Art Therapy: A Complementary Treatment for Mental Disorders

The effects of art therapy interventions on anxiety in children and adolescents: A meta-analysis

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.

Effects of Visual Art Therapy on Positive Symptoms, Negative Symptoms, and Emotions in Individuals with Schizophrenia: A Systematic Review and Meta-Analysis

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.

Art Therapy as a Nursing Intervention for Individuals With Schizophrenia

The aim of the current study was to determine the effects of group art therapy on clinical symptoms, alexithymia, and quality of life among people with schizophrenia. This single-blinded, randomized controlled trial was performed with 66 individuals with schizophrenia from a community mental health center in western Turkey between September 2021 and February 2022. Following art therapy, the intervention group had lower severity of positive, negative, and general psycho-pathology symptoms; lower levels of alexithymia; and higher levels of psychological health, social relationships, and total quality of life than the control group; and the difference between groups was statistically significant (p < 0.05). Results reveal that art therapy combined with pharmacological therapy contributes to good clinical outcomes among individuals with schizophrenia. This evidence can guide psychiatric nurses to use art therapy to reduce psychopathology severity and increase functionality and quality of life among individuals with schizophrenia. [Journal of Psychosocial Nursing and Mental Health Services, 62(5), 29-38.].

Acting and Dancing during the COVID-19 Pandemic as Art Therapy for the Rehabilitation of Children with Behavioural Disorders Living in Socially Disadvantaged Environments

Art therapy is employed in numerous ways in rehabilitation. This study focuses on an art and movement therapy project carried out during the COVID-19 pandemic. Acting and dancing methods were adapted to produce a short musical film series for ten children from disadvantaged social backgrounds displaying nonorganic behavioural disorders. The aim was to acquire novel ways of expression on the part of the participants to release painful emotions in a safe setting using the method of catharsis through acting and dancing, triggering relaxation as a physiological response and improving their attitude. This study retrospectively analyses the changes in the children's behaviour and their active participation in the project through quantitative and qualitative research. The children improved their attention and self-esteem, their behaviour became less aggressive and impulsive, and half showed increased empathy. The active participation rate during the project was 82%.

Behind the creative canvas: An innovative trauma-informed art-based educational approach using an immersive learning pedagogy

Trauma has been increasingly considered in mental health policies and strategies worldwide. However, the implementation of such initiatives into practice remains inconsistent resulting in a fragmented approach to trauma-informed care. One explanation for the current state of trauma services is the unpreparedness of mental health nurses in line with emerging traumagenic theoretical frameworks. We addressed this gap by implementing an innovative pedagogic project co-produced with people with lived experience of trauma. The aim of this qualitative study was to explore mental health nursing students' perspective on the usefulness of an art-based approach to learning about, and working with, trauma in a non-interactive virtual reality (VR) environment. Ten mental health nursing students have been conveniently selected to take part in a focus group. The thematic analysis revealed authenticity, the power of arts, and underutilisation of arts in mental health nursing as key themes following students' reflections and critical discussions. Recommendations to enhance trauma-informed nursing education and practice are made to support an approach that has the potential to instil positive changes in the way mental health nursing students perceive and work with trauma in their practice.

Art-delivered episodic future thinking reduces delay discounting: A phase IIa proof-of-concept trial

INTRODUCTION

High rates of delay discounting (DD), or the preference for immediate rewards over delayed rewards, is associated with substance use disorder (SUD). Lower rates of DD predict better treatment outcomes, and thus strategies that reduce DD may support SUD recovery. The process of vividly imagining a future event, known as episodic future thinking (EFT), may be a particularly viable approach to reduce DD. Some limited research has examined delivery of EFT in treatment settings, using verbal prompts that are typical of studies in non-treatment settings. We propose that the creation of visual art represents a unique alignment of the purpose of EFT with an innovative delivery modality in treatment settings.

METHODS

This single arm, proof-of-concept trial evaluated art-delivered EFT (ArtEFT) to reduce DD in a sample of women (N = 39) in a residential SUD treatment center. Participants engaged in a single, 1-h ArtEFT session during which they engaged in EFT and created a visual representation using art materials. The study collected DD measures for hypothetical money ($50 and $1000 magnitude conditions) before and after ArtEFT.

RESULTS

Using area-under-the-curve (AUCord) as the index of DD, the study observed predicted changes following the ArtEFT session. The ANOVA revealed statistically significant main effects of both magnitude [F(1,38) = 11.184, p = .002] and time [F(1. 38) = 4.731, p = .036], with a non-significant interaction [F(1,38) = 3.821, p = .058].

