Cumulative trauma is relatively undocumented in art therapy practice, although there is growing evidence that art therapy provides distinct benefits for resolving various traumas. This qualitative study proposes an art therapy treatment framework for cumulative trauma derived from semi-structured interviews with three art therapists and artistic representations of their approaches. Key components of practice include attention to the variability of symptom presentation, treatment approach, essential elements of therapy, and the use of art as a treatment modality. Art therapists attune themselves to their clients' subjective levels of distress throughout assessment and the course of treatment.