Beebe A, Gelfand EW, Bender B. A randomized trial to test the effectiveness of art therapy for children with asthma. Journal of Allergy & Clinical Immunology. 126(2):263-6, 266.e1, 2010.
Twenty-two children with asthma were randomly assigned to wait list control or to a weekly hour long art therapy group for 7 weeks. Those who received art therapy were less anxious and had a better asthma-related quality of life. There were no differences in the number of asthma attacks between the two groups. At 6 months, the active group maintained some positive changes relative to the control group including less worry and anxiety and better quality of life. Frequency of asthma exacerbations before and after the 6-month study interval did not differ between the two groups. This was the first randomized trial demonstrating that children with asthma receive benefit from art therapy that includes decreased anxiety and increased quality of life.
Brain tumor, pediatric
Madden JR, Mowry P, Gao D, et al. Creative arts therapy improves quality of life for pediatric brain tumor patients receiving outpatient chemotherapy. Journal of Pediatric Oncology Nursing. 27(3):133-45, 2010.
This pilot study evaluated the effects of the creative arts therapy on the quality of life of children receiving chemotherapy. The study compared art therapy with a volunteers attention in 16 children. Results showed improved mood with statistical significance on the Faces Scale, and patients were more excited, happier, and less nervous. Provider focus groups revealed positive experiences.
Breast Cancer Coping
Thyme KE, Sundin EC, Wiberg B, et al. J. Individual brief art therapy can be helpful for women with breast cancer: a randomized controlled clinical study. Palliative & Supportive Care. 7(1):87-95, 2009.
The aim of this randomized controlled clinical trial was to study the outcome of five sessions of art therapy given at a 5-week period of postoperative radiotherapy. Half the participants (n = 20) received art therapy and the other half (n = 21) were assigned to a control group. At follow-up, significant lower ratings of depression, anxiety, and somatic symptoms and less general symptoms were reported for the art therapy group compared to the control group. The conclusion suggests that art therapy has a long-term effect on the crisis following the breast cancer and its consequences.
Potash S, Hy Ho A, Chan F, et al. Can art therapy reduce death anxiety and burnout in end-of-life care workers? A quasi-experimental study. Int J Palliat Nurs. 2014 May 20;5:233-40.
Sixty-nine participants enrolled in a 6-week, 18-hour art-therapy-based group, and another 63 enrolled in a 3-day, 18-hour standard skills-based supervision group. Significant reductions in exhaustion and death anxiety and significant increases in emotional awareness were seen in participants in the art-therapy-based supervision group. This study provides early evidence that art-therapy-based supervision for end-of-life care workers can reduce burnout by enhancing emotional awareness and regulation, fostering meaning-making, and promoting reflection on death.
Cancer and Chemotherapy
Puetz TW, Morley CA, Herring MP. Effects of creative arts therapies on psychological symptoms and quality of life in patients with cancer. JAMA Intern Med. 173(11):960-9, 2013.
Creative arts therapies (CATs) can reduce anxiety, depression, pain, and fatigue and increase quality of life (QOL) in patients with cancer. Twenty-seven studies involving 1,576 patients were included in this systematic review. During treatment, arts therapies significantly reduced anxiety, depression, and pain and increased QOL, but this effect is reduced during follow-up.
Bar-Sela G, Atid L, Danos S, et al. Art therapy improved depression and influenced fatigue levels in cancer patients on chemotherapy. Psycho-Oncology. 16(11):980-4, 2007.
Sixty cancer patients on chemotherapy participated in once-weekly art therapy sessions (painting with water-based paints). Nineteen patients who participated four or more sessions were evaluated as the intervention group, and 41 patients who participated in 2 or less sessions comprised the participant group. In the intervention group, the median score for depression was 9 at the beginning and 7 after the fourth appointment. The median fatigue score changed from 5.7 to 4.1. Art therapy is worthy of further study in the treatment of cancer patients with depression or fatigue during chemotherapy treatment.
