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Çitil ET, Canbay FÇ. The Effect of Art on Premenstrual Syndrome Symptoms: A Randomized Controlled Study. Holist Nurs Pract 2024:00004650-990000000-00025. [PMID: 39042713 DOI: 10.1097/hnp.0000000000000659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
Art-based interventions can serve as a complementary and alternative method in managing various illnesses. This study aimed to investigate the impact of art-based interventions on symptoms of Premenstrual Syndrome (PMS). This study was conducted between September and December 2022, involving 72 midwifery students with PMS (37 in the experimental group [EG] and 35 in the control group [CG]). Art-based interventions were applied to the EG weekly for 8 weeks, while the students in the CG continued with their usual coping habits. The data were collected using the Personal Information Form and the Premenstrual Syndrome Scale (PMSS). At the end of 8 weeks, both the EG and the CG were reassessed with the PMSS. The students who participated in the study were similar in terms of sociodemographic, obstetric, and medical characteristics (P > .05). Analysis of the difference between pre- and posttest measurements revealed that the PMSS scores of the EG significantly decreased (P = .000), whereas the PMSS scores of the CG did not improve (P = .000). The findings of the study demonstrate that art-based interventions had a therapeutic effect on PMS symptoms.
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Affiliation(s)
- Elif Tuğçe Çitil
- Author Affiliations: Department of Midwifery, Health Science Faculty, Kütahya Health Science University, Kütahya, Turkey (Dr Çitil); and Department of Midwifery, Health Science Faculty, Atatürk University, Erzurum, Turkey (Dr Canbay)
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Kırca AŞ, Dağlı E, Derin E, Aka N. The effect of mandala coloring on anxiety and quality of life of women in the climacteric period: a randomized controlled study. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2024; 70:e20240059. [PMID: 39045964 PMCID: PMC11288254 DOI: 10.1590/1806-9282.20240059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 02/12/2024] [Indexed: 07/25/2024]
Abstract
OBJECTIVE This study was conducted to determine the effect of mandala coloring on anxiety and quality of life of women in the climacteric period. METHODS This research was conducted as an experimental study based on a randomized controlled pre-test and post-test model (single-blind). The study was conducted with women in the climacteric period who presented to a training and research hospital in a western city of Turkey between November 1, 2022, and April 28, 2023. Participants were divided into mandala coloring (n=38) and control groups (n=38). RESULTS According to the women's socio-demographic and descriptive characteristics, mean age, body mass index, and frequency of menopausal symptoms were similar in both groups. The mean post-test scores of the women in the mandala coloring group on the state-trait anxiety inventory and menopause-specific quality of life questionnaire vasomotor, psychosocial, physical, and sexual subscales (29.71±5.22, 0.86±0.97, 0.53±0.61, 0.79±0.84, and 0.92±1.24, respectively) were lower than the mean post-test scores of the women in the control group on the same scales (41.02±1.20, 1.79±1.76, 1.49±1.39, 1.72±1.38, and 1.95±1.82, respectively) (p=0.000). CONCLUSION Mandala coloring reduces menopause-related anxiety levels and improves quality of life effectively.
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Affiliation(s)
- Ayça Şolt Kırca
- Kırklareli University, Faculty of Health Sciences, Department of Midwifery – Kırklareli, Turkey
| | - Elif Dağlı
- Çukurova University, Abdi Sütcü Vocational School of Health Services, Department of Health Care Services – Adana, Turkey
| | - Efsun Derin
- Kırklareli University, Faculty of Health Sciences, Department of Midwifery – Kırklareli, Turkey
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Luo X, Zhang A, Li Y, Zhang Z, Ying F, Lin R, Yang Q, Wang J, Huang G. Emergence of Artificial Intelligence Art Therapies (AIATs) in Mental Health Care: A Systematic Review. Int J Ment Health Nurs 2024. [PMID: 39020473 DOI: 10.1111/inm.13384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 05/26/2024] [Accepted: 06/11/2024] [Indexed: 07/19/2024]
Abstract
The application of artificial intelligence art therapies (AIATs) in mental health care represents an innovative merger between digital technology and the therapeutic potential of creative arts. This systematic review aimed to assess the effectiveness and ethical considerations of AIATs, incorporating robots, AI painting and AI Chatbots to augment traditional art therapies. Aligning with the Preferred Reporting Items for systematic reviews (PRISMA) guidelines, we meticulously searched PubMed, Cochrane Library, Web of Science and CNKI, resulting in 15 selected articles for detailed analysis. To ensure methodological quality, we applied the Joanna Briggs Institute (JBI) criteria for quality assessment and extracted data using the PICO(S) format, specifically targeting randomised controlled trials (RCTs). Our findings suggest that AIATs can profoundly enhance the therapeutic experience by providing new creative outlets and reinforcing existing methods, despite possible drawbacks and ethical challenges. This examination underscores AIATs' potential to enrich mental health therapies, emphasising the critical importance of ethical considerations and the responsible application of AI as the field evolves. With a focus on expanding treatment efficacy and patient expressiveness, the promise of AIATs in mental health care necessitates a careful balance between innovation and ethical responsibility. Trial Registration: PROSPERO: CRD42024504472.
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Affiliation(s)
- Xuexing Luo
- Faculty of Humanities and Arts, Macau University of Science and Technology, Taipa, Macau
| | - Aijia Zhang
- Faculty of Humanities and Arts, Macau University of Science and Technology, Taipa, Macau
| | - Yu Li
- State Key Laboratory of Quality Research in Chinese Medicines, Macau University of Science and Technology, Taipa, Macau
- Faculty of Chinese Medicine, Macau University of Science and Technology, Taipa, Macau
| | - Zheyu Zhang
- Faculty of Humanities and Arts, Macau University of Science and Technology, Taipa, Macau
| | - Fangtian Ying
- Faculty of Humanities and Arts, Macau University of Science and Technology, Taipa, Macau
- Zhejiang University, Hangzhou, China
| | - Runqing Lin
- Faculty of Humanities and Arts, Macau University of Science and Technology, Taipa, Macau
| | - Qianxu Yang
- Department of Social and Preventive Medicine, Faculty of Medicine, Centre for Epidemiology and Evidence-Based Practice, University of Malaya, Kuala Lumpur, Malaysia
| | - Jue Wang
- State Key Laboratory of Quality Research in Chinese Medicines, Macau University of Science and Technology, Taipa, Macau
- Faculty of Chinese Medicine, Macau University of Science and Technology, Taipa, Macau
- Guangdong-Hong Kong-Macao Joint Laboratory for Contaminants Exposure and Health, Guangzhou, China
| | - Guanghui Huang
- Faculty of Humanities and Arts, Macau University of Science and Technology, Taipa, Macau
- Zhuhai M.U.S.T. Science and Technology Research Institute, Macau University of Science and Technology, Taipa, Macau
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Zhang B, Wang J, Abdullah AB. The effects of art therapy interventions on anxiety in children and adolescents: A meta-analysis. Clinics (Sao Paulo) 2024; 79:100404. [PMID: 38936289 PMCID: PMC11260852 DOI: 10.1016/j.clinsp.2024.100404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 05/18/2024] [Indexed: 06/29/2024] Open
Abstract
OBJECTIVE This study aimed to assess the effects of art therapy on anxiety among children and adolescents. METHODS We searched several databases, including PubMed, Web of Science, Embase (via Ovid), PsychINFO (through EBSCO), and The Cochrane Library, comprising the Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials. Additionally, Chinese databases such as CNKI (China National Knowledge Infrastructure) and Wan Fang Data were explored from their beginnings until October 22, 2023. Studies that investigated the impact of art therapy on anxiety compared to a control group were included. The methodological quality of these randomized controlled trials was evaluated using the Cochrane Handbook's risk of bias instrument. RESULTS Six studies involving 422 participants were included. The findings indicated a notable decrease in anxiety symptoms due to art therapy, with a Standardized Mean Difference (SMD) of -1.42, 95% Confidence Interval (95%CI -2.33, -0.51), p < 0.002. Notably, there was pronounced heterogeneity, as evidenced by Tau2 = 1.41, Chi2 = 101.19, df = 6, and I² = 94%, with Z = 3.06. CONCLUSION Art therapy significantly improved the anxiety symptoms of children and adolescents, positioning it as an effective means of treating anxiety.
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Affiliation(s)
- Bo Zhang
- Guizhou Equipment Manufacturing Polytechnic, Guizhou, China; Universiti Utara Malaysia, Malaysia.
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Nasiri MA, Sajadi SA, Farsi Z, Heidarieh M. The effect of mandala coloring and free coloring on the happiness in veterans with post-traumatic stress disorder in the Covid-19 pandemic: a randomized clinical trial. BMC Psychiatry 2024; 24:467. [PMID: 38918742 PMCID: PMC11197346 DOI: 10.1186/s12888-024-05886-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 06/04/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) can lead to complications such as depression and grief, which are more prevalent in veterans than in the general population. Recently, art-making, including mandala coloring, has gained attention as a potential treatment for PTSD patients. METHODS This randomized clinical trial was conducted on 84 male veterans diagnosed with PTSD and hospitalized at the Milad Psychiatric Center in Tehran, Iran. The patients were recruited using a convenience sampling method and were assigned to either the mandala coloring group or the free coloring group. The Post-Traumatic Stress Disorder Checklist DSM-5 and the Oxford Happiness Scale were used to collect data. The intervention group colored mandala designs, while the control group colored squares freely. Coloring was done twice a week for three weeks. RESULTS The mean baseline happiness scores did not differ significantly between mandala coloring group and free coloring group (p = 0.376). However, at the end of study, happiness scores were significantly higher in mandala coloring group than in free coloring group (p < 0.001). After the intervention, happiness score of both groups increased significantly (p < 0.001). CONCLUSION Both coloring methods increased veterans' happiness scores; however, mandala coloring was more effective than free coloring. It is recommended that art-making be added to conventional treatments for veterans with PTSD. TRIAL REGISTRATION This study was registered in Iranian Registry of clinical trials (No. IRCT20210604051491N1, 29/08/2021).
