A fuller picture: evaluating an art therapy programme in a multidisciplinary mental health service

Interdisciplinarity in cultural gerontology and geriatric medical humanities - a bibliometric survey

BACKGROUND

Cultural gerontology - understanding ageing through the lens of arts and humanities-has emerged as an important element of epistemology of ageing. As a boundary area between geriatric medicine/gerontology and arts/humanities disciplines, joint-working/interdisciplinarity is desirable. This project aims to assess the degree of joint-working manifested in cultural gerontology by authorship and acknowledgements in papers dedicated to cultural gerontology in five journals.

METHODS

Observational survey of authorship in 5 journals from the founding of the specific sections on cultural gerontology or specific dedicated journals, assessing number of authors, disciplinary identities, and evidence of joint working within cultural gerontology.

RESULTS

Of 591 papers, 481 (81%) were single authors. There was a spread of disciplinary affiliations, 247 (41.8%) gerontology/age studies, 169 arts/humanities/social sciences (28.6%) and 133 of uncertain affiliation (22.5%): only 38 papers had a clear indication of joint working across the disciplines (6.4%). In the two geriatric medicine journals, European Geriatric Medicine and Journal of the American Geriatrics Society, authorship was almost exclusively from geriatric medicine/gerontology. There was extremely limited use of acknowledgements.

CONCLUSION

Our study indicates that single authorship is the most frequent mode of peer-reviewed publishing in cultural gerontology, whilst acknowledging that some authors may have scholarly training in multiple fields but are listed as unidisciplinary. Leaders in the field and editors of relevant journals/section need to consider ways of encouraging and recognising joint working, through fuller descriptions of multiple affiliations, brief author biographies, fuller use of acknowledgements and consideration of brief accompanying discussant responses from complementary disciplines.

Active Visual Art Therapy and Health Outcomes: A Systematic Review and Meta-Analysis

Importance

Art therapy has a long-standing tradition in patient treatment. As scientific interest in its use has recently grown, a comprehensive assessment of active visual art therapy is crucial to understanding its potential benefits.

Objective

To assess the association of active visual art therapy with health outcomes across patient groups and comparators.

Data Sources

The systematic literature search included the Cochrane Library, Embase, MEDLINE, CINAHL, ERIC, American Psychological Association PsycArticles, American Psychological Association PsycInfo, PSYNDEX, the German Clinical Trials Register, and ClinicalTrials.gov. No filters regarding language were applied. The search covered all dates before March 2021. Data analysis was conducted from April 24 to September 8, 2023.

Study Selection

Randomized clinical trials with any type of patient population comparing the intervention with any control not using active visual art therapy were included. Two researchers independently screened the abstracts and full texts.

Data Extraction and Synthesis

Data extraction followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and study quality was evaluated using the Cochrane Risk of Bias tool. Data were synthesized using narrative summaries, forest plots, and random effects meta-analyses.

Main Outcome and Measures

In line with the protocol, all outcome measures of the included studies were extracted.

Results

The search identified 3104 records, of which 356 outcomes of 69 studies were included, with a total of approximately 4200 participants, aged 4 to 96 years, in the review. The meta-analyses included 50 studies and 217 outcomes of 2766 participants. Treatment indications included mental, neurological, and other somatic disorders, and prevention. Most outcome measures focused on depression, anxiety, self-esteem, social adjustment, and quality of life. Art therapy was associated with an improvement in 18% of the 217 outcomes compared with the controls (1%), while 81% showed no improvement. The standardized mean difference in the change from baseline of the meta-analyses of 0.38 (95% CI, 0.26-0.51) and posttest analysis of 0.19 (95% CI, 0.12-0.26) also indicated an improvement of outcomes associated with art therapy. Overall study quality was low.

Conclusions and Relevance

In this systematic review and meta-analysis of randomized clinical trials, visual art therapy was associated with therapeutic benefits for some outcomes, although most studies were of low quality. Further good-quality studies are needed to provide additional insights for its best possible integration into routine care.

Authorship in the Medical Humanities: Breaking Cross-field Boundaries or Maintaining Disciplinary Divides?

PURPOSE

Medical humanities is a field which implies collaborative work across disciplines although the degree to which this actually occurs is unknown. Our purpose was to determine the degree of joint work in medical humanities through analysis of authorship and acknowledgements in the two main medical humanities journals.

METHODS

Observational survey of authorship. We studied authorship data in all papers published in the two major general medical humanities journals between 2009 and 2018 (n=595).

RESULTS

Two-thirds of papers (67.4%) had single authors, of whom a majority declared a single disciplinary affiliation (70.3%). The titles of 60.8% of papers explicitly suggested collaborative content of which 19.9% had multiple authors from more than one discipline (not within the same school); of the remainder, almost half (48.1%) had a single, single-disciplinary author (although 8.5% demonstrated interdisciplinarity in the acknowledgements). One-third of papers (193/595;33%) referenced one or more people in the acknowledgements. Among papers whose titles suggested humanities or medical content only, authorship lists of 10.2% and 17.9% respectively demonstrated collaborative scholarship.

