological healing. Carl Rogers’s seminal work On Becoming a Person (1961) crystallized the person-centered approach, emphasizing client agency and experiential growth. Concurrently, the anti-psychiatry movement challenged medicalized models of mental illness. Within this milieu, pioneers such as Paolo Knill, Shaun McNiff, and Mary Whitehouse began integrating visual art, music, drama, and movement into counseling—laying the foundation for expressive arts therapy as a distinct, multimodal discipline (Levine & Levine, 2017; Malchiodi, 2020; Rosen & Atkins, 2014).

Artistic Technique and Expressive Arts Therapy

Early development in creative-arts therapies emphasized specificity, with practitioners mastering single-modality approaches—visual art, music, dance/movement or drama—before integrating multiple forms. A comprehensive literature review by Garrett (2020) outlines how therapies historically focused on one discipline, each developing distinct theories and clinical techniques before research supported multimodal methods for complex cases such as childhood trauma (Garrett, 2020). Similarly, Woodford (2024) notes that single-modality specialists meet clients’ deep affinities for a particular art form, while integrative therapists flexibly shift between modalities to address diverse needs. This progression echoes the alchemical principle of Solve et Coagula (Irvine, 2010), in which analysis precedes synthesis. Building on this lineage, Knill, Levine, and Levine (2005) demonstrated the value of a holistic framework combining multiple creative channels. Although everyone “wears” clothes daily, few therapists have specialized in the symbolic and embodied dimensions of dress. Fashion as Therapeutic Expression (FaTE) mirrors this historical sequence—first defining its unique territory through specialized garment work, then weaving it into a comprehensive, multimodal practice.

Second Path of FaTe

Analytical Psychology and Symbolic Expression

At the heart of Analytical Psychology is the individuation process, an autonomous pathway of self-healing and psychological integration that emanates from the self (Roesler, 2016). Jung proposed that this process follows a universal pattern—recognizable across cultures and eras—and developed a “map” to guide therapists in accompanying patients through its stages (Vogel, 2017; Münch, 2016). Empirical analyses of clinical material have since demonstrated markers of individuation in case studies, lending systematic support to its validity (Knox, 2003).

A second cornerstone of Analytical Psychology is active imagination, in which clients engage unconscious content through creative expression (Chodorow, 2006). Jung’s own Red Book (Liber Novus), produced between 1914 and 1930, exemplifies this method: elaborate paintings and calligraphic text document his dialogues with inner figures, laying the groundwork for archetype theory and the concept of the collective-unconscious (Shamdasani, 2009; Cambray, 2013).

Where The Red Book (Jung, 2009) shows Jung’s active imagination transcribed onto parchment—images and dialogues held on a two-dimensional plane—the Bollingen Tower represents the next logical step in that same imaginal process: the psychic material is lifted off the page and incarnated in stone. Carving alchemical aphorisms into its walls and expanding the structure whenever new inner content demanded form, Jung demonstrated that active imagination does not end with visioning; it culminates when symbols are embodied as inhabitable, three-dimensional environments that the ego can literally walk through and negotiate (Hoerni, 2010).

Jung’s emphasis on symbolic embodiment has informed modalities such as sandplay therapy, where tactile scenes create a “transitional space” for transformation (Turner, 2017). Dance therapists—exemplified by Chodorow (2009) and Whitehouse (2001)—have similarly demonstrated how movement enacts archetypal dynamics, offering further evidence that the psyche’s self-healing capacities can be accessed through creative media (Van Lith, 2015).

Together, these Jungian principles—individuation as an innate movement toward psychic wholeness and active imagination as the dialogical method that mobilizes it—converge on a core therapeutic insight: inner images gain transformative power when they are transposed into sensorial, manipulable form. In that respect, clothing occupies the same symbolic register as the sand-tray miniature or the danced gesture. A jacket, skirt, or scarf is not a neutral accessory but an “animated object” whose fabric, cut, and provenance are saturated with personal as well as collective meaning each time it meets the skin (Entwistle, 2015).