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Affiliation(s)
- Mohammad-Amin Nasiri
- Medical Surgical Nursing Department, Nursing School, Aja University of Medical Sciences, Tehran, Iran
| | - Seyedeh Azam Sajadi
- Nursing Management Department, Nursing School, Aja University of Medical Sciences, Tehran, Iran.
| | - Zahra Farsi
- Medical-Surgical Nursing, Research and Ph.D. Nursing Departments, Nursing School, Aja University of Medical Sciences, Tehran, Iran
| | - Marzie Heidarieh
- MSc, Clinical Psychology, Psychology Department, Milad Hospital, Tehran, Iran
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Du SC, Li CY, Lo YY, Hu YH, Hsu CW, Cheng CY, Chen TT, Hung PH, Lin PY, Chen CR. Effects of Visual Art Therapy on Positive Symptoms, Negative Symptoms, and Emotions in Individuals with Schizophrenia: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2024; 12:1156. [PMID: 38891231 PMCID: PMC11171575 DOI: 10.3390/healthcare12111156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 06/01/2024] [Accepted: 06/05/2024] [Indexed: 06/21/2024] Open
Abstract
Schizophrenia is characterized by psychiatric symptoms and emotional issues. While pharmacological treatments have limitations, non-pharmacological interventions are essential. Art therapy has the potential to enhance emotional expression, communication, and health; however, the effectiveness of visual art therapy remains uncertain. This systematic review and meta-analysis synthesizes the findings of randomized controlled trials (RCTs) of visual art therapy on positive symptoms, negative symptoms, and emotions in patients with schizophrenia. This study reviews RCTs published prior to February, 2024. The PubMed, Embase, Cochrane Library, CEPS, CNKI, Wanfang, and Yiigle databases were searched, and three independent researchers screened the studies. In this meta-analysis, standardized mean difference (SMD) was employed as a measure to calculate effect sizes for continuous variables using a random effects model, while the meta-regression and subgroup analyses were performed with patient and intervention characteristics. A total of 31 studies revealed visual art therapy had a significant small-to-moderate effect on positive symptoms (SMD = 0.407, 95% CI 0.233 to 0.581), a moderate effect on negative symptoms (SMD = 0.697, 95% CI 0.514 to 0.880), a moderate effect on depression (SMD = 0.610, 95% CI 0.398 to 0.821), and a large effect on anxiety (SMD = 0.909, 95% CI 0.386 to 1.433). The subgroup analysis revealed painting and handcrafts had significant effects on positive symptoms, negative symptoms, and emotions. Combined Chinese calligraphy and painting had significant effects on positive symptoms, depression, and anxiety. Better improvement was noted among the Asian population, and a longer weekly treatment duration was associated with better improvement in positive symptoms. Female participants tended to have more improvements in negative symptoms and anxiety through visual art therapy. The results indicate that visual art therapy has positive effects on the psychiatric symptoms and emotions of individuals with schizophrenia. We recommend future research further investigate art therapy modalities and durations.
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Affiliation(s)
- Shih-Cing Du
- Department of Occupational Therapy and Graduate Institute of Behavioral Science, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan;
| | - Chih-Yen Li
- Department of Occupational Therapy, Shu-Zen Junior College of Medicine and Management, Kaohsiung 821004, Taiwan; (C.-Y.L.); (Y.-Y.L.); (Y.-H.H.); (T.-T.C.); (P.-H.H.)
| | - Ya-Yun Lo
- Department of Occupational Therapy, Shu-Zen Junior College of Medicine and Management, Kaohsiung 821004, Taiwan; (C.-Y.L.); (Y.-Y.L.); (Y.-H.H.); (T.-T.C.); (P.-H.H.)
| | - Yu-Hsuan Hu
- Department of Occupational Therapy, Shu-Zen Junior College of Medicine and Management, Kaohsiung 821004, Taiwan; (C.-Y.L.); (Y.-Y.L.); (Y.-H.H.); (T.-T.C.); (P.-H.H.)
| | - Chi-Wei Hsu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833401, Taiwan; (C.-W.H.); (C.-Y.C.); (P.-Y.L.)
| | - Chung-Yin Cheng
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833401, Taiwan; (C.-W.H.); (C.-Y.C.); (P.-Y.L.)
| | - Tzu-Ting Chen
- Department of Occupational Therapy, Shu-Zen Junior College of Medicine and Management, Kaohsiung 821004, Taiwan; (C.-Y.L.); (Y.-Y.L.); (Y.-H.H.); (T.-T.C.); (P.-H.H.)
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833401, Taiwan; (C.-W.H.); (C.-Y.C.); (P.-Y.L.)
| | - Pei-Hsuan Hung
- Department of Occupational Therapy, Shu-Zen Junior College of Medicine and Management, Kaohsiung 821004, Taiwan; (C.-Y.L.); (Y.-Y.L.); (Y.-H.H.); (T.-T.C.); (P.-H.H.)
| | - Pao-Yen Lin
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833401, Taiwan; (C.-W.H.); (C.-Y.C.); (P.-Y.L.)
| | - Chyi-Rong Chen
- Department of Occupational Therapy, Shu-Zen Junior College of Medicine and Management, Kaohsiung 821004, Taiwan; (C.-Y.L.); (Y.-Y.L.); (Y.-H.H.); (T.-T.C.); (P.-H.H.)
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833401, Taiwan; (C.-W.H.); (C.-Y.C.); (P.-Y.L.)
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Iizuka A, Ura C, Yamashita M, Ito K, Yamashiro M, Okamura T. "GO" to move toward dementia-friendly communities: A pilot study. Brain Behav 2024; 14:e3581. [PMID: 38849985 PMCID: PMC11161391 DOI: 10.1002/brb3.3581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 04/25/2024] [Accepted: 05/19/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND To the creation of mutual aid relationships among people with cognitive decline is important in aging societies. This study aimed to develop and examine the feasibility of a GO Program in which older adults, with experience in playing GO, support the learning of GO by older adults with cognitive decline and other barriers to social participation, which in turn reduces social isolation and creates opportunities for older adults to use their role. METHODS This single-arm intervention study was conducted in Tokyo, Japan. Introductory GO classes were held for 10 participants who had never played GO (beginners) and 10 participants who had (supporters) once a week for an hour, for a total of 12 sessions. Supporters and beginners were paired to solve problems and play games. We assessed the feasibility of the program and its effects on mental health social network, and cognitive function. RESULTS Cognitive test scores were at the mild cognitive Impairment level for beginners as well as for supporters. Satisfaction with the program was high, with an overall class attendance rate of 99.1% and none leaving the program. No significant changes were observed over time for beginners in each measurement; however, there was a significant improvement in the Mini Mental State Examination-Japanese scores for supporters (p < .05). CONCLUSIONS The results suggest that this program could contribute to the creation of mutual aid relationships among older adults with cognitive decline; even if they have mildly declined cognitive function, they can still play an active role in society. Moreover, creating such opportunities may positively impact cognitive function.
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Affiliation(s)
- Ai Iizuka
- Research Team for Social Participation and Healthy Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi-ku, Tokyo, Japan
| | - Chiaki Ura
- Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi-ku, Tokyo, Japan
| | - Mari Yamashita
- Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi-ku, Tokyo, Japan
| | - Koki Ito
- Research Team for Social Participation and Healthy Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi-ku, Tokyo, Japan
| | - Miyuko Yamashiro
- Research Team for Social Participation and Healthy Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi-ku, Tokyo, Japan
| | - Tsuyoshi Okamura
- Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi-ku, Tokyo, Japan
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Pedra Cruz Bettin B, Urquiza Nogueira L, Bertasso de Araujo PA, Antunes LC. Visual art- and music-based interventions as adjuvants in the treatment of eating disorders: a systematic review and a theoretical model. Arts Health 2024; 16:167-188. [PMID: 37259246 DOI: 10.1080/17533015.2023.2218408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 05/13/2023] [Indexed: 06/02/2023]
Abstract
AIM To assess the effect of visual art- and music-based interventions in the treatment of eating disorders. METHODS This study was registered in PROSPERO (CRD42020161503). Six databases (CINAHL, EMBASE, Lilacs, PsycINFO, PubMed and The Cochrane Library) were consulted. The searches were performed on 19 June 2019, and updated on 18 March 2022. No restriction on language, date, or publication status was applied. Methodological quality was assessed using Joanna Briggs Institute's instruments. All steps were performed by two independent reviewers and a third participated in the event of disagreement. RESULTS Eight studies were included. Few statistically significant results were found. Overall, both interventions might help to reduce negative emotional states. CONCLUSION Visual art- and music-based interventions present limited and inconclusive scientific evidence in patients with eating disorders and therefore their effectiveness is currently unknown. A theoretical model is proposed to guide future research. Further studies are needed to clarify their clinical relevance.