CONCLUSION

This study reveals promising preliminary indicators that art may be an effective modality to deliver EFT, with particular advantages for implementation given the popularity of art programming in SUD treatment programs.

Effectiveness of Fabric Weaving Therapy for Children with Autism Spectrum Disorder: A Randomized Waitlist-Controlled Trial

Objectives: To evaluate the effectiveness of weaving therapy on clinical outcomes and quality of life of autistic children. Design: Randomized waitlist-controlled trial. Setting/Location: Developmental and Behavioral Pediatrics Clinic, Faculty of Medicine Ramathibodi Hospital. Subjects: Twenty-three autistic children. Interventions: Weaving therapy was performed weekly for 6 months (3 months for hospital-based intervention and 3 months for home-based intervention). Outcome measures: Childhood Autism Rating Scale-second edition (CARS-2) and Pediatric Quality of Life Inventory (PedsQL) were measured at preintervention, 3 and 6 months postintervention. Methods: Twenty-three autistic children, aged 7.8-16.6 years, were randomized into an intervention group (N = 11) and a 3-month waitlist period group (N = 12). Ten weaving sessions were performed by the children, along with their parents, weekly for 3 months in hospital, and continued at home for an additional 3 months. The weaving therapy was delayed for 3 months in the waitlist group, followed by a 6-month intervention as the intervention group. Results: There was significant improvement on CARS-2 (p < 0.01) and PedsQL scores (p < 0.01) in the intervention group after the first 3-month weaving therapy. Meanwhile, in the waitlist group, no significant difference was found on CARS-2 (p = 0.09) and PedsQL scores (p = 0.26) during no weaving period. After the waitlist group began weaving therapy for 3 months, the authors found a significant improvement on both CARS-2 and PedsQL scores (p < 0.01both). Between-group comparisons showed that the intervention group had significant improvement on CARS-2 (p = 0.002) and PedsQL (p < 0.001) after 3-month weaving comparing with the waitlist group. After all the 23 participants finished a 6-month weaving therapy, there was significant difference in CARS-2 (p < 0.001) and PedsQL scores (p < 0.001) between pre- and postintervention. Conclusions: These findings suggest that traditional Thai fabric weaving therapy, as an alternative and complementary intervention, appears to be an effective therapy in improving the clinical symptoms and quality of life among autistic children. Clinical Trial Registration number: TCTR20200420002.

Visual art therapy and its effects in older people with mild cognitive impairment: A systematic review

INTRODUCTION

Mild cognitive impairment (MCI) is a known risk factor for the development of dementia. The potential benefits on cognition from non-pharmacological measures such as art-based interventions are of increasing interest. This systematic review examines the evidence for the impact of one form of art-based intervention, visual art therapy (VAT), on the cognition and psychological wellbeing of older people with MCI.

METHODS

Randomised controlled and quasi-experimental trials evaluating the efficacy of VAT in older persons aged over 60 years with MCI were included. A search was performed on electronic databases: MEDLINE, CINAHL, Embase and PsycINFO. Joanna Briggs Institute critical appraisal and extraction tools were utilised for risk of bias assessment and data extraction, respectively. A narrative descriptive approach was used to outline the findings.

RESULTS

Seven studies were identified from 4311 articles screened. Improvement in cognition was reported in five studies, with two of these reporting sustained improvement at 6-9 months, while the remaining three studies showed improvement only at the immediate post-intervention period. A positive impact was reported in four of six studies that examined the effect of VAT on participant psychological wellbeing. The overall methodological quality of the studies ranged from moderate in four of five RCTs, to high in the quasi-experimental studies and one RCT. However, the low study power in the context of small sample sizes limits the applicability of these studies to the population of interest.

CONCLUSIONS

VAT is potentially an effective non-pharmacological intervention that may enhance cognition and provide benefits for psychological wellbeing in older persons with MCI. Given the limited studies available, with the majority emerging over the last 5 years, further research is required to confirm these reported benefits, as well as to determine whether VAT impacts on the progression of cognitive decline in MCI.

Designing environments that contribute to a reduction in the progression of Parkinson's disease; a literature review

Parkinson's Disease (PD), a prevalent neurological disorder, causes physical difficulties like stiffness and impaired walking and affects patients' emotional well-being. Regular exercise and exposure to enriched environments are crucial to managing these symptoms. This review aims to extract evidence from studies regarding built environments' impact on reducing the progression of PD. Keywords from 2005 to 2022 were used in five databases, including PubMed, Clarivate Web of Science, UGA Library, and Google Scholar. Many studies emphasized physiotherapy and training for physical enhancement, often utilizing virtual games and smart devices. Others highlighted the advantages of non-slip flooring and accessible outdoor spaces, with some based on universal design principles. Few studies considered the emotional impact of built environments, showing a considerable gap in the studies simultaneously evaluating psychological and physical perspectives of Parkinson-friendly environments. There needs to be more consistency when considering these aspects of planning. Our findings suggest future research modeling enriched environments and tracking their impact on patients via Virtual Reality to find a comprehensive guideline for the most effective PD management environments.