CONCLUSIONS

Despite considerable involvement from both humanities and medical practitioners, there is still substantial scope for enhanced emphasis on collaborative (multi-, inter- and trans-disciplinary) seminars and exchanges in the medical humanities and editorial policies to promote transparency of the nature of collaborative work among disciplines. Journal editors and editorial boards should reflect on the opportunity to promote enhanced visibility of joint work in scholarship in the medical humanities through reflection and review of current editorial policies.

An Investigation into Art Therapy Aided Health and Well-Being Research: A 75-Year Bibliometric Analysis

Considering the physical, and psychological impacts and challenges brought about the coronavirus disease 2019 (COVID-19), art therapy (AT) provides opportunities to promote human health and well-being. There are few systematic analysis studies in the fields of AT, which can provide content and direction for the potential value and impact of AT. Therefore, this paper aims to critically analyze the published work in the field of AT from the perspective of promoting health and well-being, and provides insights into current research status, hotspots, limitations, and future development trends of AT. This paper adopts a mixed method of quantitative and qualitative analysis including bibliometric analysis and keyword co-occurrence analysis. The results indicate that: (1) the current studies on AT are mostly related to research and therapeutic methods, types of AT, research populations and diseases, and evaluation of therapeutic effect of AT. The research method of AT mainly adopts qualitative research, among which creative arts therapy and group AT are common types of AT, and its main research populations are children, veterans, and adolescents. AT-aided diseases are trauma, depression, psychosis, dementia, and cancer. In addition, the therapeutic methods are mainly related to psychotherapy, drama, music, and dance/movement. Further, computer systems are an important evaluation tool in the research of AT; (2) the future development trend of AT-aided health and well-being based on research hotspots, could be focused on children, schizophrenia, well-being, mental health, palliative care, veterans, and the elderly within the context of addressing COVID-19 challenges; and (3) future AT-aided health and well-being could pay more attention to innovate and integrate the therapeutic methods of behavior, movement, and technology, such as virtual reality and remote supervision.

Preferences for group arts therapies: a cross-sectional survey of mental health patients and the general population

OBJECTIVES

The arts therapies include music therapy, dance movement therapy, art therapy and dramatherapy. Preferences for art forms may play an important role in engagement with treatment. This survey was an initial exploration of who is interested in group arts therapies, what they would choose and why.

DESIGN

An online cross-sectional survey of demographics, interest in and preferences for the arts therapies was designed in collaboration with patients. The survey took 10 min to complete, including informed consent and 14 main questions. Summary statistics, multinomial logistic regression and thematic analysis were used to analyse the data.

SETTING

Thirteen National Health Service mental health trusts in the UK asked mental health patients and members of the general population to participate.

PARTICIPANTS

A total of 1541 participants completed the survey; 685 mental health patients and 856 members of the general population. All participants were over 18 years old, had capacity to give informed consent and sufficient understanding of English. Mental health patients had to be using secondary mental health services.

RESULTS

Approximately 60% of participants would be interested in taking part in group arts therapies. Music therapy was the most frequent choice among mental health patients (41%) and art therapy was the most frequent choice in the general population (43%). Past experience of arts therapies was the most important predictor of preference for that same modality. Expectations of enjoyment, helpfulness, feeling capable, impact on mood and social interaction were most often reported as reasons for preferring one form of arts therapy.

CONCLUSIONS

Large proportions of the participants expressed an interest in group arts therapies. This may justify the wide provision of arts therapies and the offer of more than one modality to interested patients. It also highlights key considerations for assessment of preferences in the arts therapies as part of shared decision-making.

Overcoming barriers to implementing ward-based psychosocial interventions in acute inpatient mental health settings: A meta-synthesis

BACKGROUND

The culture of acute mental health wards is often dominated by medical models of care despite some patient dissatisfaction with care in these settings and a demand for increased access to psychosocial interventions. Research has found that psychosocial interventions can improve a number of patient and staff outcomes, however, implementation within these settings is often challenging.

OBJECTIVES

The aim of this review was to provide a comprehensive synthesis of the barriers and facilitators to implementing psychosocial interventions on acute wards, in order to develop a list of recommendations for embedding psychosocial interventions within the ward culture in acute settings.

METHODS

Databases were systematically searched using search terms related to acute mental health wards and psychosocial intervention implementation from inception to December 2019. Thirty-nine studies (forty-three papers) that explored the implementation of psychosocial interventions on adult acute mental health wards using qualitative methods met inclusion criteria. Data relating to barriers and facilitators to implementing psychosocial interventions extracted from the results sections of the papers were synthesised using the COM-B model.

RESULTS AND CONCLUSIONS

We conclude that to address barriers to the implementation of psychosocial interventions, services should provide clear information to patients regarding the benefits of engagement, and additional training for staff. A shift in ward culture is required and can be achieved through the recruitment of empathic implementers, together with providing staff with protected time for delivery of psychosocial interventions with clear accountability for intervention delivery through the provision of clearly defined roles.