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Affiliation(s)
- Bibiana Pedra Cruz Bettin
- Multiprofessional Residency in Family Health, University of Santa Catarina State, Florianópolis, SC, Brazil
| | - Lauriana Urquiza Nogueira
- Multiprofessional Residency in Family Health, University of Santa Catarina State, Florianópolis, SC, Brazil
| | | | - Luciana C Antunes
- Health Sciences Center, Department of Nutrition, Clinical Nutrition Division, Federal University of Santa Catarina, SC, Brazil
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Malhotra B, Jones LC, Spooner H, Levy C, Kaimal G, Williamson JB. A conceptual framework for a neurophysiological basis of art therapy for PTSD. Front Hum Neurosci 2024; 18:1351757. [PMID: 38711802 PMCID: PMC11073815 DOI: 10.3389/fnhum.2024.1351757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 03/28/2024] [Indexed: 05/08/2024] Open
Abstract
Post-traumatic stress disorder (PTSD) is a heterogeneous condition that affects many civilians and military service members. Lack of engagement, high dropout rate, and variable response to psychotherapy necessitates more compelling and accessible treatment options that are based on sound neuroscientific evidence-informed decision-making. Art therapy incorporates elements proven to be effective in psychotherapy, such as exposure, making it a potentially valuable treatment option. This conceptual paper aims to inform the neurophysiological rationale for the use of art therapy as a therapeutic approach for individuals with PTSD. A narrative synthesis was conducted using literature review of empirical research on the neurophysiological effects of art therapy, with supporting literature on neuroaesthetics and psychotherapies to identify art therapy factors most pertinent for PTSD. Findings were synthesized through a proposed framework based on the triple network model considering the network-based dysfunctions due to PTSD. Art therapy's active components, such as concretization and metaphor, active art engagement, emotion processing and regulation, perspective taking and reframing, and therapeutic alliance, may improve symptoms of PTSD and prompt adaptive brain functioning. Given the scarcity of rigorous studies on art therapy's effectiveness and mechanisms of alleviating PTSD symptoms, the suggested framework offers a neurophysiological rationale and a future research agenda to investigate the impact of art therapy as a therapeutic approach for individuals with PTSD.
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Affiliation(s)
- Bani Malhotra
- Department of Creative Arts Therapies, Drexel University, Philadelphia, PA, United States
| | - Laura C. Jones
- Brain Rehabilitation Research Center, North Florida/South Georgia Veterans Affairs Medical Center, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Heather Spooner
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. in support of Creative Forces: NEA Military Healing Arts Network, Bethesda, MD, United States
- Center of Arts in Medicine, University of Florida, Gainesville, FL, United States
| | - Charles Levy
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. in support of Creative Forces: NEA Military Healing Arts Network, Bethesda, MD, United States
| | - Girija Kaimal
- Department of Creative Arts Therapies, Drexel University, Philadelphia, PA, United States
| | - John B. Williamson
- Brain Rehabilitation Research Center, North Florida/South Georgia Veterans Affairs Medical Center, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
- Center for OCD, Anxiety and Related Disorders, Department of Psychiatry, University of Florida, Gainesville, FL, United States
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Morales-Alonso A, Iglesias-de-la-Iglesia Á, Alonso-Maza M. A nursing intervention based on the Zentangle® method: Experiences of patients diagnosed with borderline personality disorder. Int J Nurs Sci 2024; 11:205-213. [PMID: 38707684 PMCID: PMC11064625 DOI: 10.1016/j.ijnss.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 02/29/2024] [Accepted: 03/06/2024] [Indexed: 05/07/2024] Open
Abstract
Objective The application of the Zentangle® Method in relation to relaxation and well-being has not been tested in patients with borderline personality disorder (BPD). This study was to analyze the practising Zentangle® experience in patients with BPD. Methods With a phenomenological interpretative approach, this qualitative study conducted semi-structured interviews with patients who participated in a 6-session Zentangle® program accomplished monthly over six months in a Personality Disorders Unit. A total of 15 patients were interviewed for this study. Smith, Flowers & Larkin method was applied for evaluation in the data analysis. Results Based on our findings, three categories were extracted: As you sow, so shall you reap (participants reported improvements in concentration, relaxation, interpersonal relationships, and interaction with their environment as well as positive experiences toward acceptance and change); Many hands make light work (patients admitted feeling better in a group and developed group membership. They described how a group environment influences individual behavior); Drawing your own path (this method provides a medium for self-expression and self-knowledge through drawing, improving well-being through emotional expression, enhancing creativity, and increasing self-confidence). Conclusions By practicing Zentangle®, patients achieve behavioral responses such as flexibility and adaptability, reaching greater emotional well-being through anxiety management, impulse control, learning to cope with problems, or improving self-esteem or concentration. Mental health nursing plays a critical active role in the comprehensive treatment of BPD, as well as the mobilization and coordination of complementary and diverse interventions.
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Affiliation(s)
- Ana Morales-Alonso
- Dr. Rodríguez Lafora Hospital (Hospital Dr. Rodríguez Lafora), Madrid, Spain
| | | | - Miriam Alonso-Maza
- Dr. Rodríguez Lafora Hospital (Hospital Dr. Rodríguez Lafora), Madrid, Spain
- Department of Nursing and Stomatology, University Rey Juan Carlos, Alcorcón, Madrid, Spain
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Aughterson H, Fancourt D, Chatterjee H, Burton A. Social prescribing for individuals with mental health problems: An ethnographic study exploring the mechanisms of action through which community groups support psychosocial well-being. Wellcome Open Res 2024; 9:149. [PMID: 38952567 PMCID: PMC11216282 DOI: 10.12688/wellcomeopenres.20981.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2024] [Indexed: 07/03/2024] Open
Abstract
Background Social prescribing involves connecting individuals to community groups and activities, often to support their mental health and well-being. It has received increasing support in recent years across the NHS. There is a strong evidence base for the benefits of different types of community activities, including exercise groups, arts groups and nature interventions, on mental health outcomes, however, less is known about how these groups impact mental health and well-being. This study explores through what individual-level mechanisms (the 'how') these groups support psychosocial well-being. Methods An ethnographic study was conducted over 12-months to explore key shared, individual-level mechanisms across 4 social prescribing community groups: football, singing, gardening and reading. This study focused mostly on those with severe mental illness, whereas previously most social prescribing studies have focused on mild to moderate mental health problems. To frame the findings, a 'multi-level theoretical framework of mechanisms of action' of leisure activities was used. Results Key shared psychological mechanisms were: increased self-confidence and self-esteem, increased purpose/meaning, increased sense of achievement, experience of pleasure; social mechanisms included: increased social support, formation of friendships and reduced loneliness, enhanced sense of community and belonging; behavioural mechanisms were: increased independence and openness to experience, reduction in addictive behaviours and building healthier habits, increased work-seeking behaviour, and provision of structure & routine. Conclusions It is hoped that the findings of this study can help referring professionals increase their understanding of exactly how such groups support individuals' mental health, thus enhancing referring practices.
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Affiliation(s)
- Henry Aughterson
- Behavioral Science and Health, University College London, London, England, UK
| | - Daisy Fancourt
- Behavioral Science and Health, University College London, London, England, UK
| | - Helen Chatterjee
- Behavioral Science and Health, University College London, London, England, UK
| | - Alexandra Burton
- Behavioral Science and Health, University College London, London, England, UK
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Karakaya Çataldaş S, Kutlu FY, Eren N. The effects of online art therapy on ego functions, emotion regulation, and interpersonal relationship styles in neurotic personality organization. Arch Psychiatr Nurs 2024; 48:74-84. [PMID: 38453286 DOI: 10.1016/j.apnu.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 08/31/2023] [Accepted: 12/31/2023] [Indexed: 03/09/2024]
Abstract
Art therapy, as an effective therapeutic intervention, is used to improve positive self-image and self-awareness, promote insight, and enhance therapeutic communication. This study aimed to evaluate the efficacy of art psychotherapy on ego functions, emotion regulation, and interpersonal relationship styles of individuals with neurotic personality organization. Using a quasi-experimental pretest-posttest design, 60 participants were assigned to intervention and control groups, each further divided into three subgroups (n = 10 per subgroup). The intervention group engaged in online art therapy sessions twice weekly over nine weeks, while the control group received no intervention. Data analysis involved descriptive statistics, paired samples t-tests, and independent t-tests. There was a significant decrease in the intervention group's judgmental subdimensions of the Ego Function Assessment Scale. A significant decrease was found in the intervention group in "awareness" (p < 0.01), "clarity" (p < 0.05), and "impulse" (p < 0.001) subdimensions and total scores of the Difficulties in Emotion Regulation Scale. There was no statistical difference between the intervention and control groups' mean pretests and posttests and comparing those groups with each other concerning IRSQ scores. The online group art therapy led to successful improvements in participants' ego functions and emotion regulations.
