Abstract
Childhood trauma is associated with self-injury and suicidal behaviour, yet traumatised young people often cannot put their experiences into words, particularly where family hierarchies limit emotional disclosure between children and parents, as in Vietnam. This case study describes a 17-year-old Vietnamese girl ("Lily") who presented with severe non-suicidal self-injury and previously undisclosed suicide attempts rooted in childhood adversity. She received a 12-session, three-phase intervention comprising House-Tree-Person (HTP) art therapy, prosocial community action and structured family sessions. Session records, journal entries, field notes and parent interviews were analysed using reflexive thematic analysis, and pre- and post-intervention drawings using compositional and iconographic visual analysis. Three themes were generated: art as a bridge to concealed trauma; consolidation of gains through prosocial agency; and relational repair within the family. The final drawing was interpreted as reflecting psychological integration and post-traumatic growth. Art therapy, supported by family engagement, the young person's active cooperation and a compassionate therapeutic relationship, may offer a culturally responsive pathway to recovery. Findings from a single, clinician-interpreted case without long-term follow-up are illustrative and require further study.