Garland SN, Carlson LE, Cook S, et al. A non-randomized comparison of mindfulness-based stress reduction and healing arts programs for facilitating post-traumatic growth and spirituality in cancer outpatients. Supportive Care in Cancer. 15(8):949-61, 2007.
The aim of this study was to compare a mindfulness-based stress reduction (MBSR) program and a healing through the creative arts (HA) program on measures of post-traumatic growth, spirituality, stress, and mood disturbance in cancer patients. A sample of 104 cancer with a variety of diagnoses attended either an 8-week MBSR program or a 6-week creative arts program and were assessed pre-and post-intervention. Participants in both groups improved significantly over time on overall post-traumatic growth. Participants in the MBSR group improved on measures of spirituality more than those in the creative arts group. Participants in the MBSR group also showed more improvement than those in creative arts group on measures of anxiety, anger, overall stress symptoms, and mood disturbance. MBSR may be more helpful than creative arts therapy in enhancing spirituality and reducing stress, depression, and anger.
Walsh SM, Radcliffe RS, Castillo LC, et al. A pilot study to test the effects of art-making classes for family caregivers of patients with cancer. Oncology Nursing Forum. 34(1):38, 2007.
This study tested the effects of an art-making class on reducing anxiety and stress among family caregivers of patients with cancer. Sixty-nine family caregivers were pre-tested and then a two-hour art-making class was delivered. Post-tests showed that anxiety and stress was significantly reduced after art-making class. Family caregivers may benefit from participation in art-making interventions. Nurses should continue to investigate the use of creative approaches to promote holistic care.
Oster I, Svensk AC, Magnusson E, et al. Art therapy improves coping resources: a randomized, controlled study among women with breast cancer. Palliative & Supportive Care. 4(1):57-64, 2006.
This study included 41 women, aged 37-69 years old, with non-metastatic primary breast cancer. The women were randomized to a study group with individual art therapy for 1 hour a week during postoperative radiotherapy or to a control group. There was an overall increase in coping resources among women with breast cancer after taking part in the art therapy intervention. Significant differences were seen between the study and control groups in the social domain on the second and third occasions. Significant differences were also observed in the total score on the second occasion. This study shows that individual art therapy provided by a trained art therapist in a clinical setting can give beneficial support to women with primary breast cancer undergoing radiotherapy, as it can improve their coping resources.
Monti DA, Peterson C, Kunkel EJ, et al. A randomized, controlled trial of mindfulness-based art therapy (MBAT) for women with cancer. Psycho-Oncology. 15(5):363-73, 2006.
The purpose of this study was to gather data on the effectiveness of a newly developed psychosocial group intervention for cancer patients, called mindfulness-based art therapy (MBAT). One hundred and eleven women with a variety of cancer diagnoses were paired by age and randomized to either an eight-week MBAT intervention group or a wait-list control group. Compared to the control group, the MBAT group demonstrated a significant decrease in symptoms of distress and significant improvements in key aspects of health-related quality of life.
Nainis N, Paice JA, Ratner J, et al. Relieving symptoms in cancer: innovative use of art therapy. Journal of Pain & Symptom Management. 31(2):162-9, 2006.
The specific aim of this study was to determine the effect of a 1-hour art therapy session on pain and other symptoms common to adult cancer inpatients. There were statistically significant reductions in eight of nine symptoms measured, including the global distress score, as well as significant differences in most of the areas measured by the anxiety scale. Subjects overwhelmingly expressed comfort with the process and desire to continue with therapy. This study provides beginning evidence for the efficacy of art therapy in reducing a broad spectrum of symptoms in cancer inpatients.
Walsh SM, Martin SC, Schmidt LA. Testing the efficacy of a creative-arts intervention with family caregivers of patients with cancer. Journal of Nursing Scholarship. 36(3):214-9, 2004.
This controlled clinical trial tested the efficacy of a creative arts intervention with family caregivers of patients with cancer. Forty family caregivers reported significantly reduced stress, lowered anxiety, and increased positive emotions following creative arts interventions which promoted short-term well being in this family caregiver sample. Caregivers also increased positive communication with cancer patients and health care providers.