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Affiliation(s)
| | - Fatma Yasemin Kutlu
- Department of Mental Health Psychiatric Nursing, Florence Nightingale Faculty Of Nursing, Istanbul University-Cerrahpasa, Istanbul, Türkiye
| | - Nurhan Eren
- Department of Mental Health and Diseases, Internal Medical Sciences, Faculty of Medicine, Istanbul University, Istanbul, Turkey
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13
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Şolt Kırca A, Dağlı E. The effect of mandala coloring on pregnancy-related anxiety. Eur J Obstet Gynecol Reprod Biol 2024; 292:251-258. [PMID: 38056411 DOI: 10.1016/j.ejogrb.2023.11.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/24/2023] [Accepted: 11/26/2023] [Indexed: 12/08/2023]
Abstract
PURPOSE In the literature, the efficacy of mandala coloring on pregnancy-related anxiety has been investigated, and no study has been found on its effect on anxiety. This randomized controlled trial was designed to assess the efficacy of mandala coloring application on pregnancy-related anxiety. METHODS The study included 77 primiparous pregnant women: 39 in the control group and 38 in the experimental group, and was carried out in an education-research hospital's obstetric clinic. Data for the study were gathered using Information Form, the Pregnancy-related Anxiety Scale, and the State Anxiety Inventory. While the experimental group did mandala coloring during a month twice in a week, and the control group was not do anything. The "Pregnancy-related Anxiety Scale" and "The State Anxiety Inventor" were used to assess anxiety in all groups before and after application. In the statistical analysis of the data, the SPSS 23.0 package program was used. In all tests, p < 0.005 was considered statistically significant. RESULTS Immediately post-intervention, the women in the experimental group had a significantly higher reduce pregnancy-related anxiety (p < 0.05). Especially in the mandala group within according to control group were found to have significantly reduced anxiety the application (PrAS-1 82,50 ± 2,47 vs. 84,41 ± 4,12; PrAS-2 77,92 ± 2,16 vs. 83,89 ± 3,80; PrAS-3 72,05 ± 3,97 vs. 84,10 ± 4,35; PrAS-Total 77,49 ± 5,21 vs. 84,13 ± 4,07; STAI-1 52,39 ± 2,50 vs. 51,17 ± 1,16; STAI-2 49,73 ± 0,75 vs. 49,05 ± 1,27; STAI-3 48,84 ± 3,17 vs. 49,02 ± 1,22; STAI-Total 50,32 ± 2,8 vs. 49,75 ± 1,58). CONCLUSIONS Mandala coloring is effective in reducing pregnancy-related anxiety. CLINICAL TRIAL NUMBER (NCT05534867).
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Affiliation(s)
- Ayça Şolt Kırca
- Kirklareli University School of Health Science, Midwifery Department Kirklareli, Turkey.
| | - Elif Dağlı
- Cukurova University, ABDI SÜTCÜ Vocational High School, Adana, Turkey
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14
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Le Rhun A, Caillet P, Lebeaupin M, Duval M, Guilmault L, Anthoine E, Borghi G, Leclère B, Moret L. Mind-body and art therapies impact on emotional regulation in patients with chronic diseases: a pragmatic mixed-methods randomized controlled trial. BMC Complement Med Ther 2023; 23:344. [PMID: 37770881 PMCID: PMC10536705 DOI: 10.1186/s12906-023-04173-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 09/17/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Effective emotional regulation is recognized as essential to a good mental health of people with chronic diseases, and Mind-body and Art Therapies (MBATs) could have a positive effect on emotional regulation skills in this population. Thus, we aimed to evaluate the effect of MBATs on emotional regulation as measured by the Difficulties in Emotion Regulation Scale (DERS) questionnaire. METHODS A convergent mixed approach nested in a pragmatic superiority two arms parallel randomized controlled trial was conducted. French speaking adults with one or more chronic somatic illnesses and not suffering from a chronic psychiatric disorder unrelated to one of their chronic somatic illness were included. At inclusion, non-directive interviews were conducted, followed by an initial DERS assessment. The same combination of evaluation was implemented after 6 months of activity (T1). After inclusion, each participant was randomized within either the intervention group (G1) or the control group (G2) following a controlled wait-list design by use of a pregenerated randomization list. Staff and patient were blinded to this list until the initial evaluation was completed, after which the trial was conducted in an open-label fashion. Participants chose 2 mediations: one creativity-focused (art-therapy, writing workshop, theatre of life, vocal workshop) and one mind-body-focused (mindfulness meditation, Pilates, shiatsu, ayurvedic massages). G1 started their mediations immediately after inclusion, while G2 started 6 months later. Primary outcome was the change in means at 6 months in the overall DERS score compared between each group. Non-directive interviews were carried out at the inclusion and after 6 months of MBATs. A continuous inductive analysis was carried out on gathered material in G1 to explore the participants' experiences regarding their disease and their perceived changes associated to the intervention. RESULTS A total of 150 patients was randomized (75 per groups) at the end of the study. At T1, 133 patients filled out the final questionnaire (67 in G1 vs 66 in G2) and 112 interviews were analysed (54 in G1 vs 58 in G2). All 150 patients were analysed (intention to treat) using a multiple imputation approach. The mean DERS score at T0 was equal to 82.8 ± 21.1 and 85.0 ± 20.2 in G1 and G2 respectively. On average, at T1, the score decreased in the G1 (Δ = -4.8, SD = 21.3) and in G2 (Δ = -0.11, SD = 17.8). The difference in decrease, however, was not statistically significant (p = 0.13). Qualitative analysis underlined some MBATs benefits on emotional regulation, especially on regulation strategies. No harms related to the intervention has been observed. CONCLUSIONS This study only partially supports benefits on MBAT on emotional regulation skills enhancement in patients with chronic disease receiving MBATs, as measured by the DERS scale. TRIAL REGISTRATION The protocol was registered on Clinical Trials (NCT02911207).
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Affiliation(s)
- A Le Rhun
- Nantes Université, CHU Nantes, Service de Santé Publique, 44000, Nantes, France
| | - P Caillet
- Nantes Université, CHU Nantes, Service de Santé Publique, 44000, Nantes, France
| | - M Lebeaupin
- Nantes Université, CHU Nantes, Service de Santé Publique, 44000, Nantes, France
| | - M Duval
- Nantes Université, CHU Nantes, Service de Santé Publique, 44000, Nantes, France
| | - L Guilmault
- Nantes Université, CHU Nantes, Service de Santé Publique, 44000, Nantes, France
| | - E Anthoine
- Nantes Université, CHU Nantes, Service de Santé Publique, 44000, Nantes, France
| | - G Borghi
- Nantes Université, CHU Nantes, Service de Santé Publique, 44000, Nantes, France
| | - B Leclère
- Nantes Université, CHU Nantes, Service de Santé Publique, 44000, Nantes, France
| | - L Moret
- Nantes Université, CHU Nantes, Service de Santé Publique, 44000, Nantes, France.
- Nantes Université, CHU Nantes, INSERM, MethodS in Patients-Centered Outcomes and HEalth Research, SPHERE, 44000, Nantes, France.
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15
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Zubala A, Kennell N, MacInnes C, MacInnes M, Malcolm M. Online art therapy pilot in the Western Isles of Scotland: a feasibility and acceptability study of a novel service in a rural community. Front Psychiatry 2023; 14:1193445. [PMID: 37283707 PMCID: PMC10241303 DOI: 10.3389/fpsyt.2023.1193445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 04/27/2023] [Indexed: 06/08/2023] Open
Abstract
Introduction Art therapy, despite being an evidence-based, safe and acceptable intervention, is not widely available to clients in Scotland. Online delivery has the potential to expand the reach and accessibility, but special considerations need to be given to designing successful online art therapy services, due to the unique emphasis on the role of an image and artmaking alongside the therapeutic relationship. Methods A pilot online art therapy service was developed and delivered in the Western Isles of Scotland to individual adult clients wishing to increase their psychological wellbeing. This research aimed to assess feasibility and acceptability of the novel service, identify enablers and challenges in setting up and delivering the service, explore participants' expectations and experiences of art therapy and identify any impacts of the service. Mixed-method evaluation incorporated questionnaires, focus groups, interviews and Audio Image Recordings (AIRs). Findings were grouped into themes across several key areas: service setup, research procedures, intervention design and impacts and insights. Recommendations were developed for the first three areas and the last section presents indications of change and gives voice to client experience primarily. Results Online art therapy was described by clients as a judgement-free zone which allowed freedom to experiment, express, feel and immerse themselves in the creative flow. Other benefits included readiness to accept emotions, increased understanding of self and others and being able to see things from a new perspective. Clients recognised the unique nature of art therapy in relation to other psychological treatments and valued the freedom of expression it offered, including the non-verbal. Discussion This project demonstrated that online art therapy is not only a feasible an acceptable intervention, but potentially also a powerfully impactful one, capable of instilling a positive change in a surprisingly short period of time. Exploring ways to expand current and introduce new art therapy services is highly recommended. Refinement of an intervention design, tools and research procedures is recommended through further feasibility studies of a larger scale.
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Affiliation(s)
- Ania Zubala
- Institute of Health Research and Innovation, University of the Highlands and Islands, Inverness, United Kingdom
| | - Nicola Kennell
- Research and Development, Green Tree Arts, Kinbrace, United Kingdom
| | - Catriona MacInnes
- Institute of Health Research and Innovation, University of the Highlands and Islands, Inverness, United Kingdom
| | - Marion MacInnes
- Research and Innovation, NHS Western Isles, Stornoway, United Kingdom
| | - Martin Malcolm
- Research and Innovation, NHS Western Isles, Stornoway, United Kingdom
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Cheshure A, Van Lith T. A qualitative inquiry comparing mindfulness-based art therapy, mindfulness and neutral clay tasks as a proactive mental health solution for college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-11. [PMID: 36595633 DOI: 10.1080/07448481.2022.2155462] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 09/26/2022] [Accepted: 10/12/2022] [Indexed: 06/17/2023]
Abstract
Objective: The purpose of this study was to examine how college students perceive and manage stress and anxiety in the university setting and explain their perceptions of the effects of MBAT, NCT, and MO on stress, anxiety, and general student functioning. Participants: 58 undergraduate college students participated in post-test interviews following their engagement in either mindfulness-based art therapy (MBAT), a neutral clay task (NCT) or mindfulness only (MO) interventions using a 5-week online format. Methods: Magnitude coding was used to describe participant's perspectives. Results: Many themes emerged including habitual creative practice, prioritizing time for the self, enjoyable/relaxing activity, learning new techniques, understanding of processing and developing self-insight. Themes in the NCT group were more surface level observations, whereas MBAT, and to a lesser extent, MO groups contained an element of deeper understanding and processing. Conclusions: These findings offer support for implementing online and accessible mental health strategies as a gateway to traditional therapies in college settings.