By positioning garments as living, tactile canvases for active imagination, Fashion as Therapeutic Expression (FaTE) extends Jungian theory into everyday material culture, offering clients an accessible, multisensory pathway for individuation that does not depend on verbal fluency or conventional artistic skill.

Clothing as Symbolic Expression

Clothing functions as a symbolic boundary between inner psychological experience and outer social presentation—a terrain Jung identified as central to psychological work (Woodman, 2012). Garments enact the persona, the “social mask” that mediates between the individual’s inner life and public roles (Hopcke, 1999). In Jungian terms, the persona is where the sacred (authentic self) meets the profane (social conformity and self hatred): the clothes we choose both reveal our aspirations toward wholeness and signal our compliance with cultural norms (Jacobi, 2013). As such, wardrobe decisions become rich sites for exploring identity tensions and facilitating transformative encounters with one’s deeper psyche.

At the same time, clothing can project the shadow—those disowned or unconscious aspects of the self that surface through function, fabric, cut, and color (Entwistle, 2015; Schmitt, 2017). A client’s habit of layering dark, concealing garments may mirror a shadow-driven defense against vulnerability; conversely, a sudden shift to bold patterns can signal the emergence of repressed creativity or desire. By treating each garment as a living symbol, therapists can externalize internal conflicts and create a tangible “third space” where persona and shadow engage in dialogue (Knill, Levine, & Levine, 2005; Singer, 2010).

Door to FaTe

Dialogue with Dress

A central technique within the FaTE approach is Dialogue with Dress (DwD), an extroverted adaptation of Jung’s active imagination that uses clothing as tangible symbolic objects. Traditional active imagination invites clients to close their eyes and engage internal imagery; DwD instead externalizes this work, making it accessible to those who struggle with visualization or find it overwhelming (Chodorow, 2006; Johnson, 2016).

DwD extends dialogical methods from expressive arts and psychotherapy—such as Gestalt therapy’s empty‐chair technique (Perls, Hefferline, & Goodman, 2011) and McNiff’s art‐therapy dialogues (McNiff, 2014)—by substituting garments for chairs or canvases. Because clothing physically interfaces with the body, it bridges inner experience and outer expression in ways visual or verbal media cannot (Entwistle, 2015).

During DwD, clients select a garment with personal significance and engage in a structured dialogue with it. Therapists guide observation of fabric, cut, and color, then facilitate personification and question‐and‐answer exchanges. The process externalizes unconscious content and creates a “third space” for exploration. As Hinz (2020) observes, the tactile and visual qualities of artistic media—here, clothing—can bypass verbal defenses and access sensory‐based memories and emotions that might otherwise remain inaccessible.

Dialogue with Dress Protocol

The following protocol outlines steps for implementing Dialogue with Dress in clinical practice, informed by active imagination (Johnson, 2016) and dialogical arts‐based methods (McNiff, 2014):

1. Selection: Ask the client to choose a garment—either one they’ve brought or from a therapist‐provided collection—that elicits an emotional response or feels symbolically significant. Clients often gravitate toward items resonant with conscious or unconscious aspects of their experience (Kaiser, 2012).
   

2. Placement: Position the garment in a visible “playspace,” such as on a chair or mannequin opposite the client. This arrangement creates a protected area for symbolic exploration at a safe aesthetic distance (Knill, Levine, & Levine, 2005).
   

3. Observation: Guide the client through intentional looking (Betensky, 2001), noting fabric, color, cut, and any spontaneous thoughts or emotions. This phenomenological approach deepens engagement before interpretive work begins.
   

4. Personification: Invite the client to imagine the garment possessing a persona—its own character, voice, and qualities. This activates Jung’s transcendent function, bridging conscious and unconscious content through symbolic representation (Knox, 2003).
   

5. Dialogue: Facilitate a conversation between the client and the personified garment. Simple prompts (“What would this garment say to you?”) encourage authentic expression while maintaining psychological safety (Rogers, Tudor, & Tudor, 2016).
   

6. Deepening: As themes emerge—identity, shadow material, archetypal energies or personal history—encourage exploration in greater depth, mirroring deepening into the image techniques from integrated arts modalities (Levine & Levine, 2019).
   