Favara-Scacco C, Smirne G, Schiliro G, Di Cataldo A. Art therapy as support for children with leukemia during painful procedures. Medical & Pediatric Oncology. 36(4):474-80, 2001.
Children undergoing painful procedures for leukemia exhibited resistance and anxiety during and after these procedures. By contrast, children provided with art therapy from the first hospitalization exhibited collaborative behavior. They or their parents asked for art therapy when the intervention had to be repeated. Parents stated they felt better able to manage the painful procedures when art therapy was offered. Art therapy was shown to be a useful intervention that can prevent permanent trauma and support children and parents during intrusive interventions.
Forzoni S, Perez M, Martignetti A, et al. Art therapy with cancer patients during chemotherapy sessions: an analysis of the patients perception of helpfulness. Palliative & Supportive Care. 8(1):41-8, 2010.
The aim of this study is twofold: (1) to assess whether patients during chemotherapy sessions perceive art therapy as helpful and (2) to outline in which way art therapy is perceived as helpful. 157 cancer patients attending an Oncology Day Hospital participated in free collage. A psychologist interviewed a randomized group of 54 patients after the chemotherapy treatment using a semi-structured questionnaire. Out of the 54 patients, 3 found art therapy not helpful. The other 51 patients described their art therapy experience as helpful. Three main groups emerged: Art therapy was seen as (1) generally helpful, ex: relaxing, creative; 37.3%), (2) helpful because of the relationship with the art therapist (ex., talking about oneself and feeling listened to; 33.3%), and (3) helpful because of the triadic relationship, patient-image-art therapist (ex. expressing emotions and searching for meanings; 29.4%). These data show that art therapy may help support patients during the stressful time of chemotherapy treatment. Different patients use it to fulfill their own different needs, whether it is a need to relax (improved mood) or to talk (self-narrative) or to visually express and elaborate emotions (discovering new meanings).
Hannemann BT. Creativity with dementia patients. Can creativity and art stimulate dementia patients positively? Gerontology. 52(1):59-65, 2006.
This article gives a review of practical forms of treating dementia patients with art therapeutic indications. It is also a ground for long-term research objective. Creative activity has been shown to reduce depression and isolation, offering the power of choice and decisions. Towards the end of life, art and creativity offer a path of opening up the windows to peoples emotional interiors. Nonverbal therapy methods, such as painting, music, etc., are able to influence the well-being of the patients positively, within the modern healthcare system in nursing homes.
Krpan KM, Kross E, Berman MG, et al. An everyday activity as a treatment for depression: the benefits of expressive writing for people diagnosed with major depressive disorder. J Affect Disord. 150(3):1148-51, 2013.
Forty people diagnosed with major depressive disorder (MDD) completed a series of questionnaires and mental tasks. They were then randomly assigned to either expressive writing about their deepest thoughts and feelings on an emotional event or to a control condition in which they wrote about non-emotional daily events for 20 min over 3 consecutive days. On day 5 of testing, participants completed another series of questionnaires and mental measures which were repeated again 4 weeks later. People diagnosed with MDD in the expressive writing condition showed significant decreases in depression scores by Day 5 and these benefits lasted at the 4-week follow-up. This is the first study to show the effectiveness of expressive writing in people with current major depressive disorder. Expressive writing may be a useful supplement to existing interventions for depression.
Caddy L, Crawford F, Page AC. Painting a path to wellness: correlations between participating in a creative activity group and improved measured mental health outcome. Journal of Psychiatric & Mental Health Nursing. 19(4):327-33, 2012.
This study examined the mental health outcomes of inpatients participating in art-and craft-based creative therapies at a private psychiatric hospital over a 5-year period. The creative activity group sample (n= 403) improved from admission to discharge across four different measures with moderate to strong mean effect sizes. Reductions from pre- to post-treatment in both self-reported and clinician-rated symptoms are clearly demonstrated for participants in the creative activity group. Research findings establish that participation in creative activity has potential benefits for people experiencing mental health problems.