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Affiliation(s)
- Andrea Cheshure
- Center for Translational Behavioral Science, Florida State University, Tallahassee, Florida, USA
| | - Theresa Van Lith
- Department of Psychology, Counselling, and Therapy, La Trobe University, Melbourne, Australia
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Tesfaye R, Courchesne V, Mirenda P, Mitchell W, Nicholas D, Singh I, Zwaigenbaum L, Elsabbagh M. Autism voices: Perspectives of the needs, challenges, and hopes for the future of autistic youth. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 27:1142-1156. [PMID: 36329663 DOI: 10.1177/13623613221132108] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The Autism Voices study draws on novel inclusive methods to obtain the first-person experiences of autistic youth with a range of cognitive and verbal abilities. Thirty-one autistic youth were interviewed with a strength-based protocol, enabling them to provide responses in the modality of their choice. Dynamics between youth and their environments such as home, school, and community were explored. Youth were questioned about their interests, plans for the future, experiences with various emotions, and experience of autism. Based on a thematic analysis, six themes emerged: (1) autistic identities, (2) thinking about the future, (3) seeking social connection on their own terms, (4) seeking autonomy, (5) school as both a stressor and social facilitator, and (6) experiences of stress and anxiety. The experiences described by autistic youth parallel many of the aspirations and challenges of typically developing adolescents, while being uniquely shaped by their autism. We discuss how these insights shared by autistic youth can facilitate active involvement in their communities, promote well-being, and promote optimal transition into adulthood. Autism Voices demonstrates that partnering with multiple stakeholders and the use of inclusive methodologies are pivotal steps toward capturing the voices of all autistic youth. Lay abstract Currently, our understanding of the adolescent period for autistic youth has relied on the expertise of researchers, clinicians, parents, and teachers, yet rarely involves their unique first-person experiences. Our study attempted to understand the experiences and perspectives of autistic adolescents in their home, school, and community environments using the Autism Voices protocol, a semi-structured interview specifically designed and tailored to engage with autistic youth with various language and intellectual levels. The analysis of the 31 interviews conducted with autistic adolescents aged 11–18 years highlighted six themes: (1) autistic identities, (2) thinking about the future, (3) seeking social connection on their own terms, (4) seeking autonomy, (5) school as both a stressor and social facilitator, and (6) experiences of stress and anxiety. These results highlight similarities and differences in the adolescent experiences of autistic youth compared to their typically developing peers. Our findings suggest that by removing assumptions about the experiences of autistic individuals and investing in inclusive interview methods, we can faithfully capture the experiences of autistic youth regardless of their communication and cognitive abilities. Being able to capture and amplify these diverse voices will facilitate the active involvement of autistic communities in research and clinical and policy decisions that impact them.
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18
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Gutterman D, Aafjes Van-Doorn K. An Exploration of the Intersection Between Creativity and Psychotherapy. CREATIVITY RESEARCH JOURNAL 2022. [DOI: 10.1080/10400419.2022.2127566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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19
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The Psychological Recovery of Patients in the Context of Virtual Reality Application by a Complementary Medicine Scheme Based on Visual Art. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:7358597. [PMID: 36193137 PMCID: PMC9526666 DOI: 10.1155/2022/7358597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/09/2022] [Accepted: 08/16/2022] [Indexed: 11/30/2022]
Abstract
Expressive art therapy, which originated from art therapy, uses visual art as a carrier and plays a complementary role in clinical medicine and psychological medicine in the healing process of mentally ill patients. With the rapid development of science and technology, expressive art therapy has also entered the field of technology-oriented virtual reality. This study aims to summarize the clinical psychology research of expressive art therapy based on virtual reality, to review the current state of the field, in order to provide detailed scientific research evidence summary for relevant content and complete knowledge reserve.
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20
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Odeh R, Diehl ERM, Nixon SJ, Tisher CC, Klempner D, Sonke JK, Colquhoun TA, Li Q, Espinosa M, Perdomo D, Rosario K, Terzi H, Guy CL. A pilot randomized controlled trial of group-based indoor gardening and art activities demonstrates therapeutic benefits to healthy women. PLoS One 2022; 17:e0269248. [PMID: 35793277 PMCID: PMC9258874 DOI: 10.1371/journal.pone.0269248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 05/10/2022] [Indexed: 11/18/2022] Open
Abstract
Background
There is mounting anecdotal and empirical evidence that gardening and art-making afford therapeutic benefits.
Objectives
This randomly controlled pilot study tested the hypothesis that participation in group-based indoor gardening or art-making activities for one hour twice a week for four weeks would provide quantifiably different therapeutic benefits to a population of healthy women ages 26–49.
Methods
A population of 42 volunteers was randomly assigned to parallel gardening or art-making treatment groups. A total of 36 participants initiated the treatment protocol and 32 (Gardening n = 15 and Art n = 17) received the interventions and completed all assessments. Treatments included eight one-hour group-based gardening or art intervention sessions. Self-report psychometric assessments were conducted for anxiety, depression symptomatology, mood disturbance, stress, satisfaction with discretionary social activities, and quality of life measures. Cardiac physiological data were also collected. Outcomes were measured at baseline, during, and post-intervention.
Results
Engaging in both gardening and art-making activities resulted in apparent therapeutic improvements for self-reported total mood disturbance, depression symptomatology, and perceived stress with different effect sizes following eight one-hour treatment sessions. Gardening also resulted in improvements for indications of trait anxiety. Based on time-course evidence, dosage responses were observed for total mood disturbance, perceived stress, and depression symptomatology for both gardening and art-making. However, gardening or art-making did not have an apparent influence on heart rate or blood pressure or result in marked improvement for satisfaction with discretionary leisure activities.
Conclusion
The data did not support the hypothesis of differential therapeutic benefits of gardening and art-making for healthy women. When taken together, group-based gardening or art-making can provide quantitatively measurable improvements in healthy women’s psychosocial health status that imply potentially important public health benefits.
Trial registration
ClinicalTrials.gov NCT03266120.
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Affiliation(s)
- Raymond Odeh
- Department of Environmental Horticulture, University of Florida, Gainesville, Florida, United States of America
| | - Elizabeth R. M. Diehl
- Wilmot Botanical Gardens, University of Florida, Gainesville, Florida, United States of America
| | - Sara Jo Nixon
- Department of Psychiatry, University of Florida, Gainesville, Florida, United States of America
| | - C. Craig Tisher
- Wilmot Botanical Gardens, University of Florida, Gainesville, Florida, United States of America
| | - Dylan Klempner
- Center for Arts in Medicine, University of Florida, Gainesville, Florida, United States of America
| | - Jill K. Sonke
- Center for Arts in Medicine, University of Florida, Gainesville, Florida, United States of America
| | - Thomas A. Colquhoun
- Department of Environmental Horticulture, University of Florida, Gainesville, Florida, United States of America
| | - Qian Li
- Health Outcomes & Biomedical Informatics, University of Florida, Gainesville, Florida, United States of America
| | - Maria Espinosa
- Department of Environmental Horticulture, University of Florida, Gainesville, Florida, United States of America
| | - Dianela Perdomo
- Department of Environmental Horticulture, University of Florida, Gainesville, Florida, United States of America
| | - Kaylee Rosario
- Department of Environmental Horticulture, University of Florida, Gainesville, Florida, United States of America
| | - Hannah Terzi
- Department of Environmental Horticulture, University of Florida, Gainesville, Florida, United States of America
| | - Charles L. Guy
- Department of Environmental Horticulture, University of Florida, Gainesville, Florida, United States of America
- * E-mail:
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Annous N, Al-Hroub A, El Zein F. A Systematic Review of Empirical Evidence on Art Therapy With Traumatized Refugee Children and Youth. Front Psychol 2022; 13:811515. [PMID: 35707659 PMCID: PMC9189733 DOI: 10.3389/fpsyg.2022.811515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 04/14/2022] [Indexed: 11/13/2022] Open
Abstract
The current global refugee crisis revealed that refugee children, youth, and adults are uniquely vulnerable to traumatic events. Yet, there are only a few studies available that report robust systematic data on art therapy interventions with mental health in recent refugee populations. The purpose of the study is to synthesize and evaluate (a) the available research evidence on the use of art therapy in reducing post-traumatic stress disorder (PTSD) levels in refugees, and (b) the quality of empirical evidence for each of the reviewed studies. The authors adopted the Council for Exceptional Children (CEC) evidence-based practice (EBP) standards and quality indicators to evaluate the methodological soundness of the reviewed studies and the evidence-based classification of art therapy as a treatment intervention. We systematically searched electronic databases of pertinent review articles for the period from 2010 to 2020 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Systematic searches identified 70 research articles but yielded eight eligible journals as per the inclusion criteria. Results indicated that, though considered a promising treatment approach, art therapy is presently classified as an intervention that falls under the category of practice with insufficient evidence. The findings suggest the need for further methodologically sound experimental studies to strengthen the evidence behind art therapy as an intervention to reduce PTSD symptoms in refugees around the world.