7. Integration: Help the client reflect on insights gained and consider real‐world applications, translating symbolic understanding into behavioral and psychological change (Malchiodi, 2020).
   

8. Optional Embodiment: When clinically appropriate, clients may try on or wear the garment, attending to shifts in bodily sensation, emotion, and self‐perception. Embodiment recognizes the body’s role in holding and expressing psychological material (Pallaro, 2007).

Throughout all phases, the therapist maintains curiosity and non-judgment, supporting autonomous exploration while providing structure to contain the process (Knill et al., 2005). With client consent, documentation may include garment photographs, dialogue transcripts, and client reflections.

Evolutionary Processes and Dialogue with Dress

Building on Hayes, Hofmann, and Wilson’s (2020) framing of clinical psychology as an applied evolutionary science, therapists guide clients to mindfully manage variation–selection–retention dynamics in their embodied self–presentation. During DwD, clients are encouraged to experiment with variation—trying on different garments or styles to elicit new emotional responses. As insights emerge, therapists help clients select adaptive dress behaviors that align with their therapeutic goals. Through rehearsal and reflection, clients retain these beneficial patterns, reinforcing shifts in identity and self–concept. Throughout, attention to context, dimensions, and levels of change ensures that modifications in dress support the client’s broader values and well‐being rather than merely conforming to external norms.

This evolutionary perspective dovetails with earlier DwD phases—selection, personification, dialogue, and integration—by framing garment experimentation as a series of evolutionary trials. Just as effective caregivers unconsciously apply variation–selection–retention principles in child‐rearing, skilled therapists intentionally structure these processes, helping clients navigate the fitness landscape of their psychosocial environments (Hayes et al., 2020).

Clinical Vignette

Lisa (pseudonym), a 34-year-old survivor of child sexual assault, presented in her third month of treatment with PTSD symptoms—hypervigilance, intrusive memories, nightmares, emotional numbing—and the “somatic distress” van der Kolk (2014) describes as bodily manifestations of trauma resistant to cognitive interventions. She reported feeling “invisible and unreal” in social settings, having long disconnected from her body and appearance.

For her first DwD session, Lisa brought a business suit her ex-partner had required her to wear to “look professional.” Therapists often see such garments embodying both trauma and survival strategies (Schmitt, 2017). Placing the suit on a chair, Lisa began a hesitant dialogue, addressing it as an external entity. Her dialogue included themes of suffocation and entrapment. This externalization created the therapeutic distance White and Epston (1990) identify, allowing Lisa to engage with her trauma without becoming overwhelmed by direct emotional recollection.

Over subsequent sessions, Lisa’s relationship with the suit shifted. She recognized it not only as her ex-partner’s instrument of control but also as a representation of her own “internalized critical voice” that Woodman (2012) describes as persisting after trauma. When Lisa asked, “What would you look like if you were mine instead of his?” she activated Jung’s transcendent function, generating fresh insight beyond established patterns (Knox, 2003).

Emboldened, Lisa altered the garment itself—removing rigid shoulder pads, replacing buttons, and adding colorful embroidery reflecting her suppressed qualities. This tangible transformation paralleled her psychological journey to reclaim agency and reshape her identity. By treatment’s end, she demonstrated a significant reduction in PTSD symptoms on the PCL-5, reported decreased distress on the Nightmare Distress Questionnaire (Saunders et al., 1998), and showed improved sleep quality on the Pittsburgh Sleep Quality Index (Buysse et al., 1989). She stated she felt “at home in my body and my clothes for the first time in years,” illustrating how DwD offers a concrete pathway for healing the embodied self (Malchiodi, 2020).

Scientific Rationale

Towards Scientific Perspectivism

Counselors know that no single measure tells the whole story—symptom checklists capture one slice of experience while qualitative work reveals another. Friedrich Nietzsche (1886/1967) put it plainly: “There are no facts, only interpretations,” reminding us that every assessment reflects a particular viewpoint. Eduardo Viveiros de Castro’s Amerindian perspectivism extends this idea: in many Amazonian societies, humans, animals, and spirits each inhabit their own worlds, showing how reality shifts with the observer’s stance (Viveiros de Castro, 1998). Andean traditions likewise teach that human, natural, and spiritual realms intersect to form a living tapestry of meaning (Allen, 1988; Walsh, 2010).