Is befriending a valuable intervention in schizophrenia? A scoping review

Background

Schizophrenia is a severe, chronic mental disorder that involves disruptions in cognitive processes, emotional responsiveness, and social interactions. Psychotherapeutic and social integration practices have increasingly been added to the pharmacological treatment in an effort to improve the level of functioning and the quality of life of individuals affected by this condition. Befriending, defined as a one-on-one companionship provided by a volunteer who aims to act as an emotionally supportive liaison, is hypothesized to be an effective such intervention, offering support for building and maintaining social relationships in the community. Despite its increase in popularity and acceptance, befriending remains poorly understood and under-researched.

Methods

We performed a systematic search for studies targeting befriending either as an intervention or a controlled condition in studies on schizophrenia. Searches were performed in four databases: APA PsycInfo, Pubmed, Medline and EBSCO. The keywords "schizophrenia," AND "befriending," were searched for on all databases.

Results

The search yielded 93 titles and abstracts, of which 18 met the criteria for inclusion. The studies included in this review have all incorporated befriending as an intervention or a controlled condition, as per our search criteria, and aimed at depicting the value and feasibility of this intervention to address social and clinical deficits in individuals with schizophrenia.

Conclusion

The studies selected for this scoping review revealed inconsistent findings regarding the effect of befriending on overall symptoms and the subjective reporting of quality of life in individuals with schizophrenia. This inconsistency may be attributed to differences between the studies and their specific limitations.

Hotspots, trends, and advice: a 10-year visualization-based analysis of painting therapy from a scientometric perspective

Purpose

Research on painting therapy is available worldwide and painting therapy is widely applied as a psychological therapy in different fields with diverse clients. As an evidence-based psychotherapy, previous studies have revealed that painting therapy has favorable therapeutic effects. However, limited studies on painting therapy used universal data to assemble in-depth evidence to propose a better recommendation on it for the future use. Large-scale retrospective studies that used bibliometric methodology are lacking. Therefore, this study presented a broad view of painting therapy and provided an intensively analytical insight into the structure of knowledge regarding painting therapy employing bibliometric analysis of articles. CiteSpace software was used to evaluate scientific research on painting therapy globally published from January 2011 to July 2022.

Methods

Publications related to painting therapy from 2011 to 2022 were searched using the Web of Science database. This study employed bibliometric techniques to perform co-citation analysis of authors, visualize collaborations between countries/regions as network maps, and analyze keywords and subjects relevant to painting therapy by using CiteSpace software.

Results

In total, 871 articles met the inclusion criteria. We found that the number of painting therapy publications generally trended incrementally. The United States and United Kingdom made the most contributions to painting therapy research and had the greatest impact on the practical application in other countries. Arts in Psychotherapy and Frontiers in Psychology occupied key publishing positions in this research field. The application groups were mainly children, adolescents, and females, and Western countries paid high attention to painting therapy. The main areas of application of painting therapy were Alzheimer's disease and other psychosomatic disease fields. Identified research priorities for painting therapy were emotion regulation and mood disorder treatment, personality disorder treatment, personal self-esteem enhancement, and medical humanistic care. Three keywords, "depression," "women," and "recovery," had the strongest citation bursts, which emphasized the research trends.

Conclusion

The general trend for painting therapy research is positive. Our findings provide useful information for researchers on painting therapy to determine new directions in relate to popular issues, collaborators, and research frontiers. Painting therapy holds a promising future, and further studies could explore the clinical implications of this therapy in terms of mechanisms and criteria for assessing efficacy.

The Impact of the COVID-19 Pandemic on the Management of Mental Health Services for Hospitalized Patients in Sibiu County-Central Region, Romania

INTRODUCTION

The COVID-19 pandemic brought a burden and represented a challenge for the Romanian medical system. This study explored the consequences that COVID epidemiological measures had on the quality of the mental health care provided to hospitalized patients in a regional psychiatric hospital in Romania.