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Affiliation(s)
| | - Anies Al-Hroub
- American University of Beirut, Beirut, Lebanon
- *Correspondence: Anies Al-Hroub
| | - Farah El Zein
- Emirates College for Advanced Education, Abu Dhabi, United Arab Emirates
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22
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Joschko R, Roll S, Willich SN, Berghöfer A. The effect of active visual art therapy on health outcomes: protocol of a systematic review of randomised controlled trials. Syst Rev 2022; 11:96. [PMID: 35578277 PMCID: PMC9109400 DOI: 10.1186/s13643-022-01976-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Art therapy is a form of complementary therapy to treat a wide variety of health problems. Existing studies examining the effects of art therapy differ substantially regarding content and setting of the intervention, as well as their included populations, outcomes, and methodology. The aim of this review is to evaluate the overall effectiveness of active visual art therapy, used across different treatment indications and settings, on various patient outcomes. METHODS We will include randomised controlled studies with an active art therapy intervention, defined as any form of creative expression involving a medium (such as paint etc.) to be actively applied or shaped by the patient in an artistic or expressive form, compared to any type of control. Any treatment indication and patient group will be included. A systematic literature search of the Cochrane Library, EMBASE (via Ovid), MEDLINE (via Ovid), CINAHL, ERIC, APA PsycArticles, APA PsycInfo, and PSYNDEX (all via EBSCOHost), ClinicalTrials.gov and the WHO's International Clinical Trials Registry Platform (ICTRP) will be conducted. Psychological, cognitive, somatic and economic outcomes will be used. Based on the number, quality and outcome heterogeneity of the selected studies, a meta-analysis might be conducted, or the data synthesis will be performed narratively only. Heterogeneity will be assessed by calculating the p-value for the chi2 test and the I2 statistic. Subgroup analyses and meta-regressions are planned. DISCUSSION This systematic review will provide a concise overview of current knowledge of the effectiveness of art therapy. Results have the potential to (1) inform existing treatment guidelines and clinical practice decisions, (2) provide insights to the therapy's mechanism of change, and (3) generate hypothesis that can serve as a starting point for future randomised controlled studies. SYSTEMATIC REVIEW REGISTRATION PROSPERO ID CRD42021233272.
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Affiliation(s)
- Ronja Joschko
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Luisenstr. 57, 10117, Berlin, Germany.
| | - Stephanie Roll
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Luisenstr. 57, 10117, Berlin, Germany
| | - Stefan N Willich
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Luisenstr. 57, 10117, Berlin, Germany
| | - Anne Berghöfer
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Luisenstr. 57, 10117, Berlin, Germany
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Jakobsson Støre S, Jakobsson N. The Effect of Mandala Coloring on State Anxiety: A Systematic Review and Meta-Analysis. ART THERAPY 2022. [DOI: 10.1080/07421656.2021.2003144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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24
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Srolovitz M, Borgwardt J, Burkart M, Clements-Cortes A, Czamanski-Cohen J, Ortiz Guzman M, Hicks MG, Kaimal G, Lederman L, Potash JS, Yazdian Rubin S, Stafford D, Wibben A, Wood M, Youngwerth J, Jones CA, Kwok IB. Top Ten Tips Palliative Care Clinicians Should Know About Music Therapy and Art Therapy. J Palliat Med 2021; 25:135-144. [PMID: 34665661 DOI: 10.1089/jpm.2021.0481] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Palliative care is provided by an interdisciplinary team, including physicians, advanced practice providers, nurses, social workers, chaplains, and other disciplines based on need. Music therapists and art therapists are becoming increasingly available to palliative care teams and are advancing the diverse and unique clinical services available to effectively meet the holistic needs of patients with serious illnesses and their families. This article provides a concrete exploration of clinical music therapy and art therapy within palliative care and hospice paradigms, with discussion of therapists' training and expertise, therapeutic approaches within the setting of interprofessional team-based care, and discussion of evidence-based symptom management and outcomes supporting the inclusion of music and art therapies within medical education and clinical employment.
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Affiliation(s)
- Melissa Srolovitz
- Penn Medicine Hospice, Penn Medicine at Home, University of Pennsylvania Health System, Bala Cynwyd, Pennsylvania, USA
| | - Jennifer Borgwardt
- Penn Medicine Hospice, Penn Medicine at Home, University of Pennsylvania Health System, Bala Cynwyd, Pennsylvania, USA
| | - Moreen Burkart
- VNA Hospice of the Treasure Coast, Vero Beach, Florida, USA
| | | | - Johanna Czamanski-Cohen
- The School of Creative Arts Therapies, Faculty of Welfare and Health Sciences, University of Haifa, Haifa, Israel.,Emili Sagol Creative Arts Therapies Research Center, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | | | - Molly G Hicks
- Penn Medicine Hospice, Penn Medicine at Home, University of Pennsylvania Health System, Bala Cynwyd, Pennsylvania, USA
| | - Girija Kaimal
- Department of Creative Arts Therapies, Drexel University, Philadelphia, Pennsylvania, USA
| | | | - Jordan S Potash
- Art Therapy Program, The George Washington University, Alexandria, Virginia, USA
| | | | - Daniel Stafford
- Lucille Packard Children's Hospital, Stanford University, Palo Alto, California, USA
| | - Angela Wibben
- Palliative Care Consult Service, University of Colorado Hospital, Aurora, Colorado, USA
| | | | - Jean Youngwerth
- Department of Medicine, UCHealth University of Colorado Hospital Palliative Care Service, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Christopher A Jones
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Ian B Kwok
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, New York, New York, USA
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Khademi F, Rassouli M, Rafiei F, Moayedi S, Torres M, Marzban N, Haji E, Golitaleb M. The effect of mandala colouring on anxiety in hospitalized COVID-19 patients: A randomized controlled clinical trial. Int J Ment Health Nurs 2021; 30 Suppl 1:1437-1444. [PMID: 34143568 PMCID: PMC8447083 DOI: 10.1111/inm.12901] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 05/26/2021] [Accepted: 06/02/2021] [Indexed: 01/07/2023]
Abstract
COVID-19 significantly affects patients' mental health, triggering a wide range of psychological disorders, including anxiety. The aim of this study was to investigate the effect of mandala colouring on the anxiety of hospitalized COVID-19 patients. In this randomized controlled clinical trial, 70 hospitalized patients with COVID-19 were randomly divided between the intervention and control groups. Standard care was provided for both groups. The intervention group spent 30 min/day for six consecutive days performing mandala colouring. Patient anxiety was measured prior and subsequent to the intervention in both groups using the Spielberger State-Trait Anxiety Inventory. Data were analysed using SPSS software version 25. The mean anxiety score was not significantly different between the two groups before the intervention (P = 0.08). Subsequent to the intervention, the mean anxiety score in the intervention and control groups was 44.05 ± 4.67 and 67.85 ± 6.25, respectively, indicating a statistically significant (P = 0.0001) decrease in the anxiety measured among the intervention group as compared with that of the control group. The results of this study show that 30 min of mandala colouring daily is an effective strategy for reducing anxiety in hospitalized COVID-19 patients. Mandala colouring can complement routine treatment and provides a non-pharmaceutical option for decreasing patient anxiety.
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Affiliation(s)
- Fatemeh Khademi
- Department of Nursing, School of Nursing, Arak University of Medical Sciences, Arak, Iran
| | - Maryam Rassouli
- Pediatric Nursing Department, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Rafiei
- Department of Biostatistics and Epidemiology, Scientific Research Center, School of Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Siamak Moayedi
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Mercedes Torres
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Negin Marzban
- Ayatollah Khansari Hospital, Arak University of Medical Sciences, Arak, Iran
| | - Ensieh Haji
- Amir-al-Momenin Hospital, Arak University of Medical Sciences, Arak, Iran
| | - Mohamad Golitaleb
- Department of Nursing, School of Nursing, Arak University of Medical Sciences, Arak, Iran
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26
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Hu J, Zhang J, Hu L, Yu H, Xu J. Art Therapy: A Complementary Treatment for Mental Disorders. Front Psychol 2021; 12:686005. [PMID: 34456801 PMCID: PMC8397377 DOI: 10.3389/fpsyg.2021.686005] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 07/28/2021] [Indexed: 01/05/2023] Open
Abstract
Art therapy, as a non-pharmacological medical complementary and alternative therapy, has been used as one of medical interventions with good clinical effects on mental disorders. However, systematically reviewed in detail in clinical situations is lacking. Here, we searched on PubMed for art therapy in an attempt to explore its theoretical basis, clinical applications, and future perspectives to summary its global pictures. Since drawings and paintings have been historically recognized as a useful part of therapeutic processes in art therapy, we focused on studies of art therapy which mainly includes painting and drawing as media. As a result, a total of 413 literature were identified. After carefully reading full articles, we found that art therapy has been gradually and successfully used for patients with mental disorders with positive outcomes, mainly reducing suffering from mental symptoms. These disorders mainly include depression disorders and anxiety, cognitive impairment and dementias, Alzheimer's disease, schizophrenia, and autism. These findings suggest that art therapy can not only be served as an useful therapeutic method to assist patients to open up and share their feelings, views, and experiences, but also as an auxiliary treatment for diagnosing diseases to help medical specialists obtain complementary information different from conventional tests. We humbly believe that art therapy has great potential in clinical applications on mental disorders to be further explored.