Harel S, Yanai L, Brooks R, et al. The contribution of art therapy in poorly controlled youth with type 1 diabetes mellitus. J Pediatr Endocrinol Metab. 26(7-8):669-73, 2013.
This study evaluated the effect of intensive art therapy in youth with poorly controlled type 1 diabetes mellitus (T1DM). The study population included 29 participants. The main behavioral difficulties were needle phobia and lack of compliance with nutritional recommendations or with insulin administration. The intervention group included 16 patients, with a mean age of 9.3 years and long-term data of 2.27 years. Improvement was seen in 56% of the case group and in 23% of the control group. Art therapy was associated with a decrease in hemoglobin A1c in the intervention group compared with the control group. The addition of intensive art therapy for poorly controlled youth with type I diabetes may improve their glycemic control.
Anschel DJ, Dolce S, Schwartzman A, and Fisher RS. A blinded pilot study of artwork in a comprehensive epilepsy center population. Epilepsy & Behavior. 6(2):196-202, 2005.
The present report details the results of a three-part study involving 60 subjects from a comprehensive epilepsy center population. Subjects were grouped by the following diagnoses: seizures, partial seizures, complex partial seizures with temporal focus, and nonepileptic events. The Formal Elements Art Therapy Scale task showed significant effects in patients with epileptic seizures. The Free Drawing was most sensitive to complex partial seizures with temporal focus, while the Outline was most predictive of nonepileptic events. In addition to giving some insight into the neurological functioning of these subjects, this pilot study provides a basis for the future development of diagnostic tests to be used within this patient group.
Fertility Issues in Women
Hughes EG, da Silva AM. A pilot study assessing art therapy as a mental health intervention for subfertile women. Hum Reprod. 26(3):611-5, 2011.
Weekly 2-hour art therapy group courses were held for a total of 21 women with fertility problems. The effectiveness of art therapy was assessed using Beck Hopelessness, Depression and Anxiety Inventories, administered before and after participation. Mean Beck Hopelessness Scale fell from 6.1 to 3.5 after therapy. Beck Depression Inventory-II Score fell from 19.8 to 12.5 and Beck Anxiety Inventory Score changed from 12.4 to 8.4. Women felt the course was insightful, powerful and enjoyable. Art therapy was associated with decreased levels of hopelessness and depressed mood in this group of women.
Rao D, Nainis N, Williams L, et al. Art therapy for relief of symptoms associated with HIV/AIDS. AIDS Care. 21(1):64-9, 2009.
Seventy-nine people with a diagnosis of HIV infection participated in either a one-hour art therapy session or viewed a videotape about art therapy. The analyses showed that physical symptom mean scores were better for those who participated in the art therapy compared to those who viewed the videotape, and this difference between conditions was statistically significant. Thus, the study demonstrated the potential benefits of one session of art therapy in relation to symptoms associated with HIV/AIDS.
Baumann M, Peck S, Collins C, Eades G. The meaning and value of taking part in a person-centered arts programme to hospital-based stroke patients: findings from a qualitative study. Disabil Rehabil. 35(3):244-56, 2013.
This study focused on stroke patients remaining in the hospital for above average durations and included patients with functional, cognitive and speech or language impairments. After participation in the arts program and before discharge, semi-structured interviews were undertaken with sixteen patients or a relative as a proxy. Interviews explored the experience of stroke and hospital stay and the meaning and value of taking part in Time Being Stroke and the data was analyzed according to theme. Patients accounts suggest that participation in a person-centered arts program contributed to their mental well-being. The most commonly mentioned benefits included the experiences of: pleasure and enjoyment, a sense of connection with the artists, mental stimulation, learning and creativity, engagement in purposeful occupation and relief from boredom, and reconnection with valued aspects of the self. This contrasts strongly with the acute and chronic distress associated with stroke, impairment, and spending long periods of time in hospital.