The philosopher Heidegger (1977) noted that scientific methods bring certain truths to light but can also mask other aspects of human experience. His concept of truth, aletheia, encompasses more than internal and external correspondence. Truth, for Heidegger, is a process of revealing and concealing. Notably, every act of unconcealment (another way of saying discovery) simultaneously hides other dimensions of truth. By prioritizing measurable data—like gravity or chemical reactions—traditional science can overlook the rich, qualitative textures of lived life. Adorno and Horkheimer’s Dialectic of Enlightenment (1947/2002) adds that the same drive for rational control can transform the expressions that emerge from art, ritual, and imagination into commodities, stripping them of deeper meaning and power.

Addressing these critiques, Maguire (2018) argues for scientific perspectivism—a balanced approach that combines hard data with stories, sensations, and symbols. In FaTE, this means giving weight to standard measures (PTSD scales, sleep indices) and to the embodied insights clients uncover when they engage with clothing as a therapeutic medium. By holding multiple perspectives in tension, counselors can ensure that no single method eclipses the rest, and that every client’s experience is honored in full.

In FaTE, we address the repressive risks of discovery by combining quantitative measures (e.g., symptom checklists, sleep indices) with the sensory and symbolic insights that emerge through the practice of art. This scientific perspectivism ensures counselors honor both empirical evidence and the unique, nonverbal knowledge revealed in expressive‐arts interventions (Maguire, 2018).

Empirical Rigor Within a Perspectivist Stance

While FaTE embraces multiple ways of knowing, it maintains rigorous scientific boundaries to ensure credibility and accountability. Counselors collect and analyze quantitative data—symptom scales, sleep indices, behavioral markers—using validated instruments and standardized protocols (Chambless & Hollon, 1998; Buysse et al., 1989). As Meehl (1954) demonstrated, statistical prediction often outperforms unstructured clinical judgment, underscoring the need for systematic measurement rather than sole reliance on intuition. At the same time, practitioners integrate qualitative and embodied insights from garment-based work, without elevating one method above another. This perspectivist commitment guards against methodological supremacism—where a single approach claims universal authority—and instead honors the complementary strengths of empirical measurement and expressive exploration (Meehl, 1990; Maguire, 2018). By holding both perspectives in productive tension, FaTE delivers evidence-based outcomes while remaining open to the emergent, symbolic shifts that characterize deep psychological transformation.

Mechanisms of Change

Crucial to empirical rigor is understanding mechanisms of change—the causal pathways through which interventions produce outcomes. Fashion as Therapeutic Expression (FaTE) draws on Koch’s (2017) theory of embodied aesthetics, which distinguishes between art perception (impression) and active art-making (expression) as complementary therapeutic processes. This dual focus fits fashion interventions, where clients both perceive existing garments and create or modify new ones.

FaTE’s therapeutic factors map onto Koch’s six active clusters reproduced in table 1.

Mechanism

Description & Key References

Hedonism

Sensory engagement with colors, textures, and forms triggers pleasure‐based healing and stress reduction (Stuckey & Nobel, 2010).

Beauty & Authentic Expression

Manipulation of aesthetic elements (order, coherence, harmony) affords “making special” experiences that transform materials into meaningful artifacts (Dissanayake, 2015).

Creativity & Generative Processes

Active garment design and modification bolsters agency and self‐efficacy by “bringing something new into being” through sensorimotor engagement (Barsalou, 2008; Koch, 2017).

Non-verbal Meaning Making

Clothing serves as a multi-sensory symbolic language, enabling expression beyond words—vital for trauma or alexithymia (Malchiodi, 2020).

Enactive Transitional Support

Garments function as transitional objects within a “playspace,” supporting gradual identity shifts through embodied enactment (Winnicott, 1971; Knill et al., 2005).