MATERIALS AND METHODS

Both patient-level and hospital-level indicators were considered for this comparative retrospective study. On the one hand, we extracted patient-level indicators, such as sociodemographics, diagnosis, admission, and discharge dates for 7026 hospitalized patients (3701 women, average age = 55.14) from hospital records. On the other hand, for the hospital-level indicators, we included indicators referring to the aggregated concept of mental health services, such as case mix index, length of stay, bed occupancy rate and patients' degree of satisfaction. Data extracted covered a period of two years (1 March 2019-28 February 2021) before and during the first year of the COVID-19 pandemic.

RESULTS

We found that, compared to the pre-pandemic period, the pandemic period was marked by a drastic decrease in hospitalized patient admissions, coupled with an increase in emergency-based admissions. Other management indicators, such as the case mix index, the number of cases contracted/performed, and the degree of patient satisfaction, decreased. In contrast, the average length of stay and bed occupancy rate increased.

CONCLUSIONS

The COVID-19 pandemic, especially in the first year, raised multiple difficult issues for the management of psychiatric hospitals. It imposed an application of strict measures designed to face these new and unprecedented challenges. Our findings offer a detailed snapshot of the first year of the COVID-19 pandemic in terms of its impact on mental health services and suggest some future directions. Implications for hospital management are discussed.

The Effect of the Art Therapy Interventions on Depression Symptoms Among Older Adults: A Meta-analysis of Controlled Clinical Trials

BACKGROUND

To our knowledge, no systematic reviews and meta-analyses have yet been published that examine the effect of art therapy (AT) interventions on depression symptoms among older adults, and this study aimed to systematically review and meta-analysis of clinical trials, summarize eligible relevant studies and provide a true effect measure for the association between AT and depression symptoms in older adults.

METHODS

The databases of PubMed, Web of Science, Scopus, and the Cochrane Central Register of Controlled Trials were searched until 15 February 2022. The methodological quality of the included studies was evaluated by the Delphi checklist. The heterogeneity across studies was conducted by chi-squared test and measured its quantity by the I² statistic. We performed this meta-analysis to obtain a summary measure of the mean difference in depression scores between AT and control groups using a random-effects model. All statistical analyses were carried out at a significance level of .05 using Stata software, version 14.

RESULTS

Until 15 February 2022, 222 studies through databases and 199 studies through review of references were included in the present meta-analysis. In total, the analysis covered 8 studies. The difference in mean depression score between the intervention and control groups showed significant reductions in the AT group (MD -.78; 95% CI: -1.17, -.38; I 2 = 67.9%).

CONCLUSION

Our findings suggest that AT can be considered an effective intervention for reducing depression symptoms among older adults and art therapists/psychotherapists can use this method to reduce the symptoms of depression among older adults.

The Psychological Recovery of Patients in the Context of Virtual Reality Application by a Complementary Medicine Scheme Based on Visual Art

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.

A Review of the Effectiveness, Feasibility, and Acceptability of Art Therapy for Children and Adolescents during the COVID-19 Pandemic

Art therapy has been widely offered to reduce symptoms of psychological disturbance. Pooled evidence about its effectiveness in epidemic contexts, particularly during the COVID-19 pandemic, has not been yet established. This study reviewed the effectiveness, feasibility, and acceptability of art therapy on children and adolescents during the COVID-19 pandemic and past epidemics. We searched PubMed/Medline, PsycINFO, CENTRAL (Cochrane Library), and CINAHL for articles on art therapy during COVID-19. Included studies reported improvements in measures of mental health, sleep quality, and psychological well-being in children with or without disabilities in the epidemic context. Results also showed that art therapy was highly feasible and accepted by children and adolescents as well as their families during epidemics in reviewed studies. Art therapy can be effective at improving various aspects of mental health, sleep quality, and psychological well-being. More empirical evidence is needed with larger sample sizes and longer duration of interventions.

Role of Art Therapy in the Promotion of Mental Health: A Critical Review

Art therapy is used most commonly to treat mental illnesses and can aid in controlling manifestations correlated with psychosocially challenging behaviours, slowing cognitive decline, and enhancing the quality of life. Art therapy can help people express themselves more freely, improve their mental health, and improve interpersonal relationships. The basis of art therapy is established on the idea that people can recover and feel better via artistic expression. This review examines the current research on how active participation in the arts might improve mental health. A detailed literature search was carried out utilizing essential databases such as PubMed, the WHO's mental health database, and Google and Google Scholar. This review study looks into research done on art therapy and its potential advantages for adult mental health rehabilitation. It focuses on visual art therapy since it’s a key to reducing variation within the "creative arts" and defines the peculiar elements and effectiveness of art therapy used by mental health services. It was found that the use of art therapy as an adjunct treatment showed improved mental health in patients.