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Affiliation(s)
- Jingxuan Hu
- College of Creative Design, Shenzhen Technology University, Shenzhen, China
| | - Jinhuan Zhang
- The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China.,Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Liyu Hu
- The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Haibo Yu
- The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Jinping Xu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
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Kai H, Cao L, Li Y, Zhu J, Zhu D, Qi L. Observation on the effect of painting therapy on bad emotion in children with functional gastrointestinal diseases. Minerva Pediatr (Torino) 2021; 74:245-247. [PMID: 34286945 DOI: 10.23736/s2724-5276.21.06515-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Hongxia Kai
- Department of Pediatric Gastroenterology, Anhui Provincial Children's Hospital, Hefei, China
| | - Li Cao
- Department of Pediatric Gastroenterology, Anhui Provincial Children's Hospital, Hefei, China
| | - Yajun Li
- Department of Pediatric Gastroenterology, Anhui Provincial Children's Hospital, Hefei, China
| | - Jie Zhu
- Department of Pediatric Gastroenterology, Anhui Provincial Children's Hospital, Hefei, China
| | - Dawei Zhu
- Department of Pediatric Gastroenterology, Anhui Provincial Children's Hospital, Hefei, China
| | - Ling Qi
- Department of Pediatric Gastroenterology, Anhui Provincial Children's Hospital, Hefei, China -
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de Witte M, Orkibi H, Zarate R, Karkou V, Sajnani N, Malhotra B, Ho RTH, Kaimal G, Baker FA, Koch SC. From Therapeutic Factors to Mechanisms of Change in the Creative Arts Therapies: A Scoping Review. Front Psychol 2021; 12:678397. [PMID: 34366998 PMCID: PMC8336579 DOI: 10.3389/fpsyg.2021.678397] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 06/01/2021] [Indexed: 11/14/2022] Open
Abstract
Empirical studies in the creative arts therapies (CATs; i.e., art therapy, dance/movement therapy, drama therapy, music therapy, psychodrama, and poetry/bibliotherapy) have grown rapidly in the last 10 years, documenting their positive impact on a wide range of psychological and physiological outcomes (e.g., stress, trauma, depression, anxiety, and pain). However, it remains unclear how and why the CATs have positive effects, and which therapeutic factors account for these changes. Research that specifically focuses on the therapeutic factors and/or mechanisms of change in CATs is only beginning to emerge. To gain more insight into how and why the CATs influence outcomes, we conducted a scoping review (Nstudies = 67) to pinpoint therapeutic factors specific to each CATs discipline, joint factors of CATs, and more generic common factors across all psychotherapy approaches. This review therefore provides an overview of empirical CATs studies dealing with therapeutic factors and/or mechanisms of change, and a detailed analysis of these therapeutic factors which are grouped into domains. A framework of 19 domains of CATs therapeutic factors is proposed, of which the three domains are composed solely of factors unique to the CATs: “embodiment,” “concretization,” and “symbolism and metaphors.” The terminology used in change process research is clarified, and the implications for future research, clinical practice, and CATs education are discussed.
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Affiliation(s)
- Martina de Witte
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands.,Kennisontwikkeling Vaktherapieën (KenVaK) Research Centre for the Arts Therapies, Heerlen, Netherlands.,Hogeschool van Arnhem en Nijmegen University of Applied Sciences, Nijmegen, Netherlands.,Stevig Specialized and Forensic Care for Patients With Intellectual Disabilities, Dichterbij, Oostrum, Netherlands
| | - Hod Orkibi
- Faculty of Social Welfare and Health Sciences, Emili Sagol Creative Arts Therapies Research Center, University of Haifa, Haifa, Israel
| | - Rebecca Zarate
- Division of Expressive Therapies, Lesley University, Cambridge, MA, United States
| | - Vicky Karkou
- Research Centre for Arts and Wellbeing, Edge Hill University, Ormskirk, United Kingdom
| | - Nisha Sajnani
- Educational Theatre & Rehabilitation Science Ph.D. Programs, New York University, New York, NY, United States
| | - Bani Malhotra
- Department of Creative Arts Therapies, Drexel University, Philadelphia, PA, United States
| | - Rainbow Tin Hung Ho
- Department of Social Work and Social Administration, Centre on Behavioral Health, The University of Hong Kong, Hong Kong, China
| | - Girija Kaimal
- Department of Creative Arts Therapies, Drexel University, Philadelphia, PA, United States
| | - Felicity A Baker
- Music Therapy Department, Norwegian Academy of Music, Oslo, Norway.,Faculty of Fine Arts and Music, The University of Melbourne, Parkville, VIC, Australia
| | - Sabine C Koch
- SRH University Heidelberg, Heidelberg, Germany.,Department for Creative Arts Therapies and Therapy Science, Alanus University of Arts and Social Sciences, Alfter, Germany
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29
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A pilot study of arts therapy techniques to evoke emotional states in forensic patients. ARTS IN PSYCHOTHERAPY 2021. [DOI: 10.1016/j.aip.2021.101798] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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30
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Changes in general self-efficacy and mindfulness are associated with short-term improvements in mood during art-making in a partial hospital program. ARTS IN PSYCHOTHERAPY 2021. [DOI: 10.1016/j.aip.2021.101799] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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31
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Marshall-Tierney A. Therapist art making as a means of helping service users with anxiety problems. INTERNATIONAL JOURNAL OF ART THERAPY 2021. [DOI: 10.1080/17454832.2021.1918193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Fernández-Cao ML, Camilli-Trujillo C, Fernández-Escudero L. PROJECTA: An Art-Based Tool in Trauma Treatment. Front Psychol 2020; 11:568948. [PMID: 33391085 PMCID: PMC7775401 DOI: 10.3389/fpsyg.2020.568948] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 11/27/2020] [Indexed: 11/13/2022] Open
Abstract
Artistic images, of a universal nature and validated by global culture, are carriers of an emotional potential that can be used for therapeutic purposes in cultural centers as well as in clinical spaces. Esthetic studies reveal the mobilizing power in their contemplation and the capacity to bring out personal stories with healing potential. The general objective of this paper is to design and validate the PROJECTA instrument, consisting of the therapeutic use of artistic images to approach trauma or difficult conditions in therapy, by means of the association between art images and emotions, feelings or states of mind related with a traumatic experience. A mixed approach of investigation with a concurrent triangulation design has been used for the integration of qualitative and quantitative results, where qualitative research outweighs quantitative, but both have been QUAL → quan sequentially developed. The study was carried out in two phases. The first was a systematic review of the literature. The second, divided into five steps, consisted of the validation of artworks and the associated emotions with the participation of students, experts in art therapy, psychologists and educators through focus groups, interviews and an online questionnaire. The analysis techniques were qualitative and quantitative. A set of 220 artistic images linked to emotional states were proposed by experts in education, psychology and art therapy, and validated through an online questionnaire. The respondents included 228 students and professionals and for 64.55% of these images a consensus of over 80% was obtained. These images and their associated emotions were again reviewed by a confirmatory focus group. Finally, 92 artistic works were linked to primary, secondary and tertiary emotions such as love, joy, victory, surprise, balance, sense of humor, anger, sadness, fear, and emptiness. In addition, there are mobilizing images that have not been related to any emotion because of the polysemy of their meanings. It concludes that PROJECTA is a visual art therapy tool that provides professionals with a resource that helps facilitate the identification, expression or demonstration of emotions or feelings related with trauma, and in challenging situations of vulnerability, psychological discomfort or post-traumatic stress.
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Affiliation(s)
| | - Celia Camilli-Trujillo
- Department of Research and Psychology in Education, Complutense University of Madrid, Madrid, Spain
| | - Laura Fernández-Escudero
- Pre-doctoral Researcher at Project Art, Art Therapy, Trauma and Emotional Memory (HAR2015-5 69115-R), Department of Languages, Arts and Physical Education, Complutense University of Madrid, Madrid, Spain
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33
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Forouzandeh N, Drees F, Forouzandeh M, Darakhshandeh S. The effect of interactive games compared to painting on preoperative anxiety in Iranian children: A randomized clinical trial. Complement Ther Clin Pract 2020; 40:101211. [PMID: 32891287 DOI: 10.1016/j.ctcp.2020.101211] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 05/26/2020] [Accepted: 06/08/2020] [Indexed: 01/30/2023]
Abstract
BACKGROUND AND AIMS An important responsibility of nurses is to optimize children's physiological and psychological health and to help them adapt to their new conditions and anxiety. In this study, we compare the effect of interactive games and painting on preoperative anxiety in Iranian children. METHODS This pre-post randomized clinical trial was conducted on 172 children aged 3-12 years undergoing elective surgery and randomly divided into three groups, including interactive games group (n = 64), painting group (n = 55), and control group (n = 53). The children's anxiety was assessed using the modified Yale Preoperative Anxiety Scale (mYPAS). RESULTS The results showed significant differences between the three groups (P < 0.001). Also, results showed that the mean anxiety score was significantly lower in the painting group. CONCLUSION Based on these conclusions, nurses should collaborate with medical teams to routinely use non-pharmacological methods such as the painting and the interactive games to alleviate preoperative anxiety in children.
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Affiliation(s)
- Nasrin Forouzandeh
- Community-oriented Nursing and Midwifery Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran.
| | - Fatemeh Drees
- Department of Epidemiology and Statistics, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Marzieh Forouzandeh
- Department of Midwifery, County Health Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Somayeh Darakhshandeh
- Department of Midwifery, Hajar Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran
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34
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Mehl A, Brauer D, Didwiszus A, Gelin-Kröz B, Pranga D, Zerm R, Gutenbrunner C, Reif M, Kröz M. The Anthroposophic Art Therapy Assessment Paint (AART-ASSESS-P): A peer-report instrument to assess patients' pictorial expression during Anthroposophic Painting Therapy. Explore (NY) 2020; 17:541-548. [PMID: 32843248 DOI: 10.1016/j.explore.2020.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 06/26/2020] [Accepted: 07/26/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Anthroposophic painting therapy (APT) is a specific form of art therapy that aims to activate self-healing capacities through painting aquarelles. METHODS The Anthroposophic Art Therapy Assessment-Paint' (AART-ASSESS-P) was developed to measure pictorial expression and validated in the framework of a comprehensive cohort design study. The validation study examined 68 breast cancer patients with fatigue. Art therapists made pre- and post-assessments of spontaneously drawn water-color paintings with a preliminary version of the AART-ASSESS-P (58 items). Inter-rater reliability (IRR) for the items was examined with Cohen's weighted Kappa (κw). Additionally, a reliability- and factor analysis (FA) were conducted. Convergence criteria were patients' self-report measures: the Satisfaction with Painting Therapy, Inner Correspondence with Painting Therapy and the Self-Regulation Questionnaire. RESULTS IRR for the items was heterogeneous (κw= 0.09-0.89, Mean κw= 0.40, SD = 0.17). Thirty-six items were excluded due to insufficient IRR and item-total correlation (κw= < 0.30, ρitem-total< 0.30). A FA with 22 items revealed 5 subscales: Shape Development (6 items), Shape Arrangement (6 items), Order and Symmetry (5 items), Color Application (3 items), and Color Quality (2 items) explaining 61% of total variance. Psychometric properties for the AART-ASSESS-P were satisfying with Cronbach's alpha coefficients (rα = 0.60-0.81) across subscales. Due to weak inter-subscale correlations (r = 0.18-0.48, p < 0.05) and the ambiguity of face validity a sum-score was not formed. Correlations between subscales and self-reports were small (all p < 0.05). CONCLUSION The AART-ASSESS-P is the first reliable instrument to measure pictorial expression during APT.
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Affiliation(s)
- A Mehl
- Research Institute Havelhöhe, Kladower Damm 221, 14089Berlin, Germany.
| | - D Brauer
- Medical Section, School of Spiritual Science/Goetheanum, 4134Dornach, Switzerland
| | - A Didwiszus
- Department of Internal Medicine Havelhöhe Hospital, Kladower Damm 221, 14089Berlin, Germany
| | - B Gelin-Kröz
- Research Institute Havelhöhe, Kladower Damm 221, 14089Berlin, Germany
| | - D Pranga
- Research Institute Havelhöhe, Kladower Damm 221, 14089Berlin, Germany
| | - R Zerm
- Research Institute Havelhöhe, Kladower Damm 221, 14089Berlin, Germany; Department of Internal Medicine Havelhöhe Hospital, Kladower Damm 221, 14089Berlin, Germany
| | - C Gutenbrunner
- Clinic for Rehabilitative Medicine, Hannover Medical School, Carl-Neuberg-Straße 1, 30625Hannover, Germany
| | - M Reif
- Society for Clinical Research, Hardenbergstraße 20, 10623Berlin, Germany
| | - M Kröz
- Research Institute Havelhöhe, Kladower Damm 221, 14089Berlin, Germany; Institute for Integrative Medicine, University Witten/Herdecke, Gerhard Kienle Weg 8, 58313Herdecke, Germany; Hospital Arlesheim, Research Department, Pfeffinger Weg 1, 4144Arlesheim, Switzerland
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Abstract
Total joint replacement (TJR) is one of the most commonly performed and painful surgeries in the United States. Over the past few decades, regulatory changes increased the use of oral narcotics as a first-line treatment of this population. In the current opioid crisis, new pain management techniques and therapies have emerged. Research of current therapies, their effectiveness, and emerging best practices are discussed. Clear, thoughtful, and thorough education is an essential next step for closing the gap of the pain experience. Specifically, education of the frontline nurses, patients, and their caregivers on pain reduction techniques is essential.
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Acceptance of Anxiety through Art Therapy: A Case Report Exploring How Anthroposophic Art Therapy Addresses Emotion Regulation and Executive Functioning. Case Rep Psychiatry 2020; 2019:4875381. [PMID: 32082678 PMCID: PMC6949689 DOI: 10.1155/2019/4875381] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 11/10/2019] [Accepted: 11/18/2019] [Indexed: 12/17/2022] Open
Abstract
Anxiety is a major problem for many individuals, causing impairment in daily life. Art therapy is often deployed and although positive results are communicated in clinical practice, its effectiveness and working mechanisms have hardly been studied. Therefore, it is important to systematically describe the intervention process and to detect the working mechanisms to be able to evaluate them. Narrative case studies help to understand the intervention in more depth. A typical case file was selected for case reporting according to scientific (CARE & CARE-AAT) guidelines, with the aim to explore the therapeutic elements that contributed to the reduction of anxiety. The report describes the intervention process of a 54-year-old female, suffering from anxiety since childhood and diagnosed with panic disorder, agoraphobia, claustrophobia and hypochondria. After 14 sessions of anthroposophic art therapy, reduction of anxiety was shown, as well as improvements of emotion regulation and executive functioning. The client indicated that she became more tolerant and accepting towards her anxiety. She noted a softened attitude towards herself and her complaints, even one year after art therapy. The course of treatment suggests that aspects of emotion regulation and executive functioning were addressed through implicit learning processes in different art therapy assignments.
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37
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Rajendran N, Mitra TP, Shahrestani S, Coggins A. Randomized Controlled Trial of Adult Therapeutic Coloring for the Management of Significant Anxiety in the Emergency Department. Acad Emerg Med 2020; 27:92-99. [PMID: 31957143 DOI: 10.1111/acem.13838] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 07/05/2019] [Accepted: 07/12/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Anxiety and acute distress are significant concerns in the emergency department (ED). Adult coloring books are often utilized as an effective means of relaxation in waiting rooms and newsstands, but there are no reported randomized trials examining their effectiveness as a treatment for anxiety. METHODS We set out to examine the effectiveness of adult coloring books using a randomized placebo-controlled trial at a university-affiliated tertiary ED. Anxiety was measured using a validated self-reporting score, the Hospital Anxiety and Depression Scale (HADS-A), with a range of 0 to 21. Patients with HADS-A ≥ 7 were randomly assigned to either an adult coloring pack (n = 26) or placebo pack (n = 27). The primary outcome measure was the within-patient change in HADS-A scores following 2 hours of exposure. RESULTS A convenience sample of 117 patients were screened, and 53 patients were randomized. Characteristics of allocated groups were similar in terms of sex, diagnosis, and ethnicity. A higher proportion of intervention subjects spent ≥1 hour engaged with their activity (46.2% vs. 4.0%, p = 0.01). For the primary outcome measure, the mean within-patient decrease in HADS-A score at 2 hours for intervention subjects was 3.7 (95% confidence interval [CI] = 2.4 to 5.1, p < 0.001) versus a decrease of 0.3 (95% CI = -0.6 to 1.2, p = 0.51) in the placebo group. CONCLUSIONS Among ED patients, exposure to adult coloring books resulted in lower self-reported levels of anxiety at 2 hours compared to placebo.
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Affiliation(s)
| | | | | | - Andrew Coggins
- Sydney Medical School University of Sydney SydneyAustralia
- Emergency Department Westmead Hospital Sydney Australia
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38
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Nicholson PJ. Art therapy for post-traumatic stress disorder and traumatic brain injury. Occup Med (Lond) 2019; 69:400-402. [DOI: 10.1093/occmed/kqz039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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39
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Abbing A, Baars EW, de Sonneville L, Ponstein AS, Swaab H. The Effectiveness of Art Therapy for Anxiety in Adult Women: A Randomized Controlled Trial. Front Psychol 2019; 10:1203. [PMID: 31191400 PMCID: PMC6549595 DOI: 10.3389/fpsyg.2019.01203] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 05/07/2019] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES Art therapy (AT) as a treatment option for anxiety is regularly employed in clinical practice, but scientific evidence for its effectiveness is lacking, since this intervention has hardly been studied. The aim was to study the effectiveness of AT on anxiety in adult women. The specific type of AT studied was anthroposophic AT. METHODS A RCT comparing AT versus a waiting list (WL) condition on anxiety symptom severity, quality of life, and emotion regulation. Factors influencing treatment outcome were additionally explored. Participants were women, aged 18-65 years, diagnosed with generalized anxiety disorder, social anxiety disorder or panic disorder, with moderate to severe anxiety symptoms. The trial was registered in the Dutch Trial Registration (NTR28143). RESULTS Fifty-nine women were included, of which 47 completed the trial. Both per-protocol and intention-to treat analyses demonstrated effectiveness of AT compared to WL, showing a reduction in anxiety, an increase in subjective quality of life (both with large effects) and an improvement in accessibility of emotion regulation strategies (medium effect). Treatment effects remained after 3 months follow-up. Improved acceptance of emotions and improved goal-oriented action are aspects of emotion regulation that are associated with the decrease in anxiety level. CONCLUSION AT is effective in reducing anxiety symptoms, improving quality of life and aspects of emotion regulation. Future RCTs should use active controls (treatment as usual) and study cost-effectiveness.
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Affiliation(s)
- Annemarie Abbing
- Faculty of Health, University of Applied Sciences Leiden, Leiden, Netherlands
- Clinical Neurodevelopmental Sciences, Faculty of Social Sciences, Leiden University, Leiden, Netherlands
| | - Erik W. Baars
- Faculty of Health, University of Applied Sciences Leiden, Leiden, Netherlands
| | - Leo de Sonneville
- Clinical Neurodevelopmental Sciences, Faculty of Social Sciences, Leiden University, Leiden, Netherlands
- Leiden Institute of Brain and Cognition, Leiden, Netherlands
| | - Anne S. Ponstein
- Faculty of Health, University of Applied Sciences Leiden, Leiden, Netherlands
| | - Hanna Swaab
- Clinical Neurodevelopmental Sciences, Faculty of Social Sciences, Leiden University, Leiden, Netherlands
- Leiden Institute of Brain and Cognition, Leiden, Netherlands
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