Symbolism & Communication

Externalized representations of internal states facilitate reflection and transformation, while also serving as social dialogue to reveal relational dynamics (Kaiser, 2012; White & Epston, 1990).

Table 1: Koch’s Clusters

Treatment Validation Framework

To position FaTE within established evidence‐based practice, we apply contemporary validation criteria. The Society of Clinical Psychology (SCP, 2023) defines psychological treatments as structured, clinician‐delivered interventions that engage cognitive, emotional, behavioral, and interpersonal processes to improve health outcomes and rest on scientific foundations . FaTE fulfills these requirements through its manualized protocols, delivery by trained therapists, targeted engagement with psychological mechanisms, measurable outcomes, and grounding in Jungian and expressive‐arts theory.

Validation Framework

Criteria

FaTE Classification

Chambless & Hollon (1998)

Evidence from randomized controlled trials; strong, modest, or controversial support levels.

Promising: Initial pilot studies suggest benefit, but large‐scale RCTs are pending.

Tolin et al. (2015)

Meta‐analytic evidence grading: very strong, strong, weak, or insufficient.

Insufficient: No meta‐analyses to date; individual studies exist but have not been synthesized quantitatively.

Table 2: Validation Frameworks and FaTe

Advancing FaTE’s Evidence Base
To move FaTE beyond “experimental” status, we recommend the following initiatives.

Research Initiative

Purpose & Action

Controlled Outcome Studies

Conduct RCTs comparing FaTE interventions to standard treatments across specific clinical populations (e.g., PTSD, ED).

Treatment Manualization

Develop and disseminate detailed intervention manuals to ensure fidelity and reproducibility across clinical settings.

Assessment Standardization

Adopt validated measures (e.g., PCL-5, PSQI, NDQ) and create fashion‐specific scales to facilitate meta‐analysis.

Mechanism Documentation

Use mediation analyses and process‐outcome research to confirm which sensory, symbolic, and cognitive factors drive change.

Table 3: Suggested Initiatives for FaTe

These steps align with APA’s evidence‐based practice framework, which integrates research evidence, clinical expertise, and patient values (APA Task Force, 2006) . By systematically testing FaTE protocols and measures, counselors can ensure rigorous validation while preserving the modality’s creative and symbolic strengths.

Implementation Guide

Integrating FaTE into counseling follows three interconnected phases—Assessment, Conceptualization, and Intervention—each aligned with best‐practice guidelines in evidence‐based counseling (Lambert & Barley, 2001; Prochaska & Norcross, 2018). Clinicians may consult Appendix A for the complete manualized protocol and Appendix B for illustrative case studies.

Assessment

Assessment combines standardized measures and experiential methods to capture both symptomatology and clients’ embodied relationship with dress. Established instruments (e.g., PCL-5 for trauma symptoms, PSQI for sleep quality, NDQ for nightmare distress) offer reliable baselines (Bovin et al., 2016; Buysse et al., 1989; Saunders et al., 1998), while wardrobe mapping interviews and fabric sampling draw on person‐centered approaches that prioritize client narratives and sensory preferences (Rogers, 1951; Malchiodi, 2013). This dual strategy mirrors best‐practice models emphasizing both quantitative outcome tracking and qualitative understanding of client meaning‐making (Wampold & Imel, 2015).

Assessment Component

Data Source

Function

Symptom Metrics

PCL-5; PSQI; NDQ

Provide reliable, validated measures of trauma, sleep, and nightmare distress.

Wardrobe Mapping

Semi-structured interview; Clothing Narrative

Elicit client‐generated metaphors and symbols to inform case formulation

Sensory Profile

Fabric swatch exploration

Identify tactile and aesthetic tolerances to guide safe, engaging interventions.

Table 4: FaTe Assessment Framework

Conceptualization

In the conceptualization phase, therapists synthesize assessment data into a coherent FaTE case formulation. Building on transtheoretical best practices (Prochaska & Norcross, 2018), practitioners integrate symptom metrics, wardrobe themes, and sensory profiles with personality and transferential insights. Specifically, the Shedler–Westen Assessment Procedure (SWAP) provides empirically validated personality–psychopathology profiles (Shedler & Westen, 2007), while Nancy McWilliams’ psychoanalytic case conceptualization framework (McWilliams, 1994) helps clinicians map underlying defense patterns, relational styles, and core conflicts. This enriched formulation guides selection of FaTE mechanisms—such as hedonic fabric work for clients with high need for sensory regulation or symbolic dialogue for those exhibiting complex transference issues (Lambert, 2013).

Formulation Element

Source

Clinical Implication

Presenting Concerns

PCL-5, PSQI, NDQ

Use clinical intuition to match FaTe interventions with presenting concerns.

Symbolic Patterns

Wardrobe Mapping; Clothing Narrative

Address persona-shadow dynamics that emerge through narrative tools.

Personality Structure

SWAP (Shedler & Westen, 2007)

Tailor intervention pace and modality to personality functioning.

Relational & Defense Patterns

McWilliams’ psychoanalytic conceptualization (1994)

Anticipate transference themes in DwD dialogues and prepare containment strategies.

Mechanisms of Change

Sensory Profile; client‐defined values

Use clinical intuition to target most effective mechanism of change

Table 5: FaTe Conceptualization Framework

Intervention

FaTE interventions proceed in Phase 1: Stabilization, Phase 2: Processing, and Phase 3: Integration—reflecting stage‐based models of change (Prochaska & Norcross, 2018). Each phase includes structured protocols from Appendix A, session goals, and routine outcome monitoring to align with feedback‐informed treatment standards (Prescott et al., 2020).

Phase

Techniques

Outcome Monitoring

Stabilization

Fabric sampling; basic Wardrobe Mapping

Weekly PSQI scores; client comfort ratings

Processing

Dialogue with Dress; Fashion Narratives; Symbolic Adornment

Mid‐treatment PCL-5; reflective journal entries

Integration

Design as Healing; Graduated wearing experiments

Post‐treatment NDQ; self‐efficacy scale

Table 6: FaTe Intervention Framework

Ethical Considerations

Implementing FaTE demands careful attention to the American Counseling Association’s Code of Ethics (2014) and best‐practice guidance on cultural competence, informed consent, and professional boundaries (Remley & Herlihy, 2021). Counselors must navigate issues unique to fashion‐based work—such as handling personal garments and visual materials—while upholding client autonomy, confidentiality, and inclusivity.

First, informed consent and confidentiality require explicit discussion of how clients’ clothing and any photographs will be used, stored, and eventually disposed of, in accordance with ACA Standards C.2.a–C.2.c (2014).

Second, body diversity and inclusion call for therapists to challenge beauty norms and ensure interventions accommodate all body shapes, abilities, and gender expressions, reflecting ACA’s principle of respect for diversity (A.4.b).

Third, cultural and socioeconomic sensitivity involves co‐constructing the meaning of garments with clients and minimizing cost barriers by using donated or low‐cost materials, supporting the ACA mandate for cultural competence (E.5.b).

Finally, professional boundaries and touch must be defined clearly before any tactile guidance with clothing, in line with Standards A.5.a–A.5.d, and navigated through ongoing supervision.

Future Directions

Emerging Applications

Fashion‐based therapeutic approaches show promise in novel contexts beyond individual counseling. Group applications—such as fashion co‐creation workshops for adolescents navigating identity development—can foster both self‐awareness and peer support, echoing findings from group expressive‐arts models (Parsons et al., 2019). Digital integration offers another frontier: virtual reality environments for experimenting with digital garments and online identity work may extend FaTE to remote and underserved populations (Estrella, 2017). Cross‐cultural adaptations remain critical, as indigenous and diasporic communities often possess rich dress traditions that can be harnessed for healing; future work should document traditional garment‐based rituals and co‐develop culturally specific FaTE protocols. Finally, formal training models—incorporating supervised practicum, fashion design fundamentals, and cultural competence—will ensure practitioners enter the field with both technical skill and ethical sensitivity (Rosen & Atkins, 